Common Medications That Can Cause Depression

Talk to your healthcare provider if you're taking any of these drugs and have noticed changes in your mood.

This article was medically reviewed by Steffini Stalos, DO, who is board-certified in Pathology and Lab Medicine, on June 16, 2022.

Medications are supposed to make you feel better, but they can also come with side effects. Often they're minor, but in some cases, side effects can be serious, like depression. And you don't have to have a family history of mental health problems to experience it.

What's even more worrisome is that consumers and health care providers may be unaware of this hidden risk. According to a 2018 study published in the Journal of the American Medical Association (JAMA), more than one-third of adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide.

As part of the study, researchers found that more than 200 commonly used drugs have depression or suicide listed as potential side effects. But because many of these drugs—including hormonal contraceptives, blood pressure and heart medications, antacids, and painkillers—are prescribed for purposes unrelated to mental health, they worry that patients may never be warned about the increased risk.

No one knows exactly why certain drugs have this effect. "The medications may interfere with neurotransmitters in your brain like dopamine and serotonin, [and that] may affect mood changes," said Edmi Cortes Torres, MD, assistant professor of clinical psychiatry at the University of Miami Miller School of Medicine, who was not involved in the JAMA study.

That may be especially true when patients are prescribed more than one drug—which, according to the JAMA study, is happening more often than it used to. For the study, researchers looked at medical records of more than 26,000 patients over 10 years, studying their use of those 200+ drugs with potential mood-altering side effects. About 15% of adults who used three or more medications at the same time experienced depression, compared with 9% of those who took two, 7% who took one, and 5% who took none.

In other words, the more medications you take with depression as a potential side effect, the higher your risk of experiencing depression while taking those drugs.

The researchers saw a similar pattern for drugs that listed suicide as a potential side effect. And those patterns remained, even after they excluded patients who were also taking medications prescribed for pre-existing anxiety or depression.

If you suspect you've developed depression as the result of a medication, contact your healthcare provider right away. "The most important thing is to communicate with your doctor when you experience mood changes," said Dr. Cortes Torres. "We can manage it by reducing the dosing, by changing the medication or, when the medication is really necessary to treat the illness, by giving an antidepressant to treat depressive symptoms."

Here are some commonly used drugs that are sometimes linked with depression. Talk to your doctor if you're taking one of these and notice changes in your mood.

Beta-Blockers

Beta-blockers such as metoprolol are widely prescribed to treat high blood pressure, but they're also used for chest pain, irregular heartbeat, migraine, some tremors, and even glaucoma. Generally, beta-blockers are used long-term. According to 2021 research published in The Journal of Clinical Psychiatry, certain beta-blockers, particularly ones like propranolol, may be linked with depression with continued use.

But the jury is still out on whether beta-blockers directly cause depression. In a 2021 review of the literature published in the journal Hypertension, researchers looked at 258 studies involving more than 50,000 people and found that beta-blockers did not predict depression.

However, the same study also found that insomnia, dreaming, and sleep disorders may be more frequent in people taking beta-blockers. And according to Johns Hopkins Medicine, people with insomnia have a ten-fold higher risk of developing depression.

So while there might not be a direct link between beta-blocker use and depression, there may be an indirect one.

The good news is that there are alternatives. "[Beta-blockers have] gone a little out of favor as a standard treatment because there are newer things that may work better without [the risk of depression]," said Joshua Nathan, MD, assistant professor of clinical psychiatry at the University of Illinois Chicago.

Corticosteroids

Steroids like prednisone are used to treat a surprising number of conditions, including autoimmune diseases like rheumatoid arthritis and lupus, as well as asthma, allergies, and even cancer. But they can come with a mental health downside.

"Chronic use is associated with a range of psychiatric problems," said Dr. Nathan. "It can cause depression, anxiety, psychosis—and I've seen all of those things."

Euphoria and mania seem to be more common with short-term use, while depression becomes more prominent with longer use, even if the doses aren't large.

If you have a family history of depression or alcoholism, you have an even greater risk of developing one of these side effects when using corticosteroids. Talk to your healthcare provider about your risk factors and medication alternatives.

Antibiotics

Some antibiotics have been linked with depression, notably levofloxacin and ciprofloxacin. According to Merck Manual, both belong to the family of antibiotics known as fluoroquinolones and are prescribed for a variety of bacterial infections.

According to a 2015 study published in the Journal of Clinical Psychiatry taking one course of medication in the penicillin group of antibiotics was associated with a 23% higher risk of depression. Two courses of penicillin took the risk up to 40%, and five or more courses involved a 56% higher risk.

