Could stomach medication cause depression?

A new study investigating the relationship between a common stomach drug is presented in the current issue of Psychotherapy and Psychosomatics. Several studies have established the connection between the gut microbiome and major depression and supported the potential role of brain-gut axis dysregulation in the pathophysiology of major depression. Proton pump inhibitors, commonly prescribed for more than 20 years, and which have a proven safety profile, have become the main treatment choice worldwide for acid-related disorders. However, their inappropriate use could alter the environment in the intestine and influence human gut microbiota , increasing the costs and risk of adverse effects such as bone fracture, pneumonia, gastrointestinal infection and dementia.

This study compared 2,366 patients who were prescribed proton pump inhibitors and developed subsequent major depressive disorder, and 9,464 subjects without major depressive disorder. Results suggests that individuals with major depression had a greater prevalence of cumulative daily dose of proton pump inhibitors than those without major depression. The risk of subsequent major depression significantly increased in subgroups using pantoprazole, lansoprazole and rabeprazole, whereas only a trend significance was noted in subgroups using omeprazole and esomeprazole.

The authors conclude that future studies should clarify the pathophysiology between proton pump inhibitors exposure and risk of major depressive disorder. In addition, they advise that physicians should continue prescribing proton pump inhibitors when appropriate.