Archives for Antidepressants


How long is too long for antidepressants?

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

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

Lena 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
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ADHD drugs

Think Kids Are “Overmedicated”? First Consider This.

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.

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ADHD drugs

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

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...
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Abuse and diversion

Mixing Meds and Alcohol: Just How Dangerous Is It?

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.

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Waiting Until You’re “Old Enough” for Antidepressants

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.

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ADHD drugs

A Hierarchy of Medications?

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.
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ADHD drugs

Medicating Class Cut-Ups But Overlooking the Rest

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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