When Do You Need Medication For Depression

When Do You Need Medication For Depression – More than a third of American adults use drugs that increase the risk of depression, and a quarter use drugs that increase the risk of suicide.

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When Do You Need Medication For Depression

“It’s interesting to know how often people may be at greater risk because of the drugs they’re taking,” said University of Pennsylvania psychiatry professor Michael Taze, who was not involved in the study. Getty Images / EyeEm

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The recent celebrity suicides of Anthony Bourdain and Kate Spade have caused many of us to take a closer look at what can cause people to become depressed or end their lives.

More than a third of American adults use drugs that can increase their risk of depression, a study published this week in JAMA shows, and nearly a quarter use drugs that have suicidal symptoms as a side effect.

203 drugs discovered by researchers are not hidden; these include some commonly prescribed medications — such as birth control pills, beta blockers for high blood pressure, and proton pump inhibitors for acid reflux. (You can see the full list at the end of this article.)

Surprisingly, researchers from the University of Illinois and Columbia University found that people who use these drugs have a higher risk of depression compared to the general population. And the more people use antidepressants as a side effect, the higher the risk of the disease.

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“It’s interesting to know how often people may be at greater risk because of the drugs they’re taking,” said University of Pennsylvania psychiatry professor Michael Taze, who was not involved in the study. “Thinking about these [potential side effects] should be the second or third step [of doctors] before prescribing an antidepressant. Sometimes stopping the prescription [of other drugs] is what’s needed.”

With depression affecting more than 1 in 20 adults in the U.S. each year, and the suicide rate here rising for years, these new findings are an important reminder that drugs used for one health condition can cause illness in another.

Each drug has as many side effects as possible, and most of them are rare. (Think of the warnings featured in drug commercials on TV.) When a side effect is listed on the package, it usually means that at least 1 to 2 percent of people will experience it, said study lead author Dima Mazen Kato, a. pharmacist and assistant professor in the Department of Pharmacy, University of Illinois at Chicago.

To find out how common the effects of depression and suicidal symptoms (including suicide, or suicidal thoughts and behaviors) are among the medications Americans take, researchers looked at the National Health and Nutrition Examination Survey, a government survey that tracks trends. of health in the representative. a sample of Americans since the 1970s.

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They analyzed drug use data on more than 26,000 people who participated in the study between 2005 and 2014 and found that Americans reported taking 203 drugs with depression and suicidal symptoms listed among their side effects. As of 2013-2014, 38 percent of adults reported using medications with depression as a potential side effect in the past 30 days, while 23 percent used medications that carried the risk of suicidal symptoms.

After the researchers discovered that these drugs were common, they wanted to see if there was any connection between people taking these drugs and an increased risk of depression. To find out, they turned again to the NHANES survey, which also tracks mental health. They found that the more drugs people use, the higher the risk of depression and suicide.

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The risk of depression tripled among people taking three or more drugs, a potential side effect of depression

To understand the risk of depression and suicide associated with taking these drugs, let’s look at the numbers.

In a total of more than 23,000 people (not including people taking antidepressants), 6 percent reported depression. Among users of only one drug that has depression as a side effect, the prevalence increased to 7 percent. Among people who use two or more drugs that can cause depression, the prevalence is as high as 10 percent. And among people who use three or more drugs , the prevalence was 15 percent. (Again, for all these numbers, the researchers did not include antidepressant users, as that would inflate the results.)

They found the same association with those who did not use antidepressants and those who used drugs with suicidal symptoms. In the total number of study participants who did not use drugs and had suicidal symptoms, 5 percent of the participants reported suicidal symptoms. Among adults who used one of the drugs, the prevalence increased to 8 percent, and among adults who took three or more drugs, the prevalence increased to 18 percent.

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“You might expect results like this because people who have more medical problems are more likely to take more drugs and have more depression,” said study co-author Mark Olfson, a professor of psychiatry at Columbia University. University Medical Center.

But when the researchers looked at drugs that are not associated with depression effects, they did not find the same dose response as they found in people taking one or more drugs with depressive or suicidal effects. In other words, simply taking more medications, except for a medication that listed depression or suicidality as a side effect, was not associated with an increased risk.

“It didn’t surprise me that there are so many drugs [with these side effects] and that these drugs are so commonly prescribed,” Olfson said. “But what surprised me was that you see this association [with depression] in the population, how strong it was, and that it increases with each additional drug that someone takes.”

Penn’s Thase called the findings “highly suggestive” and “strong circumstantial evidence” that taking one or more antidepressants as a side effect can lead to depression. While these drugs work in different ways, it is possible that when they are combined, the risks increase, he said.

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Although the researchers did their best to statistically control for factors that could confound their results, such as gender, age, race and employment status, there are things the paper can’t tell us.

Because this was an observational study, not an experimental study, the researchers did not say what the drug was

Sadness To find out, they need to do a follow-up study where they follow people who start taking these drugs over time and see if their risk of depression increases.

Additionally, there are many factors that can increase a person’s risk of depression and suicide, including personal and family medical history and major life stressors, that researchers have not been able to explain. The study sample was also too small to look at individual medications and their patterns of depression.

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But for now, the study is a great reminder that people should be aware that some medications carry the risk of depression and suicidal thoughts, and that they should talk to their doctors about this when starting a new medication.

“When you have a patient,” Taze said, “and their story doesn’t fit the usual pattern—no obstacles in life, no depression, no work problems, [doctors] have to think about other possible causes of masking—and the possibility. that the drug might be the reason.”

They also created a table of 203 drugs that caused depression or suicidal symptoms as side effects:

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One major health issue has dominated the mainstream media lately: antidepressants. More specifically, do they really work?

The international debate on the issue started earlier this year when the British writer Johann Hari published his book, Missing Links: Discovering the Real Causes of Depression—and Unexpected Solutions.

Hari used antidepressants for 13 years, starting as a teenager, and the new book is his attempt to answer some of the questions that have haunted him for years.

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