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Along with counseling, antidepressants are a common treatment for depression. Four out of 10 people treated with antidepressants improve with the first one they try. If the first antidepressant medication doesn't help, the second or third often will. Most people eventually find one that works for them. Yet many people who could benefit from an antidepressant never try one, often because of fears about them, experts say.
Here are eight common fears about antidepressants, as well as facts that can help you and your doctor decide if an antidepressant is right for you.
Fear: Antidepressants make you forget your problems rather than deal with them.
Fact: Antidepressants can't make you forget your problems, but they may make it easier for you to deal with them. Being depressed can distort your perception of your problems and sap you of the energy to address difficult issues. Many therapists report that when their patients take antidepressants, it helps them make more progress in counseling.
Fear: Antidepressants change your personality or turn you into a zombie.
Fact: When taken correctly, antidepressants will not change your personality. They will help you feel like yourself again and return to your previous level of functioning. (If a person who isn't depressed takes antidepressants, they do not improve that person's mood or functioning.) Rarely, people experience apathy or loss of emotions while on certain antidepressants. When this happens, switching to a different antidepressant may help.
Fear: Taking an antidepressant will make me gain weight.
Fact: Like all drugs, antidepressants have side effects, and weight gain can be a common one of many of them. Some antidepressants may be more likely than others to cause weight gain; others may actually cause you to lose some weight. If this is a concern, talk with your doctor.
Fear: If I start taking antidepressants, I'll have to take them for the rest of my life.
Fact: Most people who take antidepressants for a first-time episode of depression need to take them continuously for six to nine months, not necessarily a lifetime. Once an antidepressant gets depression under control, you should work with your doctor to decide when to stop your medication and then decrease your dose gradually. Discontinuing them suddenly may cause problems such as headaches, dizziness, and nausea.
Fear: Antidepressants will destroy my sex life.
Fact: Some antidepressants can have an effect on sex. The problem is usually in having an orgasm rather than a lack of desire. But because depression itself decreases libido, a medication that eases depression may improve your sex life. As with other side effects, certain antidepressants may be more likely than others to cause sexual problems.
Fear: Antidepressants are expensive and aren't covered by insurance.
Fact: Antidepressants are usually covered by insurance plans with prescription drug coverage. The cost of antidepressants varies widely, depending on the dosage, the drug you are taking, and whether it is available as a generic. Even without insurance coverage, it is possible to purchase a generic antidepressant for as little as $15 per month.
Fear: Taking an antidepressant is a sign of weakness.
Fact: Like medical conditions such as diabetes or high cholesterol, major depression is a condition that often responds to medication. When depression interferes with your ability to function normally, seeking treatment is not a sign of weakness. It's a sign of good self-care.
Fear: Antidepressants increase the risk of suicide.
Fact: Studies in recent years have raised concerns that antidepressants may raise the risk of suicidal thoughts or behaviors (but not deaths) among children, adolescents, and young adults. For example, a 2009 review in the British Medical Journal (BMJ) looked at 372 studies involving nearly 100,000 people who were taking antidepressants. It found that compared to placebo, antidepressants were associated with a slightly higher risk for suicidal thoughts in some children and young adults, have no effect on suicide risk among those 25 to 64, and reduce the risk in those 65 and older.
In 2004, the FDA required manufacturers of antidepressants to revise their labels to include a black box warning statement about these risks.
Other studies paint a different picture. A 2006 study published in PLoS Medicine suggests that the use of antidepressants have saved thousands of lives. Data show that the U.S. suicide rate held fairly steady for 15 years prior to the before the popular antidepressant fluoxetine (Prozac) was sold and then dropped steadily over 14 years while sales of Prozac rose. The strongest effect was among women.
The bottom line: Regardless of your age or sex, it's important to see a doctor immediately if you have suicidal tendencies thoughts.
Reviewed by Joseph Goldberg, MD on September 14, 2012
© 2012 WebMD, LLC. All rights reserved.
Important Safety Information About Cymbalta®
The most important information you should know about Cymbalta:
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away or seek emergency help if you have new or worsening depression symptoms; unusual changes in behavior, such as agitation, irritability, impulsivity, or restlessness; or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
Cymbalta may be associated with serious side effects. Call your healthcare provider right away or seek emergency help if you experience any of the following:
- Itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of life-threatening liver problems. Severe liver problems, some fatal, have been reported
- High fever, confusion, stiff muscles, muscle twitching, or racing heart rate, which may be signs of serotonin syndrome, a potentially life-threatening condition
- Abnormal bleeding, especially if Cymbalta is taken with aspirin, NSAID pain relievers (like ibuprofen or naproxen), or blood thinners
- Serious, possibly life-threatening skin reactions, which may include skin blisters, peeling rash, mouth sores, hives, or other allergic reactions
- Abnormal mood (mania), which may include greatly increased energy, severe trouble sleeping, racing thoughts, talking more or faster than usual, and reckless behavior
- Seizures or convulsions
- Decreased blood pressure upon standing, which can cause dizziness or fainting, mostly when first starting or increasing the dose. Cymbalta can also increase blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- Headache, weakness or feeling unsteady, confusion, problems concentrating, or memory problems, which may be signs of low sodium levels in the blood. Elderly people may be at greater risk
- Problems with urination, including decreased flow or inability to pass any urine
- Changes in appetite or weight. Children and adolescents should have height and weight monitored
Do not stop Cymbalta or change your dose without talking to your healthcare provider, as you could have side effects.
Cymbalta is not for everyone. Do not take Cymbalta if you:
- Are taking or have recently taken a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid, or Mellaril® (thioridazine). Taking Cymbalta close in time to these medicines can cause serious or even life-threatening side effects
- Have uncontrolled narrow-angle glaucoma (eye pain due to increased eye pressure)
Before taking Cymbalta, talk with your healthcare provider:
- About all your medical conditions, including
- kidney or liver problems, heart problems, or high blood pressure
- glaucoma or diabetes (Cymbalta may worsen diabetes or a type of glaucoma)
- seizures/convulsions, mania, or if you have bipolar disorder
- if you have ever had or been told you have bleeding problems, low sodium levels in your blood, or delayed stomach emptying
- About all prescription and over-the-counter medicines and supplements you take or plan to take, including
- antibiotics or medicines for migraine, mood, or psychotic disorders, to avoid a potentially life-threatening condition when taken with Cymbalta
- aspirin, NSAID pain relievers, or blood thinners, because they may increase risk for bleeding
- About your alcohol use (you should not take Cymbalta if you drink heavily)
- If you are pregnant or plan to become pregnant during therapy or are breast-feeding
Most common side effects of Cymbalta (this is not a complete list):
Nausea, dry mouth, sleepiness, fatigue, constipation, decreased appetite, increased sweating, dizziness. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Other safety information about Cymbalta:
- Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you shouldn't drive a car or operate hazardous machinery
- People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries
How to take Cymbalta
Take Cymbalta exactly as directed by your healthcare provider. Do not open, break, or chew capsule; swallow it whole. Cymbalta is available by prescription only.
See Prescribing Information, including Boxed Warning about antidepressants and risk of suicide, and Medication Guide.
DD CON ISI 02OCT2012
©Lilly USA, LLC 2013. All rights reserved.
Cymbalta is a registered trademark of Eli Lilly and Company.
DD83231 04/2013
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