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Drug-induced depressive disorder
Other Resources UpToDate PubMed

Drug-induced depressive disorder

Contributors: Shea A. Nagle MPH, Abhijeet Waghray MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Substance- or medication-induced depressive disorder is characterized by marked mood changes from a person's baseline mood associated with the person's exposure to a substance or medication. Onset of symptoms occurs during or within 1 month of a patient initiating use of a substance or medication. Depression persisting past a drug withdrawal period is also considered substance- / medication-induced depressive disorder. Duration of symptoms depends on the particular drug, dose, half-life, and duration of use before onset of symptoms.

The estimated lifetime prevalence of drug-induced depression is 0.26%. People with drug-induced depression are more likely to report a family history of substance use, antisocial behavior, and stressful life events. Compared to individuals with major depressive disorder, people with drug-induced depression are more likely to report feelings of worthlessness, sleep pattern changes, and suicidal ideation than depressed mood. Type of medication and dose affect the likelihood of a patient developing depressive symptoms.

Substances and medications that have been shown to induce depressive symptoms include, but are not limited to, the following:
  • Alcohol
  • Stimulants (eg, cocaine)
  • Cardiovascular agents (clonidine, guanethidine, methyldopa, reserpine, beta blockers)
  • Dermatologic agents (isotretinoin)
  • Antidepressants
  • Antipsychotics
  • Anticonvulsants (levetiracetam)
  • Antimigraine medications (triptans)
  • Hormonal agents (corticosteroids, oral contraceptives, gonadotropin-releasing hormone agonists, tamoxifen)
  • Varenicline
  • Immunological agents (interferons)
  • Levodopa
Patients with this disorder may have an increased risk of various general medical conditions.

Codes

ICD10CM:
F32.89 – Other specified depressive episodes

SNOMEDCT:
191495003 – Drug-induced depressive state

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Symptoms should resolve relatively soon after discontinuation of the causative agent (days to weeks). Symptoms lasting longer than 4 weeks should raise the possibility of alternative diagnoses, such as major depressive disorder.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:06/15/2020
Last Updated:09/17/2020
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Drug-induced depressive disorder
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Drug-induced depressive disorder : Sleep disturbance, Depressed mood, Suicidal thoughts
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