Fears and Facts About Antidepressants

Along with counseling, antidepressants are a common treatment for depression. Four out of 10 people treated with antidepressants improve with the first one they try. If the first antidepressant medication doesn’t help, the second or third often will. Most people eventually find one that works for them. Yet many people who could benefit from an antidepressant never try one, often because of fears about them, experts say.

Here are eight common fears about antidepressants, as well as facts that can help you and your doctor decide if an antidepressant is right for you.

Fear: Antidepressants make you forget your problems rather than deal with them.

Fact: Antidepressants can’t make you forget your problems, but they may make it easier for you to deal with them. Being depressed can distort your perception of your problems and sap you of the energy to address difficult issues. Many therapists report that when their patients take antidepressants, it helps them make more progress in counseling.

Fear: Antidepressants change your personality or turn you into a zombie.

Fact: When taken correctly, antidepressants will not change your personality. They will help you feel like yourself again and return to your previous level of functioning. (If a person who isn’t depressed takes antidepressants, they do not improve that person’s mood or functioning.) Rarely, people experience apathy or loss of emotions while on certain antidepressants. When this happens, switching to a different antidepressant may help.

Fear: Taking an antidepressant will make me gain weight.

Fact: Like all drugs, antidepressants have side effects, and weight gain can be a common one of many of them. Some antidepressants may be more likely than others to cause weight gain; others may actually cause you to lose some weight. If this is a concern, talk with your doctor.

Fear: If I start taking antidepressants, I’ll have to take them for the rest of my life.

Fact: Most people who take antidepressants for a first-time episode of depression need to take them continuously for six to nine months, not necessarily a lifetime. Once an antidepressant gets depression under control, you should work with your doctor to decide when to stop your medication and then decrease your dose gradually. Discontinuing them suddenly may cause problems such as headaches, dizziness, and nausea.

Fear: Antidepressants will destroy my sex life.

Fact: Some antidepressants can have an effect on sex. The problem is usually in having an orgasm rather than a lack of desire. But because depression itself decreases libido, a medication that eases depression may improve your sex life. As with other side effects, certain antidepressants may be more likely than others to cause sexual problems.

Fear: Antidepressants are expensive and aren’t covered by insurance.

Fact: Antidepressants are usually covered by insurance plans with prescription drug coverage. The cost of antidepressants varies widely, depending on the dosage, the drug you are taking, and whether it is available as a generic. Even without insurance coverage, it is possible to purchase a generic antidepressant for as little as $15 per month.

Fear: Taking an antidepressant is a sign of weakness.

Fact: Like medical conditions such as diabetes or high cholesterol, major depression is a condition that often responds to medication. When depression interferes with your ability to function normally, seeking treatment is not a sign of weakness. It’s a sign of good self-care.

Fear: Antidepressants increase the risk of suicide.

Fact: Studies in recent years have raised concerns that antidepressants may raise the risk of suicidal thoughts or behaviors (but not deaths) among children, adolescents, and young adults. For example, a 2009 review in theBritish Medical Journal (BMJ) looked at 372 studies involving nearly 100,000 people who were taking antidepressants. It found that compared to placebo, antidepressants were associated with a slightly higher risk for suicidal thoughts in some children and young adults, have no effect on suicide risk among those 25 to 64, and reduce the risk in those 65 and older.

In 2004, the FDA required manufacturers of antidepressants to revise their labels to include a black box warning statement about these risks.

Other studies paint a different picture. A 2006 study published in PLoS Medicine suggests that antidepressants have saved thousands of lives. Data show that the U.S. suicide rate held fairly steady for 15 years before the popular antidepressant fluoxetine (Prozac) was sold and then dropped steadily over 14 years while sales of Prozac rose. The strongest effect was among women.

The bottom line: Regardless of your age or sex, it’s important to see a doctor immediately if you have suicidal thoughts.