Drugs Raise Risk of Suicide (antidepressants)

[leftchick]

http://story.news.yahoo.com/news?tmpl=story&cid=1802&ncid=1802&e=2&u=/washpost/20050218/ts_washpost/a33389_2005feb17

Adults taking popular antidepressants such as Prozac, Paxil and Zoloft are more than twice as likely to attempt suicide as patients given sugar pills, according to an analysis released yesterday of hundreds of clinical trials involving tens of thousands of patients.




The results mirror a recent finding of the Food and Drug Administration (news - web sites) that the drugs increase suicidal thoughts and behavior among some children, and offer tangible support to concerns going back 15 years that the mood-lifting pills have a dark side.


The examination of 702 controlled clinical trials involving 87,650 patients is the most comprehensive look at the subject and is particularly telling because it counted suicide attempts and included patients treated for a variety of conditions, including sexual dysfunction, bulimia, panic disorder and depression.


Experts cautioned, however, that the risks should be balanced against the drugs' benefits. They have been shown to be effective against depression and a host of other disorders in adults, a positive track record largely missing in tests of the drugs on children.

[Spinzonner]

1. Nothing like a good contemplation of suicide to raise the spirits

[Stew225]

2. I hope the families of those in the "controlled" clinical group

who ended up commiting suicide were fairly compensated.

[LisaL]

29. Did you not read the article? People on sugar pills

were better off in terms of committing suicide than the ones on antidepressants.

[Igel]

47. Attempting, not committing.

At least for me, you commit suicide, you're dead.

[Don1]

3. Wow.

Talk about the drugs being a final cure for depression...

[DebJ]

4. I firmly believe the Zoloft Defense was right. My son took Zoloft

very briefly, and his response to this medication, and to several other SSRI's that his doctor attempted to use, produced results very similar to that boy's responses. Except I was smart enough to yank those meds as soon as I saw the increased hostility in my son (who has BP), so he never got to the full blown manic 'hearing voices' stage. My son's doc must have tried (in good faith) at least 6 different SSRI's. We stopped everyone of them between 4 days and 6 weeks, as his behavior patterns changed each time to very hostile. Then I heard from parents of bipolar kids, in an online resource, that there was some evidence that use of SSRI's with bipolar kids can be particularly bad news.
I'd like to write this poor kid and tell him that someone out here understands.

[etherealtruth]

9. Antidepressant use in people with bipolar disease...

... is very difficult------------did your physician prescribe "mood stabilizing" drugs or antipsychotics along with the SSRI's?

A very clear and understood side effect of SSRI's is that they DO trigger manic episodes.

[livinginphotographs]

12. From what I've seen, SSRIs are HORRIBLE for those with BP.

I've known a couple of BP sufferers, and SSRIs just made them so much worse.

I think the problem is doctor's ignorance, or people becoming consumers instead of patients. They see the pretty commercials, and demand a drug, regardless of what the doctor says.

[ElectroPrincess]

20. Yes, but it's also undeniable that those with BP depression can

become severely depressed AND neither lithium or the new "mood stabilizers" will suffice to lift them out their depression.

It's a tough balancing act, but when a person with BP is suffering from a clearly severe depressive cycle, the psychiatrist must attempt to lift the depression while staving off a manic episode.

It's being discovered that some SSRIs are less likely to trigger mania. Along with close monitoring, a psychiatrist must treat the full range of symptoms within this very difficult to treat illness.

[etherealtruth]

23. Mental illness is such a complicated issue...

Admittedly, psychiatric drugs have improved the lives of those who battle mental illness. Drugs can not be the only treatment-----one would not send a person whom has had a "heart attack" home with a prescription for anticoagulants and assume that is all she needs. So often that is what happens to those seeking treatment for mental illness.

Another important aspect in the treatment of someone with mental illness is that YOU have important responsibilities in your care also (the person whom has had a heart attack needs to lose weight, exercise...).

My long winded rambling leads me to an issue I strongly believe in -----WE NEED PARITY in the coverage of treatment of mental illness, so that all facets of these diseases can be effectively treated.

[DebJ]

74. To get parity, the public needs to comprehend that 'mental'

illness is a PHYSICAL illness: a Neurobiological Brain Disorder, or NBD.
Just as diabetes means your pancreas does not function properly, and this is a physical ailment, the same with 'mental' illness. I HATE that terminology; it is one of the things that keeps parity from happening.
Not covering NBD's the same as diabetics, is like insuring for heart trouble, but not kidney trouble. Makes no 'sense'....just 'cents' for cold hearted bastards who don't care.

I talk about this every chance I get. What do I hear, "Well, gee, when my Dad died, I was depressed. But I just got off my butt and Got Over It." AAAAAHHHHHH!!

[HuckleB]

77. Yup.

Couldn't have said it better myself.

:hi:

[Jamastiene]

5. If those sadistic

shrinks would spend one iota of time investing in some research to find drugs that help depressed people instead of always handing out pills that take weeks to work, more people would feel a lot less pain and the illegal drug use in this country would probably drop significantly. I mean come on. Give us a break. I shouldn't have read the post. I have been dealing with shrinks since I was 11 years old and suffering from so called depression forever now. I have yet to get the same diagnosis twice and no antidepressant has ever worked on me. I was better off playing hippie...

