David: For a more detailed look at the various medication side-effects, visit our psychiatric medications pharmacology.

lambieschmoo: There is a lot of talk about the negative effects of long-term SSRI use. Could you please comment on this?

Dr. Roth: To my knowledge, there are very few long-term problems with SSRIs. Generally, they are safer than most other classes of antidepressants.

David: Do patients taking medications like antidepressants, mood stabilizers, anti-anxiety medications, have to worry about becoming "addicted" to them?

Dr. Roth: For the most part, no. None of the antidepressants, mood stabilizers have addictive potential. Some of the anti-anxiety medications can be addicting, but only in very few people. Anti-anxiety medications are very safe.

David: On the same subject, here's an audience question:

Hysign3: Dr. Roth, could you please tell me the proper way to get off Ativan? I take .5mg twice a day and 1mg at bedtime and I am having bad side-effects from it.

Dr. Roth: If you are having bad side-effects of medications, you should stop taking it. However, if you can withdraw, that is highly recommended. You should talk to your doctor about a withdrawal schedule. It would be dangerous to stop it all at once.

DottieCom1: What are the consequences of lifetime use of high doses of Sinequan?

Dr. Roth: That is one of the older tricyclic antidepressants. There are no long-term side-effects problems with Sinequan when taken as directed.

Dana1: I've had severe Generalized Anxiety Disorder (GAD) and Phobias for 20 years now. I am in setback and have $4000.00 in books and tapes. Any suggestions on anything new to change my thinking besides Cognitive Behavioral Therapy (CBT)? And, can one "program" the mind to not fear the mornings and symptoms?

Dr. Roth: There are many meds which can be helpful for Generalized Anxiety Disorder (GAD) and phobias. I would imagine you have been on some of them. If not, you should talk to a doctor to prescribe medication for your condition.

David: Because some people are without insurance, or on a limited budget, given the choice of medications vs. therapy for depression, anxiety disorders, bipolar disorder, and OCD (Obsessive-Compulsive Disorder), which would you recommend?

Dr. Roth: Meds and therapy together work best. A county mental health clinic may offer treatment on a sliding scale, which you can afford without insurance. See if your county has one.

David: But if you can't get in on a program, which would you recommend-- the medications or the therapy?

Dr. Roth: Medications should work more quickly to relieve the most problematic symptoms. Some meds are relatively less expensive.

tears2: Why does it seem that SSRIs work great for about 6 months, then stop working?

Dr. Roth: They shouldn't quit working. It may be that the depression or other symptoms are relapsing or getting worse and a higher dosage may be required from time-to-time.

dano: Why do many psychiatric drugs cause weight gain?

Dr. Roth: We don't know the answer to that. We can only speculate and identify the drugs that are known to do that.

AllWithin: Does Zyprexa cause weight gain?

Dr. Roth: Yes, it does. It may be the most notorious drug for weight gain. It is also one of the best anti-psychotics on the market.

David: So, I guess what you are suggesting, Dr. Roth, is that there's a trade-off in many psychiatric drugs. Many have side-effects. Hopefully, the benefits outweigh the medication side-effects.

Dr. Roth: It's all a question of benefits and risks. That applies to surgery and all medications we have. There is nothing in all of medicine that has no side-effects or risks, and we always have to weigh them.

dhill: Why don't doctors encourage parents/patients to try other avenues first? e.g. counseling, realistic thinking, etc.?

Dr. Roth: That should depend on the symptoms of the illness. If the symptoms are not causing major dysfunction, then therapy can be very helpful and is all that is needed. But if the symptoms are serious, for example keeping you out of work, then the psychiatric medications are needed.

David: We all see or hear ads for medication trials. "Free Checkups and Medications". When people with no insurance hear that, they take that as an opportunity to get help. What do you think about the clinical trials for medications, and are patients at-risk participating in them?

Dr. Roth: I hope they would check out parties that are conducting the research. If it is a well-known medical hospital or school, it is a great opportunity to get the latest care for free. Keep in mind, that without research programs, we would have no meds at all!!