Depressogenic medication as an aetiological factor in major depression: an analysis in a clinical population of depressed elderly people.

OBJECTIVE

To study the role of depressogenic medication in the aetiology of major depression in the elderly.

BACKGROUND

Depression can be caused, provoked or sustained by drugs prescribed for other reasons. The evidence for this statement is based on case-reports, not on investigations in relevant populations.

METHOD

In the geriatric wards of three Dutch psychiatric hospitals, 195 patients with a DSM-III-R diagnosis of major depression (MDD) were studied. In the first week after admission the following data were recorded: age, gender, personal psychiatric history, family psychiatric history, Montgomery-Asberg Depression Rating Scale, Mini-Mental State Examination, history of stroke, use of medication and number of different medications used. Subjects using depressogenic medication were contrasted with subjects not using depressogenic medication on all variables.

RESULTS

There was a significant negative relationship, adjusted for the other variables, between the use of depressogenic medication and a previous admission for depression. No other significant relationships between the use of depressogenic medication and aetiological variables were found. Patients with a first-time admission for MDD use depressogenic medication 2.44 times more often than patients with previous admissions for depression.

CONCLUSION

The use of depressogenic medication is an independent and clinically relevant aetiological factor in MDD.