[fertilizeonarbusto]

26. Amen, my friend

Sorry, no anti-depressant worked better than marihuana for me. Period. And frankly, I trust the drug dealers more than the people who gave us Vioxx et al.

[Name removed]

6. Deleted message

Message removed by moderator. Click here to review the message board rules.

[shrike]

48. Clinical depression doesn't have much to do with being happy or

unhappy. It's a real illness. For some people, depressants worked wonders -- myself included.

[HuckleB]

50. Thanks for the misinformation.

Please explain to us all how cocaine affects the brain. And then please explain to us all how SSRIs affect the brain.

I can't wait to read your explanation.

[ElectroPrincess]

7. I don't want to be contentious but one rationale for this increased

risk of suicide is this: People who are coming "out of" a severe clinical depression, do not achieve the full effects of any given antidepressant for 2-3 full weeks. Why? By nature, ANY antidepressant's pharmacological effects to alter brain chemistry develop slowly with constant blood levels, they reach maximum efficiency WITHIN WEEKS not days.

Please consider the following: A person who is severely depressed is almost catatonic and unable to act on suicidal thoughts and feelings. HOWEVER, and this is the point, as the blood levels of antidepressant increase and remain steady, yet have not achieved the FULL EFFECT upon the specific brain neuro-chemical actions, the depressed person gains *more energy* to act on those suicidal thoughts and feelings.

Please don't consider that I'm a fan of psychiatrists and/or the drug companies, NOR the present mental health system.

My point: During this initial phase of antidepressant implementation, BOTH the client's primary psychiatrist as well as their family members should CLOSELY monitor the individual for signs that they may have the energy to ACT OUT their suicidal ideation.

If one of my immediate family members were diagnosed as "severely depressed" and placed on antidepressants, I'd take time off from work OR find some other trusted person to be with them 24/7 during the first three weeks of being placed on a new (even med changes may trigger action) antidepressant medication.

It's not that the antidepressant CAUSES the person to commit suicide specifically, but that in that "in between" phase of mood elevation, the client develops just enough energy to act on the ideation - BUT - is NOT experiencing the maximum desired effect of mood elevation such medication have to offer.

I hope my attempt to explain this concept above makes sense as it is not an simple process by any stretch of the imagination. Also we all must must be forewarned and alert to the possibility of any side effects, or perhaps, individual (idiosyncratic) reactions to include what IS PROPOSED above.

My opinion regarding the introduction of antidepressants is the LACK of close monitoring in this CRUCIAL PERIOD (2-3 weeks) has more to do with increased suicides much more than the biochemical effects of the particular antidepressant. If a person has a "bad reaction" to an antidepressant they can be switched, whereas if a person now has the energy to express their emotions - emote and/or cry out, there will be a loved one to encourage and comfort them so they don't follow through with a suicide attempt.

If all of the above comes together, and three weeks following implementation the particular antidepressant LIFTS the severely depressed person's mood from severely to moderately depressed, we're out of the woods for suicide and can work on behavioral/cognitive treatments with considerable less risk.

Yes, this is a very COMPLEX area and my focus is on psycho-pharmacology (how medications interact with brain chemistry to HOPEFULLY produce the desired effect) coupled with cognitive/behavioral therapy.

[Bridget Burke]

That makes a lot of sense.

But--for those on their own, or when family members can't take time off work--some kind of institutional care might be indicated for the first few weeks. In a pretty low-key place, one hopes. Or frequent clinic visits with serious monitoring.

But this kind of care is more expensive than just writing a prescription. Would the bean counters at the insurance companies & HMO's allow it? The results of this study seem to indicate that they should.

[ElectroPrincess]

15. If my loved one did not pose an *immediate* risk (judgment call)

but appeared severely depressed without behavioral acting out problems, I'd try (like there's no tomorrow!) to get SOMEONE trustworthy to be with them rather than have him put in a mental health facility as an inpatient.

It's just my personal opinion, but unless someone near and dear to me was actually on the verge of acting or a threat to the safety of others, I would not submit them to even the psychiatric ward of a fancy smancy hospital, much less a mental treatment facility.

Some of my reasons are admittedly personal and too long to list, but a mental health facility is often is NOT a good place to emotionally mend (IMO) but merely a holding area to prevent folks from causing themselves (or others) harm and/or unable to function in society the most basics of personal care.

If it was my absolute *last resort* I'd begrudgingly follow through because, during the first few weeks on antidepressants, the individual must be monitored. But I hope that I would be able to rely on a family member or trusted friend instead.

On edit: Your question on HMO coverage - I believe that a number of Insurance companies will provide for inpatient care with a deductible or a certain percentage each day. If one is blessed to have health insurance, it's probably wise to check your Individual policy for the details. There's always too many details. ;)

Again, the above is NOT advice, just my personal experience and opinion re: the state of the mental health facilities in the USA.

[amazona]

31. no I'm sorry this is too dangerous

So the family and friends have to take the risk of monitoring the patient on the new medication? That is just great for those of us who have been threatened at gunpoint by the person just placed on the new SSRI.

I am sorry. This is not the job of family and friends. When the depressed person's prescription changes, they should be placed in a proper clinical setting -- a hospital with paid professionals who are big enough to handle them if they get violent -- and the insurance companies should be forced to pay for it.

I should not have a gun in my face because insurance companies haven't cared to cover hospitalization for the depressed for the last couple of decades.

