Warning
If you are taking antidepressants, make sure you have regular blood tests to check your potasium levels and kidney and liver function. See also in left menu, sub-headings SSRI, SNRI and heading Withdrawal from medicines.
About Depression
The World Health Organisation now ranks depression as the world's fourth greatest public health problem. Depressive states can range from feelings of sadness to severe illness. Accurate diagnosis is important. It is estimated that 30% - 50% of cases of depression in primary care and medical settings are not detected. It is important to provide more training for medical practitioners, reduce the stigma and create awareness in the general population, that help should be sought. It is important to talk to someone about how you feel and to try to unravel the cause of depression.
Depression may be a side effect of your medicine
Many drugs' side effects may cause feelings of depression. This can range from feeling low, to feeling life is not worth living. Always check with your pharmacist or search the Internet to find if your changed mood may be due to medicines, even if life experiences may at first seem to be the cause. Drugs for indigestion, acne, cardiac problems, antibiotics, drugs for lowering cholesterol can all cause depressiion.
Antidepressants
An antidepressant is a psychiatric medication often prescribed before the doctor has found out if the cause of the depression may be other medicines.
All psychoactive drugs change the state of our mind, is this what is required? A drug induced state may not be the best for everyone.
Looking at the cause of the depression is important and whatever the cause it has been found that cognitive behavioural therapy (cbt) is by far the best method of dealing with depression.
Following bereavement, specialised bereavement counselling is helpful. Drugs stiffle feelings and can subdue our emotions, only delaying the progress of the journey we all have to make to cope with loss.
Drugs can cause us to suffer worse problems than they were initially prescribed for. They are often unfortunately prescribed without warnings of the long term and short term adverse effects. Coming off these drugs is a problem for many people so one should only start taking them if the withdrawal problems have been assessed and the risk benefit really contemplated.
These medications are now amongst the drugs most commonly prescribed by psychiatrists and as well as other physicians, and their effectiveness and adverse effects are the subject of many studies and competing claims.
Despite the name, antidepressants are often used in the treatment of other conditions, including anxiety disorders, bipolar disorder, obsessive compulsive disorder, eating disorders, bowel and bladder problems stopping smoking and for chronic pain. Some people may find them of benefit but no one should be unaware of the possible long term physical, neurological and psychological adverse side effects and possible withdrawal problems.
Physiotherapy, focus on relaxation, breathing, and excercise can be of value for many of the above disorders and should be tried before resorting to drugs.
Withdrawal or Discontinuation Syndrome
It is possible that some people may not be able to stop taking the drugs for reasons that the pharmaceutical companies have not yet investigated or disclosed. A person contemplating taking antidepressants should know the risks and weigh up the possible benefits before taking them. Low doses for short periods may not cause such difficulty as when the drugs are taken for many months or years at highter doses. Everyone is different and one should read as much as possible. Some people have severe reactions after only one or two doses. Missing even one dose can cause severe reactions too.
Link to video of Coming Off breakout sesson at APRIL's 2008 conference
The chief pharmacist at the Maudsley and Bethlem Hospital wrote about withdrawal from a personal as well as professional perspective:
www.socialaudit.org.uk/4200DTAY.htm there is also a link to many citations about antidepressant withdrawal from this page on the Social Audit (Charles Medawar's) web site.
The Critical Psychiatry group of UK psychiatrists comments about withdrawal:
http://www.critpsynet.freeuk.com/Recognition.pdf
Types of Antidepressant
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Noradrenergic and specific serotonergic antidepressants (NASSAs)
Norepinephrine (noradrenaline) reuptake inhibitors (NRIs)
Norepinephrine-dopamine reuptake inhibitors
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitor (MAOIs)
Psychiatric Adverse Side Effects
Insomnia, increased anxiety, suicidal thoughts, violent behavour, sedation, loss of libido, anxiety, agitation, loss of libido, failure to reach orgasm and erectile problems
The Food and Drug Administration has included Black Box warnings on all SSRIs stating how they double suicidality (from 2 in 1,000 to 4 in 1,000) in children and adolescents who are prescribed these drugs.
See Links and Support Groups
SSRI stories in the press
If you have or know of a case reported in the press concerning SSRI, SNRI and similar antidepressants please submit this to: http://www.ssristories.com/
AWARENESS SAVES LIVES
Please submit a Yellow Card report to the regulator (MHRA)
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