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  3. Vol. 14 No. 1 (2026): Winter 2026
  4. Review Article

Vol. 14 No. 1 (2026)

February 2026

Antidepressants and Diabetic Foot Ulcer: An Unclear Relationship: A Narrative Review

  • Malihe Abniki
  • Sahar Kavand
  • Farnaz Saberian
  • Arezoo Ranjbar

Novelty in Biomedicine, Vol. 14 No. 1 (2026), 8 February 2026 , Page 49-53
https://doi.org/10.22037/nbm.v14i1.50051 Published: 2026-02-08

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Abstract

Background: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus that burdens patients’ psychophysical activities. Some studies mentioned that antidepressants, as common drugs that are widely prescribed to diabetics because of their psychiatric problems, may worsen diabetic foot ulcers and their outcomes. However, the results of studies lack consensus. In this study, we aimed to review the results of previous studies regarding the relationship between antidepressant use and diabetic foot ulcer.

Materials and Methods: The keywords “antidepressant” AND/OR “diabetic foot ulcer” AND/OR “diabetic foot” were searched in the PubMed, MEDLINE, and Elsevier databases (from the beginning of 2015 to the end of 2025). Review articles, in-vitro studies, meta-analyses, systematic reviews, editorials, non-English full-text, and not-reachable full-text studies were excluded.

Results: Seven studies were assessed from 87 articles. Most of them (5 of 7) showed that antidepressant use worsened DFU or amputation-related conditions like re-infection. However, one study revealed that antidepressants improved the related condition, and another study mentioned that there is no association between antidepressants and DFU.

Conclusion: Although some studies revealed that antidepressants may increase the risk of DFU and amputation, further studies should investigate this relationship because there are limited studies in this respect.

Keywords:
  • Antidepressants
  • Amputation
  • Diabetic foot
  • Diabetic foot ulcer
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How to Cite

Abniki, M., Kavand, S., Saberian, F., & Ranjbar, A. (2026). Antidepressants and Diabetic Foot Ulcer: An Unclear Relationship: A Narrative Review. Novelty in Biomedicine, 14(1), 49–53. https://doi.org/10.22037/nbm.v14i1.50051
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References

1. Frykberg RG, Banks J. Management of diabetic foot ulcers: a review. Federal Practitioner. 2016;33(2):16.

2. Pan A, Lucas M, Sun Q, van Dam RM, Franco OH, Manson JE, et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Archives of internal medicine. 2010;170(21):1884-91.

3. Rotella F, Mannucci E. Diabetes mellitus as a risk factor for depression. A meta-analysis of longitudinal studies. Diabetes research and clinical practice. 2013;99(2):98-104.

4. Roopan S, Larsen ER. Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review. Acta neuropsychiatrica. 2017;29(3):127-39.

5. Jeffery A, Maconick L, Francis E, Walters K, Wong IC, Osborn D, et al. Prevalence and characteristics of antidepressant prescribing in adults with comorbid depression and type 2 diabetes mellitus: A systematic review and meta-analysis. Health Sciences Review. 2021;1:100002.

6. Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. The lancet NEUROLOGY. 2012;11(6):521-34.

7. Armstrong DG, Boulton AJ, Bus SA. Diabetic foot ulcers and their recurrence. New England Journal of Medicine. 2017;376(24):2367-75.

8. de Paula D, Bracco P, Gregg EW. The dynamics of diabetes prevalence, morbidity, and mortality. The Diabetes Textbook: Clinical Principles, Patient Management and Public Health Issues: Springer; 2023. p. 15-23.

9. Zhang Y, Lazzarini PA, McPhail SM, van Netten JJ, Armstrong DG, Pacella RE. Global disability burdens of diabetes-related lower-extremity complications in 1990 and 2016. Diabetes care. 2020;43(5):964-74.

