America is in the midst of a crisis. It is not the food crisis, although we do happen to be quite large. It is not the global socio-political crisis, although we do happen to be quite disliked and it is not the debt crisis although we do happen to be quite, well, broke (nationally speaking). The crisis du jour is not a crisis that is happening all around us. The crisis of the moment is the crisis that is happening within us. And within us all. Or, at least, within more than a third of us (if a new study is to be believed). It’s the crisis of depression. Read: We happen to be quite miserable.
More than one-third of adults in the United States are on some form of a prescription pill. From hormones and contraception to blood pressure medication and heartburn tablets, prescriptions have become endemic in American society. And what’s worse, a new study finds that many of these drugs list depression as a side effect. In other words: Out with heartburn and in with heartache.
The Journal of the American Medical Association, which conducted this newest of studies on America’s relationship with prescription pills, contended that the phenomenon of polypharmacy — the state of using multiple drugs at one time — has risen in the United States. The elderly are particularly at risk due to their indispensable need of many medications that carry with them potential depressive side effects.
Interestingly, antidepressants were listed as having potential depressive side effects. But the link was sometimes ill-established, meaning that if you are being helped by a pill you should probably remain on it until a more solid linkage is established for this alleged correlation (or causation).
Professor Dima Qato
Dima Qato is an assistant professor at the University of Illinois at Chicago College of Pharmacy. Qato was the lead researcher for the study. In an interview with The Washington Post, Qato commented upon what she views to be a fervent attention to social factors surrounding depression and not enough of a focus on drug-induced depression symptoms.
“We know polypharmacy is growing, we know it is not always promoting good health and longevity in patients, and we know a lot of drugs have certain adverse effects — and one of them is depression and suicidal symptoms,” Qato said. “As a pharmacist, when a patient comes in and reports depressive symptoms, I just think it’s really important to think about what other medications they are on.”
The study was conducted by analyzing a detailed survey of thousands of American adults. The survey was taken every two years (between 2005 and 2014). During these surveys, these participants granted researchers access to, and full examination of, their medicine cabinets. They also disclosed what pills they had taken in the last month and were assessed for depressive symptoms. On average, 37 percent of U.S. adults take a prescription medication that can potentially lead to depression. Depression rates tripled when people took three or more medications with a side effect, compared to those taking no drugs with a depressive side-effect potentiality. And it held true even when antidepressant users were removed from the equation.
Professor Michael Steinman
Michael Steinman is a professor of medicine at the University of California at San Francisco. He pointed out to an interviewer from The Washington Post that knowledge has always been hazy in terms of these causal relationships in the medical arena. The haziness, however, does put a moral imperative upon doctors to consider the role of medications on patients who exhibit symptoms of depression.
“It should up the ante about having the conversation about whether a medication is really helpful,” Steinman said. “A lot of times, people stay on medications for a long time. It’s easier to continue than to stop them. It’s a reminder to always be thinking: does this person really need this medication?”
Warnings of all kinds abound about what not to do when taking certain medications — things like don’t eat certain types of food, operate heavy machinery or drink alcohol — but there is not enough of a dialogue being held in the United States about the dangers of these prescription drugs themselves (or, at least, the dangers of polypharmacy). It may be due to the fact that doctors themselves are unaware, which is an unnerving thought, indeed.
“Even if the same doctor is prescribing drugs, the fact is that it’s really difficult — there’s no software that tells a doctor, ‘your patient is on three drugs that predispose them or are associated potentially with depression or suicidal symptoms,’” Qato said.
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