A 2020 study published in the journal Psychiatry Research helps explain why antibiotics might cause depression. Antibiotics kill bacteria, including the "good" bacteria in your gut, and messing with gut bacteria has been shown to cause depression—hence, the link.

Another reason to make sure you only take antibiotics when you need them: Overuse of antibiotics has also been shown to contribute to the spread of antibiotic-resistant bacteria, according to the U.S. Food and Drug Administration (FDA).

Interferon

According to a 2019 study published in the journal Brain, Behavior, and Immunity, interferon is associated with a significant risk of depression. The drug is used in the treatment of some cancers and viral infections, like hepatitis C, as well as other conditions. However, with the development and approval of several new direct-acting antivirals (DAA) against hepatitis C virus (HCV), interferon is no longer the standard treatment for hepatitis C virus.

If your healthcare provider feels interferon is the best course of treatment for your illness, antidepressants are sometimes used so you can continue the treatment. A 2014 study published in the journal Psychosomatics suggests that pretreatment with selective serotonin reuptake inhibitors (SSRIs) can lower the risk and severity of depression caused by interferon.

Anticonvulsants

Some reports have indicated that anticonvulsant (or anti-seizure) drugs like topiramate and gabapentin may contribute to depression.

One explanation behind why is that these drugs suppress the central nervous system (CNS). "We know that medications that are central nervous system depressants may be associated with depression," said Dr. Cortes Torres.

Anticonvulsants are also sometimes used to treat other conditions, including bipolar disorder, pain from damaged nerves, and fibromyalgia. And other medications are also considered CNS depressants—like benzodiazepines which include the anti-anxiety meds Xanax and Valium. These, too, have been associated with depression, according to the National Institute on Drug Abuse.

Thankfully, "medication-induced depression goes away when you stop the medication, and there are usually other options," said Dr. Nathan.

Opioids

The addictive painkillers–which are responsible for one of the greatest public health crises in American history–also seem to increase the risk of depression.

One study published in JAMA in November 2020 noted that prolonged opioid use of 30 days or more "may saturate the opioid receptor system" to affect mood and increase the risk of developing treatment-resistant depression by more than 25%.

According to the National Survey on Drug Use and Health, 62% of U.S. adults with an opioid use disorder (OUD) had a co-occurring mental illness. This begs the question: Which came first—the OUD or the mental illness?

Hormonal Birth Control

Some studies have linked popular contraceptive methods—including birth control pills, patches, vaginal rings, and hormonal IUDs—to depression or lower quality of life. Hormonal changes triggered by these medications, such as a decrease in testosterone or an increase in progesterone, may play a role.

It's important to keep in mind that birth control can affect each woman differently, and other studies haven't necessarily made the connection with hormonal contraception causing depression. For example, in a 2020 review in The American Journal of Psychiatry, researchers determined that hormonal birth control does not cause depression. And a study published in the journal Menopause in December 2017 found that hormonal birth control may actually protect women from depression later in life.

Birth control also helps regulate hormone levels, and for some women—especially those with heavy periods or conditions like endometriosis—it may reduce physical and emotional symptoms associated with menstruation every month.

Heartburn Medications

Among the 200-plus medications cited in the 2019 JAMA study are two drugs commonly prescribed to treat heartburn: Antacids and proton-pump inhibitors (PPIs). Although depression isn't a common consequence of these drugs, some in these classes do list it as a potential side effect.

Taking a PPI, like Prilosec (omeprazole) or Nexium (esomeprazole), can interfere with the body's ability to absorb vitamin B12, an essential nutrient that produces chemicals that affect mood and cognition. PPIs have been linked to depression in at least one study, published in 2018 in International Psychogeriatrics.

Antacids, which are available with a prescription and over the counter, are generally considered safe—but patients should still be aware of potential side effects, especially when they're taken frequently or in large quantities.

Antidepressants

You may have seen or heard the warnings that antidepressants can actually increase the risk of suicidal thoughts or ideation. Strange as this may seem, research backs it up.

In a 2020 review published in Psychiatric Research and Clinical Practice, researchers found that suicide deaths in adolescents and young adults who were on antidepressants had increased from 2005 to 2007. They relate this increase to the widely-publicized FDA "black box" warnings on antidepressant labels that state that a side-effect can be suicidal ideation, as well as to a decrease in mental health care.

"Teens and young adults in their early 20s in rare cases have increases in suicidal ideation when starting an antidepressant," said Dr. Nathan. "But there is no data saying that starting antidepressants can cause or worsen depression, and long-term use is not associated with depression either."

It's important to communicate with your healthcare team. Whether you're on medication or not, talk to them if you suspect your depression is getting worse or if you are contemplating harming yourself. If you are on medication for depression, do not stop taking it without supervision from your healthcare provider.

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