by Kelly Brogan MD Team
When you go to the doctor for any kind of discomfort with any kind of diagnosis, chances are that the doctor will write out a slip of paper and send you to the pharmacy. Every illness, every injury, every bodily inconvenience has some kind of corresponding medication for us to take. So that’s what we’ve done for the greater part of the last century. It’s tempting to think that we can be “fixed” by medication because it’s quick and easy. That’s why the United States pharmaceutical market was valued around 446 billion U.S. dollars in 2016 alone.
But the truth is that our bodies are more complex than we’ve been taught, and more importantly, we know much less than we think we do. Only recently have we started to understand how connected the gut, brain, hormones, and immune systems are. So it’s not a huge surprise that we think of our bodies as machines—that we can feed them some chemicals and they’ll run smoothly again like a car that just got an oil change.
The severity of consequences that result from thinking this way hasn’t really settled into the public consciousness yet, but a June 2018 study published in the Journal of the American Medical Association explores that very question:
What does this society-wide reliance on prescription drugs really cost us?
Apparently, often times, our wellness.
More Than 200 Commonly Used Prescription Drugs Have Depression as a Potential Side Effect
In the aforementioned study, researchers analysed the medication use patterns of 26,192 adults between 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey.
The research discovered that more than 200 commonly used prescription drugs have depression or suicide listed as potential side effects. The drugs on that list run the full gamut across antidepressants, blood pressure drugs, allergy medications, hormones and more.
A short and incomprehensive summary of the study’s offending drugs was compiled by the Washington Post and they include (and are certainly not limited to):
1. Beta blockers and angiotensin-converting-enzyme inhibitors (blood pressure drugs): metoprolol, atenolol, enalapril and quinapril.
2. Antidepressants: sertraline (Zoloft and generic), citalopram (Celexa and generic), bupropion (Wellbutrin and generic) and amitriptyline.
3. Anti-anxiety drugs: alprazolam (Xanax and generic), clonazepam (Klonopin and generic), diazepam (Valium and generic), and lorazepam (Ativan and generic), as well as the sedative zolpidem (Ambien and generic).
4. Opioids: hydrocodone combination meds (Lorcet, Norco, Vicodin, generic and more) and tramadol (ConZip).
5. Corticosteroids: prednisone and others.
6. Over-the-counter proton-pump inhibitors: omeprazole (Prilosec, Zegerid and generic) and esomeprazole (Nexium and generic), as well as the antacids ranitidine (Zantac and generic) and famotidine (Pepcid and generic).
7. Allergy and asthma medications: over-the-counter cetirizine (Zyrtec and generic) and the prescription drug montelukast (Singulair).
8. Anticonvulsants: gabapentin (Neurontin and generic) and topiramate (Topamax and generic).
9. Hormones: estradiol (Delestrogen, Elestrin, EstroGel and generic) and finasteride (Proscar, Propecia and generic).
As a matter of fact, the study found that the more drugs people took, the more likely they were to have depression. While about 7 percent of those taking one such drug were depressed, 15.3 percent of the patients taking at least three were depressed. Additionally, the study showed that one-third of US adults may unknowingly use medications that can cause depression.
The most alarming thing is that even your doctor who may have prescribed the drugs to you might not know about these side effects.
In an interview with Science Daily, Mark Olfson, one of the study researchers who is a professor of psychiatry and epidemiology at the Columbia University Irving Medical Center in New York said, “Many physicians may not be aware that several commonly prescribed medications are associated with an increased risk of this disorder.”
Are prescription medications really worth it?
This June 2018 study analysed more data than other previous studies have, but really, science has known that common prescription drugs cause depression for a while. Are we really that surprised that so many medications, all researched and developed under a one-size-fits-all assumption that all medications will work the same for everyone, are wreaking havoc on our unique bodies?
For example, depression has been consistently associated with interferon α treatment of hepatitis C—45% to 60% of treated patients developed mild to moderate depression and 15% to 40% of treated patients developed moderate to severe depression 15% to 40%. Other studies have linked hormonal contraceptives, β-blockers, and more drugs to depression.
The June 2018 study doesn’t detail exactly how these listed drugs can lead to depression, and there are too many for us to explore the mechanics of each one, but we might be able to get a general sense by understanding depression as a syndrome of “evolutionary mismatch.”
Think about it. Depression is our body telling us that something about our lifestyle isn’t working right. It’s our immune system yelling at us, saying our evolutionarily-unprecedented environment is out of sync with our optimal health. It’s our immune systems telling us that our lifestyle decisions—or maybe the pharmaceutical products we’re putting in our bodies— are really stressing it out.
And when our immune systems get stressed, inflammation can become chronic leading to the symptoms of depression.
Even antidepressants, which are supposed to “cure” us of depression, still come with so many problems attached. Recent studies have also uncovered antidepressant tachyphylaxis, or the loss of antidepressant “efficacy” over time. Basically, people on antidepressants lose the initial drug effect over a time period that leaves them physically dependent so that they are rendered medicated, symptomatic, and unable to easily stop taking medication due to withdrawal symptoms. Other studies have found that antidepressant use also actually induces chronic depression, a phenomenon called tardive dysphoria.
So, the study authors are working on bringing more awareness to the fact that depression is a potential side effect to so many drugs, but the study results might just be a red flag that is signaling something even more fundamentally wrong with how we approach healing and our bodies. Why make louder warnings that prescription drugs might cause depression when we should be finding pharmaceutical-free alternatives?
There’s a lot about our bodies that we don’t fully understand, and it’s time to acknowledge a new biology. We can no longer participate in impersonal medicine, ignoring details of our lifestyle, environment, relationships, and trauma histories. We’re humans, and that means that our beliefs, our stressors, our diets, our exposures, our sense of meaning and purpose all play a role in how healthy we are. As science helps us understand more about the complexity of our health, maybe it’s time to turn to a more holistic, more empowered kind of lifestyle medicine to heal ourselves, side effect free.
Kelly Brogan MD Team