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Dr Gérald Kierzek (Medical Director of Doctissimo)
Widely prescribed to treat pathologies such as eczema, asthma or arthritis, glucocorticoids are suspected of increasing the risk of depression. Indeed, a study shows that these drugs can ultimately modify brain structure and increase mood disorders.
These are the conclusions of a large study conducted by scientists from Leiden University in the Netherlands. They demonstrate that the long-term use of glucocortocoids, these drugs prescribed against chronic inflammatory pathologies such as asthma, eczema or arthritis, could affect brain structure and facilitate the onset of depression. The study is published in the BMJ Open.
MRI brain comparisons
To achieve these results, the researchers worked on volunteers aged 60 and over on average. They have in total recruited 800 British patients who are part of the UK Biobank study. Based on their brain MRIs and medical records, they did a comparison with more than 24,000 other people of the same age to compare their brain structures.
Differences between white and gray matter
Result: there is indeed a difference between gray matter and white matter in the brain of these patients, during the prolonged use of glucocorticoids in the form of tablets. Indeed, the scientists observed a decrease in the integrity of the white matter and a greater volume of gray matter in the caudate structure of the brain.
The tablets in question
Also in their results, the researchers indicate that these patients are “76% more likely to have depressive symptoms and 90% more likely to suffer from lethargy, particularly with chronic drug use”. But they also find that patients who take inhaled steroids are “35% more likely to report fatigue or lethargy” but do not increase any other risk, including depression.
Keep in mind the risk-benefit balance
But beware, if these results may seem worrying, we must not forget the risk-benefit balance, essential to take into account in medicine. Indeed, if a drug of this category is prescribed to you, it is because your doctor has weighed the advantages of treating a pathology against this potential long-term risk of depression. And that the benefit you will derive will be far greater than the risks involved.