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        New Message Board Archives >> Jan-Mar 2004 >> Anti-depressant alert
        
(Message started by: Bob_Johnson on Mar 23^rd, 2004, 9:55am)

Title: Anti-depressant alert
Post by Bob_Johnson on Mar 23^rd, 2004, 9:55am

Before you jump to any conclusions about the current SSRI alert, please read this statement from MEDSCAPE. The core of the message is--be alert for certain symptoms. NO conclusion has been drawn that this class of anti-depressants causes suicide.
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Antidepressants May Cause Depression and Suicidality

March 22, 2004 — The U.S. Food and Drug Administration (FDA) has asked manufacturers of the several antidepressant drugs to include in their labeling a warning statement that recommends close observation of adult and pediatric patients treated with their agents for worsening depression or the emergence of suicidality

The antidepressant drugs are fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), buproprion (Wellbutrin), venlafaxine (Effexor), nefazodone (Serzone), and mirtazapine (Remeron).

Several of these drugs are approved for the treatment of obsessive-compulsive disorder in pediatric patients (sertraline, fluoxetine, fluvoxamine). Only fluoxetine is approved for use in children with major depressive disorder. None of these drugs are approved as monotherapy in treating bipolar depression, either in adults or children, and fluvoxamine is not approved as an antidepressant in the U.S.

The FDA has been closely reviewing the results of antidepressant studies in children since June 2003, after an initial report appeared to suggest increased risk of suicidal thoughts and actions in the pediatric population, according to today's advisory.

Although it is unclear whether antidepressants contribute to the emergence of suicidal thinking and behavior, these interim actions are intended to draw more attention to the need for careful monitoring of patients being treated with these drugs, especially at the beginning of therapy and during dose changes.

Discontinuation of medication may be appropriate in patients whose depression is persistently worse or whose emergent suicidality is severe, abrupt in onset, or was not part of the patient's presenting symptoms. Therapy changes should be made under the guidance of a physician, as certain medications should be tapered rather than stopped abruptly.

The warning also alerts physicians, patients, and caregivers to symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia, hypomania, and mania in patients being treated with antidepressants for major depressive disorder as well as other indications. According to the FDA, there is concern that patients who experience one or more of these symptoms may be at increased risk for worsening depression or suicidality.

Title: Re: Anti-depressant alert
Post by Elaine on Mar 23^rd, 2004, 5:25pm

I heard a lot of you say you took these drugs it was on TV last night and in the Newspaper this morning about it. Its scary what some drugs can do.

Title: Re: Anti-depressant alert
Post by Cerberus on Mar 23^rd, 2004, 5:35pm

It should also be noted that a large portion of the sampling (the deceased) were pre-teens and early teenagers.

I have taken remeron (mirtazapine) for over a year and the only problem I have had was when I ran out and my levels dropped. I have also at one time or another was taking several of the others listed. I don't take those any more mainly because they made me physically ill in one way or another.

Perhaps more people should be screened for need based on disposition and age? Instead of blanket prescribing the latest fad technology in medicines.

Summary: If cluster headaches haven't caused me to commit suicide I highly doubt my medication would induce me to do so.

Ramon

Title: Re: Anti-depressant alert
Post by Lizzie2 on Mar 23^rd, 2004, 8:28pm

I do believe that the alert is worthwhile. As stated in the alert posted on MSN this morning, the problem may not be in causing suicidal thinking, but a host of other personality changes. I'd have to seek out the article again to see what exactly was written.

The reason I found it to be worthwhile was that even if I am only one person...this happened to me! Prozac didn't make me feel more suicidal....I could get to that point plenty on my own in my younger days! However, prozac did leave me feeling flat and emotionless, extremely irritable, and really flippant and rude about a lot of things. The only change I really noticed personally was that I didn't give a crap about anything that happened. I never felt joy, but I didn't react at all in the same way I had always reacted to things. I failed a number of exams the semester that I was on prozac. Being a straight A student, in the past any time I got below an A or B, I would absolutely flip out. It would cause me to study a lot harder and make sure that I did better! Not on the prozac. Instead, I'd just be like, "Oh I failed? Hmm oh well!" I could've cared less. I didn't care about my life or what happened to it.

The part I didn't notice was the irritability. One day I was having lunch with my mom and she pointed out that I was acting really strangely since coming home for summer break. I didn't care about my life, and everything that happened really got on my nerves. I would get pissed at my family for all kinds of stuff, and it just wasn't good. When I got off the prozac, this all went away, and my normal self returned. :)

I never knew for the longest time that it was because of the drug. I thought that it was something wrong with *me*. When I found out that it was because of the prozac, it all made sense. And then this article came out this morning with the new FDA warnings....I have to admit that I felt relieved. No longer will people have to wonder about those reactions and go on thinking something is wrong with themselves. It will make people more aware to potentially disturbing changes.

So that's just my thoughts!
Lizzie :)

Title: Re: Anti-depressant alert
Post by Bob_Johnson on Mar 23^rd, 2004, 9:26pm

Lizzie, your reaction may be related to the effect that some people experience with Prozac--it may energize the person to the point of being uncomfortable.

With some depressive case, the loss of energy and drive, is a major problem and Prozac is a benefit when it energizes.

The differences from one SSRI to another are slight but important. An experienced doc can often select one of them to meet subtle needs of the patient.

Title: Re: Anti-depressant alert
Post by Lizzie2 on Mar 23^rd, 2004, 9:29pm

Thanks for the message, Bob.

I don't *think* this was the case with me because I slept sometimes entire days away on the prozac. It made me awfully tired!

I was put on it for fibromyalgia. Definately didn't help the fibro, and overall...definately didn't improve whatever depression I was experiencing either!

I'm better off dealing with it without the AD's, however I'm on a tca for headaches...Norpramin (Desipramine).

Thanks again for the info!
Lizzie

Title: Re: Anti-depressant alert
Post by cootie on Mar 23^rd, 2004, 11:28pm

I can see where somea this can happen.....several years ago doc put me on paxil for anxiety attacks....always been a nervous twit anyhow. But all the signs were there after two years I was a candidate to be taken OFF it. I gained about 20 plus lbs (that's not me at all)......it'd start sum shit about goin out and I always LOVED to go out on weekends but.....I knew all my clothes looked like shit on me......nothin fit at all. Got a bit slobby.....let the house become a disaster...I jus didn't give a shit (that's not me either) ! Scarey when you realize a med can do that to you and how you felt was HONEST at the time. I began to hate myself......that's not why I was put on it. So it defeated it's purpose but doc never noticed a thing. Some things happen'd that WOKE ME UP......now I look back and am so shocked. Quittin paxil was bad.....that's when the severe depression hit and no one 'really' knew how bad that was. Prosac made me cry all the time.....others made me feel run down and sick. So now I am what ya git Pam

Title: Re: Anti-depressant alert
Post by Charlie on Mar 24^th, 2004, 3:08am

I'll tell you what's depressing: That they actually pay someone to come up with the term: "Suicidality."

Jeesh.

Charlie