You also need to consider "depression" as a side-effect of other illnesses: sinus infections, flu, Chronic Fatigue Syndrome, Fibromyalgia, any chronic condition.
2
Always has been amazing to me how much people care about organic food - no GMOS, no pesticides! - but will be perfectly happy to pump their bodies full of hormones, treating fertility as a disease, and shout about how great a thing this is for women's rights.
3
Hormones that prevent pregnancy (and abortions ... ) are constantly part of the human (male and female) body. Slightly increasing them doesn't cause any disease, doesn't endanger any species, and doesn't cause climate change, so what's your problem, actually?
By the way, this kind of pills don't "pump their bodies full of hormones", their bodies already ARE full of hormones, remember? It's just a VERY small concentration that slightly changes the hormonal balance, and as such prevents ovulation (= leaves ovules where they naturally remain for most of their lives).
As a counterpart, it means that women can decide for their own whether they want to have a child or not - and as a consequence, whether they want to have a professional career and what kind of career, or not - rather than having men taking that decision in their place.
The counterpart to pesticides and GMOs is what, more precisely?
It only has negative results, and on the entire planet ... except for the fact that the companies using it can hand over a little bit more profits to their shareholders.
Conclusion: false equivalency ... ;-)
18
@Ana Luisa progestins are NOT progesterone, which would be normal during the luteal phase for women. Natural progesterone is metabolized into neurotrophic compounds normally such as allopregnanolone which reduces anxiety. It affects the function of GABA receptors.
Synthetic progestins DO NOT form these metabolites. Most 'progestins' are closer in structure to androgens than progesterone which is why they supress LH and ovulation. Additionally our natural hormones bind to SHBG, and ethinyl estrodial (synthetic) does not. SHBG is how our body fine tunes hormone levels - bound hormones are not bioactive. It is more complicated than you suggest. Women should be informed how synthetic hormones can affect their neurotransmitters and mood. Then decide if their contraceptive needs outweigh the possible emotional side effects.
Associating any medication with depression is a fools endeavor. Unless you find a more than 2X increase in incidence as part of a prospective study with well defined controls anything else falls into a nebulous category of at best "maybe". Depression is very common, particularly in women thus trying to tie down a particular trigger is essentially mathematically impossible. For little historical perspective, the old diagnosis of "hysteria" which roughly translates into the modern depression category, come comes from the latin hysterus the classic term for uterus.
2
This has nothing to do with the old diagnosis of "hysteria" being related to the uterus. Hormones do indeed affect our physical state, mood, and behaviors, and pharmaceutical companies have made billions trying to cover up this well-known side effect and discouraging physicians from openly considering the possibility. This post's tone implies that you have a strong personal interest in not implicating, specifically, hormone medications as contributing to depression in women.
3
Two years ago , after a yearly cardiology
exam, my husband was placed on Pravastatin to lower his cholesterol levels.
We left for a vacation visiting friends and relatives around the West .
Day by day my husband became quieter and quieter sitting with his arms wrapped around his torso ( NOT his natural state). On the ninth day as we were falling asleep he turned to me to say that he had spent the afternoon fighting the impulse to grab the steering wheel and send us into oncoming traffic .
I immediately turned on the lights and googled “ psychiatric side effects of cholesterol lowering medications “ finding information concerning precipitous drops in serotonin levels in individuals taking these meds.
Additionally there were numerous postings about men committing suicide after beginning these medications . Men with no previous psychiatric issues or history of depression .
I am thankful my husband is a strong communicator .
He stopped the medication and after about a week felt normal.
When we returned home we saw the cardiologist who was shocked to hear this dangerous side effect and said that it was unknown to him.
I contacted the pharmacy , the manufacturer , and have shared this information with friends and family.
This information needs to be publicized and communicated to new patients in order to prevent such dangerous and tragic occurrences .
24
As a public health announcement, since this article doesn't include it--
1. Pseudoephedrine (sudafed) has always been a strong depressant for both me and some of my kids. Just be mindful of cold medicines. I never use decongestants for this reason.
2. My son was taking Singulair (for allergies) for nearly three years before I happened to mention to the doctor he had bad depression. The doctor said, "Oh! Singulair is well known to cause depression. Too bad. It's so effective for his allergies. But better stop taking it." He had been taking it for nearly three years and had been suicidal! If it's well known to cause depression why on earth would a doctor not ask *when proscribing??" And why did NO doctor - including those who knew of his depression - ever ask him if he was taking any other medication?
I have to stop--this is getting me too angry. But if there are any doctors reading this--Please make yourself aware of the common side effects of the drugs you proscribe. I'm not asking for esoteric side effects. But if, as the drug says itself: "leukotriene inhibitors can cause psychological symptoms such as irritability, anxiousness, insomnia, hallucinations, aggression, depression, and suicidal thinking or behavior," - then TELL THE PATIENT.
And conversely--if you are a psychiatrist or therapist, and your patient comes in for depression or anxiety--ask them what medications they're taking!!!
28
Could common prescription medications be contributing to depression/suicide?
Yes! When you consider the remedies, combination of pharmaceutical chemistry and medicinal chemistry do not sync with nature.
Safe to say the depression related disorders are largely absent in places like India and China. It's no coincident that plant drugs constitute as much as 80% in India and China.
"Herbal medicine, also known as herbalism or botanical medicine, is a medical system based on the use of plants or plant extracts that may be eaten or applied to the skin. Since ancient times, herbal medicine has been used by many different cultures throughout the world to treat illness and to assist bodily functions".
Treatment with medicinal plants is considered very safe as there is no or minimal side effects. These remedies are in sync with nature, which is the biggest advantage. The golden fact is that, use of herbal treatments is independent of any age groups and the sexes very effective
Herbal treatment of common ailments ranging from diarrhea, constipation, hypertension, low sperm count, dysentery and weak penile erection, piles, coated tongue, menstrual disorders, bronchial asthma, leucorrhoea and fevers are very effective.
That the modern western medicines for thousands of common ailments, may be the driver of people to suicidal depression, is serious enough to warrant a drive to rediscover herbal medicines,
After all they have been a part ever since human appearance on earth..
6
You forgot Trump as a source of depression. I feel worse today than I have in awhile. It’s one thing for him to be ugly to opponents but this child abuse of immigrants has me reeling.
21
Just please stop. The pharmaceutical companies have had just about every traditional politician under their thumbs and in their pockets for decades now. That's what this article is about. Pharmaceutical causes of depression.
4
I think the fact that the essential nature of our country is being destroyed is enough to depress anyone.
20
It’s a wonderful country. So much so that everyone wants to come legally or not! I feel privileged to live in this great country since 1991!
5
It is unclear from the NYT article what the comparison group is: To what group are those on drugs that list depression as a side effect being compared? Those who take no drugs? Those who take the same number of drugs that do NOT list depression as a side effect? Those that take drugs for the same conditions and take the same number per condition but their drugs do not list depression as a side effect? Please update the article to clarify. It is unclear to write, as the article does, “By contrast, patients who were not taking any such drugs had a depression rate of 4.7 percent.” The comparison group is unclear. I expect better from the New York Times.
7
As a physician who studies data on side effects, a common issue in reporting includes no placebo-controlled trials for side effects. For example, reporting only that beta-blockers can cause depression or dizziness at 5%, and not what the rate of similar side effects are on placebo in a similar population, is inadequate. It's crucial to report what the rate of actual side effects are ABOVE placebo. Many people feel symptoms even if they're receiving placebo, potentially even depression. While it's important to bring side effects from conventional medications to light, it is equally important to attribute those side effects in a rigorous, scientific manner.
12
You can correct all of these conditions (including depression) with diet and supplements if anyone cares...
5
You can treat epilepsy (gapabentin) and prevent pregnancy (BCP) and reduce intense physical pain (ibuprofen) with diet? Didn't know that.
21
No
4
Well, I'm sorry that you didn't know that. (Where did the pregnancy comment come from?)
1
Dr. Muskin, the increase in suicides might have something to do with the fact that the government is DENYING sick people their medicines, medicines that (still, at least) are legal, and are legal for a licenced physician to prescribe. These medicines are opioid pain medications. The government agency (which seems to have lost its collective mind and purpose) responsible is the CDC.
14
You might want to google "opioid use and depression." It might poke holes in your proposed solution to the suicide/depression epidemic...
1
I am taking five of the six meds listed in the fourth paragraph of this article. For the record, I'm not depressed.
6
Nowhere does this article claim that 100% of patients taking three or more drugs will experience depression. The percentages vary but are statistically significant enough to be worrisome. See paragraphs 10-12.
