Study investigates use of drugs for the stomach and risk of major depressive disorder

A new study investigating the relationship between one of the commonest type of drugs used for protecting the stomach 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 to date and with 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 and would increase the costs and risk of adverse effects such as bone fracture, pneumonia, gastrointestinal infection, and dementia.

This study compared, 2,366 patients who were exposed to 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 concluded that future studies should clarify the pathophysiology between proton pump inhibitors exposure and risk of major depressive disorder. In addition, they advised that physicians should not refrain from using proton pump inhibitors when appropriate.

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