FACTS ABOUT ANTIDEPRESSANTS
by Jay M. Pomerantz, MD

Antidepressants (Prozac, Paxil, Zoloft, Celexa, Wellbutrin, Elavil, etc.) are very useful and widely prescribed medicines. Within Health New England and other medical insurance programs, approximately 7% of all enrolled adult members are on one (or more) of these medicines. Although called antidepressants, these medicines are useful in a wide variety of medical conditions, not only depression. Generalized anxiety, panic disorder, social phobia, obsessive-compulsive disorder, sleep problems, fibromyalgia, chronic pain, pre-menstrual disorder, and a host of other conditions are often helped by these medications.

NO QUICK FIX!
Although antidepressants adjust brain function, they are not high-risk or addicting medications. Unfortunately, antidepressants are not short-term medicines, nor do they cure. Quite to the contrary, antidepressant treatment may be indicated for a year or more. So, even if you feel better after a couple of months, you shouldn’t stop the medication. Many people eventually come off antidepressants, but only because the underlying condition has resolved over time or with other treatment.

TAKE YOUR ANTIDEPRESSANT, OR IT WILL NOT WORK!
It is unfortunate that sometimes patients discontinue antidepressants on their own. That can lead to a withdrawal syndrome (different for each drug) and/or a return of symptoms and feelings of depression. Although common and relatively safe, these medicines are not to be experimented with or trivialized. One of my colleagues is correct when he tells his patients that although he is not sure if a particular antidepressant will work for them, he is absolutely sure that the medication will not work if it is not taken!

TALK TO YOUR DOCTOR ABOUT HOW YOU FEEL AND THE EFFECTS OF THE MEDICINE.
Antidepressant medicine side effects (if any) appear quickly, whereas the benefits are usually delayed and often come about only after taking the medicine for a month or two. Side effects or adverse reactions are variable and should be reported to the doctor who prescribed the medicine. About onethird of the time, the initial trial of an antidepressant does not work. Switching to another antidepressant, or adding a second medicine may be necessary. Some side effects such as weight gain or loss of sexual interest may appear only after being on the medicine for sometime. Medicine doses may need to be adjusted by your doctor. Also, some medicines should not be taken with certain other medicines. So be sure to let all of your doctors/health care providers know the names and doses of all the medicines you take – both prescription and non-prescription medicines.

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