9
Why arent benzodiazipines mentioned? “Benzos” are the most horrific substance on the planet. Drs. prescribe them like candy yet MSM never mentions their dangers ala opiates. Ive been through several opiate withdrawals and they dont even come close to the suffering caused by benzo withdrawals. Opiate withdrawal lasts a week whereas benzo withdrawal lasts years. Thats right. Years. Many people commit suicide during benzo withdrawal. The suffering cant be put into words because of how long the withdrawal lasts. Yet not a peep about the dangers of benzos. Incredible.
16
Finally! I've thought since first reading of the increase in suicides, of the side effect--clearly stated in TV ads--of many prescription medications, including anti-depressants, that "suicidal thoughts may occur." How many people who committed suicide over the "increase years" were on these medications? Unfortunately, my older brother sought help for depression and was on anti-depressants when he shot and killed himself three years ago.
5
Thank you for sharing your story. I am so sorry for your loss. I too have been suspecting medications as possible causes or contributions to the recent celebrity suicides.
I wonder if it will become the cigarette company scandal ("smoking isn't bad for your health") of this century. How much more do the pharmaceutical companies know about "suicidal thoughts may occur" than they are saying?
7
Aren't proton pump inhibitors causing low B12 which in turn causes depression? Are nutritional deficiencies at play here, including low D, low B12, and a poor quality gut microbiome?
I've never understood how the nutrition piece of depression gets ignored when talking about the biochemistry of it. Same goes for anxiety. People are addressing these mood issues with nutritional interventions, but if you dare mention it, you get flamed by people who aren't open to talking about what happens when your D level is really low and you're B12 deficient and on antibiotics.
16
Please- let us keep our prescription drugs. The administration is hurling us into dystopia. Depression is a natural reaction to Trump-Bannon-Sessions-Miller-Zinke-Pruitt horror that confronts us hourly.
32
Adderall is on the list of medications with potential depression adverse effects. (Amphetamine/Detroamphetamine)
4
An interesting study but I strongly suspect the methodology is flawed. It reminds me of earlier studies that “showed” such sensational results as a) you are less likely to die if you are a little bit overweight (being a bit overweight is good for you) or b) you are more likely to die if you take vitamins (taking vitamins is bad for you). The methodological problems are similar. In this case if the two groups compared are those who take drugs that have depression listed as a possible side effect and those who don’t, as the article seems to indicate, then healthy individuals who don’t take any drugs at all are going to fall into the second group. These super healthy people are very unlikely to suffer from depression and their inclusion in the second group would seriously skew the result for that group giving it a spuriously low rate of depression. The study needs to be re-done.
4
I have an occasional irregular heartbeat and my cardiologist put me on metoprolol a few years ago. Not long after, I began to feel depressed, unusual for me since I'm a pretty upbeat person. I attributed it to menopause. So another doctor put me on an anti-depressant. It wasn't until my next visit to the cardiologist that we realized that the metoprolol was most likely causing the depression. She took me off of both, and since then I've been fine. Lesson I learned: always ask about side effects before taking any medication.
14
I suspect the epidemic of depression is also closely correlated to the epidemic of anti-depressants. No one seems to talk about the long-term impacts of chronic anti-depressant use. When trying to understand how my sister could possibly be getting worse and worse after years of taking anti-depressants, I came across this alarming study: https://www.madinamerica.com/2017/10/rigorous-study-finds-antidepressant...
I know a lot of people say anti-depressants were a miracle for them but studies indicate that the majority of episodes of depression go away on their own after a few months (coincidentally, this is the period of time it takes for anti-depressants to 'kick in'.) Our brains heal just like our bodies do. I'd love to see more attention on the impacts of long-term use of anti-depressants and other overprescribed medications.
10
Try this book: "Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions by Johann Hari.
1
I've been off and on Prednisone for over fifty years for nephritis and have never been or considered myself depressed in any way. Of course I've had times when I was down as the result of an event, but depression - never.
5
You are lucky. Many patients who take prednisone suffer the side effects. Not everyone responds to drugs in the same way.
4
As soon as I moved to the US, I became depressed, though I loved NYC. I left last year and my depression vanished, after 20 years, and I stopped taking zoloft. The lack of family, of tribe, of security, the high stress of making a living, alienates more and more Americans -- as well as the loose mores, where everything goes. People are happier in ethnically homogenous societies with big families that act as support system -- and it is proven that they also live longer and healthier.
20
Ethnically homogeneous societies? Thank you Donald Trump.
6
Perhaps the association reflects a true cause and effect relationship. Or perhaps it just reflects that the more health problems one has, the more likely one is to become depressed.
6
And don't forget medications that can cause insomnia. If you can't get a good night's sleep for several nights in a row, your mood will eventually suffer.
8
Gabapentin. I was prescribed it for twingy back pain. After a week I found myself having truly dark depressive thoughts and, having been through severe depression 40 years ago, used cognitive behavioral techniques to look at the issue. I read about the side effects of Gabapentin, called my physician, and stopped taking it. My mood returned to normal. I'd rather have back pain than that ever again.
12
About 6 years ago I was prescribed Wellbutrin to help me with smoking cessation. I had asked for it because Several years earlier it had worked well in taming my nicotine cravings. However, this time, within 7 days a developed an overwhelming sense of dread that morphed into severe depression. My doctor's office did not want to alter my dosage, as they figured that stopping smoking was a greater benefit. After several more days I developed a near overwhelming sense of wanting to kill myself that was so profound that I ended up in the emergency room of the hospital. One of the questions the ER doctor asked me was "Did I feel like taking my life?", to which I stated that no, I wasn't going to do that, but I can sure understand how others might feel that way. After I stopped taking the Wellbutrin completely that day I quickly returned to my normal self. My reaction to the medication was intense and had a quick onset. And I have absolutely no doubt that medications of this type contributes to the suicide rate of out country.
13
You are probably right, but for me-- I have major depressive disorder-- Wellbutrin is the only antidepressant that has ever helped me without the side effect of weight gain.
9
Over several years my primary care physician ran me through a series of off-label-use drugs for my migraines. She was aware that I had a history of severe depression, so she promoted some of the drugs with the promise that “it will help your depression, too.” Gabapentin — a drug that can worsen depression and cause suicidsl thoughts — was one that she prescribed.
Every one of the drugs I tried came with so many side effects (some quite serious) that I rejected trial after trial. For some of the meds, my doctor suggested I try taking a second prescription to counteract the negative effects of the first. I put my foot down on that point: if you have to take a second (or third) medication to help you tolerate your primary med, you need to back up and reassess. Ultimately, I decided to forgo daily meds.
So many of these drugs’ side effects degraded my quality of life. Some kept me from sleeping, some made me sleep too much and made me dizzy. Some caused acne. One altered my perception of taste. Some made me gain weight. One made me lose weight and brain power at the same time (Topamax). That med even gave me a facial tic. And libido? What libido.
Even for medications where depression and suicidal thoughts are are not observed and noted possible side effects, I wonder whether living with unpleasant, life changing side effects — from prescriptions taken every day, without an end in sight — can add to a patient’s psychological and emotional spiral.
7
Nice, easy, generalizations about the use of any medication (though some are true about specific meds for some people). You went to your doctor for help with your migraines. Assuming that behavioral things like relaxation/meditation, massage or other behavioral approaches failed, should the doctor have then said ‘sorry, can’t help you- go home and suffer ‘?
6
Chronic pain and discomfort can naturally lead to depression or anxiety (will I get through this situation or will I get a migraine that debilitates me? will I ever get my old life back?)
It upset me to see that documentary about the girl in New Jersey who was a powerlifter, developed crippling migraines, and was told by the medical community to just deal with it and stop powerlifting. Meanwhile, I'm thinking, did they check her magnesium, since low levels are associated with migraines? That was her cure--magnesium supplementation. How often are doctors missing what's obvious to nutritionists?
14
Perhaps they are supposed because of the underlying illness that needed the prescription? I have a difficult and rare illness that has negatively impact my life. I would think that would also be a factor?
4
That this comes as a relevation demonstrates how the medical profession is made up of unthinking idiots. Combined with their unethical behavior where they receive kick backs for prescriptions and referrals and that they don't post prices like everybody else makes them a scourge to the rest of us. Crazy as it sounds, thank goodness for lawyers.
14
How to get happy?
Easy, just stop taking my blood pressure pill--amlodipine besylate. Blood pressure will rise, and I'll feel great.
7
Maybe you should have printed a list of drugs that don't cause side effects including depression. It would have been much shorter.
Bottom line, only take drugs, even over the counter as the last resort, not the first resort.
