FDA Issues Warning on Antidepressants

[Crick]

FDA Issues Warning on Antidepressants
Possible Suicide, Severe Depression, Anxiety, Panic Attacks in Children and Adults

By Jeanie Lerche Davis


Reviewed By Michael Smith, MD
on Monday, March 22, 2004
WebMD Medical News


March 22, 2004 -- The FDA is issuing a warning about the possibility of worsening depression or suicidal thoughts in people, particularly children, who take any of 10 popular antidepressants, especially at the beginning of treatment or when the doses are increased or decreased.


The FDA has sent a letter to drug manufacturers requesting labeling changes on these antidepressants -- warning of possible suicide, worsening depression, anxiety, and panic attacks in adults and children.

Antidepressants involved in this warning label request are:

Prozac (also sold generically as fluoxetine)
Zoloft
Paxil
Luvox
Celexa
Lexapro
Wellbutrin
Effexor
Serzone
Remeron

"We don't know that the drugs are responsible for these behavioral changes, but nonetheless we're telling physicians and families to be aware of this and that if the behaviors do emerge, to get treatment right away," said Russell Katz, a director with the FDA's Center for Drug Evaluation and Research, in a news teleconference today.


The proposed warning label will "include information about behavioral changes that may occur in patients who are prescribed antidepressant drugs," said Katz.


"This applies to adult and pediatric patients and involves the potential for suicidal thinking or suicidal behaviors and warns the physician and family about any behaviors that might emerge that haven't been experienced before," he added.


But the FDA stopped short of recommending people discontinue taking their antidepressants.


"We specifically decided not to tell people not to use these drugs," said Katz. "We don't think that is necessary at this point."


In addition to looking for signs of worsening depression, the following symptoms may also be a sign of a problem:


Anxiety
Agitation
Panic attacks
Insomnia
Irritability
Hostility
Impulsivity
Severe restlessness
Mania in both adults and children being treated with antidepressants for major depression

If these changes appear, treatment should be evaluated, the FDA says. Medications may need to be discontinued when symptoms are severe, begin abruptly, or if they signal a new disorder.


There also is concern for people who have bipolar disorder (manic depression) but don't know it. Antidepressants have the potential for provoking a manic episode in these people, the FDA says. Doctors, patients, and family members should be on the lookout for any symptoms of mania, including feeling extremely happy or very irritable, inflated self-esteem, not needing as much sleep as usual, talking, or being more active than usual.


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[Willow]

Well I take two on that list. Welbutrin and Zoloft. lol

[Crick]

I took Wellbutrin and ended up in ICU for three days. Switched to Zoloft and it didn't work. Now taking Effexor. So I'm three for three on the list. And they are wanting to increase my dosage. Wonder if my doctor is trying to tell me something!

[freeby4me]

Dont flame me because I dont really know but I always thought an anti-depressant meant that its supposed to make you happy, Not unhappy and suicidal. Help, please explain.

[Jaxx]

This mostly occurs when the medication is decreased or if your're
taken off them completly

[sea-shell]

I take Effexor and when the doctor was trying to regulate my dosage or if I forget to take a pill I get very very MEAN and UNCARING.

[NINK]

i tried one, don't knwo the name though, it just knocked me out all day, so i have no idea if i was still depressed or not because i slept thru it if i was happy,lol. i told them i was never taking any more meds, she was like "oh you need to wait till your body gets used to it" well i was suppose ot take 3 pills a day and i only took one and slept like 18 hours! i have been able to control my problems with out any meds, i knwo they say that is dangerous too but i don't like pills, hubby has to force me to take tylenol when i have a head ache. have you ever read the warning lables on stuff?

[Willow]

Of course you have to be careful with these drugs because they alter your brain chemicals. I think when you hear of people commiting suicide it isn't purely because of the drug. They are unstable to begin with. If you don't take the medication exactly how you're supposed which is not skipping dosages or trying to go off of it by completely stopping it then you are going to have a problem. I was on Paxil years ago and even though I was being weaned off of it slowly that was the worst feeling I ever had. I love the Welbutrin. It takes a while to find the right drug and the right dosage though.

[Jaxx]

Originally posted by Patchouli
Of course you have to be careful with these drugs because they alter your brain chemicals. I think when you hear of people commiting suicide it isn't purely because of the drug. They are unstable to begin with. If you don't take the medication exactly how you're supposed which is not skipping dosages or trying to go off of it by completely stopping it then you are going to have a problem.

