Ah, those loverly drug commercials. At the end, the side effects are listed, and I think “If I wanted to maybe be cured of that, would I want to have that side effect?” The answer is usually “Hell, no.”
More and more those drugs seem to cause “suicidal thoughts and increased suicides,” particularly in young people. ANTI-DEPRESSANTS have this effect, which is scary. And drugs to “treat” other conditions.
What’s up with that?
Some of these fall under what the nice people at crazymeds.us call the “freaky rare side effects” umbrella. See, for instance:
https://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Prozac
So if a side effect is reported, it can end up on the warning list, even if - like herpes! - the causal relationship is really unlikely. (I am not a drug researcher or doctor., so let me know if I got that wrong.)
The suicide problem with some kinds of antidepressants is not one of the fake/iffy ones, from what I’ve read. But it only affects a small number of patients, so patients/doctors will make a calculated decision and monitor the patient carefully for suicidality.
This. They have to report all side effects, not matter how rare they are. Someone who is depressed may already have suicidal thoughts, so they don’t want to make matters worse, but in many (most?) cases the benefits of the drug outweigh the side effects. It’s all about full disclosure.
I’d be kind of leery of a site called crazymeds.us, frankly.
This. In the pool of people recruited to try a new drug, some may already suffer from depression. And if the medication is an antidepressant, some may already be prone to having suicidal thoughts. In an effort to be comprehensive (and to avoid possible lawsuits), they have to list this as a possible “side effect”.
We recently had a scare with my ex wife. We thought her dementia had progressed to the point she would need to be in a rest home the rest of her life. We put her in the hospital where they stablized her blood pressure and then they sent her to a 21 day rehab center for further evaluation. Her dementia just continued to advance the entire time. She had zero memory, recognized no one, had no idea where she was at no matter how many times you told her. I decided to take her home and play with her drugs. I took her off of everything except blood pressure meds. Within 1 week the dementia was gone and she is now better than she has been in at least two years.
All of her drugs were moderate dosages. ! anti depressant, 1 adavan per day and 1 bladder frequency pill. The bladder pill was the one that really exagerated the allready exhisting symptoms. She is doing great now but fighting depression.
It’s like, I just paid $100 for a bunch of pills, they give me the yawns and the shits, and I won’t know if they’re working for another month. That would do it to anyone.
The problem, AIUI, is that depressed people with suicidal tendencies are sometimes too depressed to do anything, including committing suicide. So when the antidepressant first kicks in and picks these patients up off of the floor, they occasionally get the motivation to actually act on that pre-existing suicidal tendency. So the pill gets the blame, even though all it did was give the patient the energy to do what he already wanted to do.
There are a lot of different ways a chemical imbalance can cause depression.
Each anti-depressant mainly affects one or at most two types of such imbalances.
If you’re given the wrong medication for your imbalance, it might make things worse rather than better.
So there’s a lot of trial and error in finding the right medication for a particular depressed person. Made even harder in that some might take a couple weeks to have a noticeable effect.
Not feeling better after starting an anti-depressant, or even feeling worse, could push some people over the edge.
But you have to avoid the anti-vaxxer-style mentality that they are all bad and no one should take them.
Why… because many psychiatric symptoms are pretty much similar, the chemical pathways that need or may need to be modified for behavioral changes are not the same for all individuals even with similar symptoms. So guessing what medications can modify the given behavior is pretty much a crap shoot. So the docs rely on history of the patient and their own intuition to identify the pathway that can be adjusted for treatment… the prescribed meds may deliver positive or negative outcome and a side effect and depression is one common result of a poor medication match or side effect.
P.S. This is not an expert opinion… just mine
Or Chantix – well, of course I’m irritable. I just stopped smoking!!
Another of the problems with mood-affective drugs, is that PEOPLE take them. People can’t be counted on to take them at the right time and in the right amounts. Some of the depressive side effects of anti-depressants, is a sort of rubber-band effect: people start taking them, come out of their depression, and then feel so good, they decide to stop taking them. They get a reversal of the effect that doesn’t just take them back to as depressed as they were before, it goes past that point, and someone who was just bummed out, goes off their meds, and becomes suicidal or even violent.
In other words, it’s not so much a side effect of the DRUG, so much as it’s a side effect of BEING ON THE MEDICATION, and being an imperfect patient.
There are a couple of theories, but the real answer is, “We’re not sure.”