16
Whatever happened to the world-beating, self-reliant, can-do country of the 1940s and 50s? America is a nation of overweight pill-poppers, living in their cars, hypnotized by screens, subsisting on junk food, depressed. As a well-known public figure would sum it up: Sad.
12
Hiero, is it not plumb obvious? We've elected as Noble Leader and strive to emulate in every possible way and habit that sad yet well-known public figure DJT.
3
Spoken like someone who's never had a chronic illness.
7
Hey you kids! - get off my lawn!
2
Don't forget about anti-depressants as a cause of depression. Some people become less depressed taking them. Some become more depressed. Some get suicidal. The FDA has put a black box warning around certain anti-depressants because of the number of reports of suicidality with those anti-depressants. Does that mean that the other anti-depressants are squeaky clean? Ask the drug companies, if you want to get a biased answer.
10
I've always wondered about how the researchers treat suicidal ideation in those with severe depression taking anti-depressants. It seems at least possible that the drugs simply aren't working to lessen depression, not that they worsen it.
1
They just pile on even more antidepressants, believe it or not. Sometimes they add antipsychotics.
3
There is a strong link between anxiety and depression. There is so much pressure to perform, to outdo, to stand out, to shine, in the United States.
And if you don’t, then you feel your livelihood could be affected. Is it is surprise people are anxious? And then feel overwhelmed and then get depressed?
If one has less worries (great socialized medicine where I live), a job that is reasonable in its demand, and time with loved ones, one is less anxious, and lives a balanced life.
But American society denies its citizens all those things. Then offers medication as a cure.
It’s such a sham.
And people are even more depressed because they feel powerless to change it.
Taking back power to get back balance is the key to better American psychological health.
22
It's a mill, people. Docs have ten minutes or less to see you. They reach for the easy answer and then send you off to the pharmacy, scrip in hand, but totally unaware of how bad the side effects can be. In my experience, side effects are totally played down, because the doctors don't want to hear it. All this talk of "patient centered car" is just marketing jargon. What is missing, and might help those who have suffered from this depression, is any form of active follow up from doctors. When was the last time the doctor's office called YOU back to find out how you were progressing? The entire problem is left for the patient to deal with, and in the case of depression particularly, they often are not in a state of mind to do that!
17
I think there is also the idea that somehow life should be pain-free, disease free and worry-free and that if we are dealing with any (or all) of these then we are doing something wrong.
Mass media and social media promote this image of what life in America *should* be like when in reality we age, we slow down, we develop conditions that are never going to get better. We blame ourselves for not measuring up to some false and idealized narrative of life-long excellent health.
Under those conditions it seems depression is to be expected.
13
Glad things have gone well for you.
But keep in mind, the bell eventually tolls for everyone, even you.
3
I take no prescription medicines whatsoever, so how would I know? However, I got interested in the issue of medication versus talking cure (psycho-therapy), did some reading and talked to a friend who is professional therapist. It seems clear that pharmaceuticals are over-prescribed in the US, often for conditions that don’t require treatment at all. Not every bout of unhappiness, self-doubt or anxiety can or should be treated with chemicals that may dampen down your crisis but won’t really change your life or eliminate the internal and external factors that make you depressed. This requires self-insight that can be helped by cognitive therapy. The same with physical issues. Sometimes chronic pain can be mitigated with exercise and life-changes. And sometimes you just have to learn to live with it. I know a number of people who have done just that.
8
You know what helps with LOTS of conditions that might cause joint pain (from chemo side effects to fibromyalgia) ... marijuana! In fact, marijuana is so helpful for such a range of medical issues, one has to wonder why it's not legal. Could big pharma be behind efforts to not legalize it? I wonder... they're not unscrupulous or unethical now, are they? Legal marijuana could put the arthritis medicines (and there are hundreds), not to mention many many more, completely out of business.
16
I am with you. I am so sorry I suffered so. However here in Florida medical pot only just became legal. I couldn't find anyone who could help me. Trust me I have no qualms about using it. Hopefully I will not have to
3
It is legal.
1
The study fails to report that ANY incidence of depression in a patient using the drug in a clinical trial has to be counted as a potential side effect, whether it's caused by the drug or not. I wonder how much of the depressive thoughts are that the much vaulted drug simply doesn't work, and it makes the patient hopeless.
9
My wife committed suicide in 2015. She had been suffering from bouts of depression for several years and was seeing both a psychologist and psychiatrist for CBT counseling and medication. After a suicide attempt in 2015, she was hospitalized at a local mental treatment center for a brief stay. She was prescribed two medications that contain warnings about suicidal thoughts in spite of her past clinical history. (Similar warnings were attached to drugs she took prior to her first suicide attempt.) She felt her only path out of her painful situation was suicide and I'm certain as she entertained those thoughts three months after leaving the hospital the warning labels on those drugs and the drugs' effects were not on her mind.
14
Gabapentin and Lyrica are major contributors to depression and increased thoughts of suicide. Unfortunately when doctors prescribe these medications they do not warn you of the side effects. Take time to read the info that comes with the drug. I know of what I speak. I was prescribed Lyrica during chemo treatments for the intense bone and joint pain- side effects of the chemo. Added to that the screaming nerve pain I experienced after radical masectomy (which pain seemed to increase after a chemo treatment) caused the plastic surgeons to recommend Garbapentin. The oncologist office prescribed Lyrica. Lyrica and Garbapentin are similar drugs.
I did not know what hit me because I became so depressed and one morning sat there and decided going on was not worth it. I seemed unable to control my destructive thoughts. Somewhere from deep within me I had the urge to look up those medications again and decided I will not take the drug. I was taking only the Lyrica because I felt uneasy about taking the high dosage of Garbapentin that was prescribed. I also was rational enough to realize that I wasn'nt thinking normally and reached out to my oncologist who immediately got me in front of a psychologist. The psychologist agreed with me re the effects of the drugs and complimented me on being able to wade through my confusion. Albeit by the skin of my teeth. All I can say is listen to that deep voice within you because the doctors don't really see you - the patient.
12
I think the contribution of over the counter agents and other things ingested is underestimated. I write this as a physician of over 30 years in practice. Alcohol is a well known depressant and certainly potentiates any underlying depression a person may suffer. NSAIDs? I have cared for patients who have taken multiples of the maximum dose. This followed by proton pump inhibitors and/ or cimetidine because of reflux and abdominal pain. There is clearly more than enough blame to go around.
11
More than 100 million Americans are living with physical conditions that cause chronic pain. The DEA and malpractice insurers are making it virtually impossible for physicians to prescribe opiates and anti-depressants, creating an exponential increase in patient suffering.
Does anyone really wonder where the subsequent increase in depression is coming from?
10
One out of every three people is living with chronic pain? Pfft.
2
A few years ago, my doctor prescribed a popular statin. Shortly after taking it, I fell into a deep, peculiar depression. I've always struggled with dysthymia, but this was very different. It was so unusual, and seemed to spring out of nowhere, so I decided to keep a journal. That helped me realize that the only thing different in my life was the statin. I googled it and discovered patient boards where many people were complaining of the same thing. Then, I found the small print warnings on the med posted on the drug manufacturer's website--in less than 2% of people, this drug caused depression. I called my doctor who immediately switched me to another, weaker statin, which did the trick on my cholesterol but didn't depress me. I often wonder what would have happened if I hadn't questioned my new form of depression and just let it take me over.
14
I've been taking Baclofen for years for muscle stiffness due to MS. I am aware that one isn't supposed to stop suddenly due to possibility of seizures. I missed 2 consecutive doses (I take 20 mg twice a day). The next day I had an overwhelmingly hopeless feeling coming out of nowhere - less subtle than a seizure, but significant enough to report anecdotally.
4
I have an anxiety disorder that makes my life a living hell. When I was prescribed anti-anxiety medication I functioned much better and my blood pressure was always normal. The doctors I go to won't prescribe anti-anxiety medications anymore because they are afraid of the DEA. I'm on three high blood pressure medications and my blood pressure is sky high. When my brother gives me one of his Klonipin he gets from the VA my blood pressure is normal. I don't trust the doctors anymore because they don't seem to care about their patients' health. What happened to "do no harm?" I guess that's an outmoded concept since the doctors don't band together and challenge the DEA. I told one of the doctors I was terrified of having a stroke and he just shrugged his shoulders.
15
It's not just the DEA striking fear in the hearts of doctors who dare to prescribe anti-anxiety medications and opiates. Some malpractice insurers are raising their rates to ridiculous levels for clients who treat patients with appropriate medical care.
Physicians who want to practice medicine are being forced to follow the dictates of bureaucrats with no medical training whatsoever.
