Antidepressants

[Patrick]

There's been a lot of talk about newer SSRI antidepressants like Paxil and Zoloft causing suicidal behavior in some people. What are your opinions of this?

Personally, I think many of the people that they're putting on these drugs are depressed to begin with. So, in a way, it's hard to blame the drug for the suicidal behavior. But, also, in some people, these drugs do make one more depressed and impulsive, which could lead to suicidal behavior in a person that otherwise wouldn't even consider suicide.

As a medical provider, I'd recommend continuing to prescribe them, but just keeping close servaillance on them. These drugs seem to be a life saver for those with deep depression and anxiety disorders.

What do you guys think?

[Keith]

I know that when many people get started on anti-depressants, that it can take up to 4 weeks before they start feeling the effects. I know people that were on Zoloft, and they said it made them feel worse, instead of better. I also know some on Paxil that believe it is the best anti-depressant on the shelf.

As far as anti-depressants making a person suicidal, as Patrick said, most people are very depressed before they start the medication, so I don't believe it is the medication, I believe it is because of the mental state the person is in before they start taking the medication. If it takes 4 weeks for a medication to take effect, that's a long time to be in a depressed state.

[mranderson]

Fork them over! I was on Wellbutrin for a year and even lost 50 pounds.

The HMO took me off them because their policy was to keep a person on them for only a year. I could still use them.

They wanted to put me on porzac, but I said no due to the suicide rumors.

[Keith]

I'm on the generic form of wellbutrin, and I have gained weight. What's your secret?

[Patrick]

Seems like weight is a major problem with antidepressants. I was on Celexa for awhile (I have panic attacks from time to time) and I gained about 60 lbs on it. I went from 140 lbs to 200 lbs. Fortunatley I'm back down to 160 lbs, but it's taken work.

Seems like for most Wellbutrin causes weight loss. Keith, it might be Paxil. Are you still on it? Paxil can cause some pretty severe weight gain....it's probably the worst SSRI antidepressant to cause weight gain.

So mranderson, did your depression go away eventually without taking meds, or do you still suffer with it from time to time?

[mranderson]

Did it go away? Not entirely. I still feel a bit down on occasion.

What was my secret? I have a condition known as binge eating disorder. When I went on Welbutrin, I slowed down, started doing more things, and ate less because I had no reason to eat due to bordom, stress, or other reasons I over eat. The weight has come back since I was taken off it. And so have some of the habits.

If I can avoid it, never again will I do an HMO. I would probably still be on the stuff if I had a medical staff that cared about the patient (the difference between patient and client. I am a patient, not a client) instead of caring about that green papered dead President.

[Patrick]

You know, atypical type depression can cause binge eating as well, and Wellbutrin commonly helps that. I wonder if they might be connected.
Anyways, I'm sorry to hear you weren't able to stay on Wellbutrin....from what I've seen, it's a pretty effective antidepressant, with very few side effects.

[mranderson]

The only side effect was when I left a bottle of them in my Atteche' case in my car, and someone ripped them off.

I hope they were happy.

I also understand that potentially even one litium tablet could kill a person. I wonder if the guy who ripped them off knew that.

[Patrick]

That's weird....it's not like Wellbutrin is a controlled substance or anything. Maybe they didn't know what they were getting. I realize one lithium tablet can kill someone, as lithium has a very narrow therapeutic window, but Wellbutrin is a little safer than lithium.
Wellbutrin is pretty stimulating.....maybe they got a high from them or something. I've never really gotten a high from antidepressants though....they don't really cause that.

[Midtowner]

The suicidal episodes occur very infrequently. In fact, as far as I've heard, the drugs haven't even been direclty linked to them. There could end up being a link, but it seems more logical to just admit that many people on antidepressants already have tendancies towards suicide. They can't be 100% effective in the prevention of that.

[suzi]

I totally agree that the people that have committed suicide on these drugs most likely have SEVERE mental "disabilities" before they started taking them. My doctor put me on seratonin replacement therapy when I was going through a long and drawn out divorce and it was the best thing that ever happened to me. I was sitting around the house feeling sorry for myself, gaining weight because I was not physically active and had no desire to get up off my lazy butt. She put me on 25mg. Paxil and after a couple of weeks I started feeling like I had more energy and could deal better with the divorce proceedings and my life. She insisted that I stay on it for at least a year and after that I weaned myself off of it over the next six months with no side effects whatsoever. I think the reason I liked the idea of this type of antidepressant better than those that drug you out was because it's my understanding that it just replaces the seratonin that occurs naturally in your body but can be depleted due to stress, etc. My sister-in-law has been on some kind of anti-depressant for YEARS and all it seems to do is make her drugged out all the time, it has done nothing to improve her state of mind.

[Patrick]

Yeah suzi, it's interesting how in some people antidepressants rally help but in others antidepressants make them feel drugged up. Everyone reacts so differently to meds. The drugged out feelingis mainly just due to side effects of the drug. Some people experience lots of side effects, while others experience few to none.
For me, Celexa was a huge help during a stressful period of my life.
Sure, I think meds can be a band aid approach to treating mental stresses and disorders in our lives. That's why I always recommend therapy. But I think meds can really help people get out of a rutt in their lives and allow them to get the therapy they need. Sometimes people just need the meds during the stressful period and then they're oka.
And suzi, you're right about the mechanism of action of these drugs. Serotonin becomes depleted durings times of prolonged stress...this leads to anxiety and depression. The new SSRI antidepressants act to increase the amount of available serotonin at nerve synapses. Unfortunately though, they are chemicals that alter brain chmistry so they can have side effects. On Celexa I had sexual dysfunction (common with SSRI's) and headaches.