Friday, June 15, 2018

When Medication Makes You Depressed

Fair enough. The results are not definitive. To some people they are controversial. And yet, while we are having a conversation about suicidal depression we ought to place some emphasis on the role that medication plays in the process. Today’s article from the Washington Post does not directly address whether or not SSRIs produce suicidal ideation, but looks at what is called polypharmacy.

It means that more and more Americans are prescribed drug cocktails, multiple medications, many of which carry a depression risk. The question researchers are trying to answer is: how do these drugs interact? What happens to people who are taking several medicines, many of which increase the chances of becoming depressed.

More than a third of American adults are taking prescription drugs, including hormones for contraception, blood pressure medications and medicines for heartburn, that carry a potential risk of depression, according to a study published in the Journal of the American Medical Association.

The study found that people who took multiple drugs associated with a possible increased risk of depression were also more likely to be depressed, but researchers couldn’t distinguish whether the medications were the cause. It's possible people already had a medical history of depression prior to taking the drugs, or the medical conditions they were being treated for could have contributed to their depression….

The work is part of a provocative and growing body of research that documents how polypharmacy — the use of multiple prescription drugs at the same time — has risen in the United States. The number of Americans taking at least five prescription drugs at the same time rose sharply between 1999 and 2012, and the elderly are particularly at risk for dangerous interactions between drugs.

The study examined drugs that list possible adverse side effects including depression and suicide, but that does not mean the link was always well-characterized — or that people should stop taking a drug that could be helping them. Painkillers and antidepressants were listed, which could be related to underlying reasons for the depression.

Pharmacy Professor Dima Qato of the University of Illinois has led the research:

Over the decade, Qato and colleagues found that 37 percent of U.S. adults, on average, took medications associated with a side effect of depression.

The team also found that the number of people taking at least three medications that carried a potential side effect of depression increased over the survey time period, from 6.9 percent in the 2005-2006 survey to 9.5 percent in 2013-2014. The rate of depression tripled in people taking at least three medications with a possible side effect, compared to people taking no drugs with that side effect.

As we emphasize, the results are preliminary. Yet, they suggest a clear correlation between the drugs and depression.

The Post concludes:

But even if doctors don't have definitive proof that a particular drug is causing a depression, the study is a reminder that physicians should consider the role of medications  — particularly for patients on multiple medications associated with increased risk of an adverse side effect, which the study shows are commonly used.

We are all interested, perhaps too interested, in how medication can treat depression. We have overlooked the question of how medication can produce depression.

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