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1 Supplementry Online Content Qto DM, Ozenerger K, Olfson M. Prevlence of prescription medictions with depression s potentil dverse effect mong dults in the United Sttes. JAMA. doi: /jm etle 1. Associtions etween Numer of Medictions with, Popultion Chrcteristics nd Depression Among Adults in the United Sttes, etle2. The 30 most commonly used comintions of prescription medictions with potentil depression dverse effects mong US dults etle 3. Excluding psychotropic users, the ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults, etle 4. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults with hypertension, etle 5. Excluding psychotropic users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults with hypertension, etle 6. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults etween 18 to 59 yers of ge, etle 7. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd suicidl idetion mong US dults, etle 8. Excluding psychotropic users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults treted with ntidepressnts, etle 9. Associtions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults etween 18 to 59 yers of ge treted with ntidepressnts, etle 10. Associtions etween use of prescription medictions with potentil depression dverse effects nd suicidl idetion mong US dults treted with ntidepressnts, ebox 1. List of Medictions with Potentil Identified for Inclusion in Study efigure 1. Assocition etween use of prescription medictions with potentil depression nd suicidl symptom dverse effects nd depression mong dults in the US, This supplementry mteril hs een provided y the uthors to give reders dditionl informtion out their work.

2 etle 1 Associtions etween Numer of Medictions with, Popultion Chrcteristics nd Depression Among Adults in the United Sttes, Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % Overll 23,561 1,658 (5.8) [5.3, 6.3] 5.7 [5.2, 6.2] Not Applicle Numer of Medictions with None 17, (4.7) [4.2, 5.2] 4.7 [4.1, 5.2] Reference One 4, (6.4) [5.4, 7.5] 6.9 [5.7, 8.1] 2.2 [0.8, 3.6].002 Two 1, (10.4) [8.6, 12.4] 9.5 [7.6, 11.5] 4.9 [2.8, 6.9] <.001 Three or more (19.2) [15.7, 23.2] 15.3 [12.0, 18.6] 10.7 [7.2, 14.1] <.001 None 13, (5.2) [4.7, 5.8] 5.5 [4.7, 6.3] Reference One 3, (6.2) [5.3, 7.3] 6.6 [5.5, 7.7] 1.1 [-0.3, 2.5].11 Two 2, (4.9) [3.8, 6.1] 5.1 [3.8, 6.5] -0.3 [-1.9, 1.3].67 Three or more 4, (7.7) [6.8, 8.7] 6.0 [4.8, 7.3] 0.6 [-1.2, 2.3].52 Age group, yers , (5.9) [5.3, 6.6] 7.4 [6.5, 8.4] Reference , (6.3) [5.6, 7.1] 6.8 [6.0, 7.5] -0.7 [-1.8, 0.4] nd older 5, (3.9) [3.2, 4.7] 2.1 [1.6, 2.6] -5.3 [-6.5, -4.1] <.001 Gender Women 11,518 1,018 (7.3) [6.6, 8.0] 6.6 [5.9, 7.2] Reference Men 12, (4.3) [3.8, 4.8] 4.8 [4.2, 5.3] -1.8 [-2.5, -1.1] <.001 Rce/Ethnicity Non-Hispnic white 9, (4.9) [4.3, 5.5] 5.5 [4.8, 6.1] Reference Non-Hispnic lck 5, (8.3) [7.4, 9.2] 5.8 [5.1, 6.4] 0.3 [-0.4, 1.1].42 Hispnic/Ltino 6, (8.1) [7.2, 9.1] 6.5 [5.6, 7.3] 1.0 [-0.01, 2.0].05 Other 1, (4.9) [3.9, 6.2] 5.7 [4.4, 7.0] 2.1 [-1.3, 1.7].78 Mritl Sttus Mrried/living with prtner 13, (4.1) [3.7, 4.6] 4.6 [4.1, 5.1] Reference Never mrried 5, (6.9) [6.1, 7.7] 5.9 [5.0, 6.8] 1.3 [0.2, 2.3].02 Divorced or seprted 2, (11.2) [9.8, 12.7] 9.1 [7.8, 10.5] 4.5 [3.3, 5.7] <.001 Widowed 1, (7.9) [6.2, 10.0] 7.3 [5.2, 9.4] 2.6 [0.5, 4.8].02 Eduction <High School 6, (10.3) [9.1, 11.5] 7.5 [6.4, 8.6] Reference High School (or equivlent) 5, (6.6) [5.8, 7.4] 6.0 [5.2, 6.8] -1.5 [-2.6, -0.4].007 At lest some college 6, (5.6) [4.9, 6.5] 5.5 [4.7, 6.3] -2.0 [-3.3, -0.7].002

