Depression as a side effect of prescription drugs is widespread and increasingly gaining attention. Most recently added to the list of culprits are the asthma medications called leukotriene inhibitors, which are involved in suppressing the inflammatory response. These asthma medications also appear to have an impact on mental health and mood disorders.
“Over the past year Merck has added psychiatric side effects as possible outcomes with Singulair [the leukotriene montelukast], including tremor, depression, suicidality — suicidal thinking and behavior — and anxiousness,” says J. Douglas Bremner, MD, researcher and professor of psychiatry and radiology at Emory University School of Medicine in Atlanta.
Drugs with Depression as a Side Effect
Among his studies, Dr. Bremner has published on the possible relationship between the use of retinoic acid acne treatments and the development of depression. One of the drugs within this category is isotretinoin (Accutane), the controversial oral treatment for severe acne that has been associated with psychiatric problems including depression.
Besides isotretinoin and montelukast, other drugs that can cause or contribute to the development of depression or other mood symptoms include:
- Mefloquine (Lariam), used to treat malaria — “Over half of people who take it develop psychiatric symptoms,” notes Bremner.
- Oseltamivir phosphate (Tamiflu), used to treat bird flu.
- Varenicline (Chantix), used to stop smoking.
- Propranolol hydrochloride (Inderal) and other drugs in the beta-blocker class, used to treat high blood pressure.
- Birth control pills and estrogen for hormone replacement therapy
- Statins (Mevacor, Lipitor, and others)
The U.S. Food and Drug Administration (FDA) investigates drugs that have many reports of the development of depression symptoms. It requires what are called “black box” warnings to be clearly printed on medications, like isotretinoin, that have been linked to depression and suicidal behavior, among other serious health threats.
Make sure you read the information pamphlets that come with your prescription medications and stay on top of any news about their side effects. On the FDA Web site you can find a list of prescription drugs with safety concerns, including depression.
Are Your Drugs Causing Depression?
It can be challenging to figure out if your depression is caused by taking a prescription drug, but there are some indicators:
- Timeline. Depression symptoms that develop when you begin taking a drug would indicate a relationship between the two events. However, in his research, Bremner notes that for people taking isotretinoin, depression symptoms may begin weeks or even months after starting the medication. This can make it hard to connect the two events from the patient perspective. Interestingly, Bremner has found that this time delay for developing symptoms — possibly as long as two months — is the same length of time that many depression treatments take to begin working.
- Dose-response relationship. With some drugs, depression symptoms may get better as the dose is reduced or worse as it is increased. This is usually a clear indicator of a relationship.
If you are uncertain about whether your changes in mood or energy are drug symptoms, talk to your doctor. Screening tools and questionnaires can reliably identify depression.
Prescription Drug-Induced Depression Treatment
In severe cases, people have developed depression leading to suicidal behavior. Because of this risk, don’t ignore or try to wait out feelings of depression, even if you believe they are only a prescription drug side effect. Talk to your doctor about these options to correct the situation:
- Switching to an alternative treatment. If an equally effective medication exists that does not have depression as a side effect, the easiest option is to switch prescription drugs.
- Getting a psychiatric evaluation. This may be recommended in any case to make sure that you do not have an underlying psychiatric condition that has gone undiagnosed. People with a history of depression may have a worse response to some medications.
Talk therapy will not work in this case, says Bremner, because the problem is chemically based. You will need prescription medication to address the depression if you cannot stop taking the drugs that are causing it.
If you think your depression symptoms are linked to a prescription drug you’re taking, talk to your doctor right away, get screened for depression, and find a better way to manage both your health issues and your mood.