Increase in depression, suicide risks linked to simultaneous use of common prescription drugs — (The Springfield News-Sun)

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The Springfield News-Sun

By Fiza Pirani, Atlanta Journal-Constitution

Posted: 3:36 p.m. Thursday, June 14, 2018

New research published just days after the suicide deaths of fashion designer Kate Spade and renowned chef and TV host Anthony Bourdain revealed that more than one-third of American adults were using prescription medications that may potentially increase the risk of depression and suicide.

Scientists at the University of Illinois examined medication-use patterns of more than 26,000 adults between 2005 and 2014 for the study, published Wednesday in the Journal of the American Medical Association [JAMA].

They found that more than 200 commonly used prescription drugs have depression or suicide listed as potential side effects, including blood pressure and heart medications, antacids and painkillers, hormonal birth control medications and proton pump inhibitors.

>> Related: CDC: Suicide rate up 16 percent in Georgia

When the drugs were used concurrently, risk of depression increased.

In fact, 15 percent of adults who simultaneously used at least three of the 200 medications experienced depression, compared to 5 percent of those who didn’t use any of the drugs.

The risk increased to 7 percent for those on one medication and to 9 percent for adults consuming two concurrent drugs.

>> Related: A daughter’s suicide leaves a grieving Atlanta father searching for answers

“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs — many of which are also available over the counter,” lead author Dima Qato, of the UIC College of Pharmacy said in a news release. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”

>> Related: Major depression diagnoses in US up 33 percent since 2013, study finds

Qato and her team also note a trend of increasing simultaneous use (or polypharmacy) of these medications with depression and suicidal symptoms as a potential adverse effect.

Concurrent use of any prescription drug with potential depression adverse effects increased from 35 percent in 2005-2006 to 38 percent in 2013-2014. Use of antacids with depression listed as a side effect doubled between the two periods from 5 percent to 10 percent. And the concurrent use of three or more drugs increased from 7 percent to 10 percent.

>> Related: People with depression are more likely to use certain words — here’s how they express themselves

Usage of drugs with suicide as a listed potential side effect also increased — from 17 percent to 24 percent.

It’s the increase in simultaneous use of these drugs that is most concerning, Qato said. Future research, she suggests, should consider updating medical drug safety software to identify depression as a potential drug-drug interaction to assess if multiple medication use is increasing patient risk.

Over the past five years, diagnoses of major depression in the United States have risen by at least 33 percent. It is the leading cause of disability worldwide.

>> Related: Why are Americans so lonely? Massive study finds nearly half of US feels alone, young adults most of all

The country also experienced a nearly 30 percent increase in suicide rates between 1999-2016, according to a new report from Atlanta-based Centers for Disease Control and Prevention. Rates among 15- to 19-year-old girls doubled between 2007 and 2015, reaching a 40-year high.

Georgia in particular experienced a 16.2 percent increase in suicide rates, comparatively low compared with the 25 states where suicide rates rose by nearly 30 percent. But the figure is still considered a significant increase, according to the CDC.

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Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States — (JAMA)

June 12, 2018

Question How frequently do US adults use prescription medications with depression as a potential adverse effect and is use of these medications associated with concurrent depression?

Findings In this cross-sectional US population-based survey study conducted between 2005 and 2014, the estimated overall prevalence of US adults using medications with depression as a potential adverse effect was 37.2%. The adjusted percentage of adults with concurrent depression was higher among those using more concurrent medications (eg, estimated 15% for ≥3 medications).

Meaning Use of prescription medications that have depression as a potential adverse effect was common and associated with greater likelihood of concurrent depression.

Abstract

Importance Prescription medications are increasingly used among adults in the United States and many have a potential for causing depression.

Objectives To characterize use of prescription medications with depression as a potential adverse effect and to assess associations between their use and concurrent depression.

Design, Setting, and Participants Five 2-year cycles (2005-2006 through 2013-2014) of the National Health and Nutrition Examination Survey, representative cross-sectional surveys of US adults aged 18 years or older, were analyzed for use of medications with depression as a potential adverse effect. Multivariable logistic regression examined associations between use of these medications and concurrent depression. Analyses were performed among adults overall, excluding antidepressant users, and among adults treated with antidepressants and with hypertension.

Exposures Prescription medications with depression as a potential adverse effect (listed in Micromedex).

Main Outcomes and Measures Prevalence of any use and concurrent use of medications with a potential to cause depression and prevalence of depression (PHQ-9 score ≥10).

Results The study included 26,192 adults (mean age, 46.2 years [95% CI, 45.6-46.7]; women, 51.1%) and 7.6% (95% CI, 7.1%-8.2%) reported depression. The overall estimated prevalence of use of medications with depression as an adverse effect was 37.2%, increasing from 35.0% (95% CI, 32.2%-37.9%) in the cycle years 2005 and 2006 to 38.4% (95% CI, 36.5%-40.3%) in 2013 and 2014 (P for trend = .03). An estimated 6.9% (95% CI, 6.2%-7.6%) reported use of 3 or more concurrent medications with a potential for depression as an adverse effect in 2005 and 2006 and 9.5% (95% CI, 8.4%-10.7%) reported such use in 2013 and 2014 (P for trend = .001). In adjusted analyses excluding users of antidepressants, the number of medications used with depression as possible adverse effects was associated with increased prevalence of concurrent depression. The estimated prevalence of depression was 15% for those reporting use of 3 or more medications with depression as an adverse effect vs 4.7% for those not using such medications (difference, 10.7% [95% CI, 7.2%-14.1%]). These patterns persisted in analyses restricted to adults treated with antidepressants, among hypertensive adults, and after excluding users of any psychotropic medication.

Conclusions and Relevance In this cross-sectional survey study, use of prescription medications that have depression as a potential adverse effect was common. Use of multiple medications was associated with greater likelihood of concurrent depression.