By Dr. Marie Steinmetz
This column is the first of a short series on commonly used medications. This month we will discuss antidepressants.
One of the latest surprises, coming out of recent research and reported in the Journal of the American Medical Association Internal Medicine, is the effect of antidepressants on patients undergoing surgery. The study, published last month, showed that patients undergoing surgery while on antidepressants — called SSRI, or selective serotonin reuptake inhibitors — had a 10-percent increased risk of bleeding, an increased risk of readmission to the hospital and blood transfusion, and were more likely to die in the hospital.
The study was not a small one — it included 530,416 patients.
This is not the only report on adverse effects of these medications. A Canadian study last year showed there was an increased risk of having bleeding in the brain on these medications. In 2011, the U.S. Food and Drug Administration suggested that two medications in this class raised the risk of abnormal heartbeats.
If you are on these medications, do not stop them without consulting your doctor. There is a discontinuation syndrome.
Symptoms occurring with discontinuation are dizziness, nausea, fatigue, headache, anxiety and agitation. It’s very important that these medications are started and stopped under physician supervision.
These medications can be a lifesaver for many patients. I remember when these first came out, how happy I was to have something new for treatment of depression (older medications had even more side effects). These medications can be the best option for you, particularly if you have severe depression.
You may ask if there are other options for depression. First and foremost, find someone to talk to about your feelings. This can be a friend or minister but often should be a trained professional: a clinical social worker, psychologist or psychiatrist.
During my fellowship at the University of Arizona, we were introduced to many other modalities that have scientific evidence to combat depression. These include looking at your nutrition, sleep and physical activity as well as exploring botanical supplements like rhodiola, Saint-John’s-wort and even saffron. There also are many supplements, like SAM-e and fish oils, that have proven useful.
Mind-body techniques for which there is scientific evidence are yoga, biofeedback, light therapy and heart-rate variability training (HeartMath).
OK TO GET HELP
Before starting or stopping any medication, supplement or new treatment plan, it’s important that you see a professional trained in treatment options.
Depression is a serious illness. It can be a very deep hole that you need help to get out of. Don’t be afraid to ask for help. The darkness of depression can be treated and treated safely.
You can feel good again. Medications can be important in this treatment to get you back to health and wellbeing. Always weigh the risk versus benefit of any medication, but don’t hesitate to use them if you and your health professional feel it’s the best course for you.