Antidepressant use must be monitored
DEAR DOCTOR: Just how addictive are antidepressants? My doctor thinks I should take one, but I know a lot of people who have had trouble stopping them.
DEAR READER:
According to the World Health Organization, depression was the third-leading cause of disability throughout the world in 2004 and tops the list of disabilities in the developed world. A variety of medications to treat depression have been developed over the decades but have been accompanied by persistent questions about efficacy and long-term viability.
A specific group of symptoms, when experienced over time, mark a diagnosis of depression. These include low mood, low energy, feelings of worthlessness and an inability to experience pleasure, which is known as anhedonia. Additional symptoms can include altered sleep patterns, diminished appetite, an inability to concentrate and thoughts of self-harm. Diagnosis of depression, which can range from mild to moderate to severe, depends on accurate self-reporting of symptoms and of their duration.
Antidepressants tackle the various chemical pathways that are believed to play a role in the disorder. However,
depression medications don’t work for everyone. As many as two-thirds of patients don’t respond to the first drug they try. But by working with their doctors to finetune their treatment regimens — there are a number of classes of antidepressants, each with its own therapeutic pathway — many patients living with depression do find relief.
Although antidepressants were originally developed for shortterm use, six to nine months in most cases, the nature of depression and the scarcity of alternative treatment options meant patients have stayed on the drugs for years at a time.
It’s important to note that antidepressants, when used properly and as part of a comprehensive treatment program, can be helpful. If you do decide to move forward with a prescription, talk all of this over with your doctor. Make a plan regarding duration, and never make any changes to your drug regimen without medical supervision.
Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health.
Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA 90095.