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Are There Medications That Can Cause Depression?

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In 2018, a JAMA study found that more than one-third of adults in the United States take a medication that can cause depression and mood symptoms as side effects. Yet, many people who take these commonly prescribed drugs are unaware that they can cause depressive symptoms. The truth is that certain medications, prescribed to treat a variety of medical conditions, can affect the central nervous system and alter brain chemicals. This can lead to drug-induced depression with feelings of sadness, despair, and an increased risk of suicide. 

While treating a medical condition with a particular medication might be necessary, developing depression as a side effect is highly undesirable and must be addressed immediately. It is not always possible to establish with certainty that medication is the cause of a person’s depressive symptoms. However, knowing which medications can cause depression as a side effect is important so that you can discuss alternative options with your doctor.

Medications That Can Cause Depressive Symptoms

Many medications that may cause depression are not prescribed for mental health conditions. Sometimes, doctors do not warn patients of the risk of depressive symptoms. As a result, many patients are unaware that depression is one of the side effects of their medication.

Also, each individual’s reaction to medication varies. Drug interactions among your current medications can also cause unexpected side effects. That’s why it’s important to tell your doctor about all the medications you are currently taking, including over-the-counter medicines, herbal remedies, and dietary supplements. It is also recommended that you talk to your doctor about any potential medication side effects that you are aware of before starting it.

In the following paragraphs, we will describe some of the common types of drugs that may cause depression. This is not a comprehensive list. If you think you are experiencing depression as a result of medication, please do not hesitate to address your concern with your doctor or a pharmacist. 

Beta-Blockers

This is a class of drugs that are commonly prescribed to treat high blood pressure. Examples include atenolol (Tenormin), carvedilol (Coreg), and propranolol (Inderal). Besides high blood pressure, beta-blockers may be prescribed for the treatment of angina (chest pain), arrhythmias (irregular heartbeat), migraines, tremors, and glaucoma. Along with fatigue and sexual dysfunction, depression is one of the common side effects of beta-blockers. The mechanism behind it remains unknown.

Corticosteroids

Another group of medications that may cause depression is corticosteroids. These drugs are commonly prescribed to treat inflammation in people with conditions such as rheumatoid arthritis, gout, lupus, and Sjogren’s syndrome. Examples include prednisolone, methylprednisolone, cortisone, hydrocortisone, and triamcinolone. Scientists believe corticosteroids can cause depression and mood symptoms by lowering levels of serotonin, a chemical in the brain that is involved in mood regulation. 

Benzodiazepines

These are hypnotics or tranquilizers that are used to treat anxiety and insomnia. Benzodiazepines also have a muscle-relaxing effect. Examples include alprazolam (Xanax) and diazepam (Valium). Benzodiazepines suppress the central nervous system and can produce a hangover effect if they build up to toxic levels, manifesting as depressive symptoms. The risk of this side effect is higher in older individuals due to their slower rate of drug clearance. 

Medications used to treat Parkinson's Disease

Parkinson’s patients have low levels of dopamine, a neurotransmitter in the brain. The drugs used to treat Parkinson’s adjust dopamine levels in the central nervous system by directly or indirectly increasing the level of dopamine in the brain. Examples include levodopa and carbidopa (brand names Sinemet and Stalevo). Other Parkinson’s drugs like ropinirole (Requip) and pramipexole (Mirapex) affect dopamine receptors in the central nervous system. Dopamine is one of the three main neurotransmitters (along with norepinephrine and serotonin) associated with depression. Researchers believe that prolonged exposure to high levels of dopamine is associated with depression. Therefore, Parkinson’s Disease medication can cause depression as a long term side effect. 

Drugs that alter hormone levels

Some women’s health medications such as birth control pills and estrogen replacement therapy used to treat menopausal symptoms contain hormones. These medications manipulate hormone levels in the body, which can affect the central nervous system and lead to depression. If this occurs, talk to your doctor about using other prescription or over-the-counter medications. Hormone-altering drugs that contain progestin-only are believed to be less likely to cause depression.

Stimulants

This is a group of drugs that are used to treat ADHD (attention deficit hyperactivity disorder) and excessive daytime sleepiness due to conditions such as narcolepsy, hypersomnia, or sleep apnea. Examples include modafinil (Provigil), amphetamine/dextroamphetamine (Adderall), and methylphenidate (Ritalin). It is believed that these drugs can cause symptoms of depression due to prolonged exposure to elevated levels of dopamine in the central nervous system.

Anticonvulsants

Anticonvulsants are used in the treatment of epilepsy (seizures) as well as other medical conditions such as neuropathic pain, mood disorders, mania, and bipolar disorder. Examples include carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin), and pregabalin (Lyrica). It is believed anticonvulsants might cause drug-induced depressive symptoms by altering the levels of mood-regulating neurotransmitters (chemicals) in the brain. If a drug you’re taking causes depression, talk to your doctor about alternative treatment options.

Proton Pump Inhibitors and H2 Blockers

Proton pump inhibitors and H2 blockers are prescribed to suppress excess gastric acid production in people with gastroesophageal reflux disease (GERD). Examples include omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium), pantoprazole (Protonix), famotidine (Pepcid AC), ranitidine (Zantac), and cimetidine (Tagamet). Why these drugs might lead to depression is unclear, but scientists believe it could be that changes in the stomach pH affect the central nervous system. 

Statins and Other Cholesterol-Lowering Medications 

Statins such as atorvastatin (Lipitor), simvastatin (Zocor), fluvastatin (Lescol), rosuvastatin (Crestor), and pravastatin (Lipostat) are commonly prescribed to lower cholesterol levels. Other lipid-lowering drugs include colesevelam, fibrates, nicotinic acid, and ezetimibe. Research suggests these drugs may cause depressive symptoms by lowering cholesterol levels in the brain. 

Anticholinergic Drugs

This is a group of drugs that blocks acetylcholine, a neurotransmitter that causes muscle contraction. They are often used in the treatment of stomach cramps and other gastrointestinal disorders to slow the contraction of the intestines. An example of this type of medication is dicyclomine (Bentyl), which is often prescribed for irritable bowel syndrome (IBS). Anticholinergics are also used to treat a variety of other medical conditions, including overactive bladder, asthma, motion sickness, and Parkinson’s disease. These drugs are central nervous system depressants. They can cause depression and mood symptoms as side effects, especially in older patients.

Other Drugs That Can Have Psychiatric Side Effects

Several other medications have been linked to mental health and can cause symptoms of depression as side effects. These include acne medications (isotretinoin), prescription opioid pain relievers (OxyContin, Vicodin), allergy medications (cetirizine, montelukast), thyroid medications (levothyroxine), and antibiotics (gentamicin, ciprofloxacin).

It is worth noting that the risk of drug-induced depression as a side effect increases if someone is taking more than one drug that can cause depression. In other words, people who are on two medications that can cause depression as a side effect have twice the likelihood of developing drug-induced depression, and those on three drugs have three times the risk.

If you start treatment with a new medication and start noticing depressive symptoms, it might help to write down the details of your symptoms, such as what they are, when they started, and what makes them worse. This can help the prescribing doctor figure out if a specific medication could be causing depression as a side effect. The doctor may then change your dose, ask you to stop taking the drug, or prescribe an antidepressant. 

References:

  1. https://jamanetwork.com/journals/jama/fullarticle/2684607
  2. https://www.aarp.org/health/drugs-supplements/info-02-2012/medications-that-can-cause-depression.html
  3. https://www.health.harvard.edu/blog/depression-common-medication-side-effect-2018071614259
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926863/#:


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