Chicago—Pharmacists and other healthcare professionals might not realize it, but more than a third of adults in the United States are using prescription medications that raise their risk of depression or suicide, according to a new study.
The report in JAMA emphasizes that polypharmacy, particularly when several drugs with those side effects are used simultaneously, only increases the risks.
To reach those conclusions, University of Illinois at Chicago (UIC)–led researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014; information came from the National Health and Nutrition Examination Survey.
The study team determined that more than 200 commonly used prescription drugs—including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids, and painkillers—have depression or suicide listed as potential side effects.
The study is the first to point out how polypharmacy increases those dangers, noting that about 15% of adults who concurrently used three or more of those medications suffered from depression while on medication therapy compared with 5% not taking any of the drugs, 7% using one medication, and 9% using two simultaneously.
Similar results were documented for drugs that listed suicide as a potential side effect.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs—many of which are also available over the counter,” said lead author Dima Qato, PharmD, PhD, MPH, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Increasing usage of those drugs is exacerbating the problem, Qato said. Use of any prescription medication with a potential depressive adverse effect increased from 35% in the 2005–2006 time period versus 38% in the 2013–2014 period, the study found. Among those were proton pump inhibitors and H2 antagonists, which increased from 5% percent to 10% in the same period.
Polypharmacy also surged, with the use of three or more drugs concurrently jumping up from about 7% to 10%. Especially for drugs with suicide listed as a potential side effect, usage increased from 17% to 24%, while use of three or more drugs concurrently with that potential side effect rose from 2% to 3%, the report states.
“People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,” Qato said.
Possible solutions, according to the study, were updating drug safety software to recognize depression as a potential drug-drug interaction, so that pharmacists and other healthcare professionals would recognize it, and including the evaluation of medication use in depression screening and diagnostic tools, especially for patients with persistent or treatment-resistant depression.
« Click here to return to Weekly News Update.
The report in JAMA emphasizes that polypharmacy, particularly when several drugs with those side effects are used simultaneously, only increases the risks.
To reach those conclusions, University of Illinois at Chicago (UIC)–led researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014; information came from the National Health and Nutrition Examination Survey.
The study team determined that more than 200 commonly used prescription drugs—including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids, and painkillers—have depression or suicide listed as potential side effects.
The study is the first to point out how polypharmacy increases those dangers, noting that about 15% of adults who concurrently used three or more of those medications suffered from depression while on medication therapy compared with 5% not taking any of the drugs, 7% using one medication, and 9% using two simultaneously.
Similar results were documented for drugs that listed suicide as a potential side effect.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs—many of which are also available over the counter,” said lead author Dima Qato, PharmD, PhD, MPH, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Increasing usage of those drugs is exacerbating the problem, Qato said. Use of any prescription medication with a potential depressive adverse effect increased from 35% in the 2005–2006 time period versus 38% in the 2013–2014 period, the study found. Among those were proton pump inhibitors and H2 antagonists, which increased from 5% percent to 10% in the same period.
Polypharmacy also surged, with the use of three or more drugs concurrently jumping up from about 7% to 10%. Especially for drugs with suicide listed as a potential side effect, usage increased from 17% to 24%, while use of three or more drugs concurrently with that potential side effect rose from 2% to 3%, the report states.
“People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,” Qato said.
Possible solutions, according to the study, were updating drug safety software to recognize depression as a potential drug-drug interaction, so that pharmacists and other healthcare professionals would recognize it, and including the evaluation of medication use in depression screening and diagnostic tools, especially for patients with persistent or treatment-resistant depression.
« Click here to return to Weekly News Update.