We need to put the responsibility back where it belongs. It isn't that damn complex. Shrinks, drug companies, and INSURANCE COMPANIES have known about this potential side effect for years. If Andrea Yates had been placed in hospital for those two weeks after her medication was changed, we'd have never heard of her. Same for that Columbine kid whose medicine was changed just two weeks before. During that crucial time of brain change, that 2-4 weeks, the depressed person needs to be in hospital to monitor for risk of violence. Because it isn't just suicide that happens. It is murder too.

The conservation movement is a breeding ground of communists
and other subversives. We intend to clean them out,
even if it means rounding up every birdwatcher in the country.
--John Mitchell, US Attorney General 1969-72

[baba]

55. Medicaid will sometimes cover hospitalization.

Sometimes, if a person's insurance won't cover hospitalization, Medicaid will cover it.

[baba]

54. This is true.

I'm in the mental health field. We're trained to do suicidal assessments, and one of the warning signs we are trained to look for is "lifting depression" or a depression that is getting slightly better. Often a person who did not have energy to try to kill themselves before will try when the depression has started lifting and they get more energy.

[DebJ]

75. Wonderful post! Thank you!!!!!! (My son has BP) n/t

[Jamastiene]

85. The sad truthis

that not everyone who is clinically depressed has "loved ones". I know this sounds harsh, but you assuming that we have caring psychatrists/psychologists as well. It doesn't happen very often. Most of the time, they won't help during that time. In my case, suicide attempts have been unsuccessful and the only reason for that has been no guns in the house. I was never taught about them, so I am, as Deborah Harry says in the title of one of her songs, "Forced To Live". If that is going to be the case and the antidepressants never work and they never have, then yep, the hippies had the right idea. I sure as hell never though about suicide when I did that. Now, it's a romantic vision of art on the walls with my very own brains. If they are truly the culprit behind this horrible unexplainable unending pain in my chest, yes, physical effects of depression feel like a permanent heartbreak, they they need to go. And soon, I will be making the choice again. It's either break the law or break the law. I'll either be getting a gun permit so I can take care of business or I'm going back on the one drug that ever did help... I care enough about me to choose the latter of the 2, because of the off chance I'll screw up the former. I'd rather be tuning out, dropping out, and zoning out, than blowing out any time. Thanks very much.

Antidepressants are still a sadistic way to treat such a wretched feeling as clinical depression. Those of us who have been insulted by antidepressants should be forming an alliance to change this horrible state of affairs and DEMAND that some better alternative to suffering through 2 to 3 weeks, which can be an eternity with those feelings to still not get any relief. The bottom line is that you are assuming we get relief. We don't. We just feel worse because most of the time the shrinks do NOT know what they should prescribe for us, because they DON'T actually do any tests on our brain. If they know certain areas of the brain are affected, then show me and find the right fucking drug to make the pain stop or move outta the way and leave me be. You tell me. What other life threatening medical condition is treated without tests? You can't answer that one, because there are no other life threatening medical conditions that doctors in this day and age will attempt to treat based on a hunch by let's face it, most shrinks are sadistic and insane themselves, unstable people. I have yet to meet a shrink who isn't crazier than they claim other people are for a living. I used to have a shrink who wore pajamas and bedroom slippers to work. And he's telling me I am crazy? Sorry that doesn't pass the bullshit test.

[etherealtruth]

8. My understanding was...

...that an increase in suicide attempts and ideation occurred early in the drug therapy. At a time when the lethargy (associated with depression) may lift prior to an improved sense of well being. If you don't have the energy to get out of bed, you probably don't have the energy kill your self (or others).

These are serious drugs that require serious follow up. Depression is a complex illness; physicians, patients and their loved ones need to be informed of the risks associated with the disease as well as the risks associated with the drugs.

[ElectroPrincess]

10. Gosh, you put this well ... much more concise than

my genuine but long-winded attempt above.


Kudos etherealtruth! :toast:

[ender]

41. no, you're wrong.

you are repeating pharmco apolegetics for SSRI's failures.

they absolutely, positively cause suicide and suicidal thoughts, and their clinical value is questionable at best, and most likely harmful across teh board.

St. Johns Wort, in legitimate clinical studies, has been shown to be more effective, and less addictive.

I predict that soon, within 10 years, SSRI's will be looked at as barbaric and a huge mistake.

[HuckleB]

49. If the poster is wrong.

Please show us, don't tell us.

Thank you.

[doodadem]

59. Sorry--not buying it

I've been bipolar (we used to call it manic depressive) for most of my life. Horrible genetics, most of my family has dealt with their own version of this disease, and I've already lost one sibling to it. My understanding is that the SSRIs regulate seratonin in your system, levels of which directly effect well being (something St. John's Wort just can't do). I have just started a new prescription of Lexapro. Anyone with experience with this drug?
Mental illness in this country is a big, shameful secret, and still carries a huge stigma. I don't see where it is much different then the diabetes that runs in my family.

[HuckleB]

67. Indeed.

The fact that there continues to be such a ridiculous stigma attached to mental illness is a shame upon our entire society. It's no different than diabetes, or cancer, or any other illness.

As for Lexapro, in my experience it has offered fewer side effects for more people than any other SSRI. I have also received fewer reports of "cognitive clouding" with Lexapro (and Celexa) compared to the other SSRIs. Further, I've seen a great deal of benefit for anxiety-ridden patient from Lexapro. That said, there are people who can't tolerate it, as with any medication. And strange side effects may strike any individual on any type of medication. Still, it seems to have the lowest side effect profile -- while offering fairly strong benefits -- of any SSRI.

