All year round, the United States celebrates national observances each month that help shed light and remind us about issues that may not always get their due recognition. Mental health disorders are typically not brought up in daily conversations, but when we pause to acknowledge them for a few days at a time, it can go a long way towards encouraging others to come forward with their stories and share in support and advocacy. October is typically associated with other observances such as Halloween and “Sober October,” but the month is also National Antidepressant Death Awareness Month. You’ve likely never heard of this before, and that is why the designation for the month exists.
The purpose of National Antidepressant Awareness Month is to raise awareness about the deaths and injuries related to antidepressants usage. It is also a month designed to urge people always to report any adverse reactions or concerns about taking a prescription medication for depression. Depression is a much more common mental health disorder in the United States than people realize research from 2015 estimates that more than 300 million people around the globe could be suffering from depression, and approximately 16 million adults in the U.S. had at least one major depressive episode in the past year. This article is not meant to denounce the use of prescription medication to treat depression, but rather encourage more open communication between doctors and patients about safely using this kind of medication. Here are some further stats about depression that may shock you:
- Depression is the leading cause of disability around the world
- 11% of adolescents will have a depressive episode by the age of 18
- 30% of college students report feeling depressed enough to have disrupted their performance in school
- 50% of Americans with major depression do not seek treatment
- Within the UK, people are consuming four times as many antidepressants as they did two decades ago
- The UK has the seventh highest prescribing rate for antidepressants in the Western World.
Depression is a devastating mental health disorder that impacts plenty of people around the world, so unsurprisingly, antidepressant medication is a commonly used form of treatment. However, dependency on these drugs, improper dosing, and combining medications can all potentially lead to severe injury or death. You may have even witnessed individuals self-medicate with narcotics and alcohol to treat depression symptoms. Some prescription medications intended to help with physical pain are sometimes misused to treat symptoms of depression, including medications such as opioids or amphetamines. You may have even heard jokes about casually using antidepressants with phrases such as “Pop a Prozac.”
Deaths from Antidepressants
This summer, the Centers for Disease Control and Prevention confirmed that suicide rates have been on a steady rise in nearly every state in the nation since 1999. In 25 states, the rates have risen by more than 30%. Another report found that an estimated 9.3 million adults in the U.S. reported suicidal thoughts in the past year. A recent study by the Equality and Human Rights Commission found that British males between the ages of 45 of 49 had an increase of 40% in suicide rates between 2008 and 2015. As suicides skyrocket, it’s worth noting an underlying trend that has united many deaths.
A review of 70 drug trials and over 18,000 people found there could be a link between antidepressant usage and increased risk of suicide. The comprehensive report was carried out by the Nordic Cochrane Centre and has been endorsed in British medical journals. What researchers found was that usage of antidepressants more than doubled the risk of suicide and aggressive behavior in adolescents (under 18-years old). What’s more is that by comparing clinical trial information to actual patient reports, scientists concluded that pharmaceutical companies were actively misleading customers to the true extent of deaths and suicidal ideation related to antidepressant usage. Ultimately, the scientists recommended that SSRI’s (Selective Serotonin Reuptake Inhibitors) and SNRI’s (Serotonin-Norepinephrine Reuptake Inhibitors) not be given to adolescents and teens, and instead focus on exercise and psychotherapy as promising alternative treatment models.
What Are Antidepressants (SSRI’s & SNRI’s)
An antidepressant is an umbrella term for a wide variety of medications used to treat symptoms of depression. However, due to the way they increase the brains availability of feel-good chemicals such as serotonin and dopamine, they can also help alleviate symptoms of anxiety. One of the most common types of antidepressants is SSRI’s, or Selective Serotonin Reuptake Inhibitors. When compared to Benzodiazepines, SSRI’s and SNRI’s have a much lower risk of dependency and abuse. That is because they typically take 4-6 weeks of regular use before effects take place. Some of the most common include:
Other variations include:
Tricyclic antidepressant (TCA’s)
Monoamine oxidase inhibitors (MAOI’s)
Atypical antidepressants (Wellbutrin or Trintellix among others)
There are many variations of antidepressant drugs, but most do the same thing. The primary goal of these drugs is to bring neurotransmitters back into balance and alleviate symptoms of depression. SSRI’s and SNRI’s do this by increasing the availability of feel-good chemicals in the brain. SSRIs increase serotonin, while SNRIs increase both serotonin and norepinephrine, which along with the dopamine are three chemicals most closely linked to depression.
Antidepressants aren’t considered addictive, but their usage needs to be carefully administered. Stopping abruptly or missing several doses can cause withdrawal-like symptoms such as nausea, dizziness, lethargy, and anxiety. It also takes time for SSRI’s and SNRI’s to take effect. In the 4-6 weeks that the body becomes acclimated to the medication, a variety of symptoms could occur. A small number of users report thoughts of suicide, and many report occasional dry mouth, insomnia, nervousness, dizziness, and sexual dysfunction.
