WEBVTT - Why Do Antidepressants Have Warning Labels About Suicidal Thoughts?

0:00:01.960 --> 0:00:07.000
<v Speaker 1>Welcome to brain Stuff, a production of iHeartRadio. Hey Brainstuff,

0:00:07.040 --> 0:00:11.280
<v Speaker 1>Lauren Vogel bomb here. Today's episode discusses mental health, including

0:00:11.360 --> 0:00:15.200
<v Speaker 1>suicidal thoughts and tendencies. If you're not up for that today,

0:00:15.440 --> 0:00:18.360
<v Speaker 1>go ahead and skip this one, okay, and hey, take

0:00:18.360 --> 0:00:23.440
<v Speaker 1>care of yourself. Many prescription drugs taken as antidepressants, and

0:00:23.600 --> 0:00:28.400
<v Speaker 1>especially SSRIs or selective serotonin reuptake inhibitors, carry the warning

0:00:28.440 --> 0:00:35.159
<v Speaker 1>label may cause suicidal thoughts. It seems counterintuitive that medications

0:00:35.280 --> 0:00:38.960
<v Speaker 1>used to treat depression, which can lead to suicide, could

0:00:39.000 --> 0:00:41.839
<v Speaker 1>possibly have this side effect and still be considered a

0:00:41.920 --> 0:00:46.239
<v Speaker 1>viable treatment. To understand the reasons that these medications are

0:00:46.360 --> 0:00:49.880
<v Speaker 1>nonetheless prescribed, and the reasons why they need these labels

0:00:49.880 --> 0:00:53.440
<v Speaker 1>in the first place, let's talk about how antidepressants work.

0:00:56.080 --> 0:00:58.920
<v Speaker 1>For the article this episode is based on How Stuff Works.

0:00:58.920 --> 0:01:02.440
<v Speaker 1>Spoke via email with licensed clinical psychologist doctor David Goodot

0:01:02.720 --> 0:01:07.920
<v Speaker 1>with psycholob Psychology Center. He explained the name antidepressants is

0:01:08.120 --> 0:01:10.600
<v Speaker 1>kind of a marketing term that makes the problem of

0:01:10.640 --> 0:01:16.720
<v Speaker 1>suicidality less understandable. Antidepressant medications do not actually reduce depression.

0:01:17.200 --> 0:01:21.920
<v Speaker 1>They simply increase levels of certain neurotransmitters of forty years ago,

0:01:22.200 --> 0:01:25.600
<v Speaker 1>a researchers imagined that depression was caused by a shortage

0:01:25.600 --> 0:01:29.839
<v Speaker 1>of those neurotransmitters. However, research has not supported that hypothesis

0:01:29.880 --> 0:01:34.360
<v Speaker 1>at all. The brain is much more complicated than that. Indeed,

0:01:34.480 --> 0:01:38.360
<v Speaker 1>our brain seem to be constantly flipping the script. Reactions

0:01:38.360 --> 0:01:42.319
<v Speaker 1>to psychological medications and treatments can vary widely from person

0:01:42.319 --> 0:01:45.640
<v Speaker 1>to person, and the outcomes aren't always what you'd expect.

0:01:46.800 --> 0:01:49.600
<v Speaker 1>How Stuff Works also spoke with Lewis Lave's Web, a

0:01:49.640 --> 0:01:53.200
<v Speaker 1>psychotherapist in Austin, Texas whose name I hope I'm not butchering.

0:01:53.280 --> 0:01:56.520
<v Speaker 1>I did try to look it up. He said, as

0:01:56.520 --> 0:01:59.600
<v Speaker 1>depression lifts, it can make a person feel more motivated.

0:02:00.160 --> 0:02:02.560
<v Speaker 1>The vast majority of the time, this is a good thing.

0:02:03.040 --> 0:02:06.000
<v Speaker 1>It means they're motivated to engage in activities that make

0:02:06.080 --> 0:02:11.040
<v Speaker 1>their life happy and meaningful. Unfortunately, this isn't always the case,

0:02:11.320 --> 0:02:14.640
<v Speaker 1>and due to mechanisms we have yet to comprehend, a

0:02:14.680 --> 0:02:18.200
<v Speaker 1>small minority of patients find the motivation not to play,

0:02:18.480 --> 0:02:22.880
<v Speaker 1>but to make a suicide plan. How Stuff Works also

0:02:22.919 --> 0:02:26.799
<v Speaker 1>spoke with a patient who's experienced this phenomenon. A blogger

0:02:26.960 --> 0:02:30.680
<v Speaker 1>Esther Louise has used antidepressants to successfully manage her lifelong

0:02:30.760 --> 0:02:34.679
<v Speaker 1>battle with depression and anxiety, but the benefits haven't come

0:02:34.760 --> 0:02:38.720
<v Speaker 1>without some pitfalls. She said, I've been through the process

0:02:38.760 --> 0:02:42.080
<v Speaker 1>of starting the SSRIs on three occasions now, and each

0:02:42.160 --> 0:02:45.120
<v Speaker 1>time I've found it to be very difficult. When starting

0:02:45.120 --> 0:02:47.880
<v Speaker 1>the medication, I tend to experience an increase in the

0:02:47.919 --> 0:02:50.440
<v Speaker 1>severity of my symptoms for a short time before they

0:02:50.600 --> 0:02:53.920
<v Speaker 1>slowly start to get better. This means that for about

0:02:53.919 --> 0:02:56.760
<v Speaker 1>a week after starting the antidepressants, I will feel very

0:02:56.800 --> 0:03:00.480
<v Speaker 1>depressed and experience suicidal thoughts, even if I had not

0:03:00.560 --> 0:03:05.000
<v Speaker 1>been suffering with them before starting the medication. She says

