Useful information to support those on antidepressants

Anti-depressants  Part 4

Suicidal feelings with SSRIs in younger people

There is some evidence of increased suicidal thoughts (although not actual suicidal acts) and other side-effects in young people taking antidepressants. However, the National Institute for Clinical excellence in the UK has stated that Fluoxetine, an SSRI antidepressant, can be used in the under-18s. There is no clear evidence of an increased risk of self-harm and suicidal thoughts in adults of 18 years or over. Young adults are more likely to commit suicide than older adults, so a young adult should be particularly closely monitored if he or she takes an SSRI antidepressant.

How long do antidepressants need to be taken for?

Studies show that if antidepressants are stopped within 8 or 9 months, the symptoms of depression are more likely to come back. The current recommendation is that it is best to take antidepressants for at least six months after the patient starts to feel better. In patients who have had two or more attacks of depression then treatment should be continued for at least two years.

Antidepressants during pregnancy and breastfeeding

The benefits of antidepressants sometimes outweigh the risks during pregnancy and breastfeeding. Non-drug methods such as Cognitive Behavioural Therapy should be tried before drugs in pregnancy and breastfeeding. If medication is needed, for example in cases of suicidal feelings, SSRI’s are the most commonly prescribed. Tricyclics are best avoided in pregnancy and breastfeeding.

Important points when taking antidepressants

• They should be taken every day otherwise they will not work
• After commencing, it will take 1-2 weeks to start working and maybe up to 6 weeks for full effect.
• With some of the older Tricyclic drugs it's best to start on a lower dose and work upwards over a few weeks.
• The dose of SSRI antidepressant generally does not have to be increased slowly. The dose the patient starts with is usually the dose they carry on with.
• It doesn’t help to increase the dose above the recommended levels.
• Initial side-effects such as nausea. Many of them wear off in a few days. They should not be stopped unless the side-effects are very severe.
• Persevere - stopping too early is the commonest reason for people not getting better and for the depression to return.
• The doctor should be informed about any major changes in mood when the dose of antidepressant is changed.
• Alcohol should be taken in moderation only. Alcohol on its own can make depression worse, but it can also make patients slow and drowsy when taking antidepressants.

Call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).