Can drugs that treat hypertension may also treat depression?

In the current issue of Psychotherapy and Psychosomatics, the relationship of drugs that are generally used for treating hypertension (angiotensin converting enzyme inhibitors) are examined in their effects as to depression.

Mood disorders (MD) are characterized by a low-grade inflammatory state. The renin-angiotensin system, which plays a pivotal role in the regulation of blood pressure, is also one of the pathways known to modulate inflammation in the central nervous system. A theoretical framework has been developed proposing that drugs capable of decreasing angiotensin II levels would be novel therapeutic targets for neuropsychiatric disorders related to inflammation, such as depression, and indeed a large body of pre-clinical evidence shows that AT1R blockers decrease neuroinflammation.

In this study, Authors present evidence that the use of ACE inhibitors indeed prevents the occurrence of MD using a large epidemiological cohort study. In the case-control study, there were 125 men (13.1%) exposed to ACE inhibitors. After adjustment for confounding variables, exposure to ACE inhibitors was associated with reduced odds for de novo MD.

In the retrospective cohort study, among 836 men, 80 (9.6%) were exposed to ACE inhibitors. Of the 80 exposed men, none developed de novo MD, whereas among the 756 non-exposed participants, 40 (5.3%) developed de novo MD. Hence, this study provides novel epidemiological evidence to suggest that the angiotensin system may be a worthy therapeutic target in MD.