3 etle 1 (Continued) Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % College or more 4, (2.3) [1.8, 2.8] 3.4 [2.6, 4.3] -4.1 [-5.6, -2.6] <.001 Rtio of Fmily Income to Federl Poverty Level 0 to <1, lowest income 4, (12.5) [11.4, 13.8] 8.1 [7.1, 9.0] Reference 1 to <2 5, (8.2) [7.2, 9.2] 6.8 [6.0, 7.7] -1.3 [-2.3, -0.2].02 2 to <4 5, (4.3) [3.7, 5.0] 4.9 [4.1, 5.5] -3.2 [-4.3, -2.2] <.001 4, highest income 5, (2.4) [2.0, 3.0] 3.5 [2.8, 4.2] -4.6 [-5.8, -3.4] <.001 Employment No 10,128 1,017 (9.1) [8.3, 10.0] 7.6 [6.7, 8.4] Reference Yes 13, (4.0) [3.6, 4.4] 4.5 [4.0, 5.0] -3.1 [-4.1, -2.2] <.001 Numer of Chronic Conditions None 11, (4.1) [3.7, 4.7] 4.1 [3.5, 4.7] Reference One to two 8, (6.4) [5.7, 7.2] 6.9 [6.1, 7.8] 2.8 [1.8, 3.9] <.001 Three or more 2, (10.7) [9.3, 12.1] 9.7 [7.9, 11.5] 5.6 [3.5, 7.7] <.001 Body Mss Index (kg/m 2 ) Underweight, < (6.7) [4.1, 10.8] 5.7 [3.1, 8.4] Reference Norml, 18.5 to <25 6, (5.7) [4.9, 6.6] 6.3 [5.4, 7.1] 0.5 [-2.2, 3.2].69 Overweight, 25 to <30 7, (4.5) [3.8, 5.2] 5.1 [4.3, 5.8] -0.7 [-3.5, 2.1].64 Oese, 30 8, (6.9) [6.2, 7.8] 5.8 [5.1, 6.5] 0.1 [-2.7, 2.8].97 Dt from NHANES. Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge group, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions.

4 etle 2. The 30 most commonly used comintions of prescription medictions with potentil depression dverse effects mong US dults, Estimted Prevlence of Depression Unweighted No. Weighted % (95% CI) Gpentin Cycloenzprine (35.8, 81.4) Metoprolol Alprzolm (34.7, 68.8) Alprzolm Gpentin (30.9, 70.5) Hydrocodone Clonzepm (27.4, 72.7) Hydrocodone Alprzolm (34.8, 62.4) Hydrocodone Zolpidem (25.2, 69.1) Hydrocodone Gpentin (29.5, 58.6) Metoprolol Zolpidem (23.0, 60.6) Hydrocodone Esomeprzole (25.8, 55.8) Omeprzole Alprzolm (21.6, 61.3) Gpentin Esomeprzole (19.4, 59.1) Omeprzole Zolpidem (17.2, 62.7) Hydrocodone Lorzepm (14.2, 66.0) Hydrocodone Atenolol (19.1, 52.1) Gpentin Trmdol (16.5, 53.0) Hydrocodone Trmdol (12.9, 58.1) Hydrocodone Rnitidine (13.3, 54.6) Omeprzole Gpentin (18.1, 44.9) Hydrocodone Omeprzole (18.1, 43.8) Hydrocodone Dizepm (13.3, 52.4) Hydrocodone Prednisone (16.2, 45.7) Omeprzole Cycloenzprine (14.2, 47.2) Metoprolol Gpentin (14.7, 38.3) Metoprolol Iuprofen (8.7, 43.9) Hydrocodone Cycloenzprine (9.8, 35.3) Omeprzole Trmdol (10.7, 29.5) Hydrocodone Iuprofen (10.7, 29.6) Metoprolol Enlpril (7.8, 32.8) Metoprolol Trmdol (7.6, 30.8) Omeprzole Finsteride (2.7, 55.6) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Prevlence of use in for most commonly used mediction comintions with depression side effects excluding ntidepressnts in Mediction comintions ll used y <1% of dults nd rnked ccording to prevlence of depression overll. Prevlence mong men.

