Linking Medications and Mood: Could Your Prescription be Causing Depression or Mania?

Understanding the relationship between medications and mood disorders is important for anyone taking prescriptions. For some, treatments intended to alleviate physical issues can also introduce emotional challenges like depression or mania. Recognizing this connection empowers patients to have informed discussions with their healthcare providers, leading to improved mental health outcomes.

The Hidden Side Effects of Medications

When starting a new medication, many focus on its potential to treat their primary health problem. However, research indicates that certain medications can also influence mood in unexpected ways. For example, studies show that approximately 15% of patients on isotretinoin, a popular treatment for severe acne, report experiencing depressive symptoms. Similarly, oral contraceptives may cause mood swings in about 10% of users. Other medications like high blood pressure treatments and statins have also been linked to increased feelings of sadness or anxiety.

While most medications improve quality of life, some can affect brain chemistry and lead to unwanted emotional states. These effects can be particularly concerning for those already experiencing mood disorders.

Identifying Potential Culprits

To determine if a medication may be contributing to mood changes, awareness is key. People should familiarize themselves with the drugs linked to depressive or manic episodes. Here are a few common medications to be mindful of:

• Isotretinoin: Used for acne treatment; linked to depressive symptoms in some patients.

• Oral Contraceptives: Reported mood disturbances in about 10% of users.

• Corticosteroids: Associated with mood swings.

When you have a list of your current medications, discuss them with your doctor. Be clear about any emotional changes you're noticing. Your healthcare provider can evaluate whether your medications coincide with those known to affect mood and be transparent about all possible side effects.

Drugs That May Cause Depression

The following drugs have been reported to cause depression in some people. Elderly people are particularly at risk.

• Isotretinoin (Absorica , Amnesteem , Claravis, Sotret): This drug treats severe acne.

• Alcohol

• Anticonvulsants: Anticonvulsants are used to control epileptic seizures, examples include ethosuximide (Zarontin) and methsuximide (Celontin).

• 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 alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan), and triazolam (Halcion).

• 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 atenolol (Tenormin), carvedilol (Coreg), and metoprolol (Lopressor).

• 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 diltiazem (Cardizem, Tiazac), nifedipine (Procardia), and verapamil (Calan).

• Interferon alfa: This drug is used to treat certain cancers as well as hepatitis B and C.

• NuvaRing with ehinyl estradiol/etonogestrel: 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 spirin/oxycodone (Percodan), codeine, meperidine (Demerol), morphine, and oxycodone (OxyContin).

• Statins: These medicines are used to lower cholesterol, protect against damage from coronary artery disease, and prevent heart attacks; examples include atorvastatin (Lipitor), fluvastatin (Lescol), pravastatin (Pravachol), and simvastatin (Zocor).  

• Varenicline (Chantix): A medication prescribed for smoking cessation.

• Acyclovir (Zovirax): Doctors prescribe this drug to treat shingles and herpes.

Drugs That May Cause Mania (Excessive Elation)

Some medications are more commonly associated with manic symptoms. If you are taking any of the following, it's important to discuss potential risks with your doctor:

The following drugs could cause symptoms of mania. Even though the risk for some of these drugs might not be high, you should discuss the risk with your doctor if you take them:

• Corticosteroids. This group of drugs decreases inflammation (swelling) and reduces the activity of the immune system (cells that fight infection). Examples include Azmacort, Flovent, hydrocortisone, prednisone, and triamcinolone.

• Cyclosporine. This drug is used to suppress the immune system to prevent the rejection of transplanted organs.

• Carbidopa/levodopa (Duopa,  Rytary, Sinemet). These medicines treat Parkinson's disease.

• Baclofen intrathecal (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 phenelzine (Nardil) or tranylcypromine (Parnate); SSRIs (selective serotonin reuptake inhibitors such as escitalopram (Lexapro), fluoxetine (Prozac), and paroxetine (Paxil); SNRIs (serotonin/norepinephrine reuptake inhibitors, such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), venlafaxine (Effexor XR); and tricyclic antidepressants (such as nortriptyline (Pamelor).

• Methylphenidate (Ritalin) or amphetamine. These are stimulant drugs used to treat attention deficit hyperactivity disorder (ADHD).

• Levothyroxine (Levoxyl, Synthroid, Tirosint, Unithroid). This drug is commonly prescribed as a thyroid hormone replacement.

• Certain antibiotics, such as ciprofloxacin (Cipro) and gentamicin

• Antimalarial drugs, such as chloroquine and mefloquine

• Antineoplastic drugs that treat cancer such as 5-fluorouracil and ifosfamide

Understanding the Connection Between Mood and Medication

The link between medications and emotional health is complex and affected by various factors, including individual biology and pre-existing mood conditions. When mood disturbances occur due to medication, they may signal a serious interaction affecting neurotransmitters—chemical messengers that regulate emotions and mood. Significant disruptions can lead to unwanted feelings of mania or depression, a reality that impacts many patients.

Despite the essential role of medications in managing physical health, assessing the associated mood symptoms is crucial. Identifying whether a specific drug contributes to mood changes can lead to alternative treatment options that help reduce both physical and emotional distress.

What You Can Do: Advocating for Your Mental Health

If you suspect that a medication is influencing your mood, advocating for your mental health is vital. Here are practical steps to consider:

1. Keep a Mood Diary: Track your emotions and experiences while on medication. Note significant mood changes and their timing concerning medication adjustments.

   
   

2. Communicate with Your Doctor: Be honest about any mood shifts. Inform your healthcare provider about feelings of sadness, hopelessness, or unusual energy levels that align with your medication schedule.

   
   

3. Explore Alternatives: If a medication adversely affects your mood, talk to your doctor about possible alternative treatments with fewer mood-related side effects.

   
   

4. Monitor and Adjust: Sometimes, adjusting dosage rather than switching medications can be beneficial. Discuss this option with your healthcare provider.

   
   

Prioritizing Mental Health in Treatment Plans

Understanding the relationship between medications and mood is essential. Recognising that some prescriptions may unintentionally contribute to mood changes is a crucial step in prioritising mental wellness.

Through open dialogue with healthcare providers, individuals can advocate for sensible treatment plans that address both physical and emotional needs. By identifying which medications might cause mood disturbances and exploring suitable alternatives, patients can take control of their overall health.

Source: WebMD