Safety of Antidepressant Drugs QuestionedAug 2, 2003 | St. Joseph News Press Concerns about side effects from popular anti-depressants such as Paxil and Zoloft have some questioning the safety of the prescription drugs.
The U.S. Food and Drug Administration is reviewing reports that a class of antidepressant drugs, which includes Paxil and Zoloft, causes suicidal thinking in children. This precautionary action by the FDA has ignited concerns in some people about the safety of drugs classified as Selective Serotonin Reuptake Inhibitors (SSRIs).
But two local mental-health professionals say that while there is concern, there is no cause for alarm.
“There are reports which indicate there may be some relation between these medications and suicide risk, but there are no controlled studies supporting that,” said Syed Jaffri, psychiatrist for the Family Guidance Center for Behavioral Healthcare.
Local psychologist Ken Hines added that concerns about these drugs causing suicidal and homicidal tendencies isn’t anything new.
“This really started about 10 to 20 years ago when Prozac was the only SSRI out there,” he said. “There are only a few recorded cases, and it happened with people with severe depression.”
According to its government Web site, the FDA issued the cautionary recommendation in June. It said Paxil shouldn’t be used to treat major depression in children and adolescents. The recommendation was based on data from three clinical pediatric studies that found suicidal thoughts and attempts were common in children who used Paxil. The risk was found to be three times greater with Paxil as compared to a placebo or sugar pill.
No evidence was found that Paxil causes suicidal thoughts in adults.
According to the MayoClinic.com Web site, the classes of drugs known as SSRIs that are used to treat depression work by blocking certain chemicals in the brain. The site says that many doctors consider them safer than other antidepressants and that they pose less of a threat of overdose.
Nevertheless, when mixed with other types of antidepressants, SSRIs can trigger a potentially life-threatening side effect known as serotonin syndrome.
But some of the most common side effects are drowsiness, dizziness and dry mouth. Less commonly experienced as a side effect is something called akathisia.
The CancerWEB online dictionary describes akathisia as a “condition of motor restlessness an urge to move about constantly and an inability to sit still.”
“About 3 to 5 percent of people who take this drug are at risk of akathisia,” he said. “I’m saying there should be a warning about these drugs.”
Dr. Jaffri said the risk of suicide is high in depressed patients whether they’re treated with these drugs or not. If one of his patients complains about troubling side effects, he either discontinues the medication or changes it.
“If somebody calls me and says, ‘I’m taking mediation, and I think I’m having a side effect,’ then I’m not going to tell them to keep taking it and don’t worry,” he said. “I’m going to tell them, ‘OK, stop the medication, then I will see you (and) then we will evaluate whether it’s really a side effect of the medication or there’s something else going on.”
Mr. Hines said these drugs may give the person the energy to carry out suicidal behavior, but they don’t trigger the action.
“There are two components of depression. One of them is the person lacks energy, and the other is that they feel bad,” he said. “When people have it really bad and you give them an antidepressant, they start feeling like doing things. The lethargy component goes away, but the feeling of hopelessness hasn’t gone away yet, so the have the energy to attempt suicide.”
David Lawrence said he has been taking Paxil to treat his depression for a few months now. The 28-year-old St. Joseph man said he has never experienced any anxiety or suicidal thoughts.
“It doesn’t make me suicidal, but before I started taking it I was,” he said. “I wouldn’t eat for three months or talk to anybody. It doesn’t make me homicidal, but it makes me tired and drowsy.”