Just FYI -- I thought you might be interested in some of this research re: bipolar disorder:

http://www.cpa-apc.org/Publications/CJP/current/dec2004.asp

[Ironpost]

11. I suffer from anxiety and have all my life

My doctor at the v.a. won't give me anything for it, (diasapams) but he gave me paxil. I took one dose and will never again ever consider it. I couldn't sleep nor concentrate, I lost four days of my life because of it. I shudder when I of hear someone taking any of the ssri's. It was a scary ordeal for me.

[Nimrod]

16. I feel your pain - seriously

I lost two months of my life to Effexor. That was about 8 months ago and the withdrawal symptoms have still not passed. I'm currently trying to find some way to get a neurobehavioral evaluation to see if anything can be done.

Pharmaceutical labs are the new crack dealers. When a month costs over a hundred dollars they sure as HELL don't want you to be able to ever stop.

[etherealtruth]

17. I am so sorry Nimrod and ironpost...

5 years ago I was desperately depressed (associated with a divorce occurring a long way from where my heart considered home). I believe SSRI's (Paxil) saved my life. It helped me "get to a place" where I could make sound decisions and let me move on with my life (very positively).

I do not doubt your terrible experiences (and I am truly sorry for them). While I believe consumers need to be aware of the possibility of adverse effects, these drugs can be lifesavers for many.

[Nimrod]

19. Yes, they can

However (as an example) I've done a lot of research on Effexor. Long-term symptoms of withdrawal according to several reports include loss of physical coordination, loss of manual dexterity, loss of concentration, confusion (and in some cases dementia), heightened anxiety, migraines, vomiting... and the list goes on.

I have the literature still and have gone over it with a fine-tooth comb. Here's what we get for warnings: ">1% of subjects have temporarily experienced short-term and mild side effects following titration off this medication including... (lists off what I have above)."

I promise you that what I and others have experienced is NOT short-term or mild.

A drug that cures cancer in 99% of patients and inflicts the bubonic plague on the other 1% IS still a good medication. But if the company doesn't inform you that you're risking the bubonic plague, THEN it becomes an issue.

[ElectroPrincess]

22. Whoa! I have not kept up with the latest research but that's shocking ...

I didn't know that going off Effexor resulted in withdrawal symptoms. However, I do know that one must slowly wean off of Paxil in order to dampen some very nasty side effects.

Thanks for the flag ... I'll be sure to check it out. :-)

[Nimrod]

24. A good website

www.dr-bob.org

It's a message board moderated by a PHD. It's a great place to get consumer reviews of anti-depressants, including side effects and withdrawl symptoms that the drug companies print in 2-point type if they publish it at all.

[ElectroPrincess]

40. Thanks! Quality Site Reference. eom

[steve2470]

62. Discontinuation syndrome the shrinks call it: you have to wean

off all SSRI's carefully because the brain literally has to adjust to being without the chemical. Not a classic addiction, but something to be aware of.

[ElectroPrincess]

63. LOL, I stand corrected :-) ... but still, to the patient it feels just

like a withdrawal. <eg> As I recall these symptoms include nausea, headaches, mood swings. Doesn't sound like much fun and it would be NICE if the doctor would inform the client of Discontinuation Syndrome if it applies to the particular antidepressant he/she wishes to prescribe. There may be additions but Paxil and Zoloft come first to mind?

[Nimrod]

79. This is very true

I weaned off of Effexor over a period of seven weeks. Although I'm definitely better off than a friend of mine who was taken off of Effexor suddenly. He's still on disability because he has zero balance and coordination four years later. He needs assistance to walk or else he'll stumble and fall down.

[baba]

56. Your doctor.

So many doctors refuse to prescribe benzos because they "could be" addictive. This is so wrongheaded-benzos can be so helpful to people with anxiety and panic. I can see being cautious about presribing them to someone with a history of drug and alcohol abuse, but why make others suffer?

Can you find another doctor? Not all are like yours. A responsible doctor can prescribe benzos and monitor the patient closely for signs of addiction.

[HuckleB]

71. Could be that the doctors have noted far too many issues with benzos.

I for one have little positive to say about them, and the patients I know who've been on them would agree. Long-term use of benzos is fraught with dangers that make SSRIs look mild by comparison.

[baba]

80. I agree they can be misused.

If one does get addicted, benzos are the most dangerous drug to detox from.

I think that for some people with panic attacks, benzos are the only thing that works. They should always be prescribed as a PRN, and taken only when needed.

[HuckleB]

82. No disagreement there.

Nothing does the job for an acute panic attack as well as a benzo, for those who can tolerate them.

[BlackVelvet04]

76. I, too, suffered from anxiety

and found that SSRI's increased the anxiety and Xanax caused me to be depressed. I finally quit taking all that stuff and I found that taking Coral Calcium every day got rid of my anxiety. I no longer suffer from depression or anxiety for which I am very grateful. Considering calcium is safe in even high doses you might want to give it a try. I no longer buy the expensive coral calcium I buy the drug store brand from a national pharmacy.....I only buy that which has nothing extra added to it. It costs me about $10 a month.

Anyway, good luck in conquering your anxiety. I think you are fortunate your doctor has not given you any of the benzodiazipine drugs such as Valium, xanax, Librium, etc.