5 etle 3. Excluding psychotropic users, the ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults, Estimted Prevlence of Depression (PHQ-9 Score 10) n (%) Adjusted, % Adjusted Difference, % Overll 22,166 1,387 (5.0) [4.5, 5.4] 4.9 [4.5, 5.4] Not Applicle Numer of Medictions with None 16, (4.6) [4.2, 5.1] 4.5 [4.0, 5.0] Reference One to two 4, (5.7) [4.8, 6.8] 6.1 [5.0, 7.3] 1.6 [0.3, 2.9].02 Three or more (10.1) [6.8, 14.9] 8.5 [5.0, 12.0] 4.0 [0.4, 7.5].03 None 13, (5.0) [4.5, 5.6] 4.9 [4.2, 5.7] Reference One to two 5, (4.5) [3.8, 5.3] 4.9 [4.1, 5.8] [-1.2, 1.2].97 Three or more 3, (5.6) [4.8, 6.6] 4.9 [3.7, 6.1] [-1.7, 1.6].98 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions.

6 etle 4. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults with hypertension, Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % Overll 7, (7.5) [6.6, 8.5] 7.3 [6.4, 8.3] Not Applicle Numer of Medictions with None 3, (5.9) [5.0, 7.0] 5.5 [4.4, 6.6] Reference One 2, (6.8) [5.5, 8.5] 7.7 [6.0, 9.4] 2.2 [0.1, 4.3].04 Two (10.3) [8.3, 12.7] 10.4 [8.0, 12.7] 4.9 [2.3, 7.5] <.001 Three or more (18.6) [14.3, 23.9] 16.2 [11.5, 20.8] 10.7 [5.7, 15.7] <.001 None 1, (9.1) [7.6, 10.8] 9.3 [6.9, 11.7] Reference One 1, (7.3) [5.6, 9.5] 8.3 [6.3, 10.2] -1.0 [-3.4, 1.4].41 Two 1, (5.2) [3.9, 7.0] 6.5 [4.7, 8.2] -2.8 [-5.9, 0.3].07 Three or more 3, (7.6) [6.5, 8.9] 6.3 [5.0, 7.6] -2.9 [-6.0, 0.1].06 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions with suicide dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions.

7 etle 5. Excluding psychotropic users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults with hypertension, Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % Overll 6, (6.3) [5.6, 7.2] 6.2 [5.4, 7.0] Not Applicle Numer of Medictions with None 3, (5.8) [4.9, 7.0] 5.4 [4.3, 6.5] Reference One or two 2, (6.6) [5.3, 8.1] 7.1 [5.5, 8.8] 1.7 [-0.3, 3.8].10 Three or more (11.6) [7.4, 17.8] 10.6 [5.4, 15.7] 5.2 [-0.4, 10.7].07 None 1, (9.0) [7.5, 10.8] 7.8 [5.7, 9.9] Reference One or two 2, (5.2) [4.1, 6.5] 6.1 [4.8, 7.5] -1.7 [-4.0, 0.7].16 Three or more 2, (5.8) [4.9, 6.8] 5.2 [4.0, 6.5] -2.6 [-5.4, 0.3].08 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions with suicide dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions.

