Common prescription drugs can cause depression as a side effect, experts say

Jacqui Henry, who said she now feels better than ever, developed depression after taking hormonal contraceptives for 15 years to manage the pain of endometriosis.  Photo courtesy of Jacqui Henry

Jacqui Henry, who said she now feels better than ever, developed depression after taking hormonal contraceptives for 15 years to manage the pain of endometriosis. Photo courtesy of Jacqui Henry

NEW YORK, July 18 (UPI) — With some prescription drugs, treatment can be more serious than the underlying disease, as depression and even suicidal thoughts are listed as potential side effects for a variety of drugs, experts told UPI.

These include commonly used treatments for conditions ranging from attention deficit hyperactivity disorder, or ADHD, to anti-seizure drugs, heartburn therapies, and pain relievers.

Hormonal birth control drugs may also cause depression in some women who take them, experts said.

However, people who develop depression and suicidal ideation, as it is formally known, while on prescription treatment for other health conditions shouldn’t stop taking any medications that could be causing these side effects without talking to their doctors, they cautioned.

“Depression and sometimes suicidal thoughts are described as a side effect of a variety of medications used for non-psychiatric conditions, including steroids, hormonal agents and other medications,” Dr. Sanjay J. Mathew, professor of psychiatry and behavioral sciences at Baylor College of Medicine in Houston, said in an email.

Dermatologist Colleen Reisz has seen a handful of her patients report symptoms of depression after using prescription medications for acne and hair loss.  Photo courtesy of Dr. Colleen Reisz

Dermatologist Colleen Reisz has seen a handful of her patients report symptoms of depression after using prescription medications for acne and hair loss. Photo courtesy of Dr. Colleen Reisz

“However, ‘the prevalence of this as a side effect is relatively rare and varies by drug and by indication,'” he said.

Depression is a common problem

Psychiatrist Sanjay Mathew says depression and suicidal thoughts are a rare but significant side effect with some prescription drugs.  Photo courtesy of Clexio Biosciences

Psychiatrist Sanjay Mathew says depression and suicidal thoughts are a rare but significant side effect with some prescription drugs. Photo courtesy of Clexio Biosciences

Depression is a mood disorder that causes feelings of sadness that won’t go away without treatment, according to the Mayo Clinic.

Symptoms include feelings of sadness or hopelessness, irritability or frustration, loss of interest in daily activities, trouble sleeping and tiredness or lack of energy, says the health organization.

Depression has been reported as a rare side effect with prescription ADHD treatment Adderall.  Photo courtesy of Ryanaxp at en.Wikipedia

Depression has been reported as a rare side effect with prescription ADHD treatment Adderall. Photo courtesy of Ryanaxp at en.Wikipedia

Nearly 1 in 5 adults in the United States has been diagnosed with depression at some point in their lives, the Centers for Disease Control and Prevention said.

However, it’s not clear how many of them develop the condition while being treated for other health issues due to a side effect of a drug they’re taking, dermatologist Dr. Colleen Reisz said in an email.

A small percentage of patients who take the hair loss drug finasteride may experience depression, experts say.  Photo by Ryan/Wikimedia Commons

A small percentage of patients who take the hair loss drug finasteride may experience depression, experts say. Photo by Ryan/Wikimedia Commons

“This is a very big question,” said Reisz, who has studied the effects of taking multiple prescription drugs on overall health.

As a dermatologist, Reisz often prescribed the drug isotretinoin, once labeled Accutane, for cystic acne. That drug made national headlines after research linked its use to an increased risk of suicide.

Former U.S. Representative Bart Stupak, a Democrat from Michigan, launched an investigation into the drug in 1999 after his son, BJ, committed suicide while taking it, though lawmakers later lost a lawsuit against manufacturer Roche claiming the drug caused his son’s death.

“This is still under study,” Reisz said.

He still uses the drug in some patients but now starts them on lower doses, he added.

More drugs

Dozens of commonly used prescription drugs list depression and suicidal thoughts as a side effect, though only a small number of people who take them will develop these serious mental health conditions, Baylor Medicine’s Mathew said.

The list includes the corticosteroids prednisone, dexamethasone and methylprednisolone, which are used to treat inflammatory disorders such as some forms of arthritis, according to Henry Ford Health, Michigan’s health system.

Others, like the stimulant Adderall, a treatment for ADHD, and heartburn and acid reflux, drugs like omeprazole, sold under the brand name Prilosec, have been linked to depression in a small percentage of people who take them, the Health System adds.

Using hormonal contraceptives, especially those containing progestin, can also lead to a slightly increased risk of depression, according to a 2016 study.

Other hormone-based prescription drugs, such as finasteride and dutasteride, which are used to treat hair loss, among other conditions, can also cause depression in some people, Reisz said.

“I suspect 15% to 20% of women who use synthetic progestins for contraception will be sensitive to the effects on mood,” she added.

Jacqui Henry, an endometriosis-traumatized doula who splits her time between Boston and Cascais, Portugal, was one of them.

“For over a decade, I have personally struggled with depression as a side effect of hormonal birth control,” Henry told UPI in an email.

“Although I’ve never been formally diagnosed with depression, the side effects and mood swings [caused by] several contraceptive prescriptions were documented in my gynecological record and were often the reasons for switching [treatments],” she said.

She began taking hormonal contraceptives at age 15 to treat chronic pain and menorrhagia, or excessive bleeding during menstruation, “which would later be revealed to be undiagnosed endometriosis,” she added.

Despite the troubling side effect, Henry continued taking the drug for 15 years before stopping it in July 2021, he said.

She is now using nutrition-based treatment for her endometriosis and “now living pain-free,” she added.

“I feel the best I’ve ever felt in my life,” Henry said.

Steps to take

Even after prescribing medications like isotretinoin for acne, as well as hormone-based hair loss treatments, Reisz has had only “about a dozen patients” report “severe mood changes” soon after starting these therapies, he told UPI.

Most of them have noticed other changes first, including sleep problems, and have experienced the onset of health problems, such as gastroparesis, or delayed gastric emptying, which causes food and liquids to stay in their stomachs for extended periods, she said.

In most cases, the solution isn’t to stop taking the drug causing these side effects, Reisz pointed out.

Those who notice mood changes after starting a new drug treatment should speak to their doctor, who may lower the dose or prescribe an alternative treatment. Sometimes, a patient’s symptoms of depression can be the result of other causes, such as alcohol use, he added.

“If there are questions or concerns about a change in emotional state, including depression or the emergence of suicidal thoughts, the first step would be to contact the prescriber’s office and state the emerging nature of these symptoms,” Mathew said.

“Often these problems could resolve themselves or with a dose reduction,” he said.

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