Study finds frequent use of medications for which depression is an adverse effect

Use of medications that are known to include depression as an adverse effect appears common, a new study has found.

Researchers used data from two-year cycles (2005-2006 through 2013-2014) of the National Health and Nutrition Examination Survey (NHANES) to determine use of medications with depression as a potential adverse effect and to examine potential associations between medication use and depression. The main outcome measures were prevalence of any use and concurrent use of medications that could cause depression and prevalence of depression, defined as a score of 10 or higher on the Patient Health Questionnaire-9 (PHQ-9). Prescription medications that could potentially be linked to depression were obtained from the database Micromedex, which is based primarily on FDA labeling. The study results were published June 12 by JAMA.

Overall, 26,192 adults were included in the study. Mean age was 46.2 years, and 51.1% were women. A total of 7.6% reported depression during the study period. The researchers found that overall estimated prevalence of use of medications with depression as a potential adverse effect was 37.2%, increasing from 35.0% in 2005 and 2006 to 38.4% in 2013 and 2014 (P=0.03 for trend). In 2005 and 2006, an estimated 6.9% of patients reported use of at least three concurrent medications that could cause depression as an adverse effect, versus 9.5% in 2013 and 2014 (P=0.001 for trend). Any use of prescription medications with suicidal symptoms as a potential adverse effect and concurrent use of at least three prescription medications that had suicidal symptoms as a potential adverse effect also increased from 2005 and 2006 to 2013 to 2014.

Adjusted analyses that excluded patients who took antidepressants indicated an association between the number of depression-linked medications taken and increased prevalence of concurrent depression. Prevalence of depression was estimated at 15.3% in patients who reported using three of these medications, 6.9% in those who reported taking one, and 4.7% in those who reported taking none. Additional analyses found similar patterns in adults who were treated with antidepressants, adults with hypertension, and adults who did not use psychotropic medications.

The researchers noted that NHANES data include information only on prescription medications, not over-the-counter drugs, and do not allow adjustment for history of depression or other potential confounders, among other limitations. However, they concluded that use of medications that have depression as a potential adverse effect was common and that use of multiple types of these medications was associated with increased depression risk.

“The results suggest that physicians should consider discussing these associations with their patients who are prescribed medications that have depression as a potential adverse effect,” the authors wrote.