Which one of the following drugs is most likely to cause symptoms of severe depressive disorder when used in the treatment of hypertensive patients?
A. Captopril
B. Hydrochlorothiazide
C. Prazosin
D. Nifedipine
E. Reserpine
Answer: E. In addition to decreasing the storage of NE in sympathetic nerve
endings, reserpine causes a dose-dependent depletion of brain amines,
including NE and serotonin. Symptoms of depression are thought to be
related to a functional deficiency in noradrenergic and/or serotonergic neu
rotransmission in the CNS—the “amine hypothesis of depression.” Although
other drugs used in the management of HTN may cause CNS effects, reser
pine is the most likely drug to cause severe depression.