Is Your Medicine Bringing You Down?

If you develop a rash within hours of starting a new medicine, you don’t need Sherlock Holmes to help you make the connection. But some drug side effects are harder to recognize.
Psychological reactions can be insidious, appearing slowly over weeks or even months. Distinguishing between the normal ups and downs of