[amandabeech]

78. You might want to try Buspar for anxiety.

It is not a benzo, but is in a class of its own. It is not taken on a prn basis but regularly every day. I've used it and found it to be wonderfully effective.

[Mountainman]

13. Left untreated, they may be more likely to commit suicide.

I had clinical depression for 3 years. Before I got my medication I was constantly thinking about suicide. I haven't thought much about it since I started taking anti-depressants.

My guess is that there would be more suicides if the drugs were not used.

[ender]

42. you are completely wrong.

the study cited has shown the exact opposite of what you said, sugar pills lead to less suicide/suicidal thoughts than SSRI's.

SSRI's are *not* better than nothing. Nothing, would be more effective than SSRI's.

[HuckleB]

43. That's too big of a generalization.

The sugar pills may actually be leaving people in such a stagnant depressed state, that they don't have the energy to think about, plan or act upon suicidal thoughts at that time. However, as depression tends to ebb and flow in most people, they very well may find that energy later, while also being untreated for depression, thus, very possibly making it more likely that they will act upon suicidal thoughts in the long run. The general downward trend of the suicide rate with the introduction of SSRIs certainly would argue for this line of thinking.

[dandrhesse]

14. fyi about how they affect my family

Our family is adhd. Many relatives have been diagnosed incorrectly or incompletely. Because of the ignorance/and or unwillingness to admit that kids do no "grow out of" adhd many adults with the condition are diagnosed as depressed, bi-polar and obsessive-compulsive. All of these conditions can occur along with adhd but if the adhd is not treated with a stimulant medication or whatever treatment works for them, in my family we have had great success with stimulant meds, then the anti-depressants don't work and can actually make the depression worse.

That is what happens in my family, generally. for what it's worth

[etherealtruth]

18. ADHD....

I found an unexpected effect of SSRI's (taken for depression) was that it gave me an increased ability to focus... So, "who knows"....

[dandrhesse]

21. everyone's chemistry is so different. It is a "best guess" at best with

any medication. Everyone has different reactions and it is up to the patient and their family to keep a lookout for whether the meds are effective or making the condition worse. The rub comes when people live by themselves, or their family is not observant, or they and/or their family don't discuss "those matters".

Your point is the BIG PICTURE point. We are each different and it is very difficult to make any generalized statements regarding any medication. What may work for one person could be totally wrong for the next, sometimes even with siblings.

[ElectroPrincess]

25. Excellent point!

I'd only add that if one is suffering from moderate to severe depression, they take their time in finding a quality psychiatrist.

I know that many folks don't have the $ to pick and choose ... that's when you should share your thoughts and feelings with a spouse or other close relative so they can be *assertive* (or encourage you to be) with an average psychiatrist if/when you experience severe behavioral/emotional side effects and MUST be taken off and prescribed an alternate antidepressant.

A good Psychiatrist will do a thorough intake interview so he/she can consider "the most" appropriate antidepressant for your person.

More times than not, a person must try more than one antidepressant trial to achieve the right medication for their individual body chemistry.

However, a well trained and astute psychiatrist will also be more aware of the latest research being able to minimize this seemingly endless (for the client and family) trial and error period of finding the most effective antidepressant (and ideal dosage) for EACH individual in his/her care.

The above comes across as "common sense" but unfortunately many people have suffered needlessly because a stubborn (or too busy) psychiatric team are poor listeners and/or not consistently empathetic to their clients.

[Cats Against Frist]

30. On Prozac I was superwoman

At the time, I was diagnosed with obsessive-compulsive disorder and a unipolar depressive episode (which would all be changed to Bipolar II/mixed-effective w/delusions two years later) -- but, at the time I was taking Prozac, it helped me do all the crap that everyone was hassling me about. I am a messy person by nature, and it made me very meticulously clean. I had fallen out of love with my boyfriend, and had been taking Vicodin and smoking weed while fucking the next door neighbor -- and that stopped. I usually ditched my college classes, and just pulled "Bs" by reading the text and taking the tests -- it made me get up and go to class, and focus and I got all straight As, that semester, including in Empirical Research Methods, a class that I'd dropped 3 previous times, because I couldn't understand it.

That said, it gave me horrible diarrhea, decreased sexual response (though nothing terrible), and I eventually had to go off of it, because of stomach problems.

Now, I take Wellbutrin - I think I have some mild ADHD, and the Wellbutrin helps with both smoking (I'm smoking like 3-5 cigs a day, down from 15) and concentration -- but it makes me TERRIBLY anxious.

It's really weird -- as someone said above, so many drugs, so many diagnoses. I really don't believe I ever had bipolar disorder. I think I am just naturally irritable or anxious, and, at that time in my life, I was very angry.

I'm torn about the Wellbutrin. It rules, but I don't like giving money to pharma and I don't know what the long-term affects are. Who knows?

[ElectroPrincess]

37. Have you tried (are you on) Wellbutrin XL ?

Let me seriously preface this by claiming that I'm NOT an expert and NOT giving advice. However, since my field is physiological psychology, I'll put this out here from what I have observed -

Many people who have had profoundly negative side effects from Wellbutrin, do much better (able to tolerate), Wellbutrin XL. It's extended release formula does NOT flood you bloodstream with a high initial dose but keeps a sustained level of medication all day with one dose in the AM. Thereby, with lower blood levels comes less chance for negative side effects.

