Millions of Brits could be at risk of drug-induced depression by taking heartburn pills and a range of other common routine medications.
Proton pump inhibitors (PPIs), a type of medicine that helps reduce stomach acid, are one of the most commonly taken medicines in Britain, with more than 74 million prescriptions in England alone in 2023.
But they are just one of a number of routine medications that could cause symptoms of depression among those who take them.
This is because PPIs, such as omeprazole and lansoprazole, can prevent the body from properly absorbing vitamin B12, a vital nutrient found in meat, fish, dairy, eggs and some fortified cereals. and that keeps the nervous system healthy.
Lack of it is a known cause of psychological problems which, according to the NHS, can range from “mild depression or anxiety to confusion and dementia”.
The leaflets that come with the medications also acknowledge the risk and urge people to contact their doctor if they begin to experience problems with memory, confusion or depression while taking them.
A small study, published in 2017 and based on about 350 older people, found that about one-sixth of depression cases could be attributed to PPI use.
“PPIs can block up to 80 per cent of stomach acid production,” Deborah Grayson, a pharmacist and expert on PPI medications, told MailOnline.
Millions of Brits could be at risk of drug-induced depression by taking heartburn pills and a range of other common routine medications. stock image
And he added: “This means that the amount of nutrients we can get from the food we have eaten is reduced.”
‘The body needs all of our nutrients to be able to create the ‘happy hormone’ serotonin, and if we don’t absorb them from our food, then the body cannot create the hormone.
It is this lack of serotonin that can cause depression and bad mood.
But PPIs aren’t the only commonly taken medication linked to depression risk.
Some types of antibiotics, medications given to fight bacterial infections, have also been linked to bad mood.
These links focus specifically on a class of antibiotics called fluoroquinolones, of which two notable drugs are levofloxacin and ciprofloxacin.
But PPIs aren’t the only commonly taken medication linked to depression risk. Some types of antibiotics, medications given to fight bacterial infections, have also been linked to bad mood. stock image
The risk of depression for both is recognized, with the NHS specifically stating that it can trigger low mood in around one in 100 people prescribed ciprofloxacin.
Scientists have suggested that the drugs could alter the community of good bacteria in the gut, which can influence the production of mood-affecting hormones in the brain, theoretically increasing the risk of depression.
Antibiotics kill all bacteria, both the bad pathogens they are meant to attack and, as collateral damage, the good ones in our gut.
That’s why some patients are recommended to take probiotics, supplements that contain samples of good bacteria, to help boost their microbiome after a course of antibiotics.
Antiseizure medications are another class of medications linked to depression risk.
Drugs such as topiramate and gabapentin, sold as Topamax and Neurontin respectively, prescribed about 700,000 times a month, are known to cause depression or mood swings in about one in 100 people who take them.
Experts suspect the drugs may be triggering depression because of the way they suppress electrical activity in the brain and nerves to help treat conditions such as epilepsy.
Steroids, prescribed around 70,000 times a month in England to treat a wide range of conditions, are another routine medication linked to depression.
Research has also found a link between the use of steroids, used to treat inflammatory conditions, and low mood.
Deborah Grayson, a pharmacist and PPI medication expert, said people should not stop taking the medication if they experience a side effect such as depression, but rather talk to their GP or pharmacist.
These medications, also called corticosteroids, are used to dampen inflammation in asthma, allergies, and arthritis.
Experts suspect that the medications could influence the way the brain responds chemically to stress and this could cause a variety of psychiatric problems, including depression.
Some studies have estimated that the risk of serious psychiatric problems from steroid medications is one in 20, although there is thought to be considerable variation depending on the dose and the type of mental health problem that arises.
NHS advice states that mental health problems linked to steroid tablets generally only occur when people take the drugs for more than three weeks.
Depression-related medications can be difficult to diagnose due to the inherent complexities of the condition.
Doctors should consider whether a medication is causing depression or whether a patient is suffering from it for a separate reason unrelated to their medication, such as problems in their personal life.
Grayson urged people not to stop taking medication when they experience a side effect such as depression, but to speak to their GP or pharmacist.
“A GP or pharmacist can intervene in some way, switch it to another medication or monitor B12 and folate levels, which are seen in depression, and find ways to compensate for what’s happening,” he said.
She added that it was important for people to seek help with depression in all circumstances, even if it was related to their medication.
“Often patients look at the pamphlet and notice that one of the side effects is depression and assume that because it’s written in the pamphlet, they should just ride it out, which is obviously not the appropriate course of action,” he said.
If you are feeling depressed and those symptoms have been constant for more than two weeks, the NHS recommends speaking to a GP about your symptoms.
It is particularly important to do this if your symptoms are not improving, if it is affecting your work or relationships, and if you have thought about suicide or self-harm.