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Antidepressants and Thoughts of Suicide – Were You Warned?

It's hardly surprising that tens of millions of people take antidepressant medications. What is shocking is that such drugs may trigger thoughts of suicide.
Antidepressants and Thoughts of Suicide – Were You Warned?
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We are living through some really rough times. Even before the coronavirus pandemic, tens of millions of Americans were anxious or depressed. We can hardly begin to imagine how many people are in distress these days. Doctors frequently prescribe antidepressants like sertraline, escitalopram and bupropion. They may not always tell patients and their families to be on the lookout for thoughts of suicide.

How Many People Are Taking Antidepressants?

Our back-of-the-envelope calculations suggest that nearly 40 million citizens of the U.S. are taking antidepressant medications. At last count, over 200 million pill bottles were dispensed annually. If each bottle contains 30 pills, that equals 6,078,000,000 pills!

Keep in mind that was before the coronavirus. From all indications, people are far more distraught today than they were a year ago when these statistics were gathered.

Because antidepressants are dispensed to so many people so regularly, we fear that prescribers and patients may take them for granted. That could mean that families are not warned about thoughts of suicide that can be triggered by drugs like:

Sertraline
Escitalopram
Bupropion
Trazodone
Citalopram
Fluoxetine
Duloxetine
Venlafaxine
Amitriptyline
Nortriptyline

What Can Happen When People Are NOT Warned About Thoughts of Suicide”

This father wishes his son was warned about thoughts of suicide before being prescribed an antidepressant:

Q. As a grieving father who lost his beautiful son to suicide, I would like to write about the dramatic increase in antidepressant drug use. Too many doctors are writing prescriptions for off-label use.

Doctors expect their patients to monitor changes in their own mental health, even though antidepressants carry a black box warning about suicide ideation. This clearly states:

Families and caregivers should be advised of the need for close observation and communication with the prescriber.”

In my experience, this is not happening.

People with mental health concerns should receive counseling before being prescribed any psychotropic drug. In my son’s case, his university psychiatrist treated “age-appropriate stress” as a mental illness and prescribed him paroxetine and clonazepam. That resulted in suicide ideation.

The thing that angers me the most is an answer my son wrote on a questionnaire in his medical records:

“I wish I could feel the same as I did before taking psychotropic drugs.”

If my son had never been prescribed psychotropic drugs, he would be alive today, happy and healthy.

A. We are so sorry to learn about this tragedy. We agree that everyone who takes antidepressants should be carefully monitored by friends and family for thoughts of suicide.

You are right that the FDA has required a black box warning (the strongest warning there is) with most antidepressants. There is a clear statement about the emergence of thoughts of suicide. Here is the full statement that might have protected your son:

“Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.

“In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.”

Other Stories About Antidepressants and Thoughts of Suicide:

Barry developed thoughts of suicide after taking citalopram.

“After 15 years building a business, a change of directors put my workload levels at a breaking point. I was raised to just get on with it and not moan or complain. I believed mental illness was just a weakness of character.

“The stress was too much for me. I broke down and was put on the antidepressant citalopram. To get to sleep my doctor prescribed zolpidem. The sleeping tablets worked. The antidepressant made me feel worse.

“I have never before felt anything like wanting to commit suicide. With much help and care from my family I got through this very dramatic time in my life.”

Kate developed thoughts of suicide while taking a generic antidepressant:

“I was suicidal within days of taking a generic antidepressant made in India. I do not trust generic drugs from foreign suppliers. Your pharmacy will not take responsibility.”

Rob was taking duloxetine and developed thoughts of suicide:

“I was placed on duloxetine for depression, anxiety and nerve pain. I did get some relief from the neuropathy but not for the depression. The doctor phased me off duloxetine and moved me to escitalopram.

“After 17 days I feel like crap. Side effects include nausea and gas. I also have the jitters and light tremors throughout my extremities. And I have had on and off again thoughts of suicide. My psychiatric nurse practitioner will need to come up with some alternate approach.”

The People’s Pharmacy Perspective:

We know that it seems counterintuitive to warn people that an antidepressant medication might lead to thoughts of suicide. But the FDA believes such a warning is warranted. Not only that, but friends and family should be notified so that they can monitor any worrisome thinking patterns or behaviors in patients prescribed antidepressants.

Share your experience with antidepressant medications in the comment section below. How well have they worked for you? Have you experienced any side effects? What about thoughts of suicide or sexual dysfunction? Here is a link to an article about this delicate subject:

Sexual Side Effects Are Common

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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