Australia. In the seven-year period from 1990 to 1996, the Adverse Drug Reactions Advisory Committee has received 454 reports of depression as a suspected adverse reaction to therapeutic medicines. In 406 of these reports there was no evidence suggesting pre-existing depression.

For these 406 reports, ages ranged from 4 to 95 years (median: 50) and onset varied from one day to 9 months. A single drug was implicated in 92% of the reports and in 36 of these the association was considered probable because the symptoms recurred on rechallenge. Recovery following withdrawal of the suspected drug(s) was documented in more than 70% of the reports. Ten reports noted that the patient had been hospitalized because of depression. Suicide attempts were described in 19 of the reports and two fatal outcomes were documented. The drugs most commonly reported were:

Drug Reports Reports per million prescriptions

Prescribers should be aware of the possibility of drug-induced depression which can sometimes be severe. If the temporal relationship is suggestive, withdrawal of a possible precipitating drug should be tried before the initiation of antidepressants.

Reference: Australian Adverse Drug Reactions Bulletin 17(1): 3 (1998).