10. Ndosi M, Wright‐Hughes A, Brown S, Backhouse M, Lipsky BA, Bhogal M, et al. Prognosis of the infected diabetic foot ulcer: a 12‐month prospective observational study. Diabetic Medicine. 2018;35(1):78-88.

11. Petersen BJ, Linde-Zwirble WT, Tan T-W, Rothenberg GM, Salgado SJ, Bloom JD, et al. Higher rates of all-cause mortality and resource utilization during episodes-of-care for diabetic foot ulceration. Diabetes research and clinical practice. 2022;184:109182.

12. Iraj B, Khorvash F, Ebneshahidi A, Askari G. Prevention of diabetic foot ulcer. International journal of preventive medicine. 2013;4(3):373.

13. Jeffcoate WJ, Vileikyte L, Boyko EJ, Armstrong DG, Boulton AJ. Current challenges and opportunities in the prevention and management of diabetic foot ulcers. Diabetes care. 2018;41(4):645-52.

14. Kim J, Hurh K, Han S, Kim H, Park E-C, Jang S-Y. Association between antidepressants and the risk of diabetic foot ulcers and amputation in antidepressant-naïve type 2 diabetes mellitus patients: A nested case-control study. Diabetes Research and Clinical Practice. 2024;209:111591.

15. Neeru B, Gagandeep K, Pal AJ, Bajwa SJS, Harbandna S, Rajesh K. Psychosocial, psychiatric, and clinical implications of diabetic foot ulceration: A prospective analysis. Journal of Social Health and Diabetes. 2015;3(02):089-94.

16. Ahmedani MY, Ahsan S, Haque MSU, Fawwad A, Basit A. Association of depression and its treatment on the outcome of diabetic foot ulcer. Journal of Diabetology. 2017;8(2):27-31.

17. Lavery LA, Tarricone AN, Ryan EC, Crisologo PA, Malone M, Suludere MA, et al. Re‐infection after treatment for moderate and severe diabetic foot infections. International Wound Journal. 2024;21(11):e70123.

18. Cascini S, Agabiti N, Davoli M, Uccioli L, Meloni M, Giurato L, et al. Survival and factors predicting mortality after major and minor lower-extremity amputations among patients with diabetes: a population-based study using health information systems. BMJ Open Diabetes Research and Care. 2020;8(1):e001355.

19. Brooks BM, Shih C-D, Brooks BM, Tower DE, Tran TT, Simon JE, et al. The Diabetic Foot–Pain–Depression Cycle: A Multidisciplinary Cohort Study. Journal of the American Podiatric Medical Association. 2023;113(3).

20. Chen Y, Liu L, Kong X, Sun J, Li H, Chang X, et al. Clinical effects of combined use of carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot. International Journal of Neuroscience. 2024:1-7.

21. Kivimäki M, Batty GD, Jokela M, Ebmeier KP, Vahtera J, Virtanen M, et al. Antidepressant medication use and risk of hyperglycemia and diabetes mellitus—A noncausal association? Biological Psychiatry. 2011;70(10):978-84.

22.Mukai J, Maruyama S, Otori K, Kubota R. Evaluation of the potential risk of hyperglycemia and diabetes mellitus associated with antidepressant use using the JADER database. Yakugaku Zasshi. 2020;140(4):591–598.

23. Wang X, Yuan C-X, Xu B, Yu Z. Diabetic foot ulcers: Classification, risk factors and management. World journal of diabetes. 2022;13(12):1049.

24. Mariam TG, Alemayehu A, Tesfaye E, Mequannt W, Temesgen K, Yetwale F, et al. Prevalence of diabetic foot ulcer and associated factors among adult diabetic patients who attend the diabetic follow‐up clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: institutional‐based cross‐sectional study. Journal of diabetes research. 2017;2017(1):2879249.

25. Wang S-M, Han C, Bahk W-M, Lee S-J, Patkar AA, Masand PS, et al. Addressing the side effects of contemporary antidepressant drugs: a comprehensive review. Chonnam medical journal. 2018;54(2):101-12.

26. Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs in context. 2015;4:212290.

27. Yoon JM, Cho E-G, Lee H-K, Park SM. Antidepressant use and diabetes mellitus risk: a meta-analysis. Korean journal of family medicine. 2013;34(4):228.

28. van Reedt Dortland AK, Giltay EJ, Van Veen T, Zitman FG, Penninx BW. Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use. Acta Psychiatrica Scandinavica. 2010;122(1):30-9.

29. Kammer JR, Hosler AS, Leckman-Westin E, DiRienzo G, Osborn CY. The association between antidepressant use and glycemic control in the Southern Community Cohort Study (SCCS). Journal of Diabetes and its Complications. 2016;30(2):242-7.

30. Van der Feltz-Cornelis CM, Nuyen J, Stoop C, Chan J, Jacobson AM, Katon W, et al. Effect of interventions for major depressive disorder and significant depressive symptoms in patients with diabetes mellitus: a systematic review and meta-analysis. General hospital psychiatry. 2010;32(4):380-95.

31. Ait Chait Y, Mottawea W, Tompkins TA, Hammami R. Unravelling the antimicrobial action of antidepressants on gut commensal microbes. Scientific reports. 2020;10(1):17878.

32. Silva RAC, da Silva CR, de Andrade Neto JB, da Silva AR, Campos RS, Sampaio LS, et al. In vitro anti-Candida activity of selective serotonin reuptake inhibitors against fluconazole-resistant strains and their activity against biofilm-forming isolates. Microbial pathogenesis. 2017;107:341-8.

33. Ayaz M, Subhan F, Ahmed J, Khan A-u, Ullah F, Ullah I, et al. Sertraline enhances the activity of antimicrobial agents against pathogens of clinical relevance. Journal of Biological Research-Thessaloniki. 2015;22(1):4.

34. Gu W, Guo D, Zhang L, Xu D, Sun S. The synergistic effect of azoles and fluoxetine against resistant Candida albicans strains is attributed to attenuating fungal virulence. Antimicrobial agents and chemotherapy. 2016;60(10):6179-88.

35. Li L, Kromann S, Olsen JE, Svenningsen SW, Olsen RH. Insight into synergetic mechanisms of tetracycline and the selective serotonin reuptake inhibitor, sertraline, in a tetracycline-resistant strain of Escherichia coli. The Journal of Antibiotics. 2017;70(9):944-53.

36. Kim S, Thiessen PA, Bolton EE, Chen J, Fu G, Gindulyte A, et al. PubChem substance and compound databases. Nucleic acids research. 2016;44(D1):D1202-D13.

37. McGovern AS, Hamlin AS, Winter G. A review of the antimicrobial side of antidepressants and its putative implications on the gut microbiome. Australian & New Zealand Journal of Psychiatry. 2019;53(12):1151-66.

38. Bohnert JA, Szymaniak-Vits M, Schuster S, Kern WV. Efflux inhibition by selective serotonin reuptake inhibitors in Escherichia coli. Journal of antimicrobial chemotherapy. 2011;66(9):2057-60.

39. Oliveira AS, Martinez-de-Oliveira J, Donders GG, Palmeira-de-Oliveira R, Palmeira-de-Oliveira A. Anti-Candida activity of antidepressants sertraline and fluoxetine: effect upon pre-formed biofilms. Medical Microbiology and Immunology. 2018;207(3):195-200.

40. Javed S, Alam U, Malik RA. Burning through the pain: treatments for diabetic neuropathy. Diabetes, Obesity and Metabolism. 2015;17(12):1115-25.

41. Perez-Favila A, Martinez-Fierro ML, Rodriguez-Lazalde JG, Cid-Baez MA, Zamudio-Osuna MdJ, Martinez-Blanco MdR, et al. Current therapeutic strategies in diabetic foot ulcers. Medicina. 2019;55(11):714.

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