Blood Pressure Meds Don’t Raise Risk of Depression
By Serena Gordon
Although previous research hinted there might be a connection between high blood pressure medications and depression, a new study of dozens of commonly used drugs found no such link.
In fact, the Danish researchers found the opposite — nine blood pressure drugs were associated with a lower risk of depression.
“It is possible that the mechanism involved in decreasing the risk of depression is the anti-inflammatory effect among these nine medications,” study author Dr. Lars Vedel Kessing said in a statement from the journal Hypertension, where the findings were published Aug. 24. He’s a professor of psychiatry at the Psychiatric Center Copenhagen and the University of Copenhagen in Denmark.
Kessing added that more study is needed. But the findings might help doctors when choosing medications to treat high blood pressure in patients who also have depression or a high risk of depression.
He also noted that the study wasn’t designed to prove a cause-and-effect relationship between the medications and a lower risk of depression.
The new study relied on a Danish population registry. The researchers included 5.4 million people in Denmark in 2005 and followed their health outcomes until December 2015.
During that time, nearly 3.75 million people were given a prescription for a high blood pressure medication. The four major classes of medications used to treat high blood pressure: angiotensin agents; calcium antagonists, beta blockers and diuretics.
Diuretics (commonly known as water pills) were the most commonly prescribed. More than 1.1 million people were given a prescription for a diuretic. Angiotensin agents (including ACE inhibitors and ARBs) were the second most commonly prescribed high blood pressure drugs, with just over a million prescriptions. Calcium antagonists were prescribed more than 830,000 times, followed by beta blockers with almost 780,000 prescriptions.
The researchers looked at 41 drugs within those four classes of medications. None were linked to an increased risk of depression.
In fact, a few medications in each class — nine drugs total — were associated with a lower risk of depression. All nine are approved for use in the United States.
Diuretics didn’t seem to impact depression risk.
Drugs that lowered depression risk included: enalapril (Vasotec), ramipril (Altace), amlopidine (Norvasc), verapamil (Verelan), verapamil combination drugs, propranolol (Inderal), atenolol (Tenormin), bisoprolol (Zebeta) and carvedilol (Coreg).
Dr. Nieca Goldberg, an American Heart Association volunteer expert, said this study’s scientific approach showed that “many drugs for high blood pressure are not causing depression, and a couple may be associated with lower rates of depression.
“Depression is very common, and these are very stressful times. People who are having symptoms of depression, whether they’re on high blood pressure medication or not — generally negative feelings about their well-being, difficulty getting out of bed, can’t get up and get out, not eating properly — need to speak to their health care provider,” Goldberg noted. “Before you try to blame a medication for the way you’re feeling, have someone evaluate you.”
Brittany LeMonda, a senior neuropsychologist at Lenox Hill Hospital in New York City, said it’s common for people with higher blood pressure or heart disease to also have depression. Sometimes medications can exacerbate depressive symptoms.
“These new findings suggest that certain [high blood pressure drugs] could actually help reduce symptoms of depression in certain individuals. Positive side effects from a drug used to treat another condition can be a significant benefit and even reduce the need for additional medications in the future,” she said.
LeMonda agreed that lowering inflammation may play a role in why these drugs seemed to reduce the risk of depression. “Reducing inflammation has positive effects on one’s physical and mental health and is an important mechanism for future research,” she said.