0:03:05.040 --> 0:03:08.200
<v Speaker 1>she still finds this experience to be very alarming, even

0:03:08.240 --> 0:03:12.120
<v Speaker 1>though she's aware of what's going on. She explained, during

0:03:12.160 --> 0:03:15.359
<v Speaker 1>this time, I feel very out of character, more impulsive,

0:03:15.480 --> 0:03:18.840
<v Speaker 1>and not as stable. It can be incredibly scary to

0:03:18.840 --> 0:03:22.079
<v Speaker 1>feel like you're out of control in this way. However,

0:03:22.400 --> 0:03:24.880
<v Speaker 1>I have to remind myself that it is only temporary

0:03:25.120 --> 0:03:28.120
<v Speaker 1>and these feelings will go away soon. In my case,

0:03:28.200 --> 0:03:33.280
<v Speaker 1>they always have. This reaction probably occurs because it takes

0:03:33.320 --> 0:03:35.800
<v Speaker 1>time for antidepressants to really make a difference in your

0:03:35.840 --> 0:03:39.880
<v Speaker 1>brain function. A goodo explained, Oh, when you take prozac,

0:03:40.040 --> 0:03:43.200
<v Speaker 1>your serotonin levels will increase within about a half hour,

0:03:44.000 --> 0:03:47.200
<v Speaker 1>but therapeutic benefits are not expected for at least two weeks.

0:03:47.880 --> 0:03:50.720
<v Speaker 1>Oh why because something else has to happen in the

0:03:50.760 --> 0:03:54.320
<v Speaker 1>brain and body in response to the elevated neurotransmitter levels.

0:03:54.600 --> 0:03:57.680
<v Speaker 1>And frankly, no one in the world knows exactly what

0:03:57.800 --> 0:04:04.280
<v Speaker 1>that something is. Our bodies and brains are complicated. Despite

0:04:04.280 --> 0:04:07.040
<v Speaker 1>the risk, antidepressant use seems to be a case of

0:04:07.120 --> 0:04:11.080
<v Speaker 1>the good outweighing the bad. Typically, antidepressants do have a

0:04:11.120 --> 0:04:15.160
<v Speaker 1>protective effect against suicide. A death by suicide has been

0:04:15.200 --> 0:04:17.680
<v Speaker 1>shown to be more common in patients not taking an

0:04:17.680 --> 0:04:22.080
<v Speaker 1>antidepressant versus patients who are. It also appears that the

0:04:22.160 --> 0:04:25.359
<v Speaker 1>risk of suicidal thoughts is far greater in children and

0:04:25.400 --> 0:04:28.800
<v Speaker 1>adolescents taking these medications than in those over the age

0:04:28.800 --> 0:04:32.320
<v Speaker 1>of twenty five. A one review published in two thousand

0:04:32.320 --> 0:04:35.760
<v Speaker 1>and three of twenty three clinical trials using SSRIs in

0:04:35.839 --> 0:04:39.320
<v Speaker 1>children adolescents with depression found that there was a four

0:04:39.360 --> 0:04:43.520
<v Speaker 1>percent risk for suicidal thoughts when using SSRIs versus a

0:04:43.520 --> 0:04:47.680
<v Speaker 1>two percent risk when on a placebo. Although no one

0:04:47.720 --> 0:04:50.640
<v Speaker 1>died by suicide during these trials, The Food and Drug

0:04:50.640 --> 0:04:53.960
<v Speaker 1>Administration determined that it was appropriate to add a warning

0:04:54.040 --> 0:04:58.160
<v Speaker 1>that antidepressants may increase suicidal thoughts to the drug's labels.

0:04:59.320 --> 0:05:03.400
<v Speaker 1>A Lavee's Web said in number, it's only a small percentage,

0:05:03.800 --> 0:05:07.880
<v Speaker 1>but to parents of any child lost suicide due to antidepressants,

0:05:08.200 --> 0:05:13.599
<v Speaker 1>the problem is enormous and inconceivable. Since awareness of this

0:05:13.680 --> 0:05:17.320
<v Speaker 1>issue has risen, prescribing doctors have added risk of suicidal

0:05:17.320 --> 0:05:22.320
<v Speaker 1>thoughts to their patient education checklist. How stuff Works also

0:05:22.440 --> 0:05:24.760
<v Speaker 1>spoke with a therapist and author by the name of

0:05:24.839 --> 0:05:29.240
<v Speaker 1>Lauren Cook. She said providing the patient with information about

0:05:29.240 --> 0:05:32.120
<v Speaker 1>this process is crucial so that they too can look

0:05:32.160 --> 0:05:37.120
<v Speaker 1>for signs. By normalizing conversation around suicide, a patient is

0:05:37.160 --> 0:05:39.760
<v Speaker 1>that much more inclined to share if they are thinking

0:05:39.839 --> 0:05:48.320
<v Speaker 1>about hurting themselves. Today's episode is based on the article

0:05:48.480 --> 0:05:52.080
<v Speaker 1>why do antidepressants have warnings about suicidal thoughts? On HowStuffWorks

0:05:52.080 --> 0:05:54.760
<v Speaker 1>dot Com? Written by Leo Hoyt. Brain Stuff is a

0:05:54.760 --> 0:05:57.280
<v Speaker 1>production of by Heart Radio in partnership with HowStuffWorks dot

0:05:57.279 --> 0:05:59.640
<v Speaker 1>Com and is produced by Tyler Klang and Ramsey Young.

0:06:00.440 --> 0:06:03.520
<v Speaker 1>For more podcasts from my Heart Radio visit the iHeartRadio app,

0:06:03.640 --> 0:06:06.640
<v Speaker 1>Apple podcasts, or wherever you listen to your favorite shows.