Yes, Zyban (lower doses of Wellbutrin for those attempting to quit smoking/ or chew - Yuck!) has been used. But like your experience, many folks report nervousness and headaches. Sometimes these symptoms lessen over time ... sometimes. ;)

Gosh, the above reminds me of all those damn inane "Drug Company" promotions ... "Ask your doctor for THE purple pill!"

Sorry if this comes across as haughty. :spank:

[conflictgirl]

83. That's so interesting to me - I have the same side effects

I took Wellbutrin for a couple of years. It helped with the depression but over time I eventually realized that I was becoming anxious and paranoid. So I quit taking it for a while, then the depression came back, so I recently started back on the Wellbutrin (its the XL version too). And I noticed the other day that some of the paranoid thoughts are coming back too, and thinking lots of morbid thoughts too.

Basically it feels like a huge dilemma for me because I really don't like the drug and I don't like taking pharmaceutical meds instead of finding more natural methods. But I don't know what my other options are, since I've tried all the natural methods and other antidepressants and none of them worked satisfactorily either.

[MountainLaurel]

36. Yes

In fact, one of the symptoms of depression is actually the inability to concentrate, even on tasks you find interesting. I find that I am much more "scattered" (from not being able to work, to forgetting to pay bills) when I haven't been on a psychomed.

[HuckleB]

51. Exactly.

Far too many people are given the ADHD diagnosis, when the reality is that the concentration issue is related to depression and/or anxiety. ADHD should never be diagnosed unless depression, bipolar disorder and anxiety disorders have all been ruled out.

[baba]

57. True.

AD/HD is often misdiagnosed as Bipolar in adults, or missed completely. This is partially because people with AD/HD can have mood swings, depression and anxiety alomg with their inability to focus. Plus, as you noted, many professionals misdiagnose it even when a person's history clearly points to lifelong problems with concentration, attention span, and impulse control.

On edit: HuckleB also has a good point-that sometimes people are diagnosed AD/HD when they are really experiencing a mood or anxiety disorder. Also, remember that many people have co-occurring disorders.

[ElectroPrincess]

58. Yes

IMHO you got that right baba. ;) That's why it's important for the doctor to take an detailed history during the intake interview. To make matters even more complex, clinical depression can be a secondary diagnosis for those who meet clinical criteria for ADHD.

However, it is so TRUE that when a person with ADHD is misdiagnosed as BP and prescribed mood stabilizers, it's a trip through hell for their patient. Especially if there is a secondary Dx of clinical depression, the ADHD person on these inappropriate meds takes a nose dive in mood state and sometimes attempt suicide because they are falsely (medication induced) established depression. That's tragic and highly preventable.

[HuckleB]

27. So how do we save lives?

We also know that the suicide rate has gone down since the advent of SSRIs. So it's difficult to paint them as some evil thing, and it would likely be detrimental to the suicide rate to take them off the market.

Still, most practitioners know that the danger when starting SSRIs occurs in the first weeks and months, as the medication moves from simple "energizing" and other side effects to actually treating depression and anxiety. Yet, no practitioner or patient could spend much time, if any, in a hospital to be observed for safety issues, because insurance and society has chosen to be too cheap to offer that link of service, which has always been necessary for many people on these medications.

This also backs up my belief that GPs should not be prescribing these medications. They don't have the time to do a full assessment before prescribing, and they don't have the time to do the necessary follow up. That's a prescription for danger with any medicine.

Blah. Blah. Blah. I know.

Gotta go.

[etherealtruth]

33. True in a perfect world.

Mental health care is not available to many suffering from mental illness (lack of insurance coverage) and those with coverage may have to go through the maze of referrals required by HMO's. Those in the throes of mental illness, likely, do not have the time, the stamina or the financial resources to seek treatment from anyone but their GP.

[HuckleB]

34. Yes.

But it is the GP's job to get them the care they need.

[etherealtruth]

35. Once again, in a perfect world....

The GP should (and good ones try to) direct patients toward the appropriate caregivers. This is time intensive and costly...

We need insurance parity for mental illness and while I'm at it------we need affordable health coverage for ALL!

[DARE to HOPE]

38. We also need better NUTRITION...

...B vitamins and sardines, or some other source of omega-3's. The brain demands these.

Also the calcium series: vit D, magnesium, absorbable calcium. And coconut oil boosts all of these to cheer and to calm.

God bless.

[Desertrose]

45. couldn't agree more about the nutrition...

our depleted soils, GM plants, chemicals & pesticides and other factors have affected the quality of the foods we grow...plus all the chemical food we eat, natural grains being stripped then enriched with chemicals- vitamins the body is unable to absorb as well as the original ones, everything so processed and of course those additives to make it "taste good" ( ie: SELL better)......


No damn wonder our bodies can't carry out their normal functions...so what does the pharmaMD's do?? They give more chemicals......a very touchy situation to be able to cope with.

I am so sad that so many are suffering and really have little help to turn to...and that so many don't have the financial means to to afford to help themselves.... and that our choices seem to be taken away more every day....

[shrike]

52. Once again, depression is a real illness

And is as old as time. I don't think true depression can be helped by good nutrition, no matter how much "cheer" it brings one.

