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.


METHODS
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.


CONCLUSIONS
The use of depressogenic medication is an independent and clinically relevant aetiological factor in MDD.
Dhondt
T
T
Van Foreest Centre for Old Age Psychiatry, Heiloo, The Netherlands.
Derksen
P
P
Hooijer
C
C
Van Heycop Ten Ham
B
B
Van Gent
P P
PP
Heeren
T
T
D000368:Aged; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index