Clinical depression from a heartburn treatment?

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Clinical depression from a heartburn treatment?

Proton pump inhibitors (PPIs) are a class of chemicals designed to reduce stomach acid.

These are the most widely sold meds in the world. PPIs are a multibillion-dollar industry in the US alone.

Doctors prescribe these PPIs for peptic ulcers, H. pylori, GERD, and gastritis – among other things.

But a new study shows that PPIs are associated with depression.

PPIs can change a person’s bacterial profile – and this can affect mood and energy.

This human study, published in the journal Psychotherapy and Psychosomatics, was conducted at the Departments of Psychiatry and Family Medicine, Taipei Veterans General Hospital.

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The authors of the study wanted to find out if there is an association between PPIs and depression.

They suspected this connection because PPIs can alter gut bacteria and gut bacteria can cause depression.

“Studies have focused on the connection between the gut and major depression – and supported the potential role of the brain-gut connection.”

Though these PPIs have been in use for decades, there wasn’t any research into their possible relationship to depression.

“Proton pump inhibitors may alter the gut-brain axis. But the association between proton pump inhibitors and depression remains unknown.”

For this study, the researchers used data from a medical database about the use of proton pump inhibitors and the prevalence of depression.

“We investigated the associations between proton pump inhibitor use and depression based on a large human research database.”

On average, people with depression had more exposure to proton pump inhibitors.

“Patients with major depression had a greater prevalence of higher daily dose of proton pump inhibitors than those without major depression.”

The scientists then tried to rule out the influence of previous psychiatric problems.

Even for people without previous psychiatric problems, there was more depression in those using PPIs.

“After excluding psychiatric cases, we found that higher proton pump inhibitor exposure was related to an increased risk of depression.”

Some types of PPIs were more strongly correlated with depression than others.

Pantoprazole, lansoprazole, and rabeprazole all had strong associations with depression.

“The risk of major depression significantly increased in people using pantoprazole, lansoprazole, and rabeprazole.”

Now we have a mechanism and an association, so it is reasonable to believe that proton pump inhibitors can cause depression by changing gut bacteria. 

This looks very bad for PPIs.

“Gut microbiota and depression were found to be closely related through the gut-brain axis, nervous system, and connections between the gut bacteria and brain chemicals.”

By changing the acidity of the stomach, these PPIs can alter the bacterial populations in the stomach and probably further down the GI system too.

Another potential problem is that the change in stomach acid may prevent the absorption of nutrients.

“Another mechanism that might contribute to major depression is the chronic malabsorption of micronutrients after proton pump inhibitor exposure.”

And these PPIs affect a couple of nutrients that are very important to energy and mood.  

Proton pump inhibitors can decrease the absorption of vitamin B12 and magnesium.

“Proton pump inhibitors also affected the absorption of micronutrients such as magnesium and vitamin B12, which may be related to the risk of major depression development.”

While this study cannot prove that proton pump inhibitors cause depression (because of the study’s format), the association and mechanisms are cause for concern.

Depression is more strongly associated with some PPIs – and it is also dose-related.

At the very least, this should make people think about the minimum effective dose – or whether PPIs are even necessary for them at all.

You should see a healthcare professional for the diagnosis and treatment of problems with your digestive system.

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Matt Cook is editor-in-chief of Daily Medical Discoveries. Matt has been a full time health researcher for 26 years. ABC News interviewed Matt on sexual health issues not long ago. Matt is widely quoted on over 1,000,000 websites. He has over 300,000 daily newsletter readers. Daily Medical Discoveries finds hidden, buried or ignored medical studies through the lens of 100 years of proven science. Matt heads up the editorial team of scientists and health researchers. Each discovery is based upon primary studies from peer reviewed science sources following the Daily Medical Discoveries 7 Step Process to ensure accuracy.
Use of Proton Pump Inhibitors and Risk of Major Depressive Disorder: A Nationwide Population-Based Study https://www.karger.com/Article/Abstract/485190

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