Common Medications That Can Cause Depression

Medications are supposed to make you feel better, but they can also come with side effects or unwanted reactions. Some common side effects include drowsiness, dry mouth, or an upset stomach. Side effects can also be considered minor (e.g., runny nose) or major (e.g., liver damage). However, one serious, unexpected side effect of some medications can be depression.

It's important to note that depression can affect anyone with or without a family history of mental health problems. In other words, depression doesn't have to run in your family for you to experience the condition at any time—including after taking medications.

Here's what to know about commonly used medications with depression as a possible side effect—and what to do if you start experiencing depression.

The Association Between Medication and Depression

Consumers and healthcare providers may be unaware of this hidden risk. One JAMA study found that more than one-third of adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide.

Researchers found that more than 200 commonly used drugs have depression or suicide listed as potential side effects. But because many of these drugs—including hormonal contraceptives, blood pressure and heart medications, antacids, and painkillers—are prescribed for purposes unrelated to mental health, they worry that patients may never be warned about the increased risk.

No one knows exactly why certain drugs have this effect. "The medications may interfere with neurotransmitters in your brain like dopamine and serotonin, [and that] may affect mood changes," said Edmi Cortes Torres, MD, assistant professor of clinical psychiatry at the University of Miami Miller School of Medicine, who was not involved in the JAMA study.

That may be especially true when patients are prescribed more than one drug—which is happening more often than it used to.

Researchers looked at the medical records of more than 26,000 patients over 10 years, studying their use of those 200+ drugs with potential mood-altering side effects. About 15% of adults who used three or more medications at the same time experienced depression, compared with 9% of those who took two, 7% who took one, and 5% who took none.

In other words, the more medications you take with depression as a potential side effect, the higher your risk of experiencing depression while taking those drugs.

The researchers saw a similar pattern for drugs that listed suicide as a potential side effect. And those patterns remained, even after they excluded patients who were also taking medications prescribed for pre-existing anxiety or depression.

If you suspect you've developed depression due to a medication, contact a healthcare provider immediately. "The most important thing is to communicate with your doctor when you experience mood changes," said Dr. Cortes Torres. "We can manage it by reducing the dosing, by changing the medication or, when the medication is really necessary to treat the illness, by giving an antidepressant to treat depressive symptoms."

What Types of Medication Can Have Depression as a Side Effect?

Here are some commonly used drugs that are sometimes linked with depression. Talk to a healthcare provider if you're taking one of these and notice changes in your mood.

Beta-blockers

Beta-blockers such as metoprolol are widely prescribed to treat high blood pressure, but they're also used for chest pain, irregular heartbeat, migraine, tremors, and even glaucoma. Generally, beta-blockers are used long-term. Certain beta-blockers, particularly ones like propranolol, may be linked with depression with continued use.

But the jury is still out on whether beta-blockers directly cause depression. Researchers looked at 258 studies involving more than 50,000 people and found that beta-blockers did not predict depression.

Still, the researchers found beta-blockers associated with other health issues. Those issues included insomnia, dreaming, and sleep disorders may be more frequent in people taking beta-blockers. And insomnia has been noted to have a "strong association with depression."

So, while there might not be a direct link between beta-blocker use and depression, there may be an indirect one.

The good news is that there are alternatives. "[Beta-blockers have] gone a little out of favor as a standard treatment because there are newer things that may work better without [the risk of depression]," said Joshua Nathan, MD, board-certified psychiatrist at LifeStance Health in Vernon Hills, Illinois.

Corticosteroids

Steroids like prednisone are used to treat a surprising number of conditions, including autoimmune diseases like rheumatoid arthritis and lupus, as well as asthma, allergies, and even cancer. But they can come with a mental health downside.

"Chronic use is associated with a range of psychiatric problems," said Dr. Nathan. "It can cause depression, anxiety, psychosis—and I've seen all of those things."

Euphoria and mania seem more common with short-term use, while depression becomes more prominent with longer use, even if the doses aren't large.

If you have questions or concerns about taking corticosteroids, talk to a healthcare provider about your risk factors and medication alternatives.

