Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States

• Published in: JAMA : the journal of the American Medical Association 2018-06, Vol.319 (22), p.2289-2298
• Main Authors: Qato, Dima Mazen, Ozenberger, Katharine, Olfson, Mark
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Antidepressants; Cross-Sectional Studies; Depression - chemically induced; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Hypertension; Male; Mental depression; Middle Aged; Nutrition; Nutrition Surveys; Original Investigation; Polls & surveys; Prescription drugs; Prescription Drugs - adverse effects; Prescription Drugs - therapeutic use; Regression analysis; Side effects; Surveys and Questionnaires; United States; Young Adult
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.2018.6741

IMPORTANCE: Prescription medications are increasingly used among adults in the United States and many have a potential for causing depression. OBJECTIVES: To characterize use of prescription medications with depression as a potential adverse effect and to assess associations between their use and concurrent depression. DESIGN, SETTING, AND PARTICIPANTS: Five 2-year cycles (2005-2006 through 2013-2014) of the National Health and Nutrition Examination Survey, representative cross-sectional surveys of US adults aged 18 years or older, were analyzed for use of medications with depression as a potential adverse effect. Multivariable logistic regression examined associations between use of these medications and concurrent depression. Analyses were performed among adults overall, excluding antidepressant users, and among adults treated with antidepressants and with hypertension. EXPOSURES: Prescription medications with depression as a potential adverse effect (listed in Micromedex). MAIN OUTCOMES AND MEASURES: Prevalence of any use and concurrent use of medications with a potential to cause depression and prevalence of depression (PHQ-9 score ≥10). RESULTS: The study included 26 192 adults (mean age, 46.2 years [95% CI, 45.6-46.7]; women, 51.1%) and 7.6% (95% CI, 7.1%-8.2%) reported depression. The overall estimated prevalence of use of medications with depression as an adverse effect was 37.2%, increasing from 35.0% (95% CI, 32.2%-37.9%) in the cycle years 2005 and 2006 to 38.4% (95% CI, 36.5%-40.3%) in 2013 and 2014 (P for trend = .03). An estimated 6.9% (95% CI, 6.2%-7.6%) reported use of 3 or more concurrent medications with a potential for depression as an adverse effect in 2005 and 2006 and 9.5% (95% CI, 8.4%-10.7%) reported such use in 2013 and 2014 (P for trend = .001). In adjusted analyses excluding users of antidepressants, the number of medications used with depression as possible adverse effects was associated with increased prevalence of concurrent depression. The estimated prevalence of depression was 15% for those reporting use of 3 or more medications with depression as an adverse effect vs 4.7% for those not using such medications (difference, 10.7% [95% CI, 7.2%-14.1%]). These patterns persisted in analyses restricted to adults treated with antidepressants, among hypertensive adults, and after excluding users of any psychotropic medication. CONCLUSIONS AND RELEVANCE: In this cross-sectional survey study, use of prescription medications that have