Depressive symptoms attributable to medication exposure in a medical inpatient population

Exposure to certain drugs-angiotensin-converting enzyme inhibitors, beta-blockers, calcium channel blockers, corticosteroids. H2 blockers, and sedative hypnotics-may be associated with an increased risk of depression. These drugs are commonly used in inpatient medical therapeutics. Since population attributable risk (PAR) is generally related both to strength of association and to the frequency of exposure to a risk factor, the PAR of depressive symptoms associated with these drug exposures is potentially high. The objective of this study was to estimate the depressive symptoms population attributable risk percent (PAR%) in a medical inpatient population.

A prospective cohort design was used in this study. Nondepressed, nondrug-exposed subjects (N = 178) were selected from a series of 369 newly admitted medical inpatients at the Calgary General Hospital. Eighty-six of these 178 subjects were prescribed one of the drugs in question, forming an exposed cohort. The remaining subjects formed a nonexposed cohort. Depressive symptoms and associated psychosocial variables were measured in both subgroups during the hospital stay.

Seventeen of the 86 exposed subjects and 5 of the 92 nonexposed subjects developed incident depressive symptoms during their stay in hospital. The PAR% associated with drug exposure (56.0%) exceeded that associated with poverty (17.9%) or unemployment (21.7%).

Drug exposures may have a sizeable impact on the incidence of depressive symptoms in medical inpatient populations.