<Case Reports>A case of cimetidine-induced transient depressed state in an elderly woman

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A 77-year-old housewife presented with typical symptoms of depression associated with severe insomnia for ten days. Symptoms of depression included depressed mood, unhappiness, guilt, self-blame, feelings of worthlessness, hypochondriasis and suicidal ideation. Initially, we administered a regular dose of tricyclic anti-depressant, but this was not effective for these symptoms, including the profound idea of suicide. At that time, we found that the stomach medicine was cimetidine. The patient had been receiving this drug for 5 months proceeding the development of depression. Around one month after discontinuing the drug, the patient recovered dramatically from the depressed state. Previous reports on cimetidine-induced neuropsychiatric symptoms strongly suggest that the imbalance of H1 and H2 histamine neurotransmitters contributed most to the disturbance of normal mood. As this case shows, it is necessary to pay attention to the patient in a severely depressed state to whom cimetidine has been persistently administerd, particularly elderly people. Cimetidine should be discontinued before other treatment is attempted.
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