Most people experience sadness or depression sometime during their lives. Divorce, the death of a loved one, work-related problems or financial setbacks can all trigger severe depression. Once the crisis is over, though, most people recover their equilibrium. Other people, though, suffer severe depression for no apparent reason. Sometimes antidepressant medication helps, but not always. Rarely do health professionals consider the possibility that drugs they have prescribed might be causing psychological distress.
When Drugs Cause Severe Depression?
Drug side effects pose a dilemma for doctors. On the one hand they are encouraged to “first do no harm.” But all medications have the potential to cause complications.
It is neither practical nor desirable to warn patients about every potential adverse reaction. That’s why physicians have to be selective in choosing which information they share with patients.
New research suggests, however, that health professionals may need to be more attentive to an often-ignored drug side effect: severe depression.
Hundreds of Meds Can Trigger Depression:
Investigators analyzed data from more than 26,000 adults who participated in the National Health and Nutrition Examination Survey between 2005 and 2014 (JAMA, June 12, 2018). The volunteers filled out questionnaires designed to reveal depression and also answered detailed questions about medication use within the preceding month.
As part of the analysis, the researchers used a pharmaceutical database to identify medicines that have depression, suicide or suicidal thoughts listed as common or serious complications. Statistical analyses determined any association between the score on the depression questionnaire and the pharmaceuticals people were taking.
Scary Results: Severe Drug-Induced Depression
The results were shocking. Approximately seven percent of the people taking just one drug that could trigger depression reported mood disorders. Over 15 percent of those who were taking three or more drugs with this possible side effect experienced depression.
The authors note that:
“Adults in the United States reported use of more than 200 medications that have been associated with depression or suicidal symptoms as adverse effects.”
You might be surprised to learn that some of the most common include blood pressure medicines, acid-suppressing drugs, pain relievers and birth control pills.
Over-The-Counter Drugs and Depression:
Most of these drugs are prescribed, but some are available over the counter. Proton pump inhibitors, for example, such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) may all trigger symptoms of depression.
So can the emergency contraceptive levonorgestrel (Plan B). Unfortunately, OTC drug labels contain little information about depression as a side effect.
Are Patients Informed About Drug-Induced Depression?
Even when people take prescription medicines, they may not get information about side effects.
One reader wrote:
“I took the beta blocker propranolol a couple of years ago to slow my heart rate down. The medication worked, but after a week or so I started to sleep more, wanted to be alone and lost interest in cooking and eating.
“I work from home and my job is challenging and exciting. However, after few weeks I didn’t care if there were orders to process and I didn’t want to communicate with customers. I had to force myself to do things that normally I can’t wait to wake up and start my day doing.
“After six months I was really depressed. I spoke to my cardiologist’s nurse, but she said that depression was highly unlikely as a side effect. She said I could safely stop taking propranolol because I was on a very small dose. I skipped a pill for a day and felt like a dark cloud started to lift. I felt happy.
“When I went to my cardiologist and told him what had happened, he said that depression is a very common side effect of beta blockers. Really? Why was that too hard to mention before he put me on it?”
Commonly Taken Meds and Depression:
An NPR report (June 12, 2018) describes it this way:
“The list includes a wide range of commonly taken medications. Among them are certain types of proton pump inhibitors (used to treat acid reflux), beta blockers, anxiety drugs, painkillers including ibuprofen, ACE inhibitors (used to treat high blood pressure) and anti-convulsant drugs.
“’The more of these medications you’re taking, the more likely you are to report depression,’ says study author Mark Olfson, a professor of psychiatry at Columbia University.”
Drugs The Investigators Looked At:
There are hundreds of medications that can affect the mood. Some of the drugs that were on the investigators list included:
Drugs That Can Cause Depression
- Corticosteroids such as predinisone
- Ethinyl estradiol
No one should ever stop any medicine without careful consultation with the prescriber. Some of these drugs are absolutely essential and it may not be appropriate to stop, even if depression is a side effect. That said, let your physician know if you experience severe depression as a side effect. An alternative medication may be feasible.
A Close Call with Heartburn Medicine:
Many years ago a reader shared this experience:
“I was stopped at an intersection on an icy day waiting for a sand truck to pass when I almost pulled out in front of him–intentionally.
“When I saw the young man’s face, I said to myself, ‘I cannot do this to him.’ After the truck passed and I drove on, I wondered what in the world was going on. I was not depressed.
“When I arrived home, I was still shaken from what I had almost done. I read the daily newspaper while I ate lunch. The first article in your column that day was from a lady whose husband had committed suicide while taking metoclopramide (Reglan).
“That was the exact same medication my doctor had prescribed for my stomach. I jumped up and emptied that bottle down the toilet and wrote on it in large letters, DO NOT TAKE AGAIN. I thank God and the lady who wrote you that letter.”
Metoclopramide carries a warning that it can cause mental depression and suicidal ideation. Patients should always be cautioned about such a serious complication.
Sometimes a medicine is essential, and any psychological reactions it causes can be handled with another medication. But often, rather than piling one drug with potential side effects up on top of another, it makes sense to re-evaluate the original treatment.
Full Information About Drugs and Severe Depression!
Health professionals must alert their patients about the potential for drug-induced severe depression as a side effect. This is particularly true if people are taking more than one medication.
Please share your own experience with drugs and depression in the comment section below.