Depression is a significant mental health issue, affecting about 21 million Americans, roughly 8.4% of the U.S. population. Medications commonly prescribed for unrelated conditions can increase the risk of developing depression as a side effect.
Dr. Timothy B. Sullivan, chair of psychiatry and behavioural sciences at Northwell Staten Island University Hospital in New York, told The Epoch Times that various mechanisms have been suggested to explain this problem.
“But the range of medications involved, and their disparate mechanisms of action, suggests that it is unlikely that we will identify a specific cause,” he said.
People taking benzodiazepines, corticosteroids, blood pressure medication, and certain antibiotics are at a particularly high risk. Research has shown that most of these drugs work by affecting the balance of chemicals in the brain and the production and regulation of neurotransmitters involved in mood regulation.
Americans Unknowingly Exposed To Higher Risk of Depression
A 2018 study from the University of Illinois–Chicago that involved more than 26,000 adults found that 37.2% of participants used at least one prescription medication that might cause depression or increase the risk of suicide.
Researchers identified more than 200 commonly used prescription drugs, including blood pressure and heart medications, antacids, and anti-inflammatories, that listed depression or suicide as possible side effects.
The study found that adults who simultaneously used three or more of these medications had a 15% likelihood of experiencing depression. In comparison, those not using any of the drugs had a 5% chance of becoming depressed, and people using only one medication had a 7% probability of developing depression.
This risk is significant, considering that these medications are usually not prescribed to treat depression, leading to a lack of awareness of the correlation among patients and doctors.
Benzodiazepines, such as Valium and Xanax, are commonly used to treat anxiety, insomnia, and seizures. However, they can increase the risk of depression and other mental health disorders by altering the levels in the brain of the neurotransmitter gamma-aminobutyric acid, which helps regulate mood.
A 2017 review of 17 studies found a consistent association between benzodiazepines and increased suicide risk. Possible reasons include increased impulsivity or aggression, rebound or withdrawal symptoms, and overdose toxicity. The risk of suicide also appeared to be dependent on dose.
If you are using benzodiazepines and experiencing depression symptoms, it’s important to consult a health care provider. They may suggest reducing the dosage or prescribe an alternative medication without depression as a possible side effect.
Non-pharmacological treatments can be effective in managing anxiety. Cognitive behavioural therapy focuses on changing negative thoughts and behaviour patterns and has shown effectiveness without increasing the risk of depression.
Other treatments such as meditation, mindfulness, and aerobic exercise may reduce stress and improve mood, helping with anxiety and insomnia management.
Corticosteroids, such as hydrocortisone and prednisone, are used to treat inflammation and autoimmune diseases such as rheumatoid arthritis.
Although they can be effective in managing these conditions, they may also increase the risk of depression because they reduce the level of serotonin, a hormone that regulates mood, sleep, and pain perception. The risk of developing depression is particularly high when corticosteroids are taken in high doses.
Other drugs that can be effective in managing conditions for which corticosteroids are used are nonsteroidal anti-inflammatory drugs. NSAIDs are usually taken to relieve pain and fever and can effectively reduce inflammation without the associated risk of depression. NSAIDs may even improve depressive symptoms. However, NSAIDs should not be used for an extended period because of the potential for serious side effects.
Blood Pressure Drugs
Certain blood pressure medications, including angiotensin receptor blockers, beta blockers, and calcium channel blockers, may increase the risk of depression, according to a systematic review of studies involving almost 415,000 people. The exact mechanisms are not fully understood, but one theory is that these medications affect neurotransmitters involved in mood regulation.
Alternatives that don’t carry the potential side effect of depression include:
- Diuretics: These medications help eliminate excess sodium and fluids from the body, reducing blood volume and pressure.
- ACE inhibitors: They help the body produce less angiotensin, a hormone that constricts blood vessels and raises blood pressure. Research suggests that ACE inhibitors may even have a protective effect against depression, especially in older adults.
- Lifestyle changes: Eating a healthy diet, exercising, and quitting smoking can contribute to maintaining healthy blood pressure levels.
A recent study involving children and young adults found a link between the use of broad-spectrum antibiotics to treat infections and an increased risk of anxiety and depression, particularly in male participants. Another study suggested that this effect could be attributed to the effect of certain antibiotics on the gut microbiome.
“A large body of research over the past decade or more has shown that our gut microbiome has a profound effect on mood and behaviour,” Sullivan said.
Changes in gut flora have been associated with various psychiatric conditions. Although probiotics and prebiotics have been investigated as a potential solution, there is currently no consistent approach for effectively managing gut flora, according to Sullivan. He recommended dietary management aimed at promoting a healthy gut microbiome.
“But as yet, we do not have specific recommendations that would reliably reduce the risk of depression,” Sullivan noted. “Eating a diet low in red meat, and higher in fruits and vegetables, such as the Mediterranean diet, may help to reduce risk.”
Antibiotic drugs may be necessary to treat infection, and you should discuss any concerns you have with your doctor.
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