10
I'm sorry for your trouble.
But the NYTime' has determined that drugs are bad for you, and there is nothing else to be done.
2
People get depressed just knowing they have a disorder requiring medication. This is especially true if it is a chronic disorder. Then if they read about the potential adverse effects of the drug they need to take, they get more anxious and depressed. Then they go to their doctor and get a drug for the side effects.
Part of the problem is that Americans are subjected to TV advertising of drugs, making them think that for all human ailments Pharma has a pill for you. It is a travesty that we are one of only 2 countries that allow direct to consumer advertising of drugs.
21
As a child of the 60s, constituted by my culture as I was
I took every thing that was going, and there was a lot going,
I am fortunate to be still here. A wonderful psychiatrist directed me to Group Therapy and it worked. Why did it work, well
neurologically your Neurons fire off in group interaction as opposed to them not firing off if one is alone and you can't be more isolated and alone if you are dependent on drugs.
2
If you're looking for a doctor to save you, think again; as a profession, they have one of the highest rates of suicide. If you want to live a long life, try avoiding medications and doctors.
19
And it just gets worse and worse.
1
Depression is a known side affect, especially for children, of Singulair (montelukast). Yet three doctors approved this drug for my 12 year old to "see if it would help." Thankfully my son noticed the RX bottle warning and admitted to having suicidal ideation which coincided with his time taking Singulair.
Shame on the medical community and big pharma. Stop using drugs to diagnose disease. Children are not guinea pigs.
3
Side effects listed for Singulair include symptoms of allergies. These warnings are mostly noise, and virtually useless. Of course symptoms of allergies will be observed in people starting to take Singulair! It definitely is not caused by the medication.
If your child has been miserable with allergies, it's not a surprise that their mood will be affected.
2
Singular has been a lifesaver for asthmatic children. It was extensively studied for many years before it was released to the public. Please get your facts straight.
1
THC and CBD has eliminated the need for anti anxiety and sleeping pills for many people I know.
10
Was there a control group of patients who had the same conditions that motivated the use of drugs but were not taking the drugs? If not, that's not very good science, is it?
5
The problem is that the side effects warnings are very bad science - they're just a list of things observed with test subjects, with no investigation into causation vs correlation. Headaches as a side effect of pain medicine? Duh. People who take pain medicine probably have a headache! Suicidal thoughts a side effect of anti-depressants? Duh. If you are put on anti-depressants, you probably already have suicidal thoughts.
The fine print on side effect warnings usually state that they are just observational. This practice is probably due to dumb regulatory requirements, and it does more hate than good.
I would love to see a proper investigational piece by the Times on this. This is what the Times does best, not inflammatory pieces like this article.
6
Seems like great news for Big Pharm - once you're on one drug then there's a downward spiral of endless pills to buy.
7
The most disturbing fact stated is that one third of Americans take prescription drugs. Tells us a lot about the influence of big pharma on a profession that has forgotten its Hippocratic oath.
8
PeterC - No. There is nothing about the fact that one third of Americans take prescription drugs which is in itself positive or negative. You are entirely ignoring the question of whether the drugs are a net benefit or harm to those individuals. 100% of Americans eat food. We don't criticize this because we know this is a net benefit. The same analysis applies to drugs; we just don't happen to have as readily apparent an answer.
14
Pure speculation in this land of non-truth. Anyone have any facts? Causation and not conjecture would help. The NYTimes is doing a disservice by publishing these articles with no facts in a time where suicide is way too much in the news.
Please stop talking about Depression and Suicide! These articles have the potential to trigger certain people at the edge of their abyss.
How do I know? I've been there and I know statistics from grad school.
5
The article states clearly that the link is not causal, but a correlation. The study authors state it just as clearly, in this article as well as in the original research paper in JAMA. To NOT report this would be a far greater disservice.
11
I disagree. There was an opportunity here for the Times to do what it does beat, and dive deep into the irresponsible practices in side effect warnings. THAT is something that should be reported on, with studies like the one in the article being called out for extreme irresponsibility.
2
Yes, but dullards cannot make the distinction between correlation and causation, as clearly demonstrated by a large portion of readers' remarks. Read them and weep.
2
Increase in suicide and huge increase in people taking anti-depressant medications and thats a mystery Sherlock?
There are now black box warnings for suicidal ideation on many anti-depressants yet Primary care doctors and others hand them out like candy.
Interestingly no one today is unhappy or just blue or feeling down , people all say they are depressed. Depression is a disease with physiological ,observable symptoms;anti-depressant were NEVER approved for Dysthmia or unhappiness or grief .
Also there is replicable research to support the hypothesis that anti-depressant medication treat depression, none that stands up to peer review or is blinded. Its all a guessing game .
and now we know they are addictive....wonderful.
5
You have misinterpreted the article and the data. Antidepressants are not addictive, though they can be difficult to stop without symptoms. Furthermore, suicidal ideation is usually a side effect only in young people, not in adults over 25.
Obviously, serious depression carries a risk for serious suicidal ideation and attempts. As both a therapist and a patient, I can assure you that most people who have moderate to severe depression need medication. Some people who have dysthymia may need medication.
I agree though that we need a word for a down day as compared with serious depression. Using the word depression for all sorts of down moods can be confusing for lay people.
13
@ Barbara
Could you please define "moderate depression", and refer to some studies showing that these people really need medication, rather than for instance MBCT?
Thanking you in advance.
1
Someone didn't read the article. It's not about antidepressants.
3
Quite interesting that suicide is a side effect of a number of antidepressants.
1
Depressed people are at risk of suicide. Drug companies list suicide as a risk of their medications to transfer responsibility to doctors prescribing the drugs.
1
Anti - depressants will often lift a severely depressed person's depression just enough so that they will have the motivation to do away with themselves. It's difficult to kill yourself if you can't get out of bed.
THAT is the reason for the warning , and THAT is why all severely depressed people on medications need ongoing monitoring from doctors, friends and family.
Unfortunately, many people who ARE severely depressed are depressed because they have no friends and family to begin with.
And please spare me the anecdotal responses. I said many - not all.
2
Antidepressants themselves can increase the risk of suicidal ideation and violence:
https://www.bmj.com/content/358/bmj.j3697/rr-4
2
Lets not talk about etoh - too much profit invovled.
1
Unfortunately, people have to take direct responsibility for their health care. Doctors are not gods, and with today's insurance environment, the level of care that they are allowed to provide has diminished. I more than once have been told by doctors that they can only treat me with certain established protocols determined by insurance companies, protocols that delay needed treatment based on my medical history. Let me assure you of this: your insurance company would prefer to see you dead rather than pay for your treatment. They will take your premiums, but they don't want to offer nothing in return. they are like a legal mafia. Never ever let a doctor decide what is best for you. Do your research. Question absolutely everything. And, shop around if you are not getting better. Those who don't are doomed.
19
It is also well documented that people with depression “somatize” and access the health care system more. As a nurse practitioner, many patients I see complain of abdominal pain, trouble sleeping, low libido, Inability to lose weight, heartburn, hair loss, fear that they “have cancer”. Sonograms, CT’s, labwork return normal. Obesity, fast food, snacking all contribute. Lifestyle changes are needed but patients tell me they “don’t have time” to exercise or prepare healthy meals. What’s the answer?
21
Imho, the solution is no longer considering depression to be a "disease" comparable to other diseases, and to start seeing it in a way that is more compatible with what depressed people actually feel: a profound, fundamental unhappiness, suffering, and lack of motivation to live, caused by a constant stream of negative thoughts and feelings, which your self-regulation system cannot embrace in a loving and soothing way, because for one or the other reason it wasn't developed/trained enough yet.
And that lack of proper brain circuitry is causing a chemical imbalance in the brain - which antidepressants can correct, but on the one hand the effect is often merely suppressing the intensity of your emotions (whereas emotions are what drives us in life, so again cutting you off from life), and on the other hand without the proper training, the brain circuitry needed in order to fully live and thrive cannot be installed either. And as the cause isn't being dealt with, a basic restlessness/unhappiness remains - which then causes the symptoms you're describing here.
For more information, see for instance:
Mark Williams, "The Mindful Way Through Depression. Freeing Yourself from Chronic Unhappiness" (an 8-week training that studies show is AT LEAST as effective as antidepressants).
Julie Simon "When food is comfort. Nurture yourself mindfully, rewire your brain, and end emotional eating" (explains the brain mechanisms behind "self-care skills" and how to train them).
5
Judith--nothing like promoting the myth that people with depression are all hypochondriacs and access the health care system more. Where are those "well documented" statistics, btw, or is it your own bias? I suspect the latter.
