Taking Antidepressants But Still Sad

Apocalypse Suicide Page
Good Mood
Living with Depression
Mental Health Recovery
NIMH
SHOCKED! ECT

HealthyPlace.com Radio
Depression Support Groups

Books on Depression
Conference Transcripts
Depression Videos
Diaries - Journals
Disorders Definitions
Mental Health News
Online Depression Tests
Psychiatric Medications
Resources
Site Map

Email
ICQ
Instant Messenger

Visit and Post

Abuse
ADD/ADHD
Addictions
Anxiety-Panic
Bipolar
Eating Disorders
Personality Disorders
Self-Injury

send this page to a friend

Taking Antidepressants
But Still Sad

cont. from

The boom and bust

From 1988, when Prozac (the first SSRI) was introduced in the U.S., to 1998, prescriptions for antidepressants tripled from 40 million to 120 million, fueled largely by the popularity of that "celebrity pill." Radically different from the previous generation of antidepressant medication, mostly because overdosing was unlikely, the SSRIs at one point were seen as so personally transforming that even people who were not clinically depressed took them for a little performance boost.

By 2004, nearly 150 million U.S. prescriptions were written for the drugs, and they represented the third-largest selling class of medicines after cholesterol and ulcer drugs.

But last year, U.S. sales of these medications, while still sixth in the leading classes of therapeutic drugs, dropped sharply, according to IMS Health Inc. a Fairfield, Conn.-based tracker of prescription drug data. And prescriptions for patients 18 and younger have plunged by 20% since 2004 when the suicide issue was raised at FDA hearings, according to NDC Health Corp., an Atlanta healthcare information provider.

Dr. Judith Bucholtz, a psychotherapist in Brentwood, says that several years ago nearly half the people who came to her for psychotherapy were also taking antidepressants. Today, only three of 20 patients are using the drugs. "There seem to be more and more people who are reluctant to take these medications," she says. "There was more confidence in them before the FDA hearings."

The much-publicized hearings focused on the association between antidepressant medication and suicidal thoughts among children and adolescents. The following October, the FDA told makers of antidepressants to place a black-box warning on the drugs stating that antidepressants can cause suicidal actions in children and adolescents. Last year, the FDA modified its warning, saying the drugs "increased the risk of suicidal thinking and behavior in short-term studies of adolescents and children" with depression.

The FDA placed no such warnings about the medications' effects on adults. But in July 2005, the agency nonetheless issued a public health advisory to alert patients and healthcare providers that there may be a possibility of increased suicidal behavior in adults treated with antidepressants.

However, a 10-year study that also appeared in the January issue of the American Journal of Psychiatry looked at the health plan records of more than 65,000 patients and could find no evidence that antidepressants caused suicidal thoughts. In fact, it found that the number of suicide attempts actually fell by 60% in adults during the month after they began taking the medicine.

"The irony and the lost message is that the risk of suicide in depression is very real and very clear," says Leuchter. "But the risk of increasing suicidality in treatment is vanishingly small."

The sheer dimensions of depression illustrate the importance of treatment. A massive study conducted by the World Health Organization, Harvard University School of Public Health and the World Bank, found that by the year 2020, depression will be second only to heart disease in terms of disability caused. In any one-year period, 9.5% of the population, or about 18.8 million American adults, suffer from a depressive disorder, according to the National Institute of Mental Health. And though less than half seek treatment, many try to get help from their primary care physician or, less frequently, a mental health professional.

As currently offered, even treatment is no guarantee that the depression will lift.

Veering off course

Jennifer, a 38-year-old Web designer from Castro Valley, has struggled with depression since 1996. When she was most depressed, the only reason she didn't kill herself was because she simply couldn't summon the energy to do it.

She couldn't think, couldn't work and barely managed to emerge from her bedroom for days on end. When she went out, usually to a therapy appointment, she would shop compulsively, spending money she didn't have. She would then retreat, once again, into the isolation and paralysis of her home. Sometimes more than a week would slip by before she took a shower.

Then her psychiatrist prescribed the antidepressant Trazodone. The depression eventually lifted but she was left "feeling dead," she says.

"I was just blah, as if there were nothing to feel. I didn't get too happy or too sad and my libido was completely gone." She had been a computer programmer, but the medicine left her so addled cognitively that "it didn't make sense any more. It was like being a math whiz and not able to do simple algebra."

For 10 years she would take various medications that her doctors prescribed, then abandon them when the side effects bothered her or the medicine didn't seem to be working after a few days. Being urged to stick with it, or to keep taking the medications even when she felt a bit better, didn't persuade her.

"The side effects are immediate, but the beneficial effects take some time," says SUNY's Schwartz. "So if people don't have a relatively quick response, they give up. These drugs take weeks to be effective but often people think, 'These are mental medicines — they shouldn't have a physical side effect.' "

advertisement

Psychiatrists have attempted to more completely understand the mysteries of "treatment compliance" or, more simply, why some people will take their medicine while many just stop.

In a 2005 study in the journal General Hospital Psychiatry, researchers attempted to identify what made people continue, discontinue and switch their SSRI medications over a nine-month period.

continue page 3 ~ pages 1 ~ 2 ~ 3

Last updated: 3/06

Taking AntidepressantsBut Still Sad

Related Stories

Taking Antidepressants
But Still Sad