If you think a drug you're taking might be causing your depression, you may be right. Certain medications prescribed for various medical conditions do cause such feelings as sadness, despair, and discouragement. And those are feelings that are often associated with depression. Other medicines prescribed for medical problems can trigger mania (excessive elation and joy) that's usually associated with bipolar disorder.
Medications that cause mania or depression appear to alter brain chemicals in some way. And even though the drugs may be necessary to treat the condition, the side effect is hardly acceptable. As an example, Accutane, which is prescribed for the treatment of acne, has been found to also cause depression. So have oral contraceptives, high blood pressure drugs, and even statins that treat high cholesterol.
How Can I Avoid Drugs That Cause Depression or Mania?
The best way to avoid drugs that affect your mood is to know which medicines commonly cause depression and/or mania. Then talk to your doctor to see if any of the medicines you are taking are likely causing or contributing to mood symptoms, and if so, discuss whether a different medication may be an appropriate option. Your doctor should let you know up front which drugs might cause feelings of depression or mania and should evaluate whether mood symptoms are or are not likely related to medicines.
Drugs That Might Cause Mania (Excessive Elation)
The following drugs could cause symptoms of mania:
- Corticosteroids. This group of drugs decreases inflammation (swelling) and reduces the activity of the immune system (cells that fight infection). Examples include hydrocortisone, triamcinolone, prednisone, Flonase, Nasocort, Nasonex, Flovent, and Azmacort.
- Cyclosporine. This drug is used to suppress the immune system to prevent the rejection of transplanted organs.
- Dopar (levodopa). This medicine treats Parkinson's disease.
- Lioresal. This is a muscle relaxant and antispastic agent. It's often used to treat multiple sclerosis and spinal cord injuries.
- All antidepressants, including MAOIs (monoamine oxidase inhibitors, such as Parnate or Nardil), SSRIs (selective serotonin reuptake inhibitors such as Prozac, Lexapro and Paxil), SNRIs (serotonin/norepinephrine reuptake inhibitors, such as Effexor, Pristiq and Cymbalta), and tricyclic antidepressants (such Elavil or Pamelor).
- Ritalin or amphetamine. These are stimulant drugs used to treat attention deficit hyperactivity disorder (ADHD).
- Synthroid. This drug is commonly prescribed as a thyroid hormone replacement.
- Trihexyphenidyl (Artane). This medicine is used to treat Parkinson's disease.
- Yohimbine. This drug treats male impotence.
Drugs That May Cause Depression
The following drugs have been reported to cause depression in some patients. Elderly people are particularly at risk.
- Accutane: This drug treats severe acne.
- Antabuse: This medicine is used to treat alcoholism.
- Anticonvulsants: Anticonvulsants are used to control epileptic seizures, examples include Celontin and Zarontin.
- Barbiturates: These are a group of central nervous system depressants that slow down brain function. These medicines have been used to treat anxiety and to prevent epileptic seizures. They are commonly abused; examples are phenobarbital and secobarbital.
- Benzodiazepines: This group of central nervous system depressants is often used to treat anxiety and insomnia and to relax muscles; examples include Ativan, Dalmane, Halcion, Klonopin, Librium, Valium, and Xanax.
- Beta-adrenergic blockers -- Also known as beta-blockers, these medicines are used in the treatment of various heart problems, including high blood pressure, heart failure, chest pain caused by angina, and certain abnormal heart rhythms. They may also be used to treat migraine headaches; examples include Lopressor, Tenormin and Coreg.
- Bromocriptine (Parlodel): This is a medicine used to treat Parkinson's disease.
- Calcium-channel blockers: This group of medicines slows the heart rate and relaxes blood vessels. Calcium channel blockers are used to treat high blood pressure, chest pain, congestive heart failure, and certain abnormal heart rhythms, examples include Calan, Cardizem, Tiazac, and Procardia.
- Estrogens: This class of female hormones is often used in hormone replacement therapy (HRT) to treat menopause symptoms and to prevent or treat osteoporosis; examples include Premarin and Prempro.
- Fluoroquinolone antibiotics: Examples of these drugs include Cipro and Floxin.
- Interferon alfa: This drug is used to treat certain cancers as well as hepatitis B and C.
- Norplant: This is a medicine used for birth control.
- Opioids: This group of narcotics is used to relieve moderate to severe pain. These drugs have a high potential for abuse and addiction; examples include codeine, morphine, Demerol, Percodan, and OxyContin.
- Statins: These medicines are used to lower cholesterol, protect against damage from coronary artery disease, and prevent heart attacks; examples include Mevacor, Zocor, Pravachol, Lescol, and Lipitor.
- Zovirax: Doctors prescribe this drug to treat shingles and herpes.
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What Should I Do If My Medicine Causes Depression or Mania?
When a medicine produces symptoms of mania or depression, your doctor may recommend discontinuing the drug or reducing the dosage (if possible). If this is not possible, your doctor may treat the manic or depressive symptoms with other drugs.
Should I Stop Taking a Drug If It Causes Depression or Mania?
If you do experience depression or mania while taking one of these medications or any other, call your doctor immediately. Do not stop taking the medicine unless directed to do so by your doctor. In all cases, the risk of side effects must be balanced against the risk and discomfort of not treating the disease.
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Related Disease Conditions
Mental Illness in Children
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
National Institute of Mental Health: "What is Depression?"
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.
Fieve, R. Bipolar II, Rodale Books, 2006.
Reviewed by Joseph Goldberg, MD on July 24, 2012
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