Depression Linked to Drugs Commonly Given to ICU Patients

Monday, April 13, 2009 by: Sherry Baker, Health Sciences Editor
Tags: depression, health news, Natural News

(NewsTarget) People who have very serious medical conditions due to a disease or an accident or who are recovering from major surgery often end up for a while in a hospital's intensive care unit (ICU) -- and after they go home, a lot of them end up severely depressed, even months after their illness was treated in the ICU. Now a new study just reported online in Critical Care Medicine reports the development of depression six months after hospitalization appears to be linked to the anti-anxiety drugs frequently given to these patients -- benzodiazepine sedatives.

It has long been assumed that a health crisis serious enough to warrant treatment in an intensive care unit might be enough to cause people to become depressed afterwards. But Joseph Bienvenu, M.D., Ph.D., an associate professor in the Department of Psychiatry at the Johns Hopkins University School of Medicine, and colleagues decided to see if they could pinpoint just why an ICU stay might trigger depression in some patients, but not in others.

"Historically, the only goal for critical care physicians, understandably, was to keep people alive, but now there is interest in longer-term outcomes, such as patients' mental health and well-being," Dr. Bienvenu explained in a statement to the media. "So we asked ourselves, could certain aspects of critical illness and ICU care swing patients toward depression?"

To find out, Dr. Bienvenu and his research team evaluated patients recently admitted to one of 13 ICUs located at four teaching hospitals in Baltimore, Maryland, including several Johns Hopkins Hospital ICUs. All the patients were treated for a respiratory distress syndrome known as acute lung injury (ALI) and all required invasive interventions in the ICU, including being placed on ventilators. The Johns Hopkins researchers studied 160 patients who had survived at least six months after their ALI diagnosis and documented various features of each patient's status and care while in the ICU. For example, they looked at the severity of organ failure, blood glucose levels and other blood test results, and the amount and type of sedatives the research subjects had received in the ICU.

Then the researchers used a questionnaire to measure the patients' symptoms of clinical depression symptoms six months after first being diagnosed with ALI. Out of the 160, 26 percent had scores strongly indicating depression. When the medical histories of these people were compared to those of the ALI survivors who weren't depressed , the depressed patients were more likely to have suffered greater severity of organ failure -- but they were also far more likely to have received 75 mg or more of a benzodiazepine sedative daily.

In the media statement, Dr. Bienvenu pointed out that because more severe illness can lead to a longer physical recovery period after ICU discharge, patients' depression could be associated in part by a slow recovery time. However, he and his colleagues admitted they don't know how to explain what appears to be a strong link between depression and ICU benzodiazepine dose.

Although it's obvious very agitated patients in the ICU would probably have been given higher amounts of the drugs initially, Dr. Bienvenu noted that this relationship hasn't been seen with other types of sedatives commonly prescribed in the intensive care unit -- so it is possible that high doses of benzodiazepine alone may cause symptoms of depression. "This is clearly a question that needs further study," Dr. Bienvenu stated.

Benzodiazepine drugs, which include Xanax (alprazolam), Librium (chlordiazepoxide), Valium (diazepam), and Ativan (lorazepam), are frequently prescribed to treat anxiety, insomnia, convulsions and panic attacks. According to the University of Maryland's Center for Substance Abuse Research (CESAR), they are one of the most frequently prescribed drugs in their class in the U.S.

For more information:
http://www.hopkinsmedicine.org/Press_release...
http://www.cesar.umd.edu/cesar/drugs/benzos....

About the author

Sherry Baker is a widely published writer whose work has appeared in Newsweek, Health, the Atlanta Journal and Constitution, Yoga Journal, Optometry, Atlanta, Arthritis Today, Natural Healing Newsletter, OMNI, UCLA's "Healthy Years" newsletter, Mount Sinai School of Medicine's "Focus on Health Aging" newsletter, the Cleveland Clinic's "Men's Health Advisor" newsletter and many others.