Antidepressants are now the second-most-prescribed drug in the United States, to the tune of about $10 billion dollars each year, and more and more Americans are turning to their primary care physicians to prescribe antidepressant medication. According to an article recently published in the journal Health Affairs¹, seven percent of all visits to a primary care doctor now involve the doctor prescribing an antidepressant for the patient during their visit – an increase of 3 percent over 1997 figures.
Since roughly 15 million Americans² are affected by depression each year, it is heartening that so many more of those individuals who are suffering from depression are seeking treatment. But there are dangers to these increases in the prescribing of antidepressants: the glut of advertising aimed at American consumers promising a “quick-fix” for depression has left many people confused about exactly what they can expect from these drugs, when they can expect it, and how these drugs differ from other medications the public is accustomed to taking. This confusion can lead patients who try antidepressants to “give up” on antidepressant therapy when they experience minor side effects or don’t experience immediate relief “like the woman in the t.v. commercial.” It is a terrible thing to see patients who might be greatly benefited by these drugs walk away from them when just a little education could make all the difference.
When properly prescribed and monitored, the right antidepressant can absolutely work wonders to help alleviate the debilitating symptoms of depression for many people. From patients who have struggled for years with chronic depression, to those who are coping with a more isolated bout of clinical depression, many people can benefit significantly from the use of these amazing drugs. When combined with talk therapy, these drugs have been shown to be even more effective and provide even longer-lasting relief from depression symptoms.
However, these medications can, and sometimes do, have side effects that patients should be aware of and that should be monitored. It’s also important for patients to know that it is sometimes necessary to try more than one antidepressant before the “right” one is found to achieve maximum symptom relief and that there is no one-size-fits-all medication that works for everyone. Knowing that there is more to antidepressants than what is portrayed in pharmaceutical company ads is very important in order to get the full benefit of what these drugs have to offer.
Important things you should know about antidepressants:
• When you visit your doctor to discuss an antidepressant prescription, be as open and honest about your depression symptoms (as well as your other health conditions) as possible. The more information your doctor has, the better job he or she can do of matching your symptoms with the right medication. And don’t be afraid to ask questions – the more informed you are about your depression and about the medication your doctor prescribes, the better.
• ALL drugs, including antidepressants, have side effects. Talk with your doctor and/or pharmacist about possible side effects and drug interactions that might affect you when taking the antidepressant. Most patients find these side effects to be minor and that they go away over time. If you find you experience side effects that are worrisome, contact your doctor for assistance, but again, remember all drugs have side effects.
• Most antidepressant medications TAKE TIME TO BEGIN WORKING. Sometimes it takes weeks before a patient begins feeling any positive effect from the medication and they may be tempted to stop taking the medication because “it’s not doing anything.” If you have not achieved the symptom relief that you and your doctor discussed within the expected timeframe, contact your doctor to talk about your options. There may be other medications that will work better for you, or, your physician may feel a dosage change to your current medication may be appropriate.
• Each person reacts differently to antidepressant medication. So, if your sister felt better taking Drug X in a week, it does not necessarily guarantee you will react the same way if your doctor prescribes Drug X for you. That doesn’t mean that Drug X may not ultimately work well for you, it means it may just take a little longer to work for you than it did for your sister.
• It is very important that you communicate with your doctor about your symptoms and how you are reacting to your antidepressant medication for the antidepressant treatment to be successful. Just going to your doctor for the initial appointment to get a prescription isn’t enough – you must talk to him or her about any side effects that you experience, or if your depression symptoms are not improving, as well as any other concerns you may have. And don’t give up on your antidepressant without talking to your doctor first. This is the most common mistake we see patients make in regard to antidepressants.
• If you try an antidepressant and it “doesn’t help,” don’t assume antidepressants aren’t right for you. Your doctor may need to work with you to find the right antidepressant for you (there are a number of choices available), or, he or she may need to work with you on adjusting the dosage of your current medication until you achieve better results.
• The combination of talk therapy and antidepressants has been shown to be very effective in treating depression³. Talk with your doctor or psychiatrist about adding talk therapy to your antidepressant therapy for further, longer-lasting symptom relief. Studies4 have also shown that patients treated with talk therapy and antidepressant therapy were more likely to avoid relapse of their symptoms than those who were treated with antidepressants alone. Your doctor or psychiatrist can refer you to a qualified psychotherapist who can help you better understand the issues that are at the root of your depression and help you learn skills and strategies to better cope with the difficulties you encounter in your life.
• Not everyone needs an antidepressant. Just because television commercials have popularized the use of antidepressant drugs doesn’t mean that they are the right choice for everyone. Only you and your doctor can determine if they are an appropriate choice for you. Many patients choose to pursue talk therapy alone to successfully alleviate their depressive symptoms.
We believe strongly that antidepressants are a very beneficial tool for many patients, and our clinic works closely with local physicians and psychiatrists to coordinate the care of patients taking antidepressants. Our goal is to assure that each patient has the most satisfactory outcome possible from the use of antidepressant drugs. Most psychologists and psychotherapists will provide a similar service for their patients – if yours will not do so, find a new therapist that will help coordinate your care, as clinical feedback from your therapist to your physician can be invaluable in identifying the right medication and dosing levels for you.
Antidepressants are by no means a “silver bullet,” but they are powerful tools that have helped many people suffering from depression find relief from their symptoms when used correctly in the hands of patients educated in their use.
¹ Proportion of Antidepressants Prescribed Without A Psychiatric Diagnosis is growing, Health Affairs Vol. 30 No. 8 August 2011
² National Institutes of Mental Health
³ National Institutes of Mental Health, Publication No. 11-3561
4 Interpersonal Psychotherapy for Depression: A Meta-Analysis, Am J Psychiatry, Mar 1, 2011 168: A50
Copyright © 2011 Fayetteville Psychotherapy Associates, PLC