That said, probably for most people a mix of therapies tailored to specifically to them is probably the best situation. Putting nutrition into the mix for some folk may well help them. "Talk" therapy didn't work for me, but prozac did, and going on the drug also gave me the strength and calm to make a major life change that also benefited my mental health.

I thought of prozac as sort of a Popeye's spinach; for the first time in my life I had the wherewithal, albeit emotional, to do what I needed to do.

[HuckleB]

39. No argument there.

I just don't like to dismiss what should be by using terms like "in a perfect world...." I just don't think that what I'm hoping for is all that perfect.

Salud.

[etherealtruth]

46. I did not mean to be dismissive...

I think that the problems are so much larger than what GP's are capable of dealing with. Mental health issues are time intensive with little remuneration---------My "perfect world" scenario would fairly compensate GP's (and all other providers) for providing needed and appropriate care.

You are quite right, anyone who prescribes a drug, ethically must provide adequate monitoring for that drug-------I actually agreed with you all along. The system is what needs to change---to allow (and compensate) adequate follow up.

[shrike]

53. I'd have to agree with that

I got no monitoring, other than self-monitoring. Lucky for me, I got to be so obnoxious and overbearing during my quest for help I was able to get good care.

BTW, I started out by going to my primary care physician. He practically threw me out of his office, telling me he "didn't deal" with that sort of thing. Treated me like I had leprosy. But like I said, I'm a mighty stubborn b*tch.

[HuckleB]

44. Alas, the trends are not patient friendly.

http://www.cpa-apc.org/Publications/Archives/CJP/2004/may/patten.asp

[jbnow]

28. Health Canada

Has required the warnings on labels for some time, that they can increase the impulse towards self harm and/or harm to others.

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60. well gee I could have told you that

being I almost offed myself on the drug ZOLOFT. Evil crap it is ... pure evil. ugh

[steve2470]

61. I have seen many patients placed on SSRI's and I have never

seen nor heard of the suicidal side effect. I am sure with some patients that it exists. SSRI's are valuable for millions of patients, so as with all psychotropic and non-psychotropic medication, close monitoring of side effects in the early phases is well worth implementing. A point to consider: when people are clinically depressed, bothersome side effects on top of their already existing misery may be enough to "tip the balance" to get them to actively consider suicide. I'm not sure that ONLY the SSRI's are responsible for the suicidal ideation.

[HuckleB]

68. Indeed.

While I read about this via research and via courtroom drama, it seems nearly impossible to find anecdotal cases of apparent suicidal ideation caused by the medication noted by the psychiatrists, psychiatric nurse practitioners, and even non-prescribing therapists who serve patients on such medications.

[KissMeKate]

64. only effective 50% of the time- anti depressants are a scam.

they are addictive too- the withdrawal is horrendous.

[KissMeKate]

65. only effective 50% of the time- anti depressants are a scam.

they are addictive too- the withdrawal is horrendous.

[lynne]

66. Sadly, I've seen this up close and personal -

- I lost three family members in one day due to this. My cousin (by marriage) had been very depressed and he had been prescribed Zoloft. I'd known him all my life and you'd not find a kinder, gentler soul.

Something suddenly snapped in him. He got up one morning and took the shotgun to his wife (my cousin) and then to their adult son. He then took the shotgun to himself.

I was later told that a newly prescribed bottle of Zoloft was found. The date on the bottle didn't match with the number of pills left in the bottle. The thinking is that as he took the drug - and felt worse - he then took more than prescribed in an attempt to feel better.

This was about six years ago - before any connections between suicide and these meds were made public and I've no clue if there was any warning to that effect with the meds. We all wondered at the time if there was a connection . . .

[etherealtruth]

69. I am so sorry that your experience was so horrible.

I am sorry to everyone that has had really bad experiences with psych drugs (specifically SSRI's, in this thread). I do not discount your experiences and in no way do I wish to diminish your experiences...

Personally and professionally, I have seen these drugs work and work effectively---------I am so afraid that someone whom desperately needs help will not seek it because they don't believe they can be helped.

For most people with mental illness there is effective treatment (at minimum, lessening of symptoms). SSRI's are not miracle drugs,but they can certainly be effective.

For those of you who have experienced such horrible effects from SSRI's (and I'm sure other psych drugs)-------Please try an other treatment, another physician...

[coreystone]

70. The article referred to by the "staff writer" of the Washington Post....

is the typical type of reporting to consumers of concerning this most controversial topic. I am 54 years old and have suffered from depression since 6th grade. That is a long time. It was not officially diagnosed until much later in my life. The first AD that I had experience with was "ZYBAN" to help quit smoking. It is drug which was introduced in 1984 as a "anti-depressant" by the name of Wellbutrin. It was remarketed several years ago as a drug that affects the region of the BRAIN that has to do with "addictive" behavior patterns such as cocaine and nicotine consumption. Theoretically, the drug needs a certain amount of time to accumulate in the blood system to produce the effect of reduced "cravings" for nicotine. About 6 years ago I had my physician write a script for Wellbutrin (currently marketed as Zyban, but, the exact chemical composite). I found, after about a week, that the drug influenced my behavior in a most profound manner. I became much more "outwardly" honest (without emotional affect) than I would normally have been. I had relinquished the control of "not saying" things to people that I knew who would feel affronted by my "blunt honesty". This sounds simple enough, but, I work in a very internally social/political environment. The effect of the drug upon my behavior was not desired. After about 10 of usage, I self terminated consumption of this "anti-depressant".

