The relationship between antihypertensive medications and mood disorders: analysis of linked healthcare data for 1.8 million patients (original) (raw)

Shaw, Richard J. ORCID: https://orcid.org/0000-0002-7906-6066, Mackay, Daniel ORCID: https://orcid.org/0000-0001-5381-7098, Pell, Jill P. ORCID: https://orcid.org/0000-0002-8898-7035, Padmanabhan, Sandosh ORCID: https://orcid.org/0000-0003-3869-5808, Bailey, David S. and Smith, Daniel J. ORCID: https://orcid.org/0000-0002-2267-1951(2021) The relationship between antihypertensive medications and mood disorders: analysis of linked healthcare data for 1.8 million patients.Psychological Medicine, 51(7), pp. 1183-1191. (doi: 10.1017/S0033291719004094) (PMID:31973782)

Abstract

Background: Recent work suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders. Using large-scale linked healthcare data we investigated whether certain classes of antihypertensive, such as angiotensin antagonists (AAs) and calcium channel blockers, were associated with reduced risk of new-onset major depressive disorder (MDD) or bipolar disorder (BD). Method: Two cohorts of patients treated with antihypertensives were identified from Scottish prescribing (2009–2016) and hospital admission (1981–2016) records. Eligibility for cohort membership was determined by a receipt of a minimum of four prescriptions for antihypertensives within a 12-month window. One treatment cohort (n = 538 730) included patients with no previous history of mood disorder, whereas the other (n = 262 278) included those who did. Both cohorts were matched by age, sex and area deprivation to untreated comparators. Associations between antihypertensive treatment and new-onset MDD or bipolar episodes were investigated using Cox regression. Results: For patients without a history of mood disorder, antihypertensives were associated with increased risk of new-onset MDD. For AA monotherapy, the hazard ratio (HR) for new-onset MDD was 1.17 (95% CI 1.04–1.31). Beta blockers' association was stronger (HR 2.68; 95% CI 2.45–2.92), possibly indicating pre-existing anxiety. Some classes of antihypertensive were associated with protection against BD, particularly AAs (HR 0.46; 95% CI 0.30–0.70). For patients with a past history of mood disorders, all classes of antihypertensives were associated with increased risk of future episodes of MDD. Conclusions: There was no evidence that antihypertensive medications prevented new episodes of MDD but AAs may represent a novel treatment avenue for BD.

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Funder and Project Information

Mental Health Data Pathfinder

Daniel Smith

MC_PC_17217

HW - Mental Health and Wellbeing

Antihypertensives as repurposed treatments for mood disorders: a Scottish national linkage and UK Biobank investigation

Daniel Smith

TCS/16/6

HW - Mental Health and Wellbeing

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