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In their recent article, Davies et al¹ reported that among subjects referring to a hypertension clinic, depression was associated with an increased reduction or cessation of antihypertensive drugs owing to an adverse effect that reflected subjective symptoms. This finding would suggest that depressed subjects can amplify somatic symptoms, leading to a higher report rate of adverse drug events. However, in a previous study conducted in a large population of hospitalized older adults, we showed that depressive symptoms were similarly associated with adverse drug reactions represented by subjective symptoms (ie, headache, abdominal pain, and nausea) and those represented by objective signs or documented by laboratory tests or instrumental procedures (ie, skin rushes, hemorrhagic complications, and electrolytic complications).² Therefore, the association between depression and adverse drug events cannot be only explained by an overreport of somatic symptoms. Indeed, it has been hypothesized that psychological distress can determine the activation of biological processes, . . . [Full Text of this Article]

Graziano Onder, MD, PhD; Matteo Cesari, MD; Roberto Bernabei, MD
Rome, Italy

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Drug Intolerance Due to Nonspecific Adverse Effects Related to Psychiatric Morbidity in Hypertensive Patients
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Arch Intern Med. 2003;163(5):592-600.
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