Common prescription drugs may cause depression as side effect, experts say

NEW YORK, July 18 (UPI) -- With some prescription medications, the 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 that range from attention-deficit hyperactivity disorder, or ADHD, anti-seizure medications, heartburn therapies and pain drugs.

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

Still, people who develop depression and suicidal ideation, as it's formally known, while on prescription treatment for other health conditions shouldn't stop taking the drugs that may be causing these side effects without talking to their doctors, they cautioned.

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

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

Depression a common problem

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, sleep problems and fatigue or lack of energy, the health organization says.

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

However, it's unclear how many of them develop the condition while their being treated for other health problems because of a side effect of a drug they're taking, dermatologist Dr. Colleen Reisz told UPI in an email.

"That is a very big question," said Reisz, who has researched the effects of taking multiple prescription drugs on overall health.

As a dermatologist, Reisz frequently prescribed the drug isotretinoin, once branded as Accutane, for cystic acne. That drug made national news after research linked its use with an increased risk for suicide.

Former U.S. Rep. Bart Stupak, a Michigan Democrat, initiated an investigation of the drug in 1999 after his son, B.J., died by suicide while taking it, though the legislator later lost a lawsuit against manufacturer Roche alleging that the medication caused his son's death.

"This is still being studied," Reisz said.

She still uses the drug in some patients, but now starts them at lower doses, she added.

Multiple medications

Dozens of commonly used prescription drugs list depression, and suicidal thoughts, as a side effect, though only a small number of people taking 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, the Michigan health system.

Others, such as the stimulant Adderall, a treatment for ADHD, and heartburn and acid reflux, medications like omeprazole, sold under the brand name Prilosec, have been linked with depression in a small percentage of people who take them, the health system adds.

Use of hormonal contraceptives, particularly those containing progestin, can also lead to a slight increase in a person's risk for depression, a 2016 study found.

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

"I suspect 15% to 20% of women using synthetic progestins for contraception will be sensitive to effects on mood," she added.

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

"I personally struggled with depression as a side effect from hormonal birth control for over a decade," Henry told UPI in an email.

"Although I was never formally diagnosed with depression, the side effects and mood swings [caused by] different birth control prescriptions were documented in my gynecology chart and were often the reasons for switching [treatments]," she said.

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

Despite the troubling side effect, Henry continued to take the medication for 15 years before stopping in July 2021, she said.

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

"I'm feeling the best I've ever felt in my life," Henry said.

Steps to take

Even after prescribing drugs such as the acne medication isotretinoin, as well as the hormone-based hair loss treatments, Reisz has had only "10 or so patients" report "severe mood changes" immediately after starting these therapies, she told UPI.

Most of them noticed other changes first, including problems sleep, and experienced the onset of health problems, such as gastroparesis, or delayed gastric emptying, which causes food and liquid to remain in the stomach for prolonged periods, she said.

In most cases, the solution is not to stop taking the drug causing these side effects, Reisz emphasized.

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

"If there are any questions or concerns about a change in emotional state, including depression or emergence of suicidal thoughts, the first step would be contact the prescriber's office and indicate the emergent nature of these symptoms," Mathew said.

"Often these issues might resolve on their own or with dose reduction," he said.