The answer is to treat ALL of your patients equally and not categorize the obese and/or "depressed" ones as hypochondriacs.
As an NP you should know that there are other causes of obesity besides overeating and lack of exercise. One of those is side-effects from medications---that's right--anti-depressants often cause large amounts of weight gain.
I feel very sorry for your patients and I am so happy I am not one of your patients. I've had medical professionals like you who have judged me as a depressed hypochondriac. If I had continued to see those "professionals" my cancer might have been caught at a later stage. I am thankful for my doctors who finally believed me when I said my symptoms were NOT depression-related and which were, in fact, cancer.
13
The answer is leave the medical profession if you cannot over come your personal biases.
7
The first time I became depressed was shortly after starting Inderol for migraine pervention. I was taken off the Inderol and took an antidepressant for a year. Several years later my migraines were causing high blood pressure so Atenolol was prescribed. Nobody gave any thought to the fact that I became depressed last time I had a beta blocker and I wasn't told that beta blockers were the problem. I thought it was just Inderal. I'm still taking the Atenolol and an antidepressant. Maybe I shouldn't be taking either but I'm stable so why rock the boat.
4
Not wanting to rock the boat could be a symptom of depression. There are newer BP drugs available that would not require you to also be on an antidepressant forever. (And newer treatments for unresponsive migraines.) My general rule is to avoid taking any drugs long term that mess with my neurons.
2
Ibuprofen on this list is crazy. People will not get surgery and get exposed to many serious risks and heavy duty drugs in order to avoid ibuprofen for fear of depression! I wonder how rigorous methodology has been used here. association is different from causality...
3
You can't just doubt the solidity of a scientific study because the results tend to go against your own beliefs/experience/evidences ... .
I didn't read the study mentioned here yet, but based on other studies I suppose that it's about taking these medications year after year, not merely before or after a surgery, for instance.
For more information (confirming what the study in this article found), see a link someone else below sent:
https://www.ncbi.nlm.nih.gov/pubmed/1540135
7
Despite possible dangers of public outcry as over-reaction this article, and others like it, it should be considered a public service. Especially for our aging population the cost of suicide is a concern - yes, I mean cost in dollars for added social services, for burial of paupers, for providing mental health care, for loss of an elder as an unpaid caregiver. Dee raises a valid point about doctors over-prescribing. It is so much easier to simply fire off another order for another drug rather than to evaluate potential inter-reactions of drugs a patient already is taking and adjust medication and dosage to alleviate the problem.
As "nanny" to an elder who was taking pills for his reactions to other pills I finally made a spreadsheet of all his meds with notes on side effects and adverse inter-reactions. I went into the exam room with him to hand this spreadsheet to his primary care doctor and asked for his evaluation. The over-prescribing stopped, drug bills dropped dramatically, and the elder took an interest in living again. My next line of defense, had this tactic not worked, would have been to go to the pharmacy with the spreadsheet and consult with the managing pharmacist.
39
Minnesota has one of the highest rates of depression in the United States. Perhaps those of us who live in this state of 10,000 lakes should take a careful look at their prescriptions.
4
Or the lakes . .
9
Or the long, dark winters...
5
The author stated clearly, there's evidence of correlation but not causation! Many of the comments leap straight to causation. As long as we are listing correlation evidence, let's add the sudden proliferation of ads, everywhere, every-way, all the time, endlessly. The tension evoke by this unending barrage of largely useless, repetitive droning would make anyone depressed.
20
My grandmother (wife of a doctor) and mother (daughter of a doctor) used to say a general rule of thumb for treatment for illnesses is follow the sequence first Mani (gem stones, placebo effect?), then, Mantrm (chanting, placebo? physiological effects?) then Aushadam (medicines). Start with simpler, noninvasive remedies for most non life threatening ailments and conditions before resorting to pills or surgery. Of course, that approach does not work well with the business model of modern medicine (big pharma and doctors, hospitals). So, here we are, treating one illness with a pill and treating the side effects with one or more pills.
9
Also, many patients expect a prescription and feel cheated if they don't get one. I wish that schools included more education about the prudent use of the healthcare system so we could get over the idea that more intervention is better.
3
Hurray! Anecdotal "evidense." My favorite!
But your grandmother was the wife of a doctor - so it's all good.
6
I developed high blood pressure after having a child in my forties. The "doctor" prescribed beta blockers even though I had a previous medical history of depression. After two years of becoming progressively more depressed I was completely desperate and researched alternatives and found a new doctor to get me off the beta blockers and on to a old-fashioned cheaper diuretic. SInce then I have researched all my own medical treatments. Recently during an eye exam I was informed that I needed daily drops for possible glaucoma as a preventative "like a vitamin." One of the daily drops is a beta blocker and I said I would not take it. This "doctor" has all his patients over 60 using serious drugs that are nothing like vitamins. I flew to Seattle for a second opinion and it turned out that I do not have glaucoma at all. You really have to be in charge of your own medical care because Doctors by and large are over-prescribers.
64
Hmmm, might report the doctor who was prescribing those beta blocker drops as "a vitamin." This sounds dubious -- misleading at best, possibly unethical like doctors of old who gave patients methamphetamine "vitamin" shots...
1
People tend to ignore precautions about side effects, or postpone going to the doctor if problems occur. We're optimistic by nature, and who doesn't want to be healthy and feel/look/act/sleep/perform better if there's something that will help?
But I think there's another reason. We are being inundated with drug ads that extol the virtues of some medication, then end with a rapid-fire chant or page of microscopic print describing side effects that range from dire to laughable. Even the most discerning consumer can become numb after hearing about four-hour erections or watery diarrhea for the millionth time.
The problem is that too much money is being made from drugs, patients want easy fixes, and doctors try to be accommodating. The answer is another problem.
13
Here's how it seems to work when we visit the doctor for a check up or if we're ill. Medication is prescribed. We're told we need it. There is very little discussion about it. But there is the implicit statement that we, the patient, MUST take this medication, or else. There is very little discussion about side effects, what to expect from the medication, or if our plan covers it and what the co-pays are, i.e. can we afford it.
Some doctors do take the time to explain the medication to the patient. And a lot of us go onto the internet to look up whatever medication the doctor has prescribed. However, we're rarely presented with the pertinent information no matter which search engine we use. So we're forced to figure out which site is accurate and which one might be nothing more than an elaborate ad.
Another problem is that doctors are not paid enough to sit and talk with patients about non-medical treatments like changing one's diet, going to bed earlier and turning off the electronics earlier. We're not asked how we handle stress or headaches, or anger. We're not asked how our lives are going. Such a discussion would take a bit more than 7 minutes. That's depressing.
Drugs cannot substitute for human interactions. They cannot relieve the anxiety of our current uncertainties with jobs, paying our bills, etc. Life is stressful but in today's America the stresses are more unbearable because, all too often, it never ends.
22
Changing one's diet, going to bed earlier, how we handle stress and anger, these are not medical issues. We all know what our diet should be. It's not a secret and the other issues are life skills. If you did not learn how to handle these issues as a child, get a book or see a therapist.
9
They become medical issues when one doesn't improve their diet, get sufficient sleep and learn to better handle their stress and anger. I felt hen3ry made thoughtful comments regarding issues being discussed.
1
Where is the computer-triggered alert when a patient's record shows concurrent use of too many drugs that can adversely affect depression and suicide? There are many other known, adverse synergistic effects among drugs that are in their product inserts. Regardless, more research into this and other hypotheses that cause increased depression and suicide is badly needed.
This is a classic public health crisis that needs a federal government that is attentive to science and public health. The NYT has reported on how bad our government is in this regard.
11
Such computer applications exist but apparently aren't widely used. They are used by doctors routinely here. There are also medical websites that use them. Why it isn't standard procedure for doctors and pharmacists elsewhere is a good question.
8
I would make the argument that if you live in the US and pay attention to the news it would be natural and normal to be depressed. Our country is so catastrophically badly governed at the federal level: the blatant pandering to wealthy donors at the expense of ordinary citizens is so blatant and so brazen it's hard to not conclude that the long term well being of the average US citizen is in extreme peril.
Forget blaming medications - focus on the true causes of depression. Economic anxiety, dog eat dog culture, excessive marketing, and constant predation by corporations who have the law and the federal government on their side as they seek to steal everything from the 90%. Society has been strip mined for profit.
127
"If you're not depressed, you're not paying attention."
Your comment is especially germane to children who are having those societal pathologies imposed on them before they have a frame of reference in which to adapt to them. Bring back childhood.
14
You have to live in the US to understand. It’s not possible from a country where you grow up with the world right side up compared to here.
