Here’s a shocking fact: Researchers recently documented more than 200 medications that have depression as a side effect. Published in JAMA in 2018, the disturbing research made headlines.
While many medicines are necessary and lifesaving, increasing depression risk, especially for those with mental health struggles, needs to be carefully considered.
7 Common Medications That May Cause Depression as a Side Effect Share on X
To what degree the role medications with depressive side effects play in the estimated 21 million U.S. adults who typically experience at least one major depressive episode each year is not yet clear.
Here’s what is known about common medications and depression risk to help you determine with your medical doctor ways to treat medical conditions and minimize risk to your mental health.
MORE MEDICATION, MORE RISK
The mentioned eye-opening study also reported that more thanone-third of Americans take at least one of the drugs that lists depression as a potential side effect. Not surprisingly, they have comparatively higher rates of depression symptoms than those who do not take such drugs.
What’s more, with each additional medication an individual takes, the risk of developing depression increases. For example, taking one medication with depressive side effects, the risk risk of depression increased 7%; for two, it rose 9.5%; and for three or more, it jumped 15%. As older adults typically take more than one medication, they are at greater risk.
HOW TO IDENTIFY DEPRESSIVE SYMPTOMS
Whether you’re taking medications that have depression as a side effect or not, it’s important to know what depression symptoms look like and get help if you experience them.
Major depressive disorder, also known as clinical depression, is not a temporary bout of “feeling blue” that you snap out of. It is a consequential mental health condition, especially when it goes untreated. Untreated depression leads to greater incidence of work problems, relationships problems, substance abuse, heart disease, and suicide.
During a depressive episode, you may experience any of the following feelings most of the day, every day for two weeks or more:
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- Feelings of sadness, emptiness, hopelessness, or tearfulness
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- Feelings of frustration
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- Fatigue and lack of energy making even small tasks difficult
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- Reduced appetite and weight loss
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- Increased food cravings and weight gain
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- Anxious feelings
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- Sleeplessness or sleeping too much
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- Difficulty concentrating, recollecting, or making decisions
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- Frustration, angry outbursts, or irritability over small things
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- Loss of pleasure in normally enjoyable activities
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- Slowed thinking, speech, or physical movement
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- Feeling worthless or guilty, overfocusing in past failures or self-blame
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- Suicidality
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- Unexplained physical health issues like migraines or back pain
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- Negative thoughts
7 Common Medications That Can Cause Depression
Researchers believe that medications may directly or indirectly impact your mood. They may directly impact your mood by altering levels of neurotransmitters in the central nervous system. Indirectly, they may cause fatigue, sleeplessness, diminished appetite, gut biome alterations, sedation, and other side effects, which may all factor into the development of depression.
In some instances, it’s not clear if depression is a result of the condition being treated or the medication. Sometimes it is both.
1. Antibiotics
A class of antibiotics known as fluoroquinolones, commonly prescribed for bacterial infections, are associated with feeling depressed and other adverse effects in the central nervous system, reports research from 2023.
In 2016, the FDA revised the box warning of this family of antibiotics adding depression, suicidal thoughts, and other mental health conditions to a list of adverse side effects. Among the many types of fluoroquinolones, levofloxacin and ciprofloxacin were most frequently associated with depressive side effects.
Additionally, research has shown that taking any type of penicillin is associated with higher risk of depression—and that risk increases dramatically with each additional course of penicillin.
2. Corticosteroids
Corticosteroids are a class of anti-inflammatory medicines used to treat inflammatory and autoimmune conditions. Common types include cortisone, hydrocortisone, and prednisone. They are typically used to treat conditions such as rheumatoid arthritis, inflammatory bowel disease, asthma, allergies, life-threatening organ inflammation, and more.
Using them, especially at high dosages or long-term, is commonly associated with greater risk of depression side effects, according to scientific findings.
3. Antiseizure Medications
Antiseizure medications (also called anticonvulsants) help treat epilepsy and other causes of seizures, as well as conditions like bipolar disorder, anxiety disorders, and neuropathic pain. Some anticonvulsants are associated with greater risk of depression. The suppressive effects of the central nervous system are thought to be a factor in this increased risk.
Antiseizure drugs topiramate and vigabatrin are linked to greater risk of depression, some research indicates. Other evidence shows gabapentin may potentially increase risk of suicidality.
Additionally, benzodiazepines, which are more often prescribed for anxiety and sleep, are sometimes used for seizures and muscle spasms under the brand names Xanax, Valium, Ativan, Restoril, and Klonopin and can be addictive. They are also linked to an increased risk of depressive side effects, especially when misused or at high dosages, research has found.
4. Beta-Blockers
Beta-blockers are frequently prescribed to treat high blood pressure. Studies have shown mixed results when evaluating increased risk of depression as a side effect of the drug.
