Guide to Wellness – July 2019

CR.ORG GUIDE TO WELLNESS 23

Doctors might not know

this. “Many physicians may

not be aware that several

commonly prescribed medi-

cations are associated with

an increased risk of this

disorder,” says study author

Mark Olfson, M.D., M.P.H.,

professor of psychiatry and

epidemiology at the Columbia

University Irving Medical

Center in New York City.

In the study, the more drugs

people took, the higher

their depression risk. About

7 percent of those taking one

such drug were depressed;

15.3 percent of those taking at

least three were.

This is particularly con-

cerning for older adults, who

may take multiple medica-

tions and are more vulner-

able to drug side effects, says

Michael Hoch man, M.D.,

M.P.H., director of the Gehr

Family Center for Health

Systems Science at Keck

Medicine of USC.

However, “it’s important

to bear in mind that most

people taking these medica-

tions, even those who are on

three or more of them, don’t

have depression,” Olfson

says. Still, it’s wise to keep

the connection in mind

and know when a drug might

be affecting your mood.

Monitor Your Mood

Whether you take multiple

meds or none, if you’re

experiencing a low mood for

two consecutive weeks or

longer, let your doctor know.

Other depression symptoms

to watch for include loss of

interest in pleasurable

activities, appetite or weight

changes, insomnia or sleep-

ing too much, severe fatigue,

trouble concentrating, feeling

|worthless, and recurrent

thoughts of death or suicide.

Don’t wait for your doctor

to ask about your mood

at your next appointment,

Olfson says. In one study

published in the journal

Psychiatry Online in 2018,

only about 3 percent of

primary care appointments

included a depression

screening. You can also

take an online test, such as

the Patient Health Question-

naire- 9 (PHQ-9), says Mi-

chelle Riba, M.D., associate

director of the University

of Michigan Comprehensive

Depression Center in

Ann Arbor.

Check Your Meds

When you talk to your doc-

tor, ask whether any of your

ALL MEDICATIONS HAVE the potential to cause unwanted

side effects, including depression. In fact, one-third

of Americans are now taking meds that can cause this

mood disorder, according to a study published last

June in the Journal of the American Medical Association.

Other research has had similar findings, but this is

the largest review on the topic to date.

The study authors found that about 200 prescription

drugs, including some often used by older adults—such

as proton pump inhibitors to treat acid reflux and beta-

blockers for hypertension—can lead to depression. (See

“9 Drug Types That May Cause Depression,” on page 24.)

Taking drugs linked

to depression might

not be the cause

of your low mood.

“Sometimes people

were depressed

before they started

medications, or

various health

conditions have left

them depressed,”

says Igor Galynker,

M.D., professor

of psychiatry at

the Icahn School

of Medicine at

Mount Sinai in

New York City. For

instance, up to

half of people with

chronic pain also

have depression

or another mood

disorder—because

parts of the brain

that perceive pain

also affect mood.

Your primary

care physician can

try to figure it out

by taking a

thorough history

and adjusting

your medications

when appropriate.

But some people

may need to see

a psychiatrist

to pinpoint what’s

really going on.

Not Sure It’s the Meds?

Your doctor can help you figure out the cause of your depression

meds could be the cause. And

consider bringing all your pre-

scription and over-the-counter

medications with you so that

your doctor can look them

over. (You should do this kind

of “brown-bag review” at least

once a year, whether you’re

feeling depressed or not.)

“Sometimes when we do this,

we learn that a patient has

been taking a proton pump

inhib i tor to treat heartburn

for years, when they really

don’t need to,” Hochman

says. “This could also be con-

tributing to their depression.”

If your physician doesn’t

seem well-versed in the side

effects of your medications,

make an appointment

with the pharmacist where

you get prescriptions filled,

says Joan Baird, Pharm.D.,

director of pharmacy prac-

tice and government affairs

at the American Society of

Consultant Pharmacists.