title: Lower frequency of antidepressant use in patients on renin-angiotensin-aldosterone system modifying medications.
abstract: Both hypertension and depression are common disorders which may both involve components of the hypothalamic-pituitary-adrenal axis system and the Renin-Angiotensin-Aldosterone System (RAAS). These observations, coupled with growing evidence that RAAS-active drugs may have anti-depressant properties prompted us to study the frequency of anti-depressant medication usage in the patients receiving RAAS-active agents. A chart review was performed on 378 patients who were seen during a 3-month period in a primary care clinic and who were diagnosed with hypertension. Demographic information and data on the rates of co-administration of antihypertensive and anti-depressant medications was collected. Overall, 23.7% of the sample was on an antidepressant. 20% of the patients taking a RAAS-modifying medication were on an antidepressant, compared to 34% of those not taking a RAAS-modifying medication (Χ(2) = 8.88, P = 0.003). The patients taking a beta-blocker alone had the highest rate of antidepressant usage (40%). The use of RAAS-modifying medications was associated with an even lower rate of anti-depressant usage in males compared with females. It was also observed that the patients taking an additional diuretic had a significantly lower rate of antidepressant use (17.6%, Χ(2) = 5.81, P = 0.016) compared with the patients not taking a diuretic. The patients being treated with an ACE inhibitor or ARB showed significantly lower rates of antidepressant usage. The data is supportive of the hypothesis that these agents may possess anti-depressant effects.
authors.affiliation: Nasr Psychiatric Services, 2814 S Franklin St, Michigan City, IN 46360, USA. nasrpsych@sbcglobal.net
authors.forename: Suhayl J
authors.initials: SJ
authors.lastname: Nasr
authors.forename: John W
authors.initials: JW
authors.lastname: Crayton
authors.forename: Bikash
authors.initials: B
authors.lastname: Agarwal
authors.forename: Burdette
authors.initials: B
authors.lastname: Wendt
authors.forename: Rishi
authors.initials: R
authors.lastname: Kora
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects*
chemical_list: D000928:Antidepressive Agents; D000959:Antihypertensive Agents