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Anxiety and Stress Disorders

Personally Reducing Medication

05/15/2006

Question:

This is the second time that I am posting my question I have not found out the answer of previous question. My friend is suffering from depression and she has been on medication for 5 years. This is not biploar disorder but clinical depression. Instead of continuously using antidepressants (like Citalopram and Escitalopram) she rides out the bout of depression. Then the doctor either increases the dose of her medicine or he tells her to change her salt intake. Now she has decided that she will stop (by reducing the dose or tapering off slowly)taking the medicine no matter what. As she is so desperate. She used to say that she doesn`t want to take the medicine anymore. Has she developed the addiction to antidepressants? Will she have to take the antidepressants throughout her life? Do all depression patients take antidepressants through out their life? Is her decision is right as she also gained weight(while using escitolopram)?

Answer:

Antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs) like celexa, lexapro, zoloft and prozac, as well as the other classes of antidepressants are NOT addictive.  While there can be some brief withdrawal symptoms when they are suddenly stopped, when they are tapered off slowly this rarely occurs.

However, the term clinical depression encompasses a wide range of illness.  Some people have one brief (and by brief, I mean 6 to 18 months) episode of depression, that with medication, counseling or both, resolves and does not return.  Other people suffer a more prolonged or chronic course.  Some people have many episodes of depression in their lives, with periods of months to years in between when they are fine.  Other people have chronic depression that needs ongoing medication or counseling for years, if not indefinitely.

If you friend has not included counseling or therapy in her depression treatment, I would highly recommend it.  It is also important that the diagnosis be correct.  Many people with chronic depression may have more that one diagnosis -- a common situation is when drug and/or alcohol addiction occurs with the depression.  If both problems are not treated, it is difficult for patients to improve.  Clinical depression can occasionally be misdiagnosed -- it may be that the real problem is bipolar depression, or even a psychosis like schizophenia.  These illnesses need different treatments.

Your friend may wish to consider getting a second opinion as to her problem.  Good luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati