DEPRESSIVE SYMPTOMS ATTRIBUTABLE TO MEDICATION EXPOSURE IN A MEDICAL INPATIENT POPULATION

Objective: Exposure to certain drugs-angiotensin-converting enzyme inh ibitors, beta-blockers, calcium channel blockers, corticosteroids, H-2 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 r elated both to strength of association and to the frequency of exposur e to a risk factor, the PAR of depressive symptoms associated with the se drug exposures is potentially high. The objective of this study was to estimate the depressive symptoms population attributable risk perc ent (PAR%) in a medical inpatient population. Methods: A prospective c ohort design was used in this study. Nondepressed, nondrug-exposed sub jects (N = 178) were selected from a series of 369 newly admitted medi cal inpatients at the Calgary General Hospital. Eighty-six of these 17 8 subjects were prescribed one of the drugs in question, forming an ex posed cohort. The remaining subjects formed a nonexposed cohort. Depre ssive symptoms and associated psychosocial variables were measured in both subgroups during the hospital stay. Results: Seventeen of the 86 exposed subjects and 5 of the 92 nonexposed subjects developed inciden t depressive symptoms during their stay in hospital. The PAR% associat ed with drug exposure (56.0%) exceeded that associated with poverty (1 7.9%) or unemployment (21.7%). Conclusions: Drug exposures may have a sizeable impact on the incidence of depressive symptoms in medical inp atient populations.