Exactly

[Willow]

Some people try to self medicate themselves. If they are feeling good one day they think they don't have to take the medicine or if they are feeling worse than usual they try and double up the dose. You can't do that. You have to take it exactly as prescribed. It's not like taking an extra tylenol when you have a headache. Taking one extra pill here and there isn't going to help. lol

[Crick]

Patch...I'm unstable and I take my medicine. LOL:p Some days I just feel like climbing a tower and ......what were we discussing here? I just chalk it up to being old and forgetful!;)

[Willow]

Originally posted by Crick
Patch...I'm unstable and I take my medicine. LOL:p Some days I just feel like climbing a tower and ......what were we discussing here? I just chalk it up to being old and forgetful!;)


I can totally relate. lol You're not alone. :D

[Kyla Kym]

I was taking the Wellbutrin SR, but quite a long time ago because it started upsetting my stomach. But after reading this, and thinking back I was having weird thoughts of suicide, actually rather freaky thoughts...because I had no intention of killing myself, nor did I want to. But I kept imagine myself going through the motions of shooting myself. It was weird but it was happening often. That hasn't been happening anymore for a while now, so I bet it was the drug causing it. hmmmmmm

[Crick]

And then I hear the voices in my head screaming JUMP, JUMP, JUMP. But then maybe it isn't the voices in my head. I'm so confused! But then what else is new? I confuse my therapist but then that is by design. Ever talk to a therapist and watch their reactions when you mess with their minds? :D

"I was taking the Wellbutrin SR, but quite a long time ago because it started upsetting my stomach. But after reading this, and thinking back I was having weird thoughts of suicide, actually rather freaky thoughts...because I had no intention of killing myself, nor did I want to. But I kept imagine myself going through the motions of shooting myself. It was weird but it was happening often. That hasn't been happening anymore for a while now, so I bet it was the drug causing it. hmmmmmm" Kyla Kim

I went through the same thought process. Thought it was strange that the medicine was supposed to stop those thoughts but in fact it was compounding them. I also have severe panic and anxiety attacks which the Wellbutrin SR didn't address but the Effexor seems to help. Haven't had an attack since I got on the Effexor.

[cleaningla]

Originally posted by freeby4me
Dont flame me because I dont really know but I always thought an anti-depressant meant that its supposed to make you happy, Not unhappy and suicidal. Help, please explain.

I took anti-depressants for a while, at the beginning they made me feel worse. It's because I went from having all grey days (a constant state of numbness) to having bright and dark days (mostly dark).

On the bright days I would think "this is what it feels like to be human". I could actually focus long enough to read a book or play a board game with my son. I would actually feel a little optimistic, thinking things would get better.

The dark days were horrible, the pills aren't working, things are never going to get better, everyone would be better off without me.

I don't know if that helps, but it sure is easier to be in a constant state of grey, than to keep fluctuating from bright to dark and back again, but if you ride it out, the bright days do eventully outnumber the dark ones. :)

[schsa]

The main concern is that if you are in a depressed state to begin with and you start taking anti-depressants, some people who have no energy when they are depressed finally get enough energy to kill themselves. They are at risk.

Kids are at risk as well. Anyone who has ever taken anti-depressants knows that there is no magic to knowing which drug will work and which one won't. Kids don't know enough to tell their doctors when things aren't going well. And when you are in a depressed state to begin with you are so messed up that when the drugs start to kick in, you might not be able to tell someone what is going on inside, whether it is good or bad.

I know the risks. I have heard the voices. And as an adult I can't always control how I feel. It has to be 100 times worse for a kid. And it seems to me that any doctor who has had any dealings with these drugs knows enough to monitor their patients who are at risk, not just write a prescription and send them on their way.

