A number of medications may precipitate clinical depression. These are important to identify, since changing the medication can often relieve the depression.


Drugs associated with depression:

(1) methyldopa

(2) reserpine

(3) guanethidine

(4) calcium channel blockers (verapamil, nifedipine, others)

(5) benzodiazepines or other sedative hypnotics

(6) corticosteroids

(7) estrogen

(8) progesterone

(9) tamoxifen

(10) anti-Parkinsonian agents (levodopa, others)

(11) narcotic analgesics

(12) propanolol or other beta blockers

(13) cimetidine

(14) clonidine

(15) hydralazine

(16) vinblastine

(17) vincristine

(18) dextropropoxyphene

(19) drug with a marked anticholinergic effect


Criteria for diagnosis:

(1) presence of clinical depression (sad mood or diminished interest or pleasure in most activities)

(2) taking a medication associated with depression

(3) onset of depression after starting the medication or after a change in a drug regimen

(4) reversal of depression after discontinuation of the implicated drug or change in drug regimen


Patients at increased risk:

(1) elderly patients

(2) patients taking multiple drugs


Differential diagnosis:

(1) ordinary depression

(2) depression secondary to a general medical condition


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