Depression With Drugs

Many people are not aware that certain prescription drugs have been associated with the emergence or worsening of depression symptoms as a side effect, even in people who might not ordinarily be prone to depression. A 2018 study published in JAMA found that more than a third of U.S. adults are taking a prescription medication that could potentially cause depression or increase suicide risk.

Since depression is so common in patients with medical illnesses, it is often difficult to establish whether these medications are to blame for the mood symptoms. However, it is essential to be aware of these possible associations.

This article discusses depression with drugs and the types of medications that are likely to cause symptoms. It also offers advice on what you can do to cope.

Types of Medications Causing Depression

While not a comprehensive list, the following are 10 common types of drugs that are associated with depression symptoms. You should consult with a doctor or pharmacist for information about your own specific medication regimen.

Beta-Blockers

Beta-blockers are generally prescribed in the treatment of high blood pressure, although they may also be used to treat migraines, angina, irregular heartbeat, and tremors. They may also be given as eye drops in the treatment of glaucoma. Examples of this type of drug include Toprol XL (metoprolol) and Inderal (propranolol).

Corticosteroids

These medications are often used to treat inflammatory conditions, such as lupus, rheumatoid arthritis, gout, and Sjögren's syndrome as well as other medical conditions.

Corticosteroids can cause a variety of psychiatric symptoms. It is thought that among other effects, corticosteroids affect serotonin, a substance produced by the brain which is believed to be involved in mood regulation. Examples of this type of medication include cortisone, prednisone, methylprednisolone, and triamcinolone.

Benzodiazepines

These drugs are usually used to treat anxiety and insomnia or, when necessary, to cause the muscles to relax. In certain circumstances, these drugs may lead to depression symptoms.

Benzodiazepines can also be habit-forming and may lead to dependence and withdrawal symptoms when people try to stop taking them. Common examples of benzodiazepines include Xanax (alprazolam), Restoril (temazepam), and Valium (diazepam).

Parkinson's Drugs

Drugs used in the treatment of Parkinson's disease affect a substance in the brain called dopamine. Abnormalities in this neurotransmitter have been thought to be associated with depression. 

The most commonly used medication in treating Parkinson's disease is levodopa. Other common medications that may be used include Sinemet (carbidopa/levodopa) and Lodosyn (carbidopa).

Drugs That Affect Hormones

These drugs include hormonal forms of birth control as well as estrogen replacement therapy for menopausal symptoms. Variations in hormone levels in women are often associated with depression symptoms, although it is not completely understood how this interaction occurs. Research suggests that progestin-only birth control is unlikely to cause symptoms of depression.

Stimulants

Stimulant medications may be prescribed to treat daytime sleepiness associated with conditions like narcolepsy, and they may also be used in the treatment of attention deficit hyperactivity disorder (ADHD).

Ritalin (methylphenidate) and Provigil (modafinil) are some examples of this type of medication. Although they have been used to augment antidepressants, there is also an association of mood worsening with their use in some patients.

Stimulant medications can also produce dependence and withdrawal, which may lead to symptoms of depression, such as fatigue and sleep difficulties when people stop taking their medication.

Anticonvulsants

These drugs are used in the treatment of seizures, although they may also be used in treating other conditions, such as bipolar disorder and neuropathic pain.

Some examples these types of medication associated with an increased risk for depression include Tegretol (carbamazepine), Topamax (topiramate), and Neurontin (gabapentin), and barbituates and Sabril (vigabatrin).

Proton Pump Inhibitors (PPIs) and H2 Blockers

These medications are most commonly prescribed to treat gastroesophageal reflux disease (GERD) and have occasionally been associated with depression for reasons that aren't clear.

Statins and Other Cholesterol-Lowering Drugs

While statins are the most commonly prescribed drugs for lowering cholesterol, other drugs, such as fibrates, colesevelam, ezetimibe, and nicotinic acid can also be used for this purpose.

There have been some reports linking these drugs with depression. It is thought that these drugs may cause depression by lowering the levels of cholesterol in the brain, where it serves many important functions.

Anticholinergic Drugs

Anticholinergic drugs influence a variety of functions in the body, including slowing down the action of the intestines. They are often used to treat irritable bowel syndrome (IBS) with medications like Bentyl (dicyclomine). However, because they affect the central nervous system, they may have some association with depressive symptoms, particularly in older adults.

Some case reports have indicated there may be an association between anticholinergic medications and mood disorders. However, some more recent research has not found such a link. However, research suggests that long-term use of such drugs may increase the risk of dementia.

Signs of Depression

The most noticeable symptom of depression is, of course, a feeling of sadness and low mood. Other than a depressed mood, however, there are other possible symptoms of depression that you might experience, like the following:

• Feelings of hopelessness or helplessness
• Feelings of guilt or worthlessness
• Anxiety
• Irritability and restlessness
• Fatigue and low energy
• Problems with sleep
• Problems with appetite or weight
• Problems with thinking, memory, and concentration
• Loss of interest in things once enjoyed
• Thoughts of death or suicide

It can be helpful to write down details like when your symptoms first started and when they are the most severe. With many medications, you may start noticing such signs within the first few weeks after you begin a new drug.

It is also difficult to know what your individual reaction to a drug may be, or how it may interact with other medications that you are currently taking. For this reason, it is important to always fully inform your doctor about anything else you are taking, including any over-the-counter medications and herbal supplements.

What to Do Next

If you believe that you may be experiencing symptoms of depression, whether they are related to a drug that you are taking or not, you should consult with your personal physician.

Every situation is different, so your doctor will look at your health history and symptoms in order to determine what steps to take next. In some cases, it may involve switching to a different medication or adjusting your dosage.

Your doctor will also try to determine if your depressive symptoms are linked to the new medication or some other cause. If there is an underlying depressive disorder, your doctor may recommend treatments such as antidepressants and psychotherapy.