Drug-Induced Depression

Abstract

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), drug-induced depression may be classified as an Organic Mood Syndrome, Depressed Type. Unfortunately, the DSM-III-R diagnostic criteria are not sufficiently precise for application in research, and studies of drug-induced depression have rarely utilised these criteria. Research concerned with drug-induced depression is characterised by a number of methodological complications. These include differing definitions of depression, including depression defined as a symptom, a syndrome, or by diagnostic criteria for a specific mental disorder. In addition, patients undergoing pharmacological treatments for medical illnesses are typically exposed to considerable psychosocial stress due to the suffering and disability associated with illness. These psychosocial factors may in themselves precipitate episodes of depression. Due to these complicating factors, sophisticated study designs are required to confirm an aetiological role for medications as risk factors for depression. Unfortunately, adequate studies have rarely been conducted, and much of the literature consists of case reports and clinical observations. Consequently, clinicians are frequently required to make clinical judgements about the aetiology of patients' depressive symptoms in the absence of definitive scientific information about the role of drugs. Nevertheless, a knowledge of the relevant literature will assist clinicians in making reasoned judgements about the aetiology, prevention and management of these disorders.

??-Blockers Drug Interactions of Clinical Significance

“…Firstly, reserpine, as well as the lipid-soluble P-blockers, have been associated with depression. [58] Secondly, the antihypertensive effect observed with the use of both P-blockade and reserpine may be severe. Thirdly, reserpine has been shown to upregulate Padrenergic receptors in the kidney, [59] and has been associated with supersensitivity in the heart to adrenergic agents unrelated to' a change in receptor affinity.l60] It is, therefore, possible that an upregulation in the number of p-receptors observed in the kidney is occurring in the heart and other tissues, which may enhance the sensitivity of patients pretreated with reserpine to the effects of ~-blockade.…”