Antidepressants Articles

How long is too long for antidepressants?

Friday, April 18th, 2014

long-term medicationYoung people spend too long on antidepressants without examining whether they still need them, a Duke psychiatrist argued in a recent New York Times post.

The psychiatrist, Doris Iarovici, is almost certainly right that more young adults are taking these meds for longer these days than in the past. The problem is that we don’t have a very good idea of how many – or for how long. As a result, it’s hard to know how much concern is justified.


How Lena Dunham’s real-life OCD made it onto Girls

Monday, April 8th, 2013

Girls_logoHow closely does a writer’s work mimic her life experiences? It’s a perennial question made all the more irresistible as it pertains to Lena Dunham,  the 26-year-old creator of one of TV’s most talked-about shows, and her recently-revealed history of  Obsessive-Compulsive Disorder.

In the first season of HBO’s Girls, Dunham stirred up debate by, among other things, repeatedly revealing her less-than-perfect body while playing the show’s main character, Hannah Horvath. What got people talking as the second season progressed, though, was how serious the show seemed to be getting, especially with its depiction of Hannah coping with a resurgence of her OCD symptoms.

Critics, fans, mental illness activists and patients have largely praised the Girls’ depiction of OCD, which they’ve hailed as convincing and nuanced, but agonizing to watch. One hollywood.com writer and self-described former OCD patient called it “some of the darkest, most difficult material with which Girls has wrestled to date,” lauding the show for avoiding the temptation to turn OCD into a mere joke.

The fact that Dunham revealed in a March cover story for Rolling Stone that she’s struggled with OCD since childhood – and taken medication for it on and off – gave the topic more buzz. (I discussed what she revealed-and what she didn’t-here).

In a HBO behind-the-scenes look at one of the episodes, Dunham disclosed a little more about the connection between her experience and the show’s representation of Hannah’s OCD – though she didn’t go into specifics.

For those looking for a more direct comparison, here’s a look about what Dunham has said about her own experiences with OCD symptoms and treatment – and how they compare to Hannah’s.


How did Lena Dunham turn OCD and ‘countless psychiatric meds’ into a hit TV show?

Monday, April 8th, 2013

Lena Dunham-Rolling Stone-croppedLena Dunham, the 26-year-old force behind HBO’s popular and much-discussed show Girls, hasn’t grown famous through discretion.

Part of the cringe-inducing delight of watching Girls is hearing Hannah say things and do things she knows she shouldn’t. And part of what’s refreshing about Dunham herself are her irreverent, indecorous comments and self-revelations, whether on Twitter, New Yorker essays, or interviews.

So I was especially curious to hear what Dunham had to say about her obsessive-compulsive disorder and medication use in a just-released Rolling Stone cover story. Especially since it was titled Girl on Top: How Lena Dunham Turned a Life of Anxiety, Bad Sex, and Countless Psychiatric Meds into the Funniest Show on TV.


Think Kids Are “Overmedicated”? First Consider This.

Friday, December 14th, 2012

I’ve argued before that declaring American kids and teens to be “overmedicated” is something of a cop-out.

How can people say what constitutes overmedication when they can’t – or won’t – specify what would constitute an acceptable number or percentage of kids taking psychiatric meds?

Still, I do care about the numbers, because they can give us clues as to which kids and how many are getting appropriate treatment for emotional and behavioral problems.

A recent and widely publicized study by researchers from The National Institute of Mental Health provides data on some -but not all – key measurements of youth medication use.

Its main finding: Just one in seven teens with a diagnosable psychiatric conditions have recently taken medications to treat it.


Study Finds Autistic Kids With Psychiatric Disorders More Likely To Be Medicated

Monday, November 19th, 2012

Many children with autism spectrum disorders (ASD) take psychotropic medications to treat associated symptoms of their conditions, such as irritability and anxiety. Usage has increased in recent years, and some recent studies have questioned the evidence base supporting the drugs’ effectiveness in young people with ASD.

A new study, published in a supplement to the November issue of Pediatrics, suggests that coexisting psychiatric conditions and problem behaviors might account for much of that prescribing.

The study, which examined children and teens ages 2 and 17 with autism spectrum disorders, found that 80 percent of children with a comorbid psychiatric condition were taking medication, compared to just 15 percent without any psychiatric comorbidity.

Depending on the condition in question, those with a comorbid disorder were between 5 and 17 times more likely to be taking a psychotropic medication as those without the additional disorder.

The study included 2853 children enrolled in a registry run by the Autism Treatment Network, a consortium of 17 academic medical centers in the United States and Canada that is associated with the advocacy group Autism Speaks.

The registry used DSM-IV-TR criteria and the Autism Diagnostic Observation Schedule to diagnose autistic disorder, Asperger syndrome, or pervasive developmental disorder not otherwise specified. It relied on parent reports for information about comorbid psychiatric diagnoses and medication use.

Some metaanalyses have questioned the effectiveness of treating ASD with psychiatric medications, though they have not always taken psychiatric comorbidity into account. Comorbidity is very common in autism spectrum disorders, with studies finding that between 70% and 95% percent qualify for at least one additional psychiatric diagnosis. Other researchers, however, have said these high rates partly reflect overlapping symptoms and problems with diagnostic criteria.

The Pediatrics study didn’t collect information about why the children and teens had been prescribed medication – that is, whether the meds were to treat the comorbid condition, symptoms of the ASD, or both.

However, it found that current psychotropic use was also correlated with high scores on the Child Behavior Checklist, a measure of overall problem behavior. That …


Mixing Meds and Alcohol: Just How Dangerous Is It?

Tuesday, November 6th, 2012

Most psychiatric drugs bear some version of the warning: “Do not drink alcoholic beverages when taking this medication.”

In reality, though, many people taking psych meds drink anyway. They have various reasons: not wanting to curtail their fun, not putting much stock in the warnings, or simply thinking it’s easier to take a proffered drink than explain why they’re turning it down.

Doctors oftentimes don’t bother to talk to patients about potential dangers. Or they tell patients not to drink, but don’t explain why. To make matters worse, because of a lack of studies on the subject, patients inclined to do their own research will have a hard time just how risky it is to drink while taking various kinds of psychiatric medications (I’ve written elsewhere about this troubling lack of evidence).

A widely publicized study that came out last month in the journal Neurology underscores the problem. The findings, which pooled data from 16 studies, showed that people taking SSRI antidepressants like Zoloft or Celexa were 40 percent more likely to suffer a type of stroke caused by bleeding in the brain and 50 percent more likely to suffer any bleeding in the skull.


Youth Suicide and Medications – What’s the Link?

Monday, September 10th, 2012

Youth Suicide and Medications - What's the Link?To recognize World Suicide Prevention Day, I wanted to post again about the topic of medications, suicide and young people.

First, the sad statistics: Worldwide, suicide is the second-leading cause of death among young people ages 15 to 19. In the United States, according to the CDC, suicide was the third-leading cause of death in 2009 for people ages 10-14, 15-19 and 20-24. It was the second-leading cause of death for people ages 25 to 34.

The vast majority of people
who commit suicide have a mental illness. But for nearly a decade doctors and researchers have been debating whether certain classes of medications used to treat mental illness increase or decrease the risk of suicide – as well as suicidal thoughts and behaviors – in young people.

In 2004, the FDA placed a black-box warning on all antidepressants, warning that they increase the risk of suicidal thinking and behavior (called “suicidality”) in children and teens.

An FDA analysis had found that one type of antidepressants in particular, the SSRIs, which include Prozac, Zoloft, Paxil, Lexapro and others, doubled the risk of suicidality in young people from 2% to 4%. But it found no completed suicides in the studies it looked at, which included some 2,200 children.

In 2005, the European medications regulatory authority urged European countries to put strong warnings about using either SSRI antidepressants, or SNRI antidepressants, such as Effexor and Cymbalta, for children or teens. The warning was based on the drugs’ potential to induce suicidality and hostile or aggressive behavior.

Also in 2005, the UK’s National Health Service issued guidelines urging doctors to avoid prescribing antidepressants to kids under 18 unless other therapies for depression didn’t work.

In 2007, the FDA expanded its black box warning on antidepressants to include all young people under age 25. The risk is greatest in the first month or two of treatment, the FDA warned.

After the U.S. and European warnings went into effect, prescribing of antidepressants to children and teens decreased. At the same time, some …


Waiting Until You’re “Old Enough” for Antidepressants

Sunday, September 9th, 2012

What’s it like to suffer from severe depression for as long as you can remember – and to be too scared to ask for help until age 18?

Today I’m featuring the story of Allie, a 21-year-old college senior in Wisconsin who was ultimately diagnosed with bipolar disorder. Allie kept her unhappiness a secret and didn’t begin taking medication when she was old enough to ask for it without her parents finding out.

Allie’s story is interesting, because it shows how kids can suffer from severe depression from a very young age. It also shows how in a culture where psychiatric drugs seem ubiquitous kids can come to focus on medication as a source of salvation.


A Hierarchy of Medications?

Sunday, August 26th, 2012

People who take psychiatric medications long-term are no strangers to stigma, or the threat of it. We perennially face, for example, the question of whether it’s worth risking others’ judgment and the potential negative repercussions of disclosing our conditions — and the fact that we take medication for them.

But you can commit to taking medications long-term and still perpetuate or further the stigma associated with meds. And I don’t just mean that in the sense of keeping your medication regimen secret. Most of us do so in another way altogether that we’re largely unaware of.

The fact is, most people have some kind of internal barometer when it comes to medications – which ones they are willing to take, and which ones they’re not.


Medicating Class Cut-Ups But Overlooking the Rest

Monday, August 20th, 2012

This weekend a mother published a New York Times column about how her son came to be diagnosed with ADHD and became a member of the ballooning “Ritalin Generation.”

“Just a little medication,” the teacher told the boy’s mother, “could really turn things around” for the boy, who was having trouble focusing on class worksheets and lining up quietly for transitions between classes.

When the mother firmly responded that she and her husband weren’t going to medicate their son, the teacher backtracked, sounding mock-horrified.

She wasn’t explicitly suggesting medication, she said. The law prohibited such a thing. She just didn’t want him to fall through the cracks – and thus was was merely suggesting the boy’s parents have him evaluated by a psychologist.

The boy was evaluated, and sure enough, he ended up on Ritalin for a short-time, though he quit it on his own a year later, matured out of his former inattentiveness, and eventually ended up a well-adjusted, school-loving honor-roll student – and medication-free.

Such stories are commonly invoked as cautionary tales about the alleged over-diagnosis of ADHD and other behavior disorders and over-prescribing of drugs like Ritalin to keep children’s behavior in check. Teachers recommending meds for disruptive students often feature prominently. In fact, the debate over school involvement in medicating disruptive children showed up as early as the early 1970s.


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Recent Comments
  • vegasangie: What can we do? Evan was so brave and had so much courage for a 15 year old boy. I am 48 and have...
  • Jay: This article very aptly points out the stigma attached to taking these drugs but then seems to stumble in...
  • Kaitlin Bell Barnett: Richard, it sounds like you have a very measured approach to this topic. Very refreshing...
  • Richard: I think that the most important thing that anyone taking any form of anti depressant meds should be aware...
  • psyche RN: Well put, Kaitlen
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