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Depression associated with cimetidine

R F Billings, S W Tang, V M Rakoff

    Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
    |June 1, 1981
    PubMed
    Summary
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    Cimetidine may cause depression in susceptible individuals by disrupting brain histamine receptor balance. Tricyclic antidepressants can alleviate this depression by restoring the H1 and H2 receptor equilibrium.

    Area of Science:

    • Neuroscience
    • Psychiatry
    • Pharmacology

    Background:

    • Cimetidine, a histamine H2 receptor antagonist, is widely prescribed for gastrointestinal issues.
    • Primary Affective Disorder (PAD) is a clinical diagnosis characterized by mood disturbances.

    Observation:

    • Twelve patients developed depression while taking cimetidine over three years.
    • The observed depression clinically resembled Primary Affective Disorder.
    • Two representative cases illustrate this association.

    Findings:

    • Cimetidine may precipitate depressive reactions in vulnerable individuals.
    • A potential mechanism involves cimetidine blocking central nervous system (CNS) H2 receptors, creating an H1/H2 imbalance.
    • This imbalance is hypothesized as an etiological factor for depression.

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    Implications:

    • Tricyclic antidepressants (TCAs) effectively treat cimetidine-induced depression.
    • TCAs, potent H1 receptor blockers with minimal H2 effects, may restore the H1/H2 balance.
    • This suggests a novel therapeutic approach for specific depressive states linked to histamine receptor modulation.