Importance Prescription medications are increasingly used among adults in the United States and many have a potential for causing depression. Objectives To characterize use of prescription medications with depression as a potential adverse effect and to assess associations between their use and concurrent depression. Design, Setting, and Participants Five 2-year cycles (2005-2006 through 2013-2014) of the National Health and Nutrition Examination Survey, representative cross-sectional surveys of US adults aged 18 years or older, were analyzed for use of medications with depression as a potential adverse effect. Multivariable logistic regression examined associations between use of these medications and concurrent depression. Analyses were performed among adults overall, excluding antidepressant users, and among adults treated with antidepressants and with hypertension. Exposures Prescription medications with depression as a potential adverse effect (listed in Micromedex). Main Outcomes and Measures Prevalence of any use and concurrent use of medications with a potential to cause depression and prevalence of depression (PHQ-9 score ≥10). Results The study included 26 192 adults (mean age, 46.2 years [95% CI, 45.6-46.7]; women, 51.1%) and 7.6% (95% CI, 7.1%-8.2%) reported depression. The overall estimated prevalence of use of medications with depression as an adverse effect was 37.2%, increasing from 35.0% (95% CI, 32.2%-37.9%) in the cycle years 2005 and 2006 to 38.4% (95% CI, 36.5%-40.3%) in 2013 and 2014 (P for trend = .03). An estimated 6.9% (95% CI, 6.2%-7.6%) reported use of 3 or more concurrent medications with a potential for depression as an adverse effect in 2005 and 2006 and 9.5% (95% CI, 8.4%-10.7%) reported such use in 2013 and 2014 (P for trend = .001). In adjusted analyses excluding users of antidepressants, the number of medications used with depression as possible adverse effects was associated with increased prevalence of concurrent depression. The estimated prevalence of depression was 15% for those reporting use of 3 or more medications with depression as an adverse effect vs 4.7% for those not using such medications (difference, 10.7% [95% CI, 7.2%-14.1%]). These patterns persisted in analyses restricted to adults treated with antidepressants, among hypertensive adults, and after excluding users of any psychotropic medication. Conclusions and Relevance In this cross-sectional survey study, use of prescription medications that have depression as a potential adverse effect was common. Use of multiple medications was associated with greater likelihood of concurrent depression.

中文翻译：

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抑郁症作为美国成年人潜在不良反应的处方药流行率

重要性 处方药越来越多地在美国成年人中使用，其中许多有可能导致抑郁。目的 将抑郁症处方药的使用描述为潜在的不良反应，并评估它们的使用与并发抑郁症之间的关联。设计、设置和参与者 国家健康和营养检查调查的五个 2 年周期（2005-2006 年至 2013-2014 年），对 18 岁或以上美国成年人的代表性横断面调查，分析了药物使用情况抑郁症作为潜在的不利影响。多变量逻辑回归检验了这些药物的使用与并发抑郁症之间的关联。分析是在成年人中进行的，不包括抗抑郁药使用者，在接受抗抑郁药和高血压治疗的成年人中。暴露 具有抑郁症作为潜在副作用的处方药（在 Micromedex 中列出）。主要结果和措施 任何使用和同时使用可能导致抑郁症的药物的流行率和抑郁症的流行率（PHQ-9 评分≥10）。结果 该研究包括 26 192 名成年人（平均年龄，46.2 岁 [95% CI，45.6-46.7]；女性，51.1%）和 7.6%（95% CI，7.1%-8.2%）报告有抑郁症。使用以抑郁症为不良反应的药物的总体估计流行率为 37.2%，从 2005 年和 2006 年的周期年的 35.0%（95% CI，32.2%-37.9%）增加到 38.4%（95% CI，36.5%） -40.3%）在 2013 年和 2014 年（趋势 P = .03）。估计为 6.9%（95% CI，6.2%-7。6%) 报告在 2005 年和 2006 年同时使用 3 种或更多可能导致抑郁症的药物作为副作用，9.5% (95% CI, 8.4%-10.7%) 报告在 2013 年和 2014 年使用这种药物（趋势 P .001）。在排除抗抑郁药使用者的调整分析中，抑郁症可能产生的不良反应的药物数量与并发抑郁症的患病率增加有关。报告使用 3 种或更多药物对抑郁症有不良反应的患者的估计抑郁症患病率为 15%，而未使用此类药物的患者为 4.7%（差异，10.7% [95% CI，7.2%-14.1%]）。这些模式在仅限于接受抗抑郁药治疗的成年人、高血压成年人以及排除任何精神药物使用者后的分析中仍然存在。结论和相关性 在这项横断面调查研究中，使用具有抑郁症作为潜在不良反应的处方药很常见。使用多种药物与并发抑郁症的可能性更大有关。