Depression is the most common mood disorder in people with multiple sclerosis (MS). Standard antidepressant therapies are usually used to treat depression. For reasons not yet understood, some medicines for MS treatment (interferon beta, corticosteroids, benzodiazepines and baclofen) can trigger or worsen depression in susceptible patients.
Several studies have suggested that clinical depression develops more frequently among people with MS than in those with other illnesses, or throughout the general population. Depression is also common in other immune-mediated neuroinflammatory diseases, suggesting that inflammation may contribute to the condition. In fact, inflammation in a brain region called the hippocampus might explain why people with MS face depression far more often than people with other chronic brain diseases.
Other factors may also contribute to depression, such as coping with a recent MS diagnosis, realizing that it will bring major lifestyle changes, and understanding that the evolution of the disease itself could damage parts of the brain associated with emotion and behavior.
If left untreated, depression will likely reduce quality of life and worsen MS symptoms that include fatigue, pain, and cognitive changes. Severe depression can be life-threatening because it may cause thoughts of suicide and suicidal behavior.
In addition to using antidepressants, some lifestyle changes might help ease depression. Patients should exercise as they are able, try yoga and meditation, stay connected with a social network, and eat healthy foods.
Some antidepressants prescribed to patients with multiple sclerosis include:
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