In this pilot study we investigate whether the heterogeneous variety of drugs classified in our previous work as depressogenic contributes to the occurrence of depression and whether there are differences in this contribution between major depressive disorder (MDD) and non-MDD. The study was performed in a small sample ( N = 96) of community-dwelling elderly, population-based and weighed for the distribution of age, gender and prevalence of depressive symptoms. Other aetiological aspects of depression, such as age, female gender. cerebral deterioration, a previous history of mental disorder or a family history of mental disorder, were controlled for. When subjects with a M D D were separated from the other depressed subjects, all associations with medication became stronger in MDD, except for the use of the depressogenic medication, which was less frequent in MDD. This contrast only reached the level of significance after correcting for the other aetiological contributions. In MDD, the use of depressogenic medication may play an aetiological role but other factors seem more relevant. We found a significant association between depressogenic medication and non-MDD; this strengthens our suspicion that DAD is not MDD. DAD, especially in the elderly population, may (often) not be a M D D but a non-MDD with an atypical presentation.
KEY woaDs4epression; elderly; drugs; side-effects
There is little doubt that depression can be caused, provoked or continued by drugs prescribed for other reasons (Whitlock and Evans, 1978;Dhondt and Hooijer, 1995). Popkin and Tucker (1994) cite Pascually and Veith (1989) detailing the methodological limitations of existing literature on depression as adverse drug reaction. 'Consisting of largely anecdotal reports, the literature seldom uses explicit criteria for depression and fails to distinguish drug response from possible underlying primary mood disorder. In addition, it does not