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“In the past two years alone, the US Food and Drug Administration (FDA) has issued alerts concerning suicidal ideation linked to the drug varenicline (Chantix®) as well as to numerous antiepileptic drugs. Meanwhile, the antiobesity drug rimonabant (Accomplia®)—not yet available in the US—was given a vote of no confidence by an FDA advisory panel, owing in part to the drug’s association with suicidality. All this occurs against the backdrop of intense controversy surrounding newer antidepressants and their possible association with increased suicidal ideation in a small percentage of younger patients.
The notion of a “depressogenic” drug is hardly new to medical practitioners. More than a half century ago, Freis first reported on “mental depression” in association with the antihypertensive drug, reserpine. And in his classic, Anatomy of Melancholy (1621), the English scholar Robert Burton identified alcohol as one cause of melancholy. Indeed, if alcohol is considered a drug, the concept of drug-induced depression (DID) may be traced to antiquity: In the Old Testament, for example, we read: “Who has woe? Who has sorrow? …Those who tarry long over wine…” (Proverbs 23:29–30).
In our own time, numerous medications and classes of medications have been implicated in DID, sometimes called substance-induced depression or drug-related depression. DID has important medical, medicolegal, and commercial implications. Any physician who has observed steroid-related mood swings—either mania or depression—knows that DID can drastically affect a patient’s clinical course. For example, one of us (R.P.) reported a case in which a young woman appeared to develop persistent bipolar mood swings after a single course of corticosteroids for treatment of ulcerative colitis.”
Peer-reviewed journal article discussing drug-induced depression, what drugs are typically associated with DID, and how difficult it is to establish DID.
- General Medical Drugs Associated with Depression
- December 2008
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