“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
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I infrequently get depressed — at least, not severely. One of the only times I can remember experiencing significant depression was during a very difficult medical internship year more than 50 years ago. I wrote about it in my memoir Damn the Naysayers.
I was surprised to read in a recent survey of more than 26,000 adults that 37 percent of Americans take at least one medication that lists depression or suicidal symptoms as a potential side effect. People using such drugs had higher rates of depression than those who didn’t take them. The risk of depression increased with each additional drug taken at the same time: 7 percent for those taking one drug; 9 percent for two drugs; 15% for three or more; versus only 4.7 percent for those not taking any drug.
The overall use of any prescription medication that had depression as a potential adverse effect increased from 35 percent to 38.4 percent between 2005 and 2014. The percentage of adults taking three or more drugs with a depression side effect increased from 6.9 percent to 9.5 percent, and the use of medications with suicidal symptoms as potential side effects increased from 17.3 percent to 23.5 percent. This certainly cannot be helping the well-being of people in our society, already on edge dealing with a variety of issues.
The list of drugs with depression or suicidal thoughts as a side effect include 200 prescription drugs, some well-known to have those side effects, like beta-blockers (e.g., Toprol), but some that may be surprises: common medications like proton pump inhibitors used to treat acid reflux, birth control pills and emergency contraceptives, anticonvulsants like gabapentin, corticosteroids like prednisone, and prescription-strength ibuprofen. Some drugs with depressive side effects are sold over-the-counter.
It’s important to stress that the study, while important, doesn’t establish causality but only an association between these medications and depression. 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 might have contributed to their depression. However, the findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use. In addition, the dose-response pattern, i.e., more medications linked to more depression, lends additional credence to the observation.
It is quite clear that polypharmacy can be dangerous and can lead to depressive or suicidal symptoms. Know your drugs! Read the labels! Be sure to review your entire medication list, even dietary supplements, at each encounter with your health care provider, especially if you are cared for by multiple physicians. Take responsibility for your own health. Do not leave it entirely in the hands of someone else. No one will be more concerned about your well-being than you.
If you are having thoughts of suicide, please reach out and talk to someone.
- In the U.S., call the National Suicide Prevention Lifeline, available 24/7 at 1-800-273-TALK (8255)
- The Trevor Project— 866-488-7386 — is a hotline for LGBT youth
- The International Association for Suicide Prevention and Befrienders Worldwidealso provides contact information for crisis centers around the world
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