Many medications list depression as a side effect—but the evidence linking a particular medication to depression isn’t always conclusive. And because depression is common in people who have certain chronic illnesses, it’s often difficult for doctors to determine whether a particular medication is to blame or if a patient’s depressed state results from the illness itself. Having said that, there are certain medications that do indeed cause depression in some patients. These medications should be used cautiously in people with current or prior depression, or those who are otherwise at high risk for depression, including
– Vigabatrin (Sabril)
– Topiramate (Topamax)
– Efavirenz (Sustiva)
Some of these medications may cause depressive symptoms directly by altering levels of neurotransmitters in the central nervous system. Others may do so indirectly by causing fatigue, diminished appetite, sedation or other side effects, which can lead to depression. It’s important for patients to let their doctors know if they experience a depressive episode while taking any of the medications on the list. If the doctor determines that the symptoms are related to a medication or combination of medications that the patient is taking, he or she may alter the dosage or switch to another drug or combination.
Classes of medications that may contribute to depression or depressive symptoms include:
– Alzheimer’s disease drugs such as donepezil (Aricept) and rivastigmine (Exelon)
– Anti-androgens such as bicalutamide (Casodex) and nilutamide (Nilandron)
– Anti-convulsants such as carbamazepine (Tegretol), lamotrigine (Lamictal) and zonisamide (Zonegran)
– Benzodiazepines such as alprazolam (Xanax), diazepam (Valium), estazolam (ProSom) and lorazepam (Ativan)
– Beta-blockers such as atenolol (Tenormin), propranolol (Inderal) and timolol (Timoptic)
– Calcium channel blockers such as diltiazem (Cardizem, Tiazac and others) and verapamil (Calan)
– Hormone replacement therapies such as estrogen (Premarin) and medroxyprogesterone (Provera)
– Parkinson’s disease medications such as amantadine and levodopa/carbidopa (Duopa, Sinemet)
– Other medications such as clonidine (Catapres, Duraclon), clopidogrel (Plavix) and raloxifene (Evista)
Even when depression is listed as a rare side effect of a medication, be aware that the risk of the medication triggering depression may increase with age because of changing body chemistry. Medication-related depression may lead to suicidal ideations or suicidal attempts in patients with a history of mood disorders and those who are taking multiple medications.