DÄ internationalArchive24/2015List of Drugs That Can Cause Depression
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As a neurologist working in a large hospital without a department of psychiatry, I am regularly asked questions about the treatment of depressive disorders when providing consultation services. Compared with reading through the current article (1), it is significantly more taxing to study a guideline of more than 250 pages or its summary with still more than 50 pages. I find the authors’ clear statement with regard to the diagnosis and stepwise therapy of chronic and treatment-resistant depression plausible and it will become a clear guiding principle.

Only the list of drugs that can cause depression was somewhat disappointing. Initially, I was enthusiastic about it as it addresses a common problem. When the Department of Internal Medicine calls me for a consultation, I am frequently confronted with patients taking ten different medicines and I am asked whether these are responsible for the patient’s depressive mood. This list, unfortunately, seems to have no sensible structure (item 1 would include items 2 to 4; are digitalis preparations no cardiac medications?) And there are mistakes (levodopamine is actually levodopa—by the way, it reportedly has an antidepressant effect, at least in patients with Parkinson’s disease; or is the substance blamed for the depression often associated Parkinson’s disease?). It would have been very helpful if the authors had highlighted substances from each of the various drug classes that have a comparatively low depression-promoting effect. In clinical practice, it is unfortunately unrealistic to simply discontinue the heart and antihypertensive medications. To compile such a table would have been much more difficult—from such an authoritative source, I would have wished to receive this kind of support.

Nevertheless, I am happy to add this article—especially in its electronic version—to my “consultation library“.

DOI: 10.3238/arztebl.2015.0420a

Dr. med. Stephan Kinze

Klinik für Neurologie, Unfallkrankenhaus Berlin

stephan.kinze@ukb.de

Conflict of interest statement
Dr. Kinze is a lecturer at the Institut für Verhaltenstherapie (IVT) GmbH in Lübben, Germany.

1.
Bschor T, Bauer M, Adli M: Chronic and treatment resistant depression —diagnosis and stepwise therapy. Dtsch Arztebl Int 2014; 111: 766–76 VOLLTEXT
1.Bschor T, Bauer M, Adli M: Chronic and treatment resistant depression —diagnosis and stepwise therapy. Dtsch Arztebl Int 2014; 111: 766–76 VOLLTEXT

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