Question

Could common prescription medications be contributing to depression and rising suicide rates? A study published in JAMA found that over one-third of Americans take at least one prescription drug that lists depression as a potential side effect, and users of such drugs have a higher risk of depression than those who do not take such drugs. About 200 prescription drugs can cause depression, and the list includes common medications like proton pump inhibitors used to treat acid reflux, beta-blockers used to treat high blood pressure, birth control pills and emergency contraceptives, anticonvulsants like gabapentin, corticosteroids like prednisone and prescription-strength ibuprofen. The researchers used the National Health and Nutrition Examination Survey to analyze the medications used by a representative sample of more than 26,000 American adults from 2005 to 2014. Among patients using one drug that could cause depression as a side effect but who were not taking an antidepressant drug, 6.9 percent had depression, while the depression rate for patients taking three or more drugs with the side effect was 15.3 percent. By contrast, patients who were not taking any such drugs had a depression rate of 4.7 percent. The researchers adjusted for other risk factors that can cause depression, including poverty, marital status, unemployment and certain medical conditions, like chronic pain, which themselves are associated with depression. “There’s been an increase in suicide, that we know,” Dr. Muskin said. “Does it correlate to the use of these medications? The honest answer is we don’t know. Could it play a role? The honest answer is yes, of course it could.” Considering the variables mentioned in this article, identify the most appropriate type of analysis that could have been used to make this conclusion by selecting one and only one of the following:

a. Linear regression

b. One-way ANOVA

c. Two-way ANOVA

d. ANCOVA

e. Logistic regression

Answer 1

e. Logistic regression

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.