2
Another correlation--some 40% of adults in the US suffer from obesity and all the attendant illnesses together, including depression, hypertension, hyperlipidemia, and diabetes. Those folks are often prescribed pills for the related symptoms, many of which may cause depression (as this article suggests), and *all* the medications have some sort of deleterious side effects, with long lists of big fat scary disclaimers. Obesity is very good business for Big Pharma.
As far as I know, Big Pharma doesn't make a profit from "lifestyle changes," such as diet, exercise, stress reduction, meditation, and improved relationships. However, the industry behind the Standard American Diet is very profitable indeed, which is completely counter productive. And the SAD spreads illness around the world, wherever it's exported along with KFC and Mickey-D. Shouldn't the food and pharma industries work together for public health instead of behaving like vampires, sucking the health out of people, all for profit?
31
Americans are far too reliant on pills to solve their ills. Lose weight, exercise 4+ days a week, eat in moderation, eat the right foods and you can eliminate many of the drugs you take. Big Pharma won't like this and neither will your insurance company but think also of the huge amounts of money you'll save too. Win, win, win.
16
Alcohol can cause depression after heavy use. Chronic alcohol abuse is the common denominator in some celebrity suicides such as Anthony Bourdain and Robin Williams.
9
So true. Usually alcohol is the cause of depression (speaking for myself): as with everything this day, most people are binging… Binging on Netflix etc. and so forth. And a lot of people self medicate with alcohol (as I did), exacerbating the problem, as well as compounding it with other maladies… I guess my liver was not Green enough, besides ‘glowed across the ocean to Ireland’ (Chernobyl), on an alcohol fueled ‘working’ vacation; crew on a fishing boat in the North Sea
2
You are incorrect about Robin Williams. He suffered from a medical condition known as Lewy Body Dementia, a physical disease of the brain.
10
Robin Williams had Lewy Body dementia .
4
It's depressing not knowing which ones they're talking about.
3
In Donald Trump's pro-life Christian America, there is no room for mental weaklings. I suspect the longer Trump stays in power, the higher the suicide rate will be. When a migrant recently committed suicide after being separated from his children, NO ONE commented on this because in Donald Trump's pro-life Christian America, migrants, many of whom are Christians fleeing violence in their own countries, which are run by pro-U.S. dictators and strongmen, are "breeding animals." In Jesus' name.
28
So this all started with Trump. Is that your position.
3
Jay David – Many understand that in Donald Trump's pro-life Christian America the Mental Weaklings are now in charge, from top on down.
3
What about Chantix? Anthony Bourdain said, "I take Chantix... and it causes suicide." in a podcast with Marc Maron.
17
Can the Times or a commenter please run the full list of prescription drugs than can cause depression, or a link to that full list? The link to the JAMA articles leads to a paywall, not to details.
8
There is a link to the list. It's a graphic from JAMA.
2
This article is depressing enough.
3
What worries me most about this article is the comments section, and how much blame and how little understanding are shown in most comments.
First of all, we do have a problem in the US with overmedication, but "don't take pills" isn't good advice. Some conditions do need intervention, and no one should be shamed for following their doctor's advice. None of us are in a position to judge another person's behavior or health.
There's also a difference between being depressed and having depressive disorder. Everyone is depressed at some time, and a lot of comments point out that the conditions that many drugs treat can cause people to feel depressed. This is not the same as having the psychiatric condition of depressive disorder, which can happen to seemingly OK people (like Anthony Bourdain and Kate Spade). This is not to say that people treating other conditions never have depressive disorder, it is to point out that feeling depressed is a normal emotion and not necessarily a medical condition.
Finally, the list of side effects generally comes from the clinical study, in which patients report a given condition that arose after they started taking the medication. Sometimes these conditions are strongly correlated to the medication (like sleepiness with Benadryl), others show weaker correlation. But because the underlying cause of the new condition is not established, that condition is listed as a POSSIBLE side effect.
27
American healthcare at its finest: a public warning that more than 200 prescribed drugs could lead to depression -- particularly in certain combinations -- yet the only seemingly accessible article which lists exactly what those medications are is behind a paywall, and one from a respected scholarly journal.
11
You can generally access scholarly articles through public libraries, and certainly from university or college libraries.
2
It's highly unlikely that this list of medications which "cause" depression is going to be of use. This article is about medications which are -listed- as having depression as a -possible- side effect. (Many commenters have pointed out the shortcomings of this approach.) Very few are likely to have been examined in a study to determine whether they actually cause depression.
Also, its complicated: oral contraceptives can cause depression, but hormone replacement at menopause can lift depression.
8
I like Nancy Reagan's advice: "Just Say No." To drugs. I like to think she had our pharmaceutical industry, and medical industry, in mind when she offered her famous advice.
Ask what alternatives would work -- probably even more effectively. Then try those.
Hint: Healthy eating and exercise. Eat mostly unprocessed, mostly to only plant food. It's that simple.
7
"I like Nancy Reagan's advice: 'Just Say No.' to drugs." -comment by Dr. J.
Nancy Reagan was clueless about drugs and drug abuse. Her famous quote was "A joint at a party is the moral equivalent of heroin use in a back alley."
15
Kale has yet to abate my bipolar disorder and beets do do nothing for to quell the myriad of symptoms that come from my genetic condition.
Not everyone's body is manufactured directly in G-d's image. If eating right were a panacea, we would all be immortal.
18
"Dr. J?"
Unfortunately, doc, it's not that simple for millions of real disease.
2
I have taken a proton pump inhibitor for many years now - my GERD is quite severe. And i often must also take steroids when my chronic respiratory disease is having a major flare-up.
Do they cause me to be depressed? NO! But having uncontrollable GERD and not being able to breath make me VERY depressed! My quality of life goes down the tubes.
Yes, I have made all the lifestyle changes possible for my two chronic health conditions. No, I was not a smoker. No, I am not obese. I'm just unlucky. And these drugs help me immensely.
All medications have side effects. I know dozens of people who take the same drugs I do. All become quite depressed when their health fails, to when they take these medications.
21
If you are taking PPIs long term, please make sure you have an endoscopy as long term GERD plus PPI has been implicated in stomach and esophageal cancer. GERD alone has been associated with stomach cancer. I agree with your point though - living with severe GERD alone would make a person depressed!
3
Did you try an elimination diet? Food intolerances and celiac disease can cause GERD; hopefully your doctor ruled those out before turning to the PPIs.
4
PPIs have been shown to have many bad side effects, including cognitive impairment, kidney disease and brittle bones. You should speak to your doctor about using H2 blockers.
Sure, some of these drugs can cause depression. But the positive effect of these drugs must be considered on equal footing. People in chronic, untreated pain are more likely to become depressed: gabapentin eases neuropathic pain. Propranalol is a very effective anti-anxiety medication that is non-addictive, unlike like Xanax or Klonopin. A recent study showed that weightlifting --even light weights of 3-5 pounds! -- just 20 minutes a day, should be considered a "front line" treatment for depression. As someone with depression and chronic pain, I'll take my chances with the medications. And do a little more lifting.
12
The largest over the counter cause of depression is alcohol. Beer, wine and spirits are depressants. People suffering with depression often try to self-medicate with booze. The results can be disastrous.
Medications that may cause depression can't come close to the depressing damage done by alcohol.
87
Booze is unlikely to be the cause of depression for most people, it makes it worse. The causes are lifestyle changes which affect the mind - relationships, jobs, money, anxieties. These may or may not cause chemical changes in the brain, no-one really knows, but booze will always exacerbate the problem. I think you are trying to say that long-term heavy drinking will lead to depression, I'm not sure that's right.
1
Ask any cop on the street: Alcohol is by far the most dangerous drug out there in acute terms (however, tobacco use leads to a large variety of chronic disease conditions). However, outlawing alcohol in 1919 actually causes a huge increase in the number of alcohol-related deaths. And most people weren't even driving in 1919. And alcohol, sugar and tobacco are sacred. The slave-based colony economy was almost exclusively about producing this products.
6
Alcohol is a known depressant , it depresses the system. After the initial high it is a well know well documented physiological depressant.
1
I can think of one pretty clear example of reverse causation. Two of the common symptoms of obstructive sleep apnea (itself a fairly common malady, and very often undiagnosed) are acid reflux and depression. Many OSA sufferers will therefore take PPIs for their acid reflux and also be depressed. Thus the population who take PPIs will almost certainly have higher rates of depression, even if PPIs themselves have no causative effect on depression.
Untangling all these threads is incredibly complex, and studies only showing correlations are far more likely than not to lead to false conclusions.
