Taking charge of your health by treating an issue like high blood pressure, acid reflux, or allergies is supposed to make you feel better, not worse. But some people on a new med regimen are suddenly engulfed in waves of sadness and anger, or strangely indifferent toward things they used to love (e.g., you give no shits about T. Swift’s new album despite being a Swiftie since her ringlet days).
What you’re feeling could be symptoms of depression or anxiety, and whether they’ve now spiked for no apparent reason or this is your first time experiencing them, the culprit may be hiding inside your bathroom, right above your sink.
A whole list of prescription medications feature depression or even suicidal thoughts as potential side effects, and—little known fact—most are common drugs that have nothing to do with alleviating mental health conditions.
MENTAL NOTE: If you are having suicidal thoughts or experiencing a mental health crisis, text or call 988, the Suicide & Crisis Lifeline, any time day or night to speak with a trained counselor.
The numbers are kinda shocking. More than 37 percent of people taking prescription medications are on a drug that lists depression as an adverse side effect, according to a study published in the journal JAMA.
No wonder you feel blindsided: Out-of-nowhere symptoms can be unsettling, and most of us don’t assume the medicine we’re taking to help with one issue could be causing another. That’s why connecting the two can be such a crucial step, says Michelle Ogunwole, M.D., internal medicine specialist and research fellow at the Johns Hopkins University School of Medicine.
The biggest Rx culprits?
- Acid reflux: omeprazole, esomeprazole, ranitidine, famotidine
- Allergies: montelukast, cetirizine
- Birth control pills and hormone therapy
- Blood pressure: atenolol, metoprolol, enalapril, quinapril
- Pain: cyclobenzaprine, hydrocodone, tramadol
- Antiseizure and nerve pain: gabapentin, topiramate, lamotrigine
Of course, not everyone who takes these meds will become depressed. But if you started on one of these drugs and things just don’t feel right—or your existing depression has deepened—it’s time to make a change.
When Prescriptions Collide
In some cases, a single medication may not be the problem. That JAMA study above? Many of that 37 percent of people were on three or more meds. It’s possible, says Dr. Ogunwole, that multiple meds could be interacting with each other.
“Sometimes, you’re prescribed a medication to address the side effects of another medication,” she says. “This can be a helpful combination if it works well, but it can also set off what’s known as a prescription cascade, which gets very complicated.”
Say, for example, you just had surgery and your doc calls in an opioid for the pain. But that makes you constipated, so you get a prescription for a drug specifically designed for opioid-related constipation. Then that drug causes insomnia, which is strongly linked to depression, so you’re put on an antidepressant and another pill to help you fall asleep. Those two come with their own potential side effects, and the domino effect begins.
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“Prescription cascades are, unfortunately, very common since the point is to alleviate symptoms in the short term,” says Dr. Ogunwole. “But if you’re continuing to struggle with new issues all the time, particularly emotional difficulties, you should take a step back and figure out what you actually need to be taking.”
4 Steps to Stop the Cascade
Here are some common-sense steps to take if you think your meds may be causing problems.
Grab a pen and paper. Or your pointer finger and your Notes app. Keep track of when your symptoms started and how they’ve progressed over time to see how the side effects sync up with the time you took that first pill.
Read labels. Research the side effects of all your prescription meds, and be sure to get a rundown of potential negatives before starting anything new. All that paperwork that comes with an Rx? Stop shredding it before perusing it! It’s your best starting point to understand what’s happening to you.
Talk to the prescribing doctor. Sucks that this is still true in 2022, but some people are hesitant to mention feelings of depression or anxiety to their health provider for fear of stigma—especially if it’s a primary care doc, versus a mental health specialist, who seems like the dismissive type.
If you’re worried, think of these feelings as exactly what they are: side effects, says Dr. Ogunwole. If you were having a physical reaction to a medication, such as stomach upset or headache, you’d mention it, right? Especially if it was interfering with your everyday activities. Depression and other emotional changes are no different—mental and physical health are inextricably connected.
Call your pharmacist. Not getting all the deets? Pharmacists are often more accessible than doctors, and could have the info you need.
“It’s our job to know an extensive amount of information about the medications we dispense, and also how these drugs might be interacting with each other,” says Danielle Plummer, PharmD., who runs her own consulting firm, HG Pharmacist. “If you’re experiencing discomfort in any way, your pharmacist may be able to suggest an alternative medication with the same mechanism of action that is not prone to those effects.”
At the least, said pharmacist can help you take a deeper look at your medications and might recommend ways to cut down on how many you’re taking, which could help alleviate side effects.
But—and this is a big one—any intel from your pharmacist should be used to inform a convo with your doctor, not as an action plan. Never stop medication you’ve been prescribed unless your doc tells you exactly how and why to do so (ignoring this can lead to a world of potentially bad effects). Got it? Good. You’re on your way to figuring out which meds might be messing with your head.