This past year a team of researchers from the University of Illinois and Columbia University in New York published a study that found a strong correlation between depression and prescription drugs. Appearing in the June issue of the Journal of the American Medical Association, it has only now received notice in the mainstream media. It is not the first study of its kind, but Consumer Reports described it as “the largest review on the topic to date.”
What is surprising about the study is the number and variety of drugs linked to depression. Among them:
- blood pressure medications (beta blockers and ARBs)
- asthma medications and antihistamines
- anti-anxiety meds (i.e., Xanax and Valium, et. al.)
- opioids such as Vicodin and ConZip (tramadol)
- proton pump inhibitors (Prilosec, Nexium, Pepcid)
- hormone replacement drugs
- corticosteroids (prednisone)
Ironically, anti-depressants (including Zoloft, Celexa, and Wellbutrin) are also part of the list, being one more example of medication that can cause the very conditions they were supposed to prevent or mitigate.
Not surprisingly, most patients have no idea that it may be their meds that are causing their depression. However, psychiatry professor Mark Olfson of Columbia University, lead author of the study, points out that even doctors don’t always understand the problem. “Many physicians may not be aware that several commonly prescribed medications are associated with an increased risk of this disorder,” he says.
The study also discovered that the risk of clinical depression grew with the number of medications being taken. Among the case studies analyzed, 7 percent of those taking one prescription suffered from depression. However, by the time a person was taking three or more, the risks more than doubled. It almost goes without saying that older patients are at greatest risk, as many take several different medications and may be more likely to experience side effects.
Olfson reminds people that in studies such as the present one association does not necessarily mean causation. He points out, “Most people taking these medications, even those who are on three or more of them, don’t have depression”
One of Olfson’s colleagues at Mount Sinai Hospital concurs. Dr. Igor Galynker, who also teaches psychiatry, notes that in some cases patients may already have been clinically depressed. It may also be due to co-morbidities, or other health conditions, such as chronic pain. The latter is not unusual since pain and mood are perceived and processed in the same regions of the brain.
Still, if you are among those who take multiple prescription medications, it is important to self-monitor for symptoms of depression. It is not unusual for someone to have an occasional bout of the “blues,” but if such moods last for more than two weeks it is a good idea to contact the doctor.
It is worth noting that a growing number of physicians are starting to “de-prescribe” medications for some patients. However, this practice is still new, and doctors are still learning when it is safe to remove a patient from some medications. In any event, you should not stop taking any medication until you have discussed it with your primary care physician.