There are many medications used to treat depression, and most of these carry risks. However, when depression is untreated, risks of things like suicide can greatly increase. A balance must be struck between judiciously administering depression medications and considering the potential side effects of psychopharmacological treatment.
Studies on depression medications show that there is greater risk, especially at onset in treating teens with SSRIs (selective serotonin reuptake inhibitors) like Zoloft® or Prozac®. In teens and young adults, SSRIs can create suicidal impulses that did not previously exist. It’s not known how much these suicidal impulses would occur without treatment, since this is a hallmark of depression. However most SSRIs now carry strong warnings that people should contact their physicians if they find they begin to have suicidal ideation.
Another risk of using most depression medications is if they are used to treat mood disorders like bipolar. Bipolar disorder can be very difficult to diagnose and may often be mislabeled as major depressive illness. The risk of many of the depression medications is that they can produce a manic or hypomanic state, which is very dangerous to people. There are even some theories that suggest people who were not previously bipolar but who were cyclothymic, may progress into a bipolar state if treated for with depression meds.
Certain populations need to avoid specific depression medications. In populations of the elderly, drugs that may be prescribed along with antidepressants can prove very dangerous and are not advised. These include many drugs called atypical antipsychotics. Types of drugs included in this group are Zyprexa®, Risperidal®, and the drug Abilify®. These medications may be used alone to treat people with dementia and they’ve also been used as augment therapy when depression medications don’t work by themselves. Per the US Food and Drug Administration (FDA), use in elders is not recommended because it greatly increases risk of death. For instance Abilify® has been shown to increase risk of stroke in elders and should not be used.
There are several depression medications that may pose some risks for the general population. Some atypical anti-psychotics like Zyprexa® fall into this category because they may increase weight gain and raise risk levels for major diseases like diabetes. It should be noted that most people taking antidepressants to treat major depressive illness do not need Zyprexa&;; however those with bipolar and mood disorders could be prescribed this medication.
Virtually all medications have some side effects and what people must weigh is risk versus benefits. As mentioned, untreated depression can be highly dangerous. There are non-drug treatments for depression, including electroconvulsive therapy (ECT), but this treatment may have risks too, and is not indicated for certain populations. Working with a good psychiatrist can be a vital step toward deciding what treatment is most beneficial for each individual and how to choose medications that hazard the least risk while offering the most benefit.