As many as one third of Americans may be unwittingly taking drugs that can cause depression as a side effect, new research suggests.
Many are taking several of these medications at once, doubling the risk that they will experience depression while on the pill cocktail.
Nearly a quarter of people in the US take three or more prescription drugs, and almost 20 percent of adults are depressed.
Yet the new study from the University of Illinois at Chicago found that many are unaware that they are on one – or several – of 200 common prescriptions that may leave them depressed.
More than 200 common prescription drugs have depression as a possible side effect, and a third of Americans may unaware that they could develop the mood disorder from their drugs
These included drugs like beta blockers, hormonal birth control, proton pump inhibitors, blood pressure and heart medications, antacids and painkillers.
Every prescription drug comes with a seemingly endless list of side effects, which seems inevitably to conclude in ‘death.’
‘Patients are understandably freaked out by the long list of side effects, although they are not even all necessarily associated with the drugs, but are things that happened in clinical trials so they have to be included,’ says New Jersey psychiatrist Dr Steven Levine, who was not involved in the research.
‘Depression is one among that list that probably is more important to discuss because it is so common and it can be a life-threatening condition,’ he explains.
Of the 26,192 people included in the University of Illinois study, published in JAMA, 7.6 percent said that they had depression.
Thirty-five percent of the participants were taking three or more medications for which depression is a possible side effect.
The more of these medications a person was taking, the greater the odds were that they would report depression too.
For example, just under five percent of those who were not taking any such medications were depressed. Three-times as many (15 percent) people on three or more medications with depressive side effects felt the symptoms.
Worse yet, taking one or several of these drugs is becoming a more common practice, and depression is becoming a more common side effect.
By 2014, rates of prescriptions for these drugs were up 8.6 percent over what they had been in 2006, according to the new research.
‘Many [patients] may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis,’ says lead study author Dr Dima Qato.
But, ‘this is not a surprise to me,’ says Dr Levine.
‘For one, just because I’m familiar with the number of medications with depression as a side effect, and because it’s a bit of a fiction and an unnecessary illusion that our medicines are so specific that they just affect one condition or disease state when we know that most medications have many targets in the body and the brain.’
He says that drug side effects tend to cause depression via two pathways: by disrupting the gut flora and by over-activating the body’s stress response system.
The former primarily applies to proton pump inhibitors and antibiotics, while the stress response can be thrown out of whack by beta blockers and heart medications, allergy and asthma drugs, the acne drug Accutane and an antimalarial drug that is now seldom used because its psychological effects are so dramatic.
‘With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue, and this study provides evidence that patterns of medication use should be considered in strategies that seek to eliminate, reduce or minimize the impact of depression in our daily lives,’ Dr Qato says.
Despite these worrisome associations, Dr Levine is quick to not that they are currently just that – associations – and not causal links.
So stopping any one medication if someone is feeling depressed is not necessarily the immediate solution.
‘For most people, there are probably many possible pathways to depression. It probably takes more than one hit for most people [to develop depression], so even if some component of a drug is contributing to depression, this maybe means stopping the drug, but maybe it doesn’t,’ says Dr Levine.
To him, the key to parsing out whether the drug is the problem, a part of the problem, or wholly unrelated to someone’s depression is mainly a matter of taking a careful history of each patient.
‘This is another wrinkle in how to strike a balance of disclosing potential risks and [highlighting] something that is so vague it is hard to interpret,’ he says.
But ‘the chances are a drug is going to affect other body systems, positively or negatively… The brain bone is connected to the neck bone, is connected to the shin bone.’