24
Most of these medicines do good, but all of them have side effects. Understanding those side effects, particularly long-term side effects, is not easy, but as time passes we should have better understanding and thus greater ability to prescribe appropriately.
For some people, the side effects are worse than the problem the drug is intended to address.
The biggest problem we have now is the tremendous pressure brought by the pharma industry to use patented drugs. Pharma companies make more profit for those drugs and pressure doctors to prescribe them.
Decisions as to which drugs might be beneficial are skewed by that pressure. Statistics are manipulated to exaggerate benefits and to downplay risks. Patients are often in the dark about potential side effects.
1
I feel for the person who feels the need to take a drug for depression. All such drugs alter the brain permanently. If you find out that you are overall worse off after taking such drugs, you can't simply stop and go back to where you were before. I am glad I have never had more than occasional bouts of depression, caused by specific events in my life. However, I am taking Prednisone after having eye surgery, and I think it is altering my mental state at least a little.
2
As a primary care doctor, it is my perception that we prescribe far too many medications, and there is good evidence that reducing the number of medications patients take can improve their health.
However there are some big problems with this study. First, the researchers included any drug which had depression "listed" as a complication. Drug companies list as many adverse effects as they can, because it protects them against litigation, thus they list adverse effects which may have been insignificant in the drug's approval.
Second, this study has a major problem with "reverse causation." patients with depression utilize healthcare, including medications, at a higher rate than the non-depressed. For example, they are more likely to have pain and therefor take ibuprofen. This would falsely suggest that ibuprofen causes depression.
The reason patients end up on so many medications is complex: Drugs are improving, and some work very well. It is not unusual to use three separate drugs to treat high blood pressure. Also, patients want medication, so we are under pressure to provide them. Many of the conditions I see are directly related to poor lifestyle, but not many of my patients are receptive to the idea that they should loose 10 pounds, and exercise three times a week. They want a pill.
Widespread use of ibuprofen is not causing an increase in suicide!
106
I agree and tend to think that since suicide is becoming more common, we must blame depression on something other than poverty, social isolation, chronic unrelieved pain, work stress and of course genetics. These factors are probably more likely to contribute to depression than Rx. or over the counter drugs do.
8
You're "lucky" if there is but one identifiable cause for depression, Fred. It would more likely be the conditions you mention with the drugs thrown on top as a kind of accelerant. I believe what the article is referring to is depression suffered by people taking prescription drugs who have no other reason for it. I experienced this while taking Ticagrelor: short bursts of depression coming out of nowhere. It was quite noticeable: I'd be going out to ride my bike, for instance, and a strong pressure would hit me telling me to not go outside, even get back in bed. This stopped when I stopped taking it.
2
Ibuprofen may be more problematic than you think.
https://www.ncbi.nlm.nih.gov/pubmed/1540135
Without folate, you have a risk of low B12. With low B12, impaired serotonin receptors, diminished cognition, etc.
Combine that with lower red meat consumption (a source of B12) and some alcohol (which can impair B12 metabolism), and you've got a great situation not for sadness, but for clinical depression and anxiety.
5
There is a logical next step in this research; Investigate how many suicide or attempted suicide victims were taking these drugs known to cause depression, and compare that number to the general non-suicidal population not taking these drugs.
5
We can't even investigate the link between guns and gun deaths in mass shootings. What makes you think Big Pharma would ever allow such research?
10
This article epitomizes what is wrong with "medical science" and with the grasping, amoral leadership elite in the United States.
"About 200 prescription drugs can cause depression, and the list includes common medications like proton pump inhibitors (P.P.I.s) used to treat acid reflux, beta-blockers used to treat high blood pressure, birth control pills and emergency contraceptives, anticonvulsants like gabapentin, corticosteroids like prednisone and even prescription-strength ibuprofen...the authors of the study were surprised at how many drugs were on the list."
So where's the "list"? In the article? No. In the main text of the article in JAMA (which the average reader would have to pay about $35 to view)? No. Rather it is in a "Supplement" to the article that is difficult to find. Yet, is not the list the key element in the discussion? Of course it is. But guess who is very reluctant to have you see that list? Drug companies. And they are in charge. This merits the Robert De Niro response. But anyone who expects any change anytime soon should add that expectation to the unknown drugs s/he takes that are already causing depression.
128
Most public libraries have subscriptions to scholarly journal databases, and even if they don't they are usually able to get access to specific articles through interlibrary cooperation. Pretty much all universities have those subscriptions, and anyone can walk into the libraries and access the subscriptions. One of the things that really needs changing is the willingness of the public to access quality information, even when it requires a bit of effort on their part.
4
I suspect the list was developed with a Federal grant, at least partially. That means your tax money paid for the list. As a taxpayer, you should be entitled to free and unhindered access to it, or any other information you as a taxpayer paid for. That could include vital nutritional, consumer or safety information. Yet politicians and Federal agencies regularly allow companies total access with license to sell to all others.
Physicians have known for years that many medications have depression as a potential side-effect.
Sadly, if someone just read The Times, it would have been easy to come to the view that the only medications that caused depression were antidepressants as it has run repeated articles on their doing so for at least the past 25 years and virtually nothing on any of the other drugs that do so.
3
Antidepressants CAUSING depression?
Any link to such a NYT article?
1
Anti -depressants do not CAUSE depression.
What they CAN do is ease profound depression to enough of an extent that the profoundly depressed person can actually motivate themselves to take action - commit suicide.
That is why advertisements for anti depression medication state - if you have suicidal thoughts after taking such and such medication - call your doctor.
That is why all patients on anti-depressants need to be constantly monitored by there doctors.
2
"all patients on anti-depressants need to be constantly monitored by their doctors." Wishful thinking. A doctor--even a psychiatrist-- usually prescribes the pills like candy and then forget about the patient as soon as they walk out of the office--and then it's on to the next patient.
Seems pretty clear to me that the underlying reason people need these drugs is likely the cause of increased depression rates. Was this controlled for in the study?
Decades long GERD, high blood pressure worries, heart rhythm problems (also beta-blockers) and chronic head aches or other pains (strong NSAIDs) are likely much more likely to result in anxiety and depression than the drugs themselves.
Yes, I'm a layman. But it seems to me the value of some studies are questionable.
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Reading this story can cause depression.
That is why you should take any medicine as a last resort, after all other methods fail and something is still affecting your health or quality of life in a major way.
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Yes it is alarming that our so called anti-depressants cause suicide. Remember when our vets really started up because of a so called anti-depressant? Did you note that once again the real drug dealers got to walk away with million$. Then there's our broken out dated mental health education which is 40 yrs behind the times and is part of the war on drugs therefor a threat to most patients. Also note that every time we increase help suicide rates go UP not down indicating that our current treatments are no good and made worse by the media willfully ignoring all of this.
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The pill popping culture is reinforced by all the advertisements touting medicines. The U.S. is the only country in the world that allows drug ads on TV. And, then we are bombarded at every turn with vitamin enriched food and drink while we remain among the sickest people in any industrialized nation. Take a pill, and if that doesn't help, take another, is the mindset of a lot of Americans.
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This has been evident by my mother, a non-college educated immigrant, for decades. A significant portion of America is on mind-altering drugs with the obvious crazy results. Americans seek a quick and easy pill for every problem, rather than doing the work necessary to address the problem. This is truly a sick society.
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If one reads carefully the published side effects, that come with prescription medications, one will find most published side effects, are all the same. Seems like the variety of those listed, are written by Lawyers to avoid lawsuits. If a person is at all prone to hypochondria, (very common), it is quite easy to find a side effect you think you have. As known, millions take protein pump inhibitors for life . New Blood pressure guidelines, (again reversed guideline's), will put another forty million, on a 3 drug cocktail for High Blood Pressure, where just a few years ago, readings requiring treatment were relaxed. Rule of thumb is, we never know much about a drug, until it has been on the market for 10 years.
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Dan Green--So why do these medications come with a long list of COMMON side-effects in the first place if at least the majority of those taking these drugs experience "copy-cat" side-effects? You would think they would not need to list most of the side-effects or even just mention them in passing if many people also have experienced these same side-effects. And these side-effects were probably already seen in strict trials. Again--why list them if only a few people have experienced them?
Btw, Hypochondria is NOT as common as some people think. Enough with patient bashing.
From my own experience please allow me to warn others when quitting smoking: the nicotine gum works great to stop smoking cigarettes but of course you are still getting the "ding" from nicotine. When you finally quit the gum be ready for months of mild depression. Your brain misses that nicotine "ding" and your own endorphins have been dormant since the nicotine was doing their job for them. This will pass and your endorphins will kick back in and life is beautiful (and smoke free) but it will be dark for while. If it gets bad waiting for this, rescue a dog and you will have to focus on that.
