Depression: Common medication side effect?

Monique Tello, MD, MPH

Contributing Editor

Do you take medication for acid reflux, allergies, anxiety, birth control, blood pressure, or pain? If so, depression or suicidal thoughts may be listed as a side effect, and those side effects may occur far more often than we realized.

At risk of depression and suicide

A recent study published in JAMA found that people who take medications with depression or suicidal thoughts listed as a side effect are, in fact, more likely to be depressed or suicidal. Researchers looked at data collected between 2005 and 2014 from the large and ongoing National Health and Nutrition Examination Survey, conducted by the US government. This included responses from a nine-item depression and suicidality questionnaire.

In addition, the study found that 37% of respondents used at least one prescription medication with depression as a side effect, that use of these medications had significantly increased between 2005 and 2014, and that people who took them were more likely to be older (65 or older), female, widowed, and have other chronic health problems. For people taking no medications with depression as a side effect, the likelihood of having depression was 5%, and this remained stable regardless of how many other medications they took that did not have depression as a side effect (even if that number was zero).

Likelihood of depression from medication

What was striking was that the likelihood of depression increased significantly for each medication with depression as a side effect a person was taking. For one such medication, the risk was 7%; for two it was 9.5%, and for three or more it was 15%. Put another way, people who took two medications with depression as a side effect had double the likelihood of having depression as those who took none; people who took three had triple the likelihood. They ran the same analysis for medications with suicidal thoughts as a side effect, even correcting for those who were also on antidepressants (and perhaps already at risk for having those thoughts). Those who took no medications with suicidal thoughts as a side effect had a 5% likelihood of having suicidal thoughts. The likelihood of suicidal thoughts increased significantly for each medication with suicidal thoughts as a side effect, so for people taking one it was 8%, for two it was 12%, and for three or more it was 18%.

Also interesting were the findings when the analysis was limited only to people taking antidepressants. Just like everyone else, the more medications with depression as a side effect they took, the higher their risk of depression. So, for people on an antidepressant who took no medications with depression as a possible side effect, the risk of depression was 14%, for one it was 18%, for two it was 27.5%, and for three or more it was 28%.

Medications with depression as a side effect

What are the medications with depression as a side effect? These were among the most common ones listed:

  • acid reflux medications like omeprazole, esomeprazole, ranitidine, and famotidine
  • allergy medications like montelukast and cetirizine
  • anxiety medications like alprazolam, diazepam, and lorazepam (and the sleep medication zolpidem)
  • birth control and hormone therapy, which includes anything containing estrogen
  • blood pressure medications like atenolol, metoprolol, enalapril, and quinapril
  • pain medications like ibuprofen, cyclobenzaprine, hydrocodone, and tramadol
  • antiseizure medications (which are often used for other reasons too) like gabapentin, topiramate, and lamotrigine.

What does this mean for you?

This study is especially thought-provoking, given that more and more people are taking medications with depression or suicidal thoughts as possible side effects. The CDC just released updated data showing a troubling recent rise in suicide rates, and that 54% of those who die from suicide do not have a known mental health disorder, so this is an important public health issue.

That said, it is important to note: in this study, people who used these medications were more likely to be widowed and have chronic health problems, both of which are associated with a higher risk of depression. And many (but not all) of these medications are often prescribed to treat symptoms associated with existing depression, such as anxiety, insomnia, pain, and even acid reflux (chronic stress can cause acid reflux).

The next step is to run a study where people are randomly assigned to take these medications, or alternate ones without depression as a side effect, and then follow them over time to see what happens. That’s a randomized, controlled, clinical trial, the gold standard in research studies.

While we’re waiting for that to happen, if you’re suffering from depression, and you’re also taking any of these listed medications, then you may want to consider talking to your doctor about switching to something else for a while, and see if your mood improves.

Related Information: Understanding Depression

Comments:

  1. Arn O'brian

    Thank you for the comprehensive information regarding the depression as medication side effect. I also read other interesting articles to preventing depression. Very useful article, the only solution would be to start living and eating healthy already in the childhood. I think the source of the problem is that people need instant solutions for their health problems. People should take as less medication as possible. The side effects of medication never will allow people to live full life.

