Every day, we are bombarded on TV and social media by slick, well-produced ads for drugs promising to treat a range of conditions, including high blood pressure, acid reflux, arthritis pain, and diabetes. While these ads may include a hurried recitation of potential side effects, we probably shouldn’t be too quick to give Big Pharma a “pat on the back” for full disclosure. After all, one very serious adverse effect – drug-induced depression – is rarely mentioned.
The truth is that almost 200 different prescriptions and over-the-counter medications can put the user at risk for drug-induced depression. For instance, according to a recent study, hormonal contraception, especially older pills with ethinylestradiol, may contribute to depression in some patients. Another study shows that a shocking one-third of adults in the United States regularly take prescription medications with depression as a potential adverse effect. You’ll want to keep reading to see which common medications can carry this hazardous side effect.
Rates of drug-induced depression rise with every medication taken
To conduct the population-based survey, which was published in the prestigious Journal of the American Medical Association, the researchers used data from the National Health and Nutrition Examination Study involving the years 2005 to 2014. The team found that 37.2 percent of American adults use medications that feature depression as a potential adverse effect.
And according to clinical pharmacist HaVy Ngo-Hamilton, concurrent usage raises risk. People who use two of these problematic medications, Ngo-Hamilton notes, double their risk of developing drug-induced depression. And a troubling 15 percent of the adult population uses three or more of these medications simultaneously, effectively tripling the risk.
Furthermore, there has been a significant uptick in the use of the drugs implicated in depression. The reported use of prescribed medications with depression as a side effect increased from 35 percent in the year 2005 to 2006 to 38.4 percent in 2013 to 2014. Concurrent use of three or more medications increased from 6.9 percent to 9.5 percent over those years. This means that a significant percentage of Americans are at risk from the very drugs they turn to for relief from chronic conditions such as type 2 diabetes and hypertension.
Can the “little purple pill” really leave you feeling “blue?”
The potential for depression lurks inside a laundry list of popular medications. According to the study, two common drugs – proton pump inhibitors and beta-blockers – are responsible for the majority of depressive symptoms, such as anxiety, sadness, and insomnia. Proton pump inhibitors and H2 blockers, which include Nexium (esomeprazole) and Pepcid (famotidine), are commonly advised for acid reflux, ulcers, and indigestion.
According to recent estimates, 7.8 percent of Americans take these medications. Beta-blockers, which include atenolol and metoprolol, are prescribed for high blood pressure and heart problems. The Cleveland Clinic reports that approximately 30 million adults use beta-blockers daily, but these are far from the only medications that can cause drug-induced depression.
Corticosteroids such as cortisone and prednisone can lower serotonin levels and affect levels of GABA, a neurotransmitter that helps control anxiety. Stimulants used to treat ADHD, such as Adderall and Ritalin, temporarily increase serotonin and dopamine levels, but when the medicine wears off, the lower levels can cause fatigue, anxiety, and insomnia.
Other drugs with the potential to trigger depression include statin drugs, anticholinergic drugs used for inflammatory bowel disease, benzodiazepines such as alprazolam (Xanax), Parkinson’s medications, and anticonvulsants. Opioid pain relievers, acne drugs, allergy remedies, and thyroid treatments are also implicated.
Even antibiotics are not free from the potential for depression. And interferon, used to treat autoimmune conditions and hepatitis C, has long been recognized as a source of long-term, recurrent depression. Mild to moderate depression is diagnosed in 45 percent to 60 percent of patients, with 15 to 40 percent developing moderate to severe depression.
Clearly, an overwhelming assortment of drugs can cause negative psychological effects. Yet, in many cases, this fact is nowhere to be found on product labels.
Supreme irony: Antidepressants are linked to suicide
Ironically, antidepressants can place younger people at risk for the most serious depression symptom of all – suicide. For this reason, all antidepressants, including SSRIs (selective serotonin reuptake inhibitors), have an FDA-imposed “black box” warning for suicidal ideation and behaviors in young adults under 25 years old. (Singulair, a popular asthma treatment, also carries this warning.)
This doesn’t mean it is not safe to use these drugs, Ngo-Hamilton asserts. “However, it is very critical that family and friends are aware of this side effect so they can closely watch out for their loved ones.” Any mood or behavior-related changes such as agitation, newly developed aggressive behavior, hallucinations, trouble sleeping, and bad or unusually vivid dreams should be reported to your doctor right away. And, if suicidal ideas turn into thoughts of a plan, you should seek emergency help immediately.
It’s time to expose the threat of drug-induced depression
Clearly, physicians should candidly discuss the risk of drug-induced depression with their patients when prescribing medications. And patients should be alert to indications of plummeting mood or thoughts of self-harm after starting new medications – and honestly discuss them with their doctor. Your doctor may advise reducing the dosage or even switching to an alternative medication. However, don’t stop taking any medications unless your qualified integrative doctor advises it.
Keeping a journal of mood changes can be immensely helpful. General signs to look out for include feelings of sadness, hopelessness, loss of interest, changes in sleep, energy levels, appetite, and mood.
It’s important to tell your doctor about all medications you are currently taking, including over-the-counter remedies, herbal interventions, and dietary supplements.
Incidentally, many herbs and vitamins have evidence-based abilities to support positive mood and reduce anxiety, and you may be able to work with your holistic doctor to find those that work for you. Many people have reported improvements with Rhodiola rosea, saffron, N-acetyl cysteine, vitamin D3, B vitamins, magnesium glycinate, omega-3s, and zinc.
As the study authors noted, over 16 million American adults experience an episode of major depression each year – at an annual price tag of $210 billion. The research raises the potential that the medications so many people rely on could, in fact, be contributing to this sad state of affairs.
If your goal is to enjoy “the best performance of your life” then the wisest course is to arm yourself with knowledge of this destructive side effect – one that may be hiding in plain sight in a bottle of pills.
Sources for this article include: