Wednesday, October 13, 2010

antidepressants and suicide

Popular hype. do they increase risk of suicide? Not a new concept, been around since antidepressants were around. Yet some seem to find antidepressants more sinister than depression, schizophrenia, ptsd, hmmm they all have an increased risk of suicide right. Generally untreated mental illness can have a fatal outcome. Sometimes it is just really debilitating, and causes a lot of suffering.
so we have mixed reviews on antidepressants, some studies showing a slight increase in suicidal risk when on these meds.
Here is a fact, meds are not there to hurt people or make them worse or make somebody kill themselves.
There is very little data on if and how many lives antidepressants save. I mean think about it, how can we really research that.
Not to mention the fact that there is more media hype on the dangers of antidepressants than on the fact that alcohol is associated with most completed suicides.
So the meds prescribed by doctors to actually prevent suicide may increase the risk, even a little bit?
First of all if they were truly dangerous, would not your wonderful Federal Government that we all know love and trust pull them from the market??
Lets say you are a liberal and you love big government, you have a nice 401k and cheap or free health insurance, you have enough money to afford to be liberal, generally speaking, you by default hate doctors, are suspicious and mistrusting of them and perceived authority and you really groove on the concept of these meds being dangerous prescribed by mean non-caring doctors, okay fine, but you love government, and generally vote in the direction of bigger government. If that was the case, think about it, WOULDN'T THE GOVERNMENT PULL THESE MEDS OFF THE MARKET IF THEY WERE TRULY DANGEROUS???? oh sorry I forgot it is the big bad drug companies that are out of control, and the government just has to control them better?
Well you see all the political issues involved here.
Anyways, since the government put out stern warnings on suicide risk of these meds in people under say 24 years old, it scared the hell out of doctors and the teen suicide rate has been climbing ever since. SAD. Doctors afraid to treat, afraid of getting blamed and sued? Maybe who knows.
What is known clinically and generally still accepted is this, when you start and antidepressant the vegetative signs of depression improve before the cognitive signs. Generally in the first couple weeks.
This means a person with depression responding to antidepressants gets their energy back before there sad hopeless suicidal thinking improves. So they actually get enough energy in those first few weeks,  to kill themselves. A risky time. Not new, been around and clinically known like forever, The patient must be monitored closely in those first few weeks. Something your health care reform does not like much. The suicidal thinking does improve for many, if not most people that are depressed and get adequately treated. That is assuming you have the CORRECT diagnosis of major depression , the person is sober, and actually following a treatment plan prescribed, hopefully by a physician. It also helps for the person suffering to have a decent psychotherapist,  that does not have a chip on their shoulder about meds and psychiatry, and actually some understanding of the expectations and limitations of meds, and not just what they read on the internet or heard on TV. See my earlier blogs.
What if these meds really were meant to help people, actually saved some lives, and were prescribed by doctors who knew how to diagnose and treat and had their patients best interest at heart and were trying to help them because that was their profession and their vocation and that's what they do all day? That is just no fun to believe? Or we actually know better than that, cause we do.
I just wish we did not want to have are cake and eat it too. If we could just take these medications seriously for a minute, we devalue them, yet evetrybody wants to prescribe them with a minimal amount of training. So which is it? And yes we all know many terrible stories, of the bad med and the bad doctor and the terrible things that happened because of the meds. There are 100 of those stories to one, wear somone actually is allowed to speak out on how medicaiton actually helped them.
And no meds are not the panacea. no one is saying that. Frankly they have profound limitations but they actually do save lives whether we want to admit that part or not.

1 comment:

karen said...

OMG!!! Very scary. I am still waiting for someone to say deod. Causes breast cancer but no one told us because the deod. Companies paid someone off. LOL!

Talking about the book with the Lake Superior wind....... a calm day