As I have said previously, I have suffered from depression for the majority of my life; at least stemming back to about 40 years. About three years ago, I experimented with PAXIL (with a proper MD script). This drug tended to elevate my "lows" to a moderate level, and, at the same time "squashed" down some of the "high" anxiety ridden feelings. I have been diagnosed with "anxiety disorder", and, have had full panic attacks that would simulate the 3 to 6 seconds of "smashing" into a maple tree on a "lost" curve at 85 miles an hour seem as though an equivalent feeling which would last 45 minutes to a much longer time. For this psychological problem, I take "clonazepam" (Klonapin) at a minimal dosage (1 mg - three times a day), though, I attempt to minimize the daily dosage as much as possible; as needed.

NOW! I could proceed on and write a book about the psycho/psychiatric experiences that I have had in reference to medications, therapeutic sessions, and hospital admittances, but, I would rather spend the remainder of my post for responding to the original post of this thread.

Unfortunately, when such an article is published, the consumer reads it as "truth" and does not have the sophistication of asking questions regarding the scientific methodology being utilized. Nor, does this article explicitly offer the specifics of the "study groups", the scientific correlation scales, the t tests, et cetera. It does not reference the "psycho/psychiatric" journals which would enable on to "vet" the studies which have been conducted. TRUE, most would not have the education or professional background to comprehend the more detailed information which would be published in a more comprehensive expose of the "conclusions" of such studies which Mr. Vedantam concluded in the article.

There is nothing in the article which describes the "control" groups taking "Prozac, Paxil, or Zoloft" as would be distinguished by those taking the placebo" sugar pills. Have all of those groups been clinically diagnosed with "depression"?

I can remember that Del Shannon, a "rock 'n roll" idol of the early 60's, committed suicide in 1990. There was a big "ta-doo" about the fact that he had been taking Prozac. My understanding was that he had discontinued the medication, and, had committed suicide in the aftermath of his discontinuance. Any time that the chemistry of one's body undergoes chemical intervention, it would be obvious that cessation of such intervention would require a "withdrawal" of that "intervention". Although the FDA would not consider Prozac, Paxil, or Zoloft as being physically dependent addictive drugs, it is not clear to the consumer that an "abrupt" discontinuance of AD's without a gradual "withdrawal" could result in the patient being extremely "unbalanced" in their inability to deal with their lives lacking the "artificial" chemical effects of these types of such medications.

I do not support the use of "anti-depressants" if there is any way to implement other methods of intervention. This subject is a wide open area which requires much information which is necessary for the consumer to understand the ramifications of inducing such chemical interventions in their lives. It is most serious.

I am still attempting to ameliorate the "self need" for medicating my anxiety disorder; I hope that I will be able to accomplish that goal at some time. I deal with my "depression" with exercise....to the Nth degree. For me, I have found that the excersise "naturally" creates chemicals that negate the "extreme" effects of depression. But, there still is always a "let down".

Thank you for letting me roll on a bit, but, I really could write 100's of pages of this. I could also bore you even more with the studies, as I have a strong academic background in Psychology at a undergraduate and post graduate level. I am not a professional in the field!!!!


:-)

[ElectroPrincess]

73. I respect that and your efforts with research and applying what

you believe - the treatment is right for you. Most people with extensive education in Psychology are humbled by what we do NOT know. I try to keep an open mind as the research is still inconclusive.

Other people may have different personal experiences. However, if you have a trusted mental health professional to share your concerns with, as well as your continuing efforts with staying current on the latest in scientific breakthroughs, then you are doing EXACTLY what is right for you.

IMHO nobody should fault you for being true to yourself.

[superconnected]

72. I know plenty of people on anti-depressants who have said this before

my brother in law really stressed that he didn't like them because they made him suicidal.

I also know people who say when they stopped taking them it suddenly made them very suicidal because of the sudden chemical imbalance from no longer having the drugs. These people pulled themselves off antidepressants without doctors orders because they didn't like what they did to them.

[QC]

81. There are many millions whom these drugs have helped.

That's something that always gets lost in our discussions of this subject, which tend to follow the very same form as this thread.

I would very likely be dead today if not for antidepressants. Other people have had negative experiences with them. Different people respond in different ways and have different therapeutic needs. That's the truth of the matter, which is a bit too complex for the hysterical, black/white approach to the issue that so many people apparently can't resist taking.

[lynne]

86. Many helped but will we ever know the true number of those harmed ? -

- In my case, THREE of my relatives are DEAD yet only one took the meds. An entire family destroyed and uncounted as victims.

No connection was made at the time between the murders/suicide and his use of Zoloft as this was years ago. This horrific experience isn't included in any case study and the loss of this family isn't reflected in any figures.

I have to wonder how many other's have had similar "negative experiences" that we don't know about?

[geniph]

84. Were all the control subjects

in other words, the persons taking the sugar pills, judged as just as seriously depressed as the ones given the medications? One has to bear in mind that you're talking about a population that has a much, much higher suicide risk than the general population to begin with. The studies have some merit insofar as the control subjects and the drug test subjects had precisely the same diagnoses.

Antidepressant medications have been the only thing that has kept me alive many more times than I care to count. While I think they are being overused, I'm fearful that studies like this will lead persons who have a genuine need for such treatment to avoid them.

Antidepressants are just a tool, and they're just one tool.