Lesson 3: Antidepressants
Do's and Don'ts, Breasfeeding and Pregnancy
If early in your treatment you begin to feel agitated or hyper, notify your physician at once. If you are an undiagnosed manic depressive, an antidepressant without a mood stabilizer can send you into orbit. Others who do not have manic depression can have these reactions as well.
The flip side of agitation is the drowsy feeling many users experience, particularly in the early phases of taking the drug, when the body has not yet adjusted. All antidepressants come with the warning to be careful about operating heavy machinery, and this includes your car.
Other things to be watch out for include:
- Other substances that affect your mood, be it alcohol, legal or illegal drugs, caffeine, or foods rich in sugars or carbohydrates. Alcohol and recreational drugs should be regarded as taboo, caffeine should be taken advisedly, and junk foods should be only an occasional indulgence.
- Different names, same drug. Sarafem, which is prescribed for premenstrual dysphoric disorder, is a new trade name for Prozac. Let your doctor know if you are on one or the other. More worrying is the fact that the FDA has allowed GlaxoSmithKline to market its antidepressant drug Wellbutrin as an anti-smoking drug under the name Zyban. Wellbutrin should not be prescribed for people who are at risk of having seizures. An unwitting consumer taking both Zyban and Wellbutrin could find him or herself in double jeopardy.
- Antidepressants and other drugs. Let your doctor know what other drugs you are taking, as some drugs affect the metabolism of the other. This includes herbal supplements, as well.
Access to Meds
Lack of disposable income should not prevent you from seeking antidepressant therapy. True, each pill retails in the neighborhood of $2.00 in the US, but few individuals wind up paying the full price. Private health plans and state welfare usually pick up the tab or most of the tab, and for those who otherwise do not qualify, the best-kept secret in America is that pharmaceutical companies have patient assistance programs that give away drugs to those in need.
You need to work through your prescribing physician to take advantage of these programs. The drug companies have 1-800 numbers for your physician's office manager to call. Once the paperwork is completed, you will be able to pick up your medications at your doctor's office.
Breastfeeding and Pregnancy
Breastfeeding while on antidepressants is considered safe, with only small traces being found in the mother's milk.
A WebMD report on research presented at the APA General Meeting held in May 2001 notes that:
Saliva collected from the infants of mothers with a history of depression found higher cortisol levels, indicating a greater response to stress.
Prozac and tricyclics appear to be safe during the first trimester of pregnancy, but less is known about other SSRIs such as Paxil or Zoloft.
One study reviewing the records of 70 infants whose mothers took antidepressants during pregnancy showed no apparent negative effects, but long term effects remain unknown. The same study also suggested continuing antidepressant medication through labor and delivery.
Another study of 95 women found no significant differences in obstetric outcomes between nonmedicated and medicated women in each trimester, but the study's authors caution that "what is safe for one woman isn't safe for another."
Finally
As stated in the beginning, antidepressant treatment should be regarded as but one small part of your wellness program. Our next lesson will look at alternative therapies and smart lifestyle choices.
