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Antihypertensive medications and depression.

M H Beers1, L J Passman

  • 1Department of Medicine, University of California, Los Angeles.

Drugs
|December 1, 1990
PubMed
Summary

Certain antihypertensive medications can cause depression by affecting neurotransmitters. Diuretics, calcium channel blockers, and ACE inhibitors are safer choices for patients at risk of depression.

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Area of Science:

  • Pharmacology
  • Neuroscience
  • Psychiatry

Background:

  • The link between antihypertensive drugs and depression is recognized, with neurotransmitter roles in depression etiology now understood.
  • Biogenic amine depletion is a key factor in depression, and some antihypertensives interfere with this system.

Purpose of the Study:

  • To review the association between various antihypertensive medications and depression.
  • To identify antihypertensive drug classes with lower risks of inducing or worsening depression.

Main Methods:

  • Literature review and analysis of existing evidence on antihypertensive drugs and depression.
  • Categorization of antihypertensives based on their potential to cause depression.

Main Results:

  • Reserpine and alpha-methyldopa are strongly linked to inducing or worsening depression.
  • Beta-blockers have a less certain association with depression.
  • Guanethidine, clonidine, hydralazine, and prazosin have low reported risks.
  • Diuretics, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors show the lowest association with depression.

Conclusions:

  • Physicians must be aware of antihypertensives that pose a risk for depression.
  • Safer alternatives like diuretics, calcium channel blockers, and ACE inhibitors are recommended for at-risk patients.
  • Periodic depression screening is crucial for all patients on antihypertensive medication.

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