One of the more common theories is, as already stated, that antidepressants make you feel better enough to have the energy to kill yourself. The problem with this theory is that most of the increase in suicide with antidepressant therapy happens in the first 9 days on the med, before it’s had much of a therapeutic effect.
Another theory is that as an SSRI inhibits the reuptake of serotonin, the brain compensates by producing less serotonin, paradoxically making antidepressants cause depression. But again, same problem as with the first theory - if this is happening in the first week, why not in week 3 or 10 or 20?
There’s also some question as to whether this association is even valid. The studies showing a link were in the early 2000s; some more recent studies have shown the opposite, that even among teens (the most at risk group in early studies) antidepressants reduce suicidal thoughts and actions.
What’s up with the scare quotes, Annie?
It’s like you’re trying to imply they’re not really medications, and they’re not really treating things.
It’s not confined to antidepressants. A couple of weeks ago my doc prescribed Lyrica, an anticonvulsant that also treats neuropathic pain (I have a very dodgy back). Listed as a noted side effect was suicidal thoughts.
Although I didn’t end up actively suicidal, the four days I took the pills gave me such a bloody scare I stopped them immediately: Very nasty and vivid dreams, followed by a ‘depressive’ hangover that lasted many hours was quite enough for me. I can imagine if taking them for a longer time the risk could have been quite substantial.
Your vivid dreams are interesting. I have been under treatment for insomnia for years. When I first started getting not just sleep, but quality sleep, I was having freaky dreams. It scared me a little at first until my doctor told me to keep a careful journal not necessarily of content of dreams, but of perceived duration, exactly how freaky they were on a scale of 1 to 10, and how long it took me to feel OK after I woke up, and the also to record how rested and functional I felt during the day.
Eventually I discovered that vivid and subjectively long dreams translated to quality sleep that made me feel rested and alert the next day.
Now, there is a relationship between depression and insomnia that hasn’t been quite teased out-- that is, it’s a big debate which one causes the other (I’m firmly in the camp of “sleep deprivation causes depression”), and it wouldn’t surprise me at all if people on antidepressants experience vivid and possibly frightening dreams they are not used to when they first start on medication, because they have been lacking in REM sleep for a long time.
I have two sleep studies that show REM sleep disruptions-- my doctor said it was as though I was such a light sleeper that the act of going into REM sleep woke me up sometimes.
Anyway, there might be some tossing and turning while a person adapts to the effects of the medication on sleep-- once you do adjust, you might need less sleep. But the initial adjustment might be upsetting, and might even make sleep deprivation worse.
Everyone I know who has started on an antidepressant has started on a dose below actual clinical effects, and they stay on that for like a week, to check for side effects and allergic reactions, then they start on a therapeutic dose, but it’s still very low. It might be six weeks before they are taking a really effective dose, but none of them has ever had anything untoward happen.
I wonder if the people who were test subjects were put on a higher dose right away: it makes the trial period shorter (thus cheaper), and it ferrets out serious side effects that are going to get the company sued (like, don’t give the drug to people with peanut allergies).
I find this interesting.
We live with the devastating knowledge that we can die at any moment. But we somehow sublimate this reality and get on with our day to day living. If we happen to have some large problems in our life, the suicide solution is always an option, but we sublimate that as well and muddle on.
But then we introduce a drug that can alter our mental processes.
That can be a very wild card.
I recall that there is a drug that can trigger a gambling compulsion. That seems to also be a deep seated mental concept that we adapt to and mostly sublimate. But actually warps a lot of our actions by it’s poorly rationalized base functions.
It does not surprise me that a person with problems bad enough to require medication that can cause altered mental functions, has certain suppressed mental drives unleashed.
In a bad state, a person has these suppressed things coming more to the surface anyway. Altering the brain functions may increase them. Our brains are quite elastic. Increasing that elasticity at times of mental stress might allow negative options to more easily be instilled.
I was told once that if 3 people in a 100 had the same effect in a study they had to list it no matter if they were the only 3 people ever in the world it happened to …
I’m not implying anything. I’ll say it outright: Medications are DRUGS! When I refused to take an anti-depressant because I don’t do drugs, the answer (direct quote) was “That’s not drugs. That’s medication.” Oh, and a prescribed medication is going to affect a person differently from the same street drug?
The biggest drug problem this country has is with prescription “medication.” Been there, done that.
So you don’t do drugs? No Tylenol, no ibuprofen? If you were diabetic you wouldn’t take metformin or insulin? No antibiotics ever? They’s DRUGS!