What medications cause depression
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Medications That Cause Depression: A Comprehensive Review
Introduction to Drug-Induced Depression
Depression is a prevalent mental health condition, affecting nearly 3% of the population. The rise in depression cases is partly attributed to the increased use of medications that impact neurotransmitter levels in the central nervous system1. Understanding which medications can induce depressive symptoms is crucial for healthcare providers to manage and mitigate these effects.
Common Medications Linked to Depression
Antipsychotics and Barbiturates
Long-acting antipsychotics and barbiturates are frequently implicated in causing depression. These medications can alter neurotransmitter functions, leading to depressive symptoms, especially in individuals with a genetic predisposition or a history of depression1.
Antihypertensive Agents
Antihypertensive medications, particularly reserpine and α-methyldopa, have a well-documented association with depression. These drugs interfere with biogenic amine levels, which are crucial for mood regulation9. While β-blockers have also been linked to depression, the evidence is less conclusive3 9.
Corticosteroids and Hormonal Agents
Corticosteroids, such as prednisone, and certain hormonal agents, including gonadotropin-releasing hormone agonists and progestin-releasing contraceptives, have been shown to induce depressive symptoms. These effects are likely due to their impact on the hypothalamic-pituitary-adrenal (HPA) axis and neurotransmitter systems3 4 5.
Psychostimulants and Their Withdrawal
Psychostimulants, including medications like methylphenidate and amphetamines, can cause depression, particularly during withdrawal phases. This is due to the sudden drop in neurotransmitter levels that these drugs modulate3.
Other Medications
Several other medications have been associated with depression, including:
- Calcium Channel Blockers: Used for hypertension and cardiac conditions, these drugs have been linked to depressive symptoms in some studies3.
- Digoxin: A cardiac glycoside, digoxin has been associated with depression, although the evidence is less robust3.
- Interferon-α and Interleukin-2: These immunomodulatory agents used in cancer and hepatitis treatments can induce depression, likely due to their effects on cytokine levels and brain inflammation4 5.
Controversial and Less Substantiated Links
Beta-Blockers
The association between β-blockers and depression remains controversial. While some studies suggest a link, others do not find significant evidence to support this claim3 9.
Oral Contraceptives
The relationship between oral contraceptives and depression is debated. Some studies report a higher incidence of depression among users, while others find no significant difference compared to non-users. The potential mechanism involves estrogen-induced pyridoxine deficiency, affecting serotonin and catecholamine levels6.
Medications with Minimal Evidence
Certain medications, such as l-dopa and histamine-2-receptor blockers, have not been conclusively linked to depression. Similarly, thiazide diuretics are generally not associated with depressive symptoms3.
Conclusion
A variety of medications can induce depressive symptoms, with some having stronger evidence than others. Healthcare providers should be vigilant in monitoring patients on these medications, especially those with a history of depression or other risk factors. Adjusting medication regimens and considering alternative treatments can help mitigate the risk of drug-induced depression.
Sources and full results
Most relevant research papers on this topic
Drugs and Depression
Depression is more likely to occur in individuals with genetic predisposition, previous depressive illness, and age, and is more likely to occur when drugs affect neurotransmitter levels.
Mechanism of action of antidepressant medications.
New antidepressants target specific brain receptors without causing unwanted side effects, improving depression treatment.
Highly CitedDrug-induced depression.
Drug exposures, particularly corticosteroids, calcium channel blockers, and digoxin, can contribute to the etiology of depressive symptoms and disorders, but the specific classification of drug-induced depression as a distinct category is not supported by the existing literature.
Systematic ReviewDrug-Induced Depression: A Systematic Review to Inform Clinical Practice
Drug-induced depression is a small group of drugs that differs symptomatically from classical major depression.
Systematic ReviewHighly CitedDepressogenic effects of medications: a review
Several medications, such as barbiturates, vigabatrin, topiramate, flunarizine, corticosteroids, mefloquine, efavirenz, and interferon-, may cause depression in some patients and should be used with caution in patients at risk
Literature ReviewHighly CitedMedication as a potential cause of depression.
Depression may be precipitated by certain medications, but their role in depression is unclear and may be influenced by other factors and the original disease process.
Literature ReviewMedication as a potential cause of depression.
Depression may be exacerbated or precipitated by certain medications, particularly antihypertensive and cardiac drugs, oral contraceptives, levodopa, and major tranquilizers.
Literature ReviewExperimental medication treatment approaches for depression
Experimental medications targeting glutamatergic, cholinergic, and opioid systems show potential for treating depression, particularly in treatment-resistant patients.
Very Rigorous JournalAntihypertensive Medications and Depression
Antihypertensive medications can cause depression, with reserpine and -methyldopa being the most likely to cause it.
Should antidepressants be used for major depressive disorder?
Antidepressants have minimal benefits for major depressive disorder and increase the risk of serious and non-serious adverse events, making their use for adults with depression questionable.
Systematic ReviewHighly Cited