Based on PubMed | Can lisinopril cause depression, and what should I do if I notice mood changes while taking it?

Lisinopril and depression: what to know Lisinopril (an ACE inhibitor used for high blood pressure and heart conditions) has occasionally been linked to depression in product safety information, but this appears to be uncommon. ^[1] In comparative research on blood‑pressure medicines, ACE inhibitors in general have one of the lowest associations with depression compared with classes such as reserpine, methyldopa, and possibly some beta‑blockers. ^[2] Some studies even suggest ACE inhibitors may maintain or slightly improve overall well‑being compared with older regimens. ^[3]

Can lisinopril cause depression?

• Product labeling for lisinopril and similar ACE inhibitors lists depression among possible nervous system/psychiatric side effects, indicating it has been reported, though not frequently. ^{[1] [4]}
• Broader evidence on blood‑pressure drugs indicates ACE inhibitors are among the least likely antihypertensive classes to cause depression, especially compared with reserpine or alpha‑methyldopa. ^[2]
• Observational work in medical inpatients did not find a clear association between ACE inhibitor exposure and self‑reported depressive symptoms. ^[5]
• Taken together, depression with lisinopril seems possible but appears to be rare, and other contributors (life stressors, underlying mood disorders, other medicines) are often more likely. ^{[2] [5]}

How to recognize mood changes

Watch for new or worsening:

• Low mood, loss of interest, or persistent sadness.
• Fatigue, sleep changes, poor concentration, or feelings of worthlessness.
• Anxiety, irritability, or restlessness. The appearance of such symptoms after starting or changing dose of any medicine warrants attention, even if the medicine is not a common cause. ^{[2] [5]}

What to do if you notice mood changes

1. Don’t stop lisinopril abruptly without guidance

• Stopping suddenly can raise blood pressure and increase cardiovascular risk; instead, speak with your prescriber promptly to weigh risks and benefits and consider alternatives if needed. ^[6]

2. Review the timing and other factors

• Note when symptoms began in relation to starting or changing lisinopril, and list other medicines that can affect mood (for example, steroids or certain beta‑blockers). ^[5]
• Consider non‑drug factors such as stress, sleep, alcohol use, thyroid disease, or prior depression, which are more common causes of new mood symptoms. ^[5]

3. Discuss options with your clinician

• If mood changes persist and a medication link is suspected, clinicians may consider dose adjustment or switching to another blood‑pressure class (e.g., ARB, calcium channel blocker, or thiazide), given the low but possible signal with ACE inhibitors. ^[2]
• Any switch should maintain blood‑pressure control to protect heart, brain, and kidneys. ^[6]

4. Seek urgent help for severe symptoms

• If you experience thoughts of self‑harm, severe functional decline, or psychotic features, seek urgent care or emergency services immediately. (General safety guidance)

Why ACE inhibitors are considered lower risk

• Many antihypertensive drugs affect neurotransmitters differently; older agents like reserpine and alpha‑methyldopa have stronger links to depression, whereas ACE inhibitors generally do not show a clear causal relationship in population studies. ^[2]
• Quality‑of‑life assessments during ACE inhibitor therapy have shown neutral to modestly favorable effects, suggesting they do not typically worsen mood. ^[3]

When to consider a medication change

You and your clinician might consider switching from lisinopril if:

• Depressive symptoms newly appear or clearly worsen soon after starting lisinopril and improve on dose reduction or discontinuation (dechallenge/rechallenge pattern). ^{[1] [4]}
• There is a strong personal or family history of medication‑induced mood disorders and no other explanation for symptoms. ^[5]
• Adequate blood‑pressure alternatives are available and appropriate for your medical profile. ^[2]

Practical checklist for your appointment

• Symptom log: dates, severity, and triggers of mood changes. (Helps clarify temporal relationship.) ^[5]
• Medication list: include prescription, OTC, and supplements, especially any started recently. ^[5]
• Medical history: previous depression/anxiety, thyroid issues, sleep problems, substance use. ^[5]
• Blood pressure readings: home logs to ensure any change in therapy maintains control. ^[6]

Bottom line

• Depression has been reported with lisinopril, but it seems uncommon, and ACE inhibitors overall have a relatively low association with depression compared with several other blood‑pressure drugs. ^{[1] [4] [2]}
• If you notice new mood changes, do not stop the medication on your own; instead, speak with your clinician to review timing, other causes, and whether an alternative blood‑pressure medicine is suitable while keeping your cardiovascular protection on track. ^{[6] [5]}

Quick reference table

Topic	What the evidence suggests	What you can do
Can lisinopril cause depression?	Listed in official side‑effect reports but appears uncommon. [1] [4]	Monitor mood after starting/changing dose and report persistent changes.
Class comparison	ACE inhibitors have lower association with depression than reserpine/methyldopa and possibly some beta‑blockers. [2]	If needed, discuss switching within antihypertensive classes.
Quality of life	ACE inhibitors may be neutral or slightly favorable for well‑being in some studies. [3]	Consider overall benefits vs. risks when evaluating symptoms.
Inpatient cross‑sectional data	No clear link between ACE inhibitors and depressive symptoms; steroids showed association. [5]	Review other medicines (e.g., steroids) and conditions that might explain mood changes.

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