Medications Most Likely to Cause Depression and Delirium

Medications Causing Depression

• Antihypertensives:

  • Beta blockers (e.g. metoprolol)

  • Calcium channel blockers

• Anticonvulsants:

  • Carbamazepine, topiramate

• Sedatives:

  • Benzodiazepines, anticholinergics

• Antihistamines:

  • Ranitidine (H2 receptor antagonist, historically)

• Corticosteroids:

  • High-dose or chronic use

Medications Causing Delirium

• Anticholinergics:

  • Oxybutynin, promethazine

  • Common in older adults due to heightened sensitivity

• Benzodiazepines:

  • Especially in high doses or prolonged use

• Opioids:

  • Morphine, particularly in older adults or renal impairment

• Corticosteroids:

  • High-dose or long-term therapy

• Dopaminergic Drugs:

  • Levodopa, used in Parkinson’s disease

• Alcohol/Illicit Drugs:

  • Intoxication or withdrawal can precipitate delirium

Additional Notes

• Polypharmacy raises the risk for both depression and delirium, especially in the elderly or those with multiple comorbidities.

• Steroids can cause mood changes ranging from depression to euphoria, anxiety, or even psychosis.

• Prevention:

  • Conduct regular medication reviews in older adults or those with a psychiatric history.

  • Adjust doses or discontinue offending agents when feasible.