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Or a cat! Rescued animals save our lives as much or more than we save theirs.
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I began smoking at the age of 45 (don't ask). After five years I realized the need to quit - after hitting almost three packs a day.
Took me two tries - the second aided by nicotine gum.
Done in two weeks - no side effects, no craving, no depression. Nothing. Zilch. Nada.
My anecdotal 'evidence' kicks your anecdotal evidence's you know what.
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The doctor prescribing a dose
Don’t care that it makes me morose.
The reason I’m blue
Is these pills I chew
sends my bank account adios.
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Polypharmacy is a huge problem in the age of specialization. People with multiple conditions may see several providers, each prescribing medication. In addition, as people age the risks from taking many different medications at the same time increase because the body is less able to metabolize and excrete the drugs.
Another factor not mentioned in the article is the gut biome, which is compromised by use of antibiotics. Some neurotransmitter precursors are generated by a healthy digestive tract. There is so much we do not know about the way the body works, and throwing drugs at conditions originating from adverse effects of medications prescribed for other problems amplifies the confusion.
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Thanks for your very thoughtful post. Polypharmacy can be a real problem when you just see one doctor. It's amazing how little most physicians understand (or care to understand) about drug/drug interaction.
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How about common antacids, which suppress intrinsic factor, necessary to the production of folate, which is necessary for metabolizing B12, which is critical to combating depression and anxiety?
https://www.hsph.harvard.edu/nutritionsource/b-12-deficiency/
https://www.mayoclinic.org/diseases-conditions/depression/expert-answers...
Of course, there's little money in that. Better to dispense a bunch of pharmaceuticals.
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There are so many disconnects in medicine, especially the way it is practiced today.
There was an interesting British study that considered patient and doctor expectations for an office visit. The researchers found that a number of doctors believed that patients scheduled the appointment because they wanted a prescription, while patients were likely to say they didn't really want a prescription but wanted the doctor to listen to them and get some good advice.
Keep in mind also that the U.S. is only 1 of 2 countries that allows direct-to-consumer advertising of prescription drugs. Now ask why all the other countries do not permit drug companies to advertise their prescription drugs in the media to the public. Or if you are not sure why, ask your doctor.
Worse, drug companies have taken to lying to pitch their drugs to doctors--no better example than the opioid crisis, which is big here in Utah. Doctors testified that drug reps told them that these new opioid drugs had few or no side effects, unlike other pain killers, and that their patients would love them for prescribing these opioids.
Drug interaction effects, the overuse and abuse of prescription drugs, and a system that is rigged in favor of prescribing drugs and medicating to solve our problems. Think alternatives, and make drugs the last choice.
See: Steve Martin's old New Yorker piece "Side Effects":
https://www.newyorker.com/magazine/1998/04/13/side-effects
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A real question I have about potential side effects listed (operative word being potential) is this:
Are the hundreds of side effects real or are they listed by the drug manufacturer to protect them from liability in the event that consumers develop any of the symptoms/side effects? And how do we know?
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What makes me laugh is a catch-all phrase which is at the end of every very long list of possible side effects I've ever seen:
"This is not a complete list."
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Where is the specific list of medication types? To obtain a full text copy of the study you have to create a JAMA account, buy, or rent a copy of the report. I was expecting a list of specific medication that could be actionable. Pitty that information seems hidden behind a pay wall. Why are we making people jump through hoops to obtain this information?
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Harvard Health has published a monograph, "Understanding Depression" where in a table they list medications that cause changes in mood and MAY cause depression. The article states: "Researchers disagree as to whether a few of these drugs--such as birth control pills or propranolol (Beta blocker)--affect mood enough to be a significant factor". Sometimes the evidence may come from the FDA trials to prove the efficacy of a medication before its approval. Other times the evidence is anecdotal. Therefore, it is important to ascertain depression by tools used by psychiatrists to determine whether someone has major depression.
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Absolutely agree, c'mon New York Times, JAMA is not going to squawk about copyright if you list the drugs - SURELY.
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There's this option:
Create a free personal account to download free article
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America's medicine cabinet is over loaded and insane. And it is not the fault of "greedy big pharma" or any other scapegoat. It is the fault of you demanding a pill to treat life.
Are you "depressed"?
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I would think that as the number of co-morbidities increases for a patient, the likelihood of developing depression would also increase regardless of the medications taken. This is another article on correlation that doesn’t belong in a newspaper. Dr. Aaron Carroll is probably already writing a piece to talk people off the ledge.
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Dr. Aron is a breath of fresh air as they say. Seems common knowledge our society is over medicated. Seeing more than one Physician gets the ball rolling.
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This article is very interesting. While many of our drugs include many side effects, and while everyone reacts differently to each, I do believe there are too many FDA approved drugs with skewed clinical trials. Having worked for a pharmaceutical company, approval is painstaking but as one of my doctors once said, "pharmaceutical reps won't try to sell me a bad drug". Just like our food products that include too much fructose and antibiotics, our health and all the components within are not getting the needed scrutinization. Facts like Canada not allowing antibiotics in their milk products seem to be a wiser decision. It appears that there has been an increase in depression and "crazed" individuals, stressful situations in our lifestyle. The cause of these mental problems need to be studied, not covering up the symptoms with more drugs. Something in our lifestyle is influencing our everyday routine and not in a good way. The simple fact that high fructose and antibiotics were approved for the production of our foods appears to be bad decisions for all and a starting point to make changes.
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Agree . So so obvious concerning fructose. Antibiotics pumped into our cattle and fowl is probably not advisable as well.
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not drinking milk is even wiser than drinking milk uncontaminated by added growth hormones (some are naturally occurring) and antibiotics. Eating a healthier diet -- unprocessed, mostly to all plant based -- would go a long way to avoiding the "need" for most of these drugs. Estimates are the poor diet contributes to about 80% of current chronic conditions. That's SAD (Standard American Diet).
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That's factory farming for 'ya.
Medication - any medication - should be a last resort for treating many of our lifestyle conditions, after the patient has tried all forms of behavioral changes - diet, exercise, social activity, career change, etc. In the States we go for the cheapest, quickest fix. No more talk therapy. No more understanding adolescence and the need for active parenting. Nope. We take drugs. And big pharma/big vitamin is filling our airwaves pushing these things. And filling our 401ks with their profits. And we have primary care doctors writing the Rxs for everything with very little follow-up.
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Well said. Often occurred to me, Physicians however well trained, practice what they are taught, prescribe medications. Couple that with the brief time we get with them, and as the old saying goes. The pen is mightier than the sword. Oh wait, now they can hit a key on their I Pad, and a prescription will print, you pick up on the way out the door. I would hope more and more evidence based trials give guidelines, and Genetics become more included.
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I agree with you but ironically the talk therapy solution is more expensive. Many insurance policies will not cover this or is very restrictive, and require a co-pay per visit which adds up very quickly and becoming unaffordable. I personally can vow that exercise and a better diet, no processed foods and no fast food, can change one's health, weight, and yes, this isn't really addressed from physicians. Good comment.
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I assume that by "no more talk therapy" you're describing primary care physicians who prescribe, for example, obese patients medications for their diabetes and hypertension or bronchodilaters to smokers with lung disease instead of discussing lifestyle changes with them in any detail.
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I hope melatonin is included in this study. It has this effect on me and others, and college kids pop them all the time. It may be helpful for some people but for others it has serious depressive side effects. Many people take it and don’t connect it with how they’re feeling afterwards. I keep sounding the alarm but most people think it’s a harmless supplement rather than a powerful hormone.
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I suggest that the NYTimes invite those who take, or were forced to take, these drugs to speak on their own nightmares of trying to deal with drugs that tore apart their lives and minds.
And while we are at it, we need to reexamine the effects that drugs are having on young people, who are daily facing the threat of an active shooter in their school or church.
It isn't just depression that gets aggravated, it is also psychosis and confusion and despair, and when one combines that with the ready availability of firearms and teenage emotional storms...
If 100,000 kids take "antidepressants", or "antipsychotics", and if only 10% have reactions that make them a danger to themselves or others, that still amounts to 10,000 kids dangerously out of control.
Don't believe me? Do the research, from Kip Kinkel in Oregon to some of the latest shooters, antidepressants and other mind altering drugs were present.
And the danger is accelerating as more and more people are routinely dosed with these dangerous substances. Maybe what we need is less drugging of our fellow citizens, and a lot more listening.
Hugh Massengill, Eugene Oregon
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