Diseases, Drugs and Nutritional Deficiencies that increase Depression risk

   Diseases, Drugs and Nutritional Deficiencies that increase Depression risk

     Although depression is a complex disease, research and other methods of learning about it have uncovered some things that can increase the chances of developing it. This is crucial information to aid people in preventing it or helping to lessen it. Depression can worsen the outcomes of some diseases such as heart attacks, and impact the quality of life.

The following disorders can cause or contribute to depression:

  • Parkinson’s disease, stroke, normal pressure hydrocephalus, dementia
  • Coronary artery disease, heart failure, TB, viral pneumonia, a high calcium level, low sodium or low potassium level
  • Diabetes, hypothyroidism, hyperthyroidism, cancer – especially GI or pancreatic
  • Hypoglycemia, hyperglycemia, liver or kidney disease, adrenal disorders
  • Rheumatoid arthritis, hip fracture, hepatitis, urinary tract infections
  • Chronic pain – and depression can increase pain
  • Stressors alone don’t contribute to the risk for depression but combined with a lack of social support can contribute to it.

There are also some medications that can cause depression or at least increase the risk of it developing. Those taking such medications should consult their health care provider if they suspect they have depression. Here are some of the medications that have been linked to depression:

Opioids and opiates including hydrocodone, barbiturates, benzodiazepines for anxiety

Indomethacin, beta blockers, digitalis, methyldopa, levodopa for Parkinson’s disease

Alcohol – those over age 65 are particularly sensitive to the adverse effects of alcohol including depression because of decreased breakdown of it

Cimetidine (for ulcers), estrogen, some chemotherapy agents, and corticosteroids such as prednisone

A lack of certain nutrients has also been associated with an increased risk of depression. Folate – a B vitamin, vitamin B12, iron, and vitamin D deficiencies have all been found to increase the risk of depression. And those with depression are more apt to not eat properly including not getting all the nutrients they need.

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Medications that can increase the risk of Pneumonia

Medications that can increase the chance of getting Pneumonia

While colds usually spread easily from person to person, the germs that cause pneumonia often are found in a dormant state in people and the lung infection doesn’t develop until the immune system is weakened and/or stomach contents backs up into the throat and into the airway. Germs in that fluid can thus get into the air sacs and start an infection there. As with any foreign invader, the pathogens (germs) are detected by the body and the inflammatory process starts. Part of inflammation includes the production of an exudate, a fluid with white blood cells and debris. This exudate fills some of the air sacs and decreases the surface area where oxygen can be absorbed and carbon dioxide eliminated. The lack of oxygen makes people feel weak and short of breath. If severe, it can kill the person.

The pneumonia vaccines can decrease the chances of getting severe, invasive (spreads throughout the body) pneumonia, but it doesn’t always prevent it. In “Use of Opioids or Benzodiazepines and risk of pneumonia in Older Adults:  A Population-based Case-Controlled Study” by S. Dublin, et al (Journal of the American Gerontological Society, 2011; 59: 1899-1907) over 90% of the people who gotten pneumonia had received the vaccine. Although the vaccine can help protect, clearly much more must be done to decrease pneumonia risk.

Because some medications increase the risk of pneumonia, this under-rated topic was selected by this author. It came to my attention after listening to “Pneumonia Diagnosis” by Willian Sonnenberg (FP Audio Digest 452, January, 2017, by the American Academy of Family Physicians). The drug classes implicated:

  • Proton Pump Inhibitors, medications used to treat ulcers and GERD (gastroesophageal reflux disease), increase stomach content pH so fewer germs that cause pneumonia are killed. These drugs have only been implicated in strep pneumoniae as a cause of pneumonia
  • Drugs with anticholinergic effects – some of those for urge incontinence, older antihistamines, and certain tricyclic antidepressants (TCAs) can increase pneumonia risk
  • Inhaled corticosteroids (used for asthma and COPD) may increase the risk up to 69%
  • Benzodiazepines, used for anxiety and sleep, could also increase pneumonia risk
  • In the Dublin article, the research didn’t confirm the link with benzodiazepines and pneumonia but did find that some opioids can make pneumonia more likely to develop.
  • Morphine, codeine and fentanyl were found to suppress some aspects of the immune and inflammatory response. This effect was particularly strong the first few weeks of use.
  • Use of benzodiazepines were associated with an increased chance of infection in the critically ill, increase the chance of community acquired pneumonia and increase the 30-day mortality following pneumonia per an on-line pharmacology journal (Formulary.journal.com for January, 2013 based on an article on such in the medical journal Thorax).

 

This article is not intended to replace your health care provider. The intent is to make important information about medications available.