[Starr_79]

You know, for one thing, I think that in our society, we have built antidepressants up to be these miraculous happy pills, and I think that some people expect to be "cured" as soon as they start taking them. I know from experience that finding the right drug can be a long, long, disheartening experience. And it takes a few weeks to try out each new pill, because you have to let your body get used to it, and while you wait through the fatigue, the nausea, the constipation, the utter lack of concentration, etc., things can get really bad. You are hoping for a relief, and instead when you start you are making everything a hundred times worse.
And the Dr.s don't make it any easier - have you ever tried telling a Dr. that you don't WANT to take a drug that THEY feel is working? I took Prozac, and from what everyone could see, it made me "all better". But the best way I could explain to them how I felt at the time was, "I just don't care about anything." And they said, "great, then you should be happy. We'll keep you on this!" But I guess a better way to say what I was feeling was apathy. And who wants to live like that? That's not a life.
But I don't understand why people aren't being monitered more closely. When my Dr.s were trying to find the right pills for me, I had to go to 2 appointments per week. If I didn't go, I didn't get my meds. All in all though, I guess, yeah, the drugs can be dangerous, but I believe that, for the people who truely need the drugs, life on it's own, might be even more dangerous.

[CowNcalves]

I'm glad to see that they are finally looking into problems these drugs can ccause. I was taking Zoloft for a very short time. IT was the first antidepressant that I ever tried. After 4 days of taking it, DH had to call the DR. because of how violent it was making me (usually nothing bother me). IT magnified all little problems 100%. One day on my way to work, I was waiting for a train to pass. I got so ticked off at having t wait that I fought myself from running into it.
Dr. response was that they never had problems with this drug and to have me continue using it. Good thing he threw them out or I wouldn't be here to type this. Some of these drugs can have some nasty side effects. I was lucky to have someone home to catch it

[ttistin]

i know I need to see a dr about me and depression, but I am so afraid of her putting me on some pill. I have a dr appt this afternoon {for my back problems} and I was thinking I would say something but I am afraid too. Afraid that I will get put on pills or that she wont believe me, i dont know.

I am glad there is meds out there to help but you would think they would do just that...help, not put you through more hell before they start working. I know on my down days {which is very often} the thought of taking the box of sleeping pills or just driving in front of that semi sounds very good {dont worry I wont do that, I wouldnt do that to my kids or family...plus I am to chicken lol} I am afriad after hearing so much bad/negitve stuff about some of these meds to be put on something.

I am happy for that do take them and they are working the way they should. {{{Hugs}}}

[newwiccan]

I've been on 6 of the ones listed and Remeron was the worst. I had NO control over my temper. Effexor worked the best but I had to be weaned off when I found out I was pregnant and I felt like I was dying. Once this baby is born and I go back on something, it won't be Effexor.

[justme23]

I'm on Wellbutrin XL and Klonopin (not listed). I have always been an 'on the spot cryer'... anything, at the drop of the hat... but it used to be over stuff that mattered... like thoughts of my mother who passed when I was 11. Now I tear up at almost everything. I fight it and don't let myself cry most of the time... cause seriously, we're talking about stupid things... like commercials... that make me want to cry... but I just don't get it. I feel better and my husband says I seem to act like I feel better... but I hate how litterally *everything* makes me cry and I litterally DON'T care at the same time. I don't really know if that makes sense... I'm glad this was posted tho cause I need to set an appt w/ the doc to discuss it.

[Starr_79]

I'm going to bump this way back up again, because I wanted to tell ttistin that you should talk to your doctor if you are feeling that way. There are other things that can be done to help you if you don't want pills, like talk therapy. If your Dr. doesn't listen to what you want and need, then find a new Dr. You should not have to live like this, I know what it is to be afraid to admit it, and talk about it, but believe me, you will be sooo glad that you did when you wake up one day and realize that you don't think about taking all the sleeping pills and other things like that.

And justme23, I know exactly what you mean about crying at everything. I cry at commercials all the time, and you know that show Extreme Makeover? I cry evertime I watch that too - I don't care about those people, but there I am with tears running down my face! I always try not to cry too, but it usually doesn't work. Just thought I'd tell you that you're not alone.

[buglebe]

[QUOTE]Originally posted by schsa
The main concern is that if you are in a depressed state to begin with and you start taking anti-depressants, some people who have no energy when they are depressed finally get enough energy to kill themselves. They are at risk.
================================================== ====================
This is what I was taught in nursing school 30 years ago. I too have suffered from depression. I have been on an anti depressant since my early twenties, 59 now. Each person has to find the right drug and dose with the interaction with their physician. I know without the drug I am on now I would not be here today. The drug I am on now has been the one to make me feel most normal.