June 12, 2018

expert reaction to prescription medications and depression

A new study, published in JAMA, investigates the association between prescription medications and depression as a possible side effect.

Prof Andrea Cipriani, Associate Professor of Psychiatry, University of Oxford, said:

“This paper makes an important contribution and the methodology is robust but the results are not alarming.

“The authors have taken a representative sample of the adult general population in the US, using cross sectional surveys over 10 years in five 2-year cycles. They have done an accurate statistical analysis taking many confounders into account and have not tried to oversell their findings.

“Out of the whole group of 26,192 people, 37% of adults (9,150 people) took prescription medicine that may have depression as a potential adverse effect and about 1 in 4 (2,318 people) had moderate to severe depressive symptoms.

“However, there are two important caveats. First, the risk of depression was higher in people that took more types of medicine and this may be a result of the medicines interacting but it may also be because people with chronic illnesses take more medicines and are also more likely to have depression. This was an observational study so we cannot tease this apart.

“Second, this study looked at many medications, including antidepressants. For many of the people who self-reported depression this may simply be because the particular antidepressants didn’t work for them, or that they were biased towards expecting feelings of depression. It doesn’t necessarily mean the antidepressants caused the depression.

“In summary, this is a strong piece of research and we should be paying attention to the medicines people are given and the interactions they have, but these findings are not a cause for concern.”

Prof Allan Young, , Director of Centre for Affective Disorders, King’s College London’s Institute of Psychiatry, Psychology & Neuroscience, said:

“This is an interesting study which reports an association between prescription medicines and depression.  The findings seem robust.

“This confirms the well-known fact that these medications might be causing depression in some people and we should be on the look-out for that so that we can detect and then manage the depression. Two points are important to note:  firstly, many prescription medicines may have depression as a possible side effect and this should be discussed with patients up front. Secondly, health should be viewed holistically and all doctors should be screening for depression in their patients with physical illness.  This is especially important as our population is ageing and older age groups are treated with more of these medicines.”

* ‘Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States’ by Mazen Qato et al.  published in JAMA on Tuesday 12^th June.

Declared interests

Prof Andrea Cipriani: “Supported by the National Institute for Health Research (NIHR) Oxford Cognitive Health Clinical Research Facility.”

Prof Allan Young: “Employed by King’s College London; Honorary Consultant SLaM (NHS UK).

Paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen. Consultant to Johnson & Johnson. No share holdings in pharmaceutical companies. Lead Investigator for Embolden Study (AZ), BCI Neuroplasticity study and Aripiprazole Mania Study. Investigator initiated studies from AZ, Eli Lilly, Lundbeck, Wyeth, Janssen. Grant funding (past and present): NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK)”