8 etle 6. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults etween 18 to 59 yers of ge, Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % Overll 16,476 1,245 (6.2) [5.6, 6.7] 6.1 [5.6, 6.7] Not Applicle Numer of Medictions with None 13, (5.0) [4.5, 5.6] 5.2 [4.6, 5.8] Reference One 2, (7.5) [6.2, 9.1] 7.4 [5.9, 9.0] 2.3 [0.6, 4.0].01 Two (13.6) [10.6, 17.4] 10.5 [7.8, 13.2] 5.3 [2.6, 8.1] <.001 Three or more (28.4) [22.4, 35.4] 17.6 [12.9, 22.3] 12.4 [7.6, 17.2] <.001 None 11, (5.3) [4.7, 6.0] 5.8 [5.0, 6.7] Reference One 2, (7.1) [5.9, 8.5] 7.1 [5.9, 8.4] 1.3 [-0.3, 2.8].10 Two 1, (6.1) [4.6, 8.0] 5.5 [3.7, 7.4] -0.3 [-2.5, 1.9].78 Three or more 1, (11.3) [9.6, 13.2] 6.7 [4.9, 8.5] 0.9 [-1.4, 3.1].44 Illicit Drug Use c Never 8, (4.8) [4.3, 5.4] 5.0 [4.4, 5.6] Reference Prior 4, (5.3) [4.5, 6.1] 6.2 [5.3, 7.1] 1.2 [0.1, 2.2].03 Current 2, (10.9) [9.4, 12.6] 9.4 [7.9, 10.8] 4.3 [2.9, 5.8] <.001 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model include survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), numer of chronic diseses, nd illicit drug use (current user, prior user, nd never user). Dt on rtio of fmily income to federl poverty level clculted y CDC sed on household size nd household income, nd provided in NHANES dtset. c Prior defined s ny illicit drug use (mrijun, heroin, cocine or methmphetmine) 30 dys prior to interview. Current defined s ny illicit drug use within <30 dys prior to interview.

9 etle 7. Excluding ntidepressnt users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd suicidl idetion mong US dults, Estimted Prevlence of Suicidl Idetion Prticipnts Adjusted c, n (%) % Adjusted c Difference, % Overll 23, (2.6) [2.4, 2.9] 2.6 [2.3, 2.9] Not Applicle Numer of Medictions with None 17, (2.3) [2.1, 2.6] 2.4 [2.1, 2.8] Reference One or two 5, (3.0) [2.4, 3.7] 2.8 [2.2, 3.4] 0.4 [-0.4, 1.2].36 Three or more (6.2) [4.3, 8.8] 4.2 [2.4, 6.0] 1.8 [-0.06, 3.7].06 None 13, (2.5) [2.2, 2.9] 2.4 [2.0, 2.8] Reference One or two 5, (2.6) [2.1, 3.3] 3.0 [2.2, 3.8] 0.6 [-0.3, 1.6].19 Three or more 4, (2.9) [2.3, 3.6] 2.8 [1.8, 3.7] 0.4 [-0.8, 1.6].51 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) The PHQ-9 includes the following question which cptures suicidl idetion: Over the lst 2 weeks, how often hve you een othered y ny of the following prolems (not t ll, severl dys, more thn hlf the dys, or nerly every dy)? Thoughts tht you would e etter off ded, or thoughts of hurting yourself in some wy. Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. c Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions

10 etle 8. Excluding psychotropic users, ssocitions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults treted with ntidepressnts, Moderte or Severe Depression (PHQ-9 Score 10) n (%) Adjusted c Prevlence, % Adjusted c Difference in Prevlence, % Overll 1, (14.4) [12.5, 16.6] 14.7 [12.6, 16.8] Not Applicle Numer of Additionl Medictions with None (11.9) [9.7, 14.6] 12.3 [9.6, 15.0] Reference One or two (16.5) [13.3, 20.2] 16.9 [13.3, 20.4] 4.5 [0.11, 8.9].05 Three or more (20.5) [13.8, 29.4] 19.0 [11.9, 26.1] 6.7 [0.00, 13.4].05 None (10.0) [7.1, 13.9] 12.4 [7.7, 17.2] Reference One or two (16.1) [13.2, 19.6] 17.2[13.7, 20.7] 4.8 [-0.01, 10.5].10 Three or more (16.4) [13.0, 20.6] 14.1 [10.1, 17.9] 1.6 [-5.2, 8.3].93 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Excludes ntidepressnts c Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions

11 etle 9. Associtions etween use of prescription medictions with potentil depression dverse effects nd depression mong US dults etween 18 to 59 yers of ge treted with ntidepressnts, Estimted Prevlence of Depression (PHQ-9 Score 10) Adjusted Adjusted, n (%) Difference, % % Overll 1, (23.1) [20.5, 25.8] 23.1 [20.5, 25.7] Not Applicle Numer of Medictions with Antidepressnts Only (12.3) [9.7, 15.6] 14.9 [11.5, 18.3] Reference One (19.5) [15.5, 24.2] 20.6 [16.0, 25.2] 5.7 [0.9, 10.6].02 Two (19.5) [15.5, 24.2] 33.2 [25.8, 40.6] 18.3 [10.6, 26.0] <.001 Three or more (40.1) [33.5, 47.1] 23.0 [24.8, 39.1] 17.1 [8.6, 25.7] <.001 None (14.4) [11.5, 18.0] 22.0 [16.8, 27.3] Reference One (24.5) [19.5, 30.4] 28.2 [22.9, 33.4] 6.2 [0.04, 12.3].05 Two (22.9) [18.5, 27.9] 20.5 [16.1, 24.9] -1.6 [-8.4, 5.3].65 Three or more (33.5) [28.6, 38.8] 21.9 [17.4, 26.3] -0.1 [-7.5, 7.2].97 Illicit Drug Use c Never (24.1) [20.4, 28.3] 23.6 [20.2, 27.1] Reference Prior (19.7) [15.9, 24.1] 21.5 [17.3, 25.6] -2.2 [-7.1, 2.7].38 Current (31.1) [24.5, 38.6] 25.5 [19.2, 31.8] 1.8 [-5.6, 9.3].62 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), numer of chronic diseses, nd illicit drug use (current user, prior user, nd never user). Dt on rtio of fmily income to federl poverty level clculted y CDC sed on household size nd household income, nd provided in NHANES dtset. c Prior defined s ny illicit drug use (mrijun, heroin, cocine or methmphetmine) 30 dys prior to interview. Current defined s ny illicit drug use within <30 dys prior to interview.

12 Tle 10. Associtions etween use of prescription medictions with potentil depression dverse effects nd suicidl idetion mong US dults treted with ntidepressnts, Prticipnts Estimted Prevlence of Suicidl Idetion Adjusted c, n (%) % Adjusted c Difference, % Overll 2, (7.6) [6.4, 9.1] 7.5 [6.2, 8.9] Not Applicle Numer of Medictions with Antidepressnts Only (5.1) [3.6, 7.0] 5.7 [3.6, 7.7] Reference One (6.6) [4.7, 9.2] 6.3 [4.1, 8.5] 0.6 [-2.4, 3.7].69 Two (10.8) [8.4, 13.8] 10.2 [7.6, 12.8] 4.5 [1.2, 7.8].008 Three or more (10.8) [8.4, 13.9] 9.5 [6.8, 12.3] 3.9 [0.1, 7.7].05 None (7.4) [5.5, 9.9] 9.1 [5.9, 12.3] Reference One (7.5) [5.0, 11.2] 8.5 [5.2, 11.8] -0.6 [-5.0, 3.7].78 Two (7.3) [5.0, 10.6] 6.4 [3.8, 9.0] -2.8 [-6.7, 1.2].17 Three or more 1, (8.0) [6.3, 10.1] 6.8 [4.9, 8.6] -2.4 [-6.3, 1.6].24 Arevitions: Ptient Helth Questionnire-9 (PHQ-9), confidence intervl (CI) Suicidl idetion determined from response to question 9 of the PHQ-9 questionnire. Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. c Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions

