"For years, the research about antidepressants has failed to fully answer questions about efficacy and side effects. Drug companies have put their products in the best light by downplaying negative clinical trials and flooding the public with positive advertisements."
Depression in Oregon: They know what pills can do
January 17, 2010, 12:05AM
Nancy Davies' teenage son took the antidepressant Zoloft in 2004 to help with some social anxiety. A few weeks after starting the pills, 15-year-old Brett committed suicide.
This Portland mom doesn't know for certain that the medication triggered her son's death. But she does echo the sentiment of readers throughout Oregon: The decision to take or avoid antidepressants must be an informed choice, because the medicine can change people's lives — for better and for worse.
"Just about everyone has been affected in some way by depression" and by extension, antidepressants, she said, adding, "This is an issue that is very near and dear to my heart."
Antidepressants are now the third-most commonly prescribed class of drug in the United States. American doctors wrote 164 million prescriptions for antidepressants in 2008, according to IMS Health, a leading analyst of health care data.
Today, a staggering 27 million Americans take antidepressants to treat problems ranging from severe depression to shyness. Yet the effectiveness of these drugs is highly variable, depending on brain chemistry and a host of other factors.
At one extreme, the medication can trigger suicidal thoughts in younger people.
At the other, it can help people want to live again.
These extremes show up in research — and in the voices of Oregonian readers who've struggled with depression themselves and responded to last week's column about antidepressants' mixed record. Though most asked me to withhold their full names, they didn't hold back in sharing their views.
A 76-year-old Oregon man named Norm, for example, described antidepressants as "magnificent lifesavers."
"I can attest to being in the hellhole of depression and anxiety, having suffered from this debilitating sickness since my teens," Norm said. "I can say wholeheartedly that antidepressants have permitted me to come out of that pit of mental collapse."
A different woman named Nancy, also from Portland, wrote this: "I am sixty years old. I grew up in an era where the word 'depression' was not part of the everyday language; in fact, I NEVER heard the word spoken, even after my father committed suicide."
"I won't bore you with my life's tale," she said, "but suffice it to say that were it not for Zoloft, I have no doubt I would not be living the normal, happy life I am living."
A man named Lee from Lincoln City told a similar story. "If it weren't for the antidepressant imipramine, I wouldn't be here today," he said. "For 27 years, something was very physically wrong with me, but no doctors could determine what."
When he finally went on an antidepressant, the results were astonishing, Lee added. "I couldn't believe I finally felt 'all right.'"
By contrast, a few readers said they continue to suffer debilitating depression after trying nearly every drug available.
For years, the research about antidepressants has failed to fully answer questions about efficacy and side effects. Drug companies have put their products in the best light by downplaying negative clinical trials and flooding the public with positive advertisements.
More useful information is emerging today. Scientists are beginning to understand on a molecular level why some patients respond better than others to medication. They've also found that some of the most popular antidepressants are no better than sugar pills at treating milder forms of depression — though the drugs do help the majority of people with severe depression.
The trouble with such studies is that they identify patterns without fully explaining profound individual differences. Based on factors as subtle as the brain's ability to process serotonin, some people get sicker from taking antidepressants and others feel inexplicably better overnight.
"Studies are wonderful and meaningful, but (they) never tell the entire story," said a Corvallis reader named Bob, who credits Prozac and a good doctor with his recovery. "People are individuals, not statistics."
More than five years have gone by since Nancy and Tom Davies lost their son Brett, who had just finished his freshman year at Jesuit High School. Enough time has passed that Nancy can talk about what happened, though the grief still feels fresh some days.
She's not entirely against antidepressants. She knows they can help. But she's glad the Food and Drug Administration finally required drug companies to put "black box" warnings on certain drugs with elevated suicide risk. She's also glad that people are talking more openly about depression and treatment.
"Let's open up a conversation," Davies said. "Let's be more aware of what we're putting in our bodies."
— Associate Editor Susan Nielsen, The Oregonian