Depressogenic medication as an aetiological factor in major depression: Ananalysis in a clinical population of depressed elderly people

Objective. To study the role of depressogenic medication in the aetiology o f major depression in the elderly. Background. Depression can be caused, provoked or sustained by drugs prescr ibed for other reasons. The evidence for this statement is based on case-re ports, not on investigations in relevant populations. Method. In the geriatric wards of three Dutch psychiatric hospitals, 195 pa tients with a DSM-III-R diagnosis of major depression (MDD) were studied. I n the first week after admission the following data were recorded: age, gen der, personal psychiatric history, family psychiatric history, Montgomery-A sberg Depression Rating Scale, Mini-Mental State Examination, history of st roke, use of medication and number of different medications used. Subjects using depressogenic medication were contrasted with subjects not using depr essogenic medication on all variables. Results. There was a significant negative relationship, adjusted for the ot her variables, between the use of depressogenic medication and a previous a dmission for depression. No other significant relationships between the use of depressogenic medication and aetiological variables were found. Patient s with a first-time admission for MDD use depressogenic medication 2.44 tim es more often than patients with previous admissions for depression. Conclusion. The use of depressogenic medication is an independent and clini cally relevant aetiological factor in MDD. Copyright (C) 1999 John Wiley & Sons, Ltd.