That said, some research suggests an increased risk of worsening depression for depressed individuals taking the beta-blocker drug metoprolol. And another study in The Canadian Journal of Psychiatry found strong evidence linking greater risk of depression with the beta-block drug propranolol.
In studies showing an association, depression became more prominent with longer use. Some evidence suggests that beta-blockers may indirectly cause a higher risk of depression due to their sleep-disturbing side effects. Insomnia has a strong association with depression.
5. Opioids and OTC Painkillers
Opioids are well-known to be addictive, but doctors still prescribe them in certain circumstances of intense pain. For example, they may be recommended after surgery or a traumatic injury, or for severe back pain or certain diseases such as cancer and rheumatoid arthritis.
In a 2016 study of more than 100,000 individuals published in the Annals of Family Medicine, opioid pain relief use of more than 30 days was associated with statistically significant greater incidence of new-onset depression. Researchers believe that opioids alter the brain regions associated with reward and pleasure, which may consequently lead to depression.
Over-the-counter pain relievers—such as acetaminophen (Tylenol) and ibuprofen (sold as Advil, Motrin, and Aleve)—have also been linked to depressive side effects with long-term use.
6. Hormonal Birth Control and Hormone Replacement Therapy
The estrogen and progestin used in birth control methods such as the pill or patch have long been linked to a higher risk of depression. A prospective cohort study of more than 1 million women living in Denmark published in JAMA Psychiatry found that all forms of hormonal contraception were linked to an increased risk of developing the mood disorder.
Higher risks were found among adolescents and in those taking the progesterone-only forms of birth control, including the IUD.
Although some other studies have had different findings, medical professionals are still advised to discuss depressive side effects and other adverse mental health effects with individuals before they begin hormonal birth control.
Newer research indicates the same association may exist with hormonal replacement therapy, which is prescribed to help lessen menopausal symptoms.
A 2022 study published in JAMA Network Open involving more than 825,000 Danish women who initiated HRT found they had a higher risk of developing depression, particularly if they started HRT before age 50. Local application of HRT, such as a vaginal cream, was linked to a lower risk of depression.
Complicating matters, some menopausal patients experiencing low mood have fewer depressive symptoms with HRT. Still, menopausal women should be aware of an increased risk of depression with HRT.
7. Ozempic and Wegovy (semaglutide)
Ozempic and Wegovy share the same active ingredient, semaglutide, and are both part of a class of drugs called glucagon-like peptide-1 (GLP-1) agonists. Ozempic is FDA-approved to treat Type 2 diabetes and reduce cardiovascular disease risk in adult diabetics. Wegovy is marketed for weight loss and heart disease prevention.
Despite their intended uses, they are wildly popular for their weight-loss benefits and are reportedly used by 15.5 million U.S. adults, along with a similar drug Saxenda (active ingredient liraglutide), according to a 2024 Gallup poll.
However, a new cross-sectional, retrospective cohort study in Diabetes, Obesity, and Metabolism found a statistical correlation of individuals dispensed a GLP-1 drug also being dispensed an antidepressant.
More research is needed to fully understand the link GLP-1 drugs have to depression. Meanwhile, the FDA has reported receiving inquiries about depression side effects among users of Ozempic.
KEY TAKEAWAY ON MEDICATION SIDE EFFECTS
This is not an exhaustive list of common medications with depressive side effects. There are many others.
Be sure to discuss the risks of any medication you plan to take with your healthcare provider before you start. Conversely, if you are taking medication and are experiencing depressive symptoms, do NOT stop taking it. Reach out to your medical doctor or a mental health professional to discuss your treatment plan.
Depression, suicidal thoughts and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
Reviewed by Amen Clinics Inc. Clinicians
Founded in 1989 by double-board certified psychiatrist and neuroscientist Daniel G. Amen, MD, Amen Clinics Inc. (ACI) is known as the best brain and mental health company in the world. Our clinical staff includes over 50 healthcare specialists, including adult and child psychiatrists, integrative (functional) medicine physicians, naturopaths, addiction specialists, forensic psychiatrists, geriatric psychiatrists, nutritionists, licensed therapists, and more.
Our clinicians have all been hand-selected and personally trained by Dr. Amen, whose mission is to end mental illness by creating a revolution in brain health. Over the last 30-plus years, ACI has built the world’s largest database of functional brain scans—over 250,000 SPECT scans on patients from 155 countries—related to how people think, feel, and behave.
Dr. Amen is also the founder of BrainMD, a fast growing, science-based nutraceutical company, and Amen University, which has trained thousands of medical and mental health professionals on the methods he has developed.
In addition, he has produced 16 national public television shows about the brain and his online videos on brain and mental health have been viewed over 300 million times. Dr. Amen is a 12-time New York Times bestselling author, including Change Your Brain, Change Your Life; The End of Mental Illness; Healing ADD; and many more. Hist latest book, Raising Mentally Strong Kids, was published March 2024.
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excellent post!
Comment by Doug Morris — July 22, 2024 @ 6:01 PM