Antibiotics

Some antibiotics have been linked with depression, notably levofloxacin and ciprofloxacin. Both belong to the family of antibiotics known as fluoroquinolones and are prescribed for bacterial infections.

Taking one course of medication in the penicillin group of antibiotics was associated with a 23% higher risk of depression. Two courses of penicillin took the risk up to 40%, and five or more courses involved a 56% higher risk.

A 2020 study helped explain why antibiotics might cause depression. Antibiotics kill bacteria, including the "good" bacteria in your gut, and messing with gut bacteria has been shown to cause depression—hence, the link.

Another reason to make sure you only take antibiotics when you need them: Overuse of antibiotics has also been shown to contribute to the spread of antibiotic-resistant bacteria.

Interferon

Interferon is associated with a significant risk of depression. The drug is used in the treatment of some cancers and viral infections, like hepatitis C, as well as other conditions. However, with the development and approval of several new direct-acting antivirals (DAA) against hepatitis C virus (HCV), interferon is no longer the standard treatment for hepatitis C virus.

If a healthcare provider feels interferon is the best course of treatment for your illness, antidepressants are sometimes used so you can continue the treatment. Pretreatment with selective serotonin reuptake inhibitors (SSRIs) can potentially lower the risk and severity of depression caused by interferon.

Anticonvulsants

Some reports have indicated that anticonvulsant (or anti-seizure) drugs like topiramate and gabapentin may contribute to depression.

One explanation is that these drugs suppress the central nervous system (CNS). "We know that medications that are central nervous system depressants may be associated with depression," said Dr. Cortes Torres.

Anticonvulsants are also sometimes used to treat other conditions, including bipolar disorder, pain from damaged nerves, and fibromyalgia. And other medications are also considered CNS depressants—like benzodiazepines, including the anti-anxiety meds Xanax and Valium. These, too, have been associated with depression.

Thankfully, "medication-induced depression goes away when you stop the medication, and there are usually other options," said Dr. Nathan.

Opioids

The addictive painkillers–responsible for one of the greatest public health crises in American history–also seem to increase the risk of depression.

Of the U.S. adults with an opioid use disorder (OUD), 62% had a co-occurring mental illness—and depression was noted to be one of the potential illnesses that might coincide with OUD.

Additionally, one study published in November 2020 noted that prolonged opioid use of 30 days or more "may saturate the opioid receptor system" to affect mood and increase the risk of developing treatment-resistant depression by more than 25%.

Hormonal Birth Control

Some research has found a potential link between hormonal birth control and depression or lower quality of life. Hormonal changes triggered by birth control, such as a decrease in testosterone or an increase in progesterone, may play a role.

However, it's important to keep in mind that birth control can affect each person differently when it comes to depression, as noted by the authors of a study published in 2021. Further, other studies haven't necessarily made the connection with hormonal contraception causing depression. For example, researchers determined that hormonal birth control does not cause depression.

And a study published in December 2017 found that hormonal birth control may actually protect people from depression later in life.

Birth control also helps regulate hormone levels. For some individuals—especially those with heavy periods or conditions like endometriosis—it may reduce physical and emotional symptoms associated with menstruation every month.

Heartburn Medications

Among the 200-plus medications cited in the 2019 JAMA study are two drugs commonly prescribed to treat heartburn: Antacids and proton-pump inhibitors (PPIs). Although depression isn't a common consequence of these drugs, some in these classes list it as a potential side effect.

Taking a PPI, like Prilosec (omeprazole) or Nexium (esomeprazole), can interfere with the body's ability to absorb vitamin B12, an essential nutrient that produces chemicals that affect mood and cognition. PPIs have been linked to depression in at least one study.

Antacids, available with a prescription and over the counter, are generally considered safe—but patients should still be aware of potential side effects, especially when they're taken frequently or in large quantities.

A Quick Review

Many medications have side effects, but one you may not expect to experience is depression. Depression can be a potential side effect of a number of commonly used medications, such as antibiotics, beta-blockers, and opioids.

With that in mind, it's important to communicate with a healthcare team about side effects related to depression. You'll want to talk to a healthcare provider if you suspect you have symptoms of depression, especially if the symptoms are worsening or if you are contemplating harming yourself. That way, they can help with treatment and alternative medication options.