- Less potential for developing an addiction than benzodiazepines
- Less disruptive to brain chemistry than benzodiazepines
- Can be used for a wide variety of anxiety disorders
- The time it takes to become effective may be a deterrent to continued use
- Could cause health complications when combined with other drugs such as alcohol and anti-inflammatories.
- Reduced appetite
Antidepressants medications can go a long way towards treating symptoms of anxiety disorders. However, they should never be considered as a single approach or fix. Combining antidepressants with continued therapy, along with a healthy diet and exercise will increase your chances of success.
Side-Effects of Antidepressants
Antidepressants can be very useful in alleviating symptoms of depression, but these drugs should always be taken according to clinical guidelines. Misusing antidepressants can cause adverse changes to emotional stability and exacerbate anxiety as well as causing physical side effects.
- Blurred vision
- Increased appetite
- Weight gain
- Sexual dysfunction
- Dry mouth
Side effects differ depending on the substance used and the individual’s body chemistry. Individuals should always consult with their doctors about any adverse side effects that arise while taking antidepressants. Additionally, antidepressant medications should never be abruptly discontinued for any reason without consulting with a doctor. It should be noted that this article is not meant to discourage use of antidepressants, as many individuals find them extremely helpful and useful in treating symptoms of depression.
Can You Overdose on Antidepressants?
The lethal dosage of antidepressants is dependent on multiple chemical and physiological factors such as the type of drug, the body’s rate of metabolism, weight, age, and pre-existing conditions. The most dangerous type of antidepressant statistically is a tricyclic antidepressant (TCA) which has the highest number of fatal overdoses than any other. The typical dosage for this type of drug is roughly 40-100 mg per day, and according to U.S. poison center data, lethal dosage typically occurs at greater than 1,000 mg, with the lowest recorded overdose coming in at just 200 mg.
SSRI’s are the most common antidepressant and can be taken in high enough quantities to be fatal. The typical dosage is roughly 20 - 80 mg per day, but as low as 520 mg dosing has caused at least one fatal outcome. This type of antidepressant becomes dangerous when combined with a narcotic, but taken alone it is typically not dangerous. SNRIs are similar, albeit slightly more toxic than SSRIs. The majority of SNRI overdoses are not fatal, and most cases involve an additional drug. MAOIs or monoamine oxidase inhibitors are not as widely used today as they were thirty years ago. This class of antidepressants has a rare overdose likelihood when taken alone, but in tandem with alcohol or an additional narcotic, it becomes significantly more dangerous.
Antidepressant medications are typically not as addictive as some other prescription medications and many doctors consider them safer to use. However, it is still possible to develop a dependency on these drugs because of the brain chemical changes that occur. Addiction typically occurs in individuals who begin taking the medication despite not needing it for medical purposes. Some people may receive an incorrect diagnosis of depression and end up with antidepressants. According to the Addiction Center, doctors could me misdiagnosing almost two-thirds of patients with depression, meaning the rate of misprescribed medication could be just as high. Here are some startling statistics about prescription antidepressant dependency in the United States.
- Roughly 10% of Americans take antidepressant medication
- More than 60% of Americans on antidepressants have taken them for two years or longer
- The rate of antidepressant use in the United States increased by almost 400% from 2005-2008
Mixing Antidepressants with Other Drugs
The use of antidepressants becomes more dangerous whenever combined with an additional drug. Alcohol is one of the most commonly used substances that people combine with other drugs. When misusing prescription antidepressants with alcohol, there are many potential and alarming side effects.
- Intense sedation
- High blood pressure
- Impaired motor control
Safety Before Stigma
While there may still be a stigma that exists in someone’s mind about taking antidepressants regularly, no one should ever be afraid or embarrassed about it. With any other illness, you would never be ashamed of having to take a medication to treat it. This kind of assistance can be essential to someone living a balanced, healthy life. Medication-assisted treatment is a controversial subject, but practitioners, citizens, and policymakers need to understand that medical assistance may be necessary for some individuals to safely and comfortably live their lives. As long as people are proactive about addressing depression symptoms, working with clinical providers, and routinely sticking to their prescriptions, we can continue to treat and understand depression, opening the door for future generations to create better and better treatment options.
Approximately 1 in 6 Americans take antidepressants today, making them among the most commonly used medications. This month, we remember all those who have suffered through depression and faced harm as a result of improper antidepressants use, whether intentional or unintentional. We also take this month to remember those who lost their lives as a result of antidepressant medication or from improperly medicating themselves to treat depression. We must continue to strive for a better understanding and use of these medications. Abuse of antidepressants is extremely dangerous, but getting the right kind of treatment at the right time can make all the difference.
Regardless of whether antidepressant medication sounds like the best option for you, it’s best to confer with a clinical professional before pursuing any treatment option for depression. Likewise, any treatment option should be accompanied by lifestyle changes aligned with addressing your physical and mental health. If you believe that you or a loved one may be self-medicating to treat depression, reach out and consult with a medical professional to talk about possible drug treatment options.