13 ebox 1. List of Medictions with Potentil Identified for Inclusion in Study (N=203) A. Suicidl Symptoms (n=103) 1. Anlgesics (Acetminophen/Trmdol, Hydropmorphone, Tpentdol, Trmdol) 2. Anticonvulsnts (Crmzepine, Clonzepm, Dizepm, Ethosuximide, Gpentin, Lmotrigine, Levetircetm, Lorzepm, Methsuximide, Oxcrzepine, Phenytoin, Preglin, Topirmte, Vlproic Acid, Zonismide) 3. Antidepressnts (Amitriptyline, Amitriptyline/Chlordizepoxide, Amitriptyline/Perphenzine, Bupropion, Citloprm, Clomiprmine, Desiprmine, Desvenlfxine, Doxepin, Duloxetine, Escitloprm, Fluoxetine, Fluoxetine/Olnzpine, Fluvoxmine, Imiprmine, Milnciprn, Mirtzpine, Nefzodone, Nortriptyline, Proxetine, Phenelzine, Protriptyline, Selegiline, Sertrline, Trzodone, Venlfxine, Vilzodone) 4. Anxiolytics, Hypnotics, nd Sedtives (Alprzolm, Butritl, Chlordizepoxide, Clonzepm, Clorzepte, Dizepm, Doxepin, Eszopiclone, Flurzepm, Pentoritl, Rmelteon, Trizolm, Zleplon, Zolpidem) 5. Gstrointestinl Agents (Metocloprmide) 6. Hormones/Hormone Modifiers (Finsteride 1, Leuprolide, Levonorgestrel, Oxndrolone 2, Progesterone) 7. Respirtory Agents (Montelukst, Rivirin, Roflumilst, Zfirlukst 3 ) 8. Other Therpeutic Clsses (Acmproste, Amntdine, Armodfinil, Aripiprzole, Asenpine, Atomoxetine, Cridop/Entcpone/Levodop, Cridop/Levodop, Ciprofloxcin, Dpsone, Efvirenz, Efvirenz/Emtricitine/Tenofovir, Iloperidone, Interferon Bet-1, Interferon Bet-1, Isotretinoin, Lursidone, Memntine, Mefloquine, Methylphenidte, Modfinil, Moxifloxcin, Nltrexone, Ntlizum, Olnzpine, Ofloxcin, Peginterferon Alf-2, Quetipine, Rltegrvir, Risperidone 4, Rivstigmine 5, Siutrmine, Tetrenzine, Vrenicline) B. Depressive (Non-Suicidl) Symptoms (n=100) c 1. Anlgesics (Cycloenzprine, Fentnyl, Acetminophen/Hydrocodone, Iuprofen, Indomethcin, Morphine, Numetone, Oxycodone) 2. Antihypertensives (Atenolol, Atenolol/Chlorthlidone, Betxolol, Bendroflumethizide/Ndolol, Brimonidine, Brimonidine/Timolol, Dorzolmide/Timolol, Enlpril, Hydrochlorothizide/Metoprolol, Hydrocodone, Metolzone, Metoprolol, Nisoldipine, Quinpril, Telmisrtn, Timolol, Trndolpril) 3. Corticosteroids (Betmethsone, Cortisone, Dexmethsone, Methylprednisolone, Prednisolone, Prednisone, Trimcinolone) 4. Gstrointestinl Agents (Atropine/Diphenoxylte, Cimetidine, Dexlnsoprzole, Esomeprzole, Fmotidine, Omeprzole, Rnitidine) 5. Hormones/Hormone Modifiers (Anstrozole, Biclutmide, Cergoline, Conjugted Estrogens, Conjugted Estrogens/Medroxyprogesterone, Desogestrel/Ethinyl Estrdiol, Dienogest/Estrdiol, Drospirenone/Ethinyl Estrdiol, Drospirenone/Ethinyl Estrdiol/Levomefolte, Esterified Estrogens, Esterified Estrogens/Methyltestosterone, Estrdiol, Estrdiol/Norethindrone, Estropipte, Ethinyl Estrdiol/Ethynodiol, Ethinyl Estrdiol/Etonogestrel, Ethinyl Estrdiol/Levonorgestrel, Ethinyl Estrdiol/Norethindrone, Ethinyl Estrdiol/Norgestimte, Ethinyl Estrdiol/Norgestrel, Etonogestrel, Exemestne, Goserelin, Hydroxyprogesterone, Medroxyprogesterone, Megestrol, Norethindrone, Tmoxifen, Testosterone) 6. Respirtory Agents (Cetirizine 6 ) 7. Other Therpeutic Clsses (Acvir/Lmivudine, Aceutolol, Acitretin, Amphetmine/Detromphetmine, Bclofen, Benzphetmine, Cinclcet, Clonidine, Cyclosporine, Dntrolene, Dexmethylphenidte, Donepezil, Droninol, Emtricitine, Erlotini, Flecinide, Fluphenzine 7, Glntmine, Hloperidol, Mrviroc, Methyldop, Metolzone, Metronidzole, Oxyutynin 8, Phentermine 9, Pimozide, Przosin, Propfenone, Proprnolol, Rsgiline, Rotigotine, Sorfeni, Tiznidine) Micromedex symptoms listed under the dverse effects section: depression, depressive disorder, suicide, suicidl thoughts, suicidl idetion, nd suicidl ehvior. Medictions were not excluded if they hd mni side effect. Micromedex symptoms listed under the Adverse Effects section: suicide, suicidl thoughts, suicidl idetion, nd suicidl ehvior. c Micromedex symptoms listed under the Adverse Effects section were considered non-suicide if they did not specify suicide side effect. These included depression nd depressive disorder. 1 Depression dverse effect included on lel. Suicide dverse effect cited in post-mrketing rticle: Irwig, M. S. (2012). Depressive symptoms nd suicidl thoughts mong former users of finsteride with persistent sexul side effects. The Journl of clinicl psychitry, 73(9), [ 2 Depression dverse effect included on lel. Suicide dverse effect cited in post-mrketing rticle: Pope HG & Ktz DL: Affective nd psychotic symptoms ssocited with nolic steroid use. Am J Psychitry 1988; 145: Depression dverse effect included on lel. Suicide dverse effect cited post-mrketing: US Food nd Drug Administrtion: Updted Informtion on Leukotriene Inhiitors: Montelukst (mrketed s Singulir), Zfirlukst (mrketed s Accolte), nd Zileuton (mrketed s Zyflo nd Zyflo CR). US Food nd Drug Administrtion. Rockville, MD Suicide dverse effect recorded on 2011 Risperdl lel. 5 Suicide dverse effect recorded on 2013 Exelon lel. 6 Depression dverse effect cited post-mrketing rticle: Arendt C & Bernheim J: Doule-lind comprison of mintennce tretment of chronic idiopthic urticri y cetirizine nd terfendine. Curr Ther Res 1989; 46: Depression dverse effect cited in post-mrketing rticle: Johnson, D. A. W. The side-effects of fluphenzine decnote. The British Journl of Psychitry, 1973; 123(576), Depression dverse effect recorded on 2008 Ditropn XL lel. 9 Depression dverse effect cited in post-mrketing rticles: (1) Steel JM, Munro JF, & Duncn LJ: A comprtive tril of different regimens of fenflurmine nd phentermine in oesity. Prctitioner 1973; 221: (2) Zoller B & Ruckert KH: Hemodynmic effects of the norexic phentermine hydrochloride. Munchen Med Wschr 1973; 115:

14 efigure 1. Associtions etween use of prescription medictions with potentil depression dverse effects nd depression overll nd mong dults with hypertension in the U.S., Non-Users of Antidepressnts Numer of Medictions with Depression Adverse Effects None One Two Three or more All dults (n=23,361) Adults with hypertension (n=7,485) Unweighted 984/17, /3, /4, /2, /1, / /710 95/503 Antidepressnt Users Numer of Medictions with Depression Adverse Effects None One Two or more All dults (n=2,631) Adults with hypertension (n=1,367) Unweighted 115/772 58/ /782 86/ /1, /678 Numer of Medictions with Suicide Adverse Effects None 1,351/21, /6,471 Numer of Medictions with Suicide Adverse Effects None 257/1, /765 One 217/1, /827 One 229/ /406 Two 64/256 38/156 Two or more 174/372 94/196 Three or more 26/53 13/ Adjusted c prevlence (95% CI) of depression Adjusted c prevlence (95% CI) of depression n 1/ n 2 = unweighted numer of prticipnts with depression / unweighted numer of prticipnts in level. Dt re expressed s unweighted numer of prticipnts nd weighted %, weighted to e ntionlly representtive. Excludes the numer of ntidepressnts. c Adjusted model includes survey cycle, numer of medictions with depression dverse effects, numer of medictions with suicide dverse effects, numer of medictions without depression dverse effects, long term use of medictions with depression dverse effects, long term use of medictions without depression dverse effect, gender, ge, rce/ethnicity, mritl sttus, employment, eduction, rtio of fmily income to federl poverty level, ody mss index (kg/m 2 ), nd numer of chronic conditions.

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