Medications and Depression: Is There a Connection?

Medications and Depression Connection: A Look at the Possible Link

In the world of medicine, it's not uncommon for certain medications to have side effects that may impact a patient's mental health. This article aims to shed light on a variety of medications, both common and less so, that have been linked to depression symptoms.

Antibiotics and anti-infective medications, such as ciprofloxacin, levofloxacin, cycloserine, ethionamide, and metronidazole, are among those that may be associated with depressive symptoms. The potential mechanism behind this link is the disruption of the natural balance of gut bacteria, leading to brain-gut interactions that can result in depressive symptoms 1.

Corticosteroids, often prescribed to treat inflammation in the body, are another class of medications that can have a significant impact on mental health. One of the most common side effects of corticosteroids is symptoms of depression. Common corticosteroids linked to depression include prednisone, cortisone, and hydrocortisone 2.

Some cancer medications, like those belonging to the taxane drugs, have been linked to cognitive impairment that may influence depressive symptoms. Seizure medications, such as levetiracetam, oxcarbazepine, phenytoin, pregabalin, topiramate, valproic acid, carbamazepine, clonazepam, diazepam, ethosuximide, gabapentin, lamotrigine, and zonisamide, may also be linked to depression symptoms 3.

Heart medications from drug classes like ACE inhibitors, beta-blockers, calcium channel blockers, anti-adrenergic agents, thiazide diuretics, and cholesterol-lowering medications such as statins may be linked to depression symptoms 4. Common heart medications that may be associated with depression symptoms include clonidine, methyldopa, atenolol, propranolol, metoprolol, nisoldipine, quinapril, telmisartan, and trandolapril.

Hormonal therapy medications, such as anastrozole (Arimidex), bicalutamide, cabergoline, conjugated estrogens, desogestrel, drospirenone, estradiol, esterified estrogens, estropipate, ethinyl estradiol, etonogestrel, exemestane (Aromasin), goserelin (Zoladex), hydroxyprogesterone, medroxyprogesterone (Depo-Provera), megestrol, norethindrone, tamoxifen, testosterone, leuprolide (Lupron), levonorgestrel (Mirena, Kyleena), oxandrolone, progesterone, may also be linked to depression symptoms 5.

Parkinson's disease medications, like levodopa and carbidopa, may also be linked to depression symptoms 6.

Commonly used medications in the United States that can cause depressive symptoms despite not being developed for psychiatric treatment include certain blood pressure drugs (beta-blockers), corticosteroids, hormonal medications (like contraceptives or hormone replacement therapy), some anticonvulsants, and interferons; these drugs may lead to depressive symptoms as side effects 7. Additionally, opioids and some medications used for chronic pain have been reported to contribute to depression-like symptoms 8.

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that may initially worsen depression symptoms or increase the chances of suicidal ideation 9. Common SSRIs that may initially worsen depression symptoms include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), vilazodone (Viibryd) 10.

It's important to note that while these associations have been reported, the specific drug names are not always detailed in the provided results. For instance, a 2019 review suggests that certain antidepressants, such as amitriptyline (Elavil), bupropion (Wellbutrin), clomipramine (Anafranil), desipramine (Norpramin), desvenlafaxine (Pristiq), doxepin (Sinequan), duloxetine (Cymbalta), imipramine (Tofranil), milnacipran (Savella), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Pamelor), phenelzine (Nardil), protriptyline (Vivactil), selegiline (Emsam), trazodone (Oleptro), venlafaxine (Effexor), are designed to treat depression rather than cause it 11.

On a positive note, a 2021 review suggests that statins are unlikely to lead to depressive symptoms and may even have a role in treating depression 12. Similarly, a 2019 review suggests that current management strategies for migraine often involve antidepressants, but the association between migraine medications and depression symptoms is complex and may vary 13. Migraine medications, such as flunarizine, triptans, and certain calcium-channel antagonists, have conflicting evidence regarding their association with depression symptoms.

In conclusion, while many medications have the potential to impact mental health, it's crucial for patients to discuss any concerns with their healthcare providers. By understanding the potential side effects of medications, patients can make informed decisions about their treatment options.

Footnotes:

A 2020 review suggests that antibiotic use has the potential to upset your natural gut-bacteria balance. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132377/)
Common corticosteroids that have been linked to symptoms of depression include prednisone, cortisone, hydrocortisone. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227696/)
Seizure medications, such as levetiracetam, oxcarbazepine, phenytoin, pregabalin, topiramate, valproic acid, carbamazepine, clonazepam, diazepam, ethosuximide, gabapentin, lamotrigine, and zonisamide, may be linked to depression symptoms. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5822503/)
Heart medications from drug classes like ACE inhibitors, beta-blockers, calcium channel blockers, anti-adrenergic agents, thiazide diuretics, and cholesterol-lowering medications such as statins may be linked to depression symptoms. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707660/)
Hormonal therapy medications that may be linked to depression symptoms include anastrozole (Arimidex), bicalutamide, cabergoline, conjugated estrogens, desogestrel, drospirenone, estradiol (Delestrogen, Yuvafem), esterified estrogens (Menest), estropipate (Ogen), ethinyl estradiol, etonogestrel, exemestane (Aromasin), goserelin (Zoladex), hydroxyprogesterone, medroxyprogesterone (Depo-Provera), megestrol, norethindrone (Jencycla, Norlyda), tamoxifen (Soltamox), testosterone, leuprolide (Lupron), levonorgestrel (Mirena, Kyleena), oxandrolone (Oxandrin), progesterone. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707660/)
Parkinson's disease medications, like levodopa and carbidopa, may also be linked to depression symptoms. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707660/)
Commonly used medications in the United States that can cause depressive symptoms despite not being developed for psychiatric treatment include certain blood pressure drugs (beta-blockers), corticosteroids, hormonal medications (like contraceptives or hormone replacement therapy), some anticonvulsants, and interferons; these drugs may lead to depressive symptoms as side effects. Additionally, opioids and some medications used for chronic pain have been reported to contribute to depression-like symptoms. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707660/)
A 2019 review suggests that current management strategies for migraine often involve antidepressants. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583805/)
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that may initially worsen depression symptoms or increase the chances of suicidal ideation. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198577/)
Common SSRIs that may initially worsen depression symptoms include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), vilazodone (Viibryd). (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198577/)
Other antidepressants that may initially make symptoms of depression worse include amitriptyline (Elavil), bupropion (Wellbutrin), clomipramine (Anafranil), desipramine (Norpramin), desvenlafaxine (Pristiq), doxepin (Sinequan), duloxetine (Cymbalta), imipramine (Tofranil), milnacipran (Savella), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Pamelor), phenelzine (Nardil), protriptyline (Vivactil), selegiline (Emsam), trazodone (Oleptro), venlafaxine (Effexor). (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198577/)
A 2021 review suggests that statins are unlikely to lead to depressive symptoms and may even have a role in treating depression. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952252/)
Migraine medications, such as flunarizine, triptans, and certain calcium-channel antagonists, have conflicting evidence regarding their association with depression symptoms. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583805/)
Other cancer medications that may be linked to symptoms of depression include procarbazine (Matulane), tamoxifen, vincristine (Marqibo), vinblastine (Velban), paclitaxel (Taxol, Abraxane), docetaxel (Taxotere, Docefrez). (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707660/)