  2. Harry Schroder

    I am diagnosed with severe depression I am 77 and male. I have constant suidal thoughts. , For at least 6 or 7 years now my treatment with a psychopharmacologist.I took at least 30 antidepressants along with combinations of diferrent ones, and the becasue I experience tremndous anxiety as well, was prescribed 4 mg a day of Alprazalom. My depression continued. Now I am on an MOAI 60 mg a day, and still taking Alprazalom, as well as Provigil 400mg a da.to give me some energy. This combo helps some, except, I need to be vigilant about taking my meds every 2 to 3 hrs., or I become seriously depressed. I also takie 1 Simvastatin 20mg at bedtime for cholesterol, though my last few Dr. check-ups did not indicate my need for it, because I changed my diet and my numbers improved. Could this be why I too cannot shake depression?

  3. Monique Tello, MD, MPH
    Monique Tello, MD, MPH

    Nellie, examining medications with memory loss listed as a side effect would be a necessary and interesting study.

  4. Jill Brunner

    Thank you for letting people know about medications they take and the side effects of their medications that they may have.

  5. betsy pelz

    re: depression as a side effect of drugs and drug combination:

    I tried 2 different anti-cholesterol drugs, one of them being simvastatin. I was sure they affected my emotional health. It seemed like they replaced ordinary emotions with excessive iterations of each. As soon as I stopped taking each drug, the violent emotions subsided. I feel sorry for all the older people being forced to take these, especially older people in nursing homes, where their behavior would then likely result in even more drugs. In addition, I noticed very frequent word loss that disappeared when I stopped the drug.

    • Monique Tello, MD, MPH
      Monique Tello, MD, MPH

      Many medications can have side effects. However, I would hope that elderly folks in nursing homes would be taken off of cholesterol-lowering agents and others with only long-term potential benefit, as the risk outweighs and chance of those benefits being realized.

  6. Diane Stapes

    I also believe weight gain is another HUGE side effects of anti depressants and anti anxiety medication, especially long term. Being mindfull about when to get off them is paramount.

    • Monique Tello, MD, MPH
      Monique Tello, MD, MPH

      Yes, almost all of the SSRIs are associated with weight gain. Bupropion is one in a different class that is actually associated with weight loss.

  7. Gary A. Favero

    Are there any anti-depressants out there that do not have a negative effect on one’s sex drive? Or is this a side effect with all anti-depressants? Mine is driving me crazy and I don’t want to not be able to get aroused or have an erection.

  8. Paul Scott

    I’m wondering if you believe this side effect is better characterized akathisia, which is sometimes coded as depression, yet which is distinct from depression and the mechanism for suicide warnings on a host of medications.

    • Monique Tello, MD, MPH
      Monique Tello, MD, MPH

      Hi Paul, In this study they used depression screening questions which have been validated for the diagnosis of depression specifically, is my understanding.

  9. Anne

    Do you think lamotrigine has a big effect on Memory, both generally and with word retrieval. Am on 100mg for depression, not bipolar at all. Am 50 so don’t know if this may be more related to hormones possibly, though not in menopause.

    • Monique Tello, MD, MPH
      Monique Tello, MD, MPH

      Hi Anne, Apologies for the delay; Yes, I have heard of this side effect with lamotrigine. It may be worth switching. Talk to your prescribing doctor about it, though.

  10. Nellie Quan

    I would also be interested in medication that lists memory lose as potential side effect, such as Trazadone. I was lucky, as I discontinued its use when I discovered that particular medication was making it difficult for me to grasp certain words. Thankfully, I was able to regain my memory after several months of discontinuing.

  11. Monique Tello, MD, MPH
    Monique Tello, MD, MPH

    That’s a difficult situation to tease apart, as Parkinson’s and depression are clearly linked. He may benefit from treatment for depression, especially if he cannot come off of those Parkinson’s medications.

  12. Monique Tello, MD, MPH
    Monique Tello, MD, MPH

    Darin, agreed. Thanks for reading!

  13. Mel | Mel's Money Mindset

    My dad takes about 5 -10 different tablets a day for his Parkinsons and the side effects of some of them are awful! It includes things like depression/suicide. As his life has changed so dramatically, it’s difficult to say if it’s because of the drugs or because he cannot do all of the things that he used to like riding his motorbike.

  14. Darin Flynn

    Thank you for reminding us of the compounding side effects of medication. I believe a contributing factor to this problem is Alert Fatigue, in that almost every medication comes with so many potential side effects, both physicians and patients tend to ignore them. Before long, the additive effects can become significant.

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