Influence of selected drugs used in the treatment of type 2 diabetes and cardiovascular diseases on depressive disorders in elderly patients

Objectives
In geriatric patients, cardiovascular diseases and type 2 diabetes are considered the most common chronic health problems. Moreover, increasing the pre­valence of depression, which significantly reduces the quality of life and increases disability in this group, has also been observed. This paper aims to review the literature on the relationship between drugs from selected pharmacological groups used in the treatment of diabetes and cardiovascular diseases and depression, both with respect to their depressive and antidepressant effects.

Literature review
The increased risk of the prevalence and the severity of depression is associated with strongly lipophilic beta-blockers and insulin therapy. In contrast, drugs that block the RAA system reduce the risk of developing and worsening symptoms of depression and improve cognitive function in elderly patients. Literature reports indicate the antidepressant effect of commonly used antidiabetic drugs such as metformin and incretin drugs (GLP-1 analogues and DPP-4 inhibitors). The potential anti-depressive effect of intranasal insulin administration requires further research.

Conclusions
Based on the review, it should be stated that due to the frequent occurrence of mood disorders in elderly patients, the selection of drugs used in the therapy of somatic diseases should allow for the risk of causing or worsening symptoms of depression. However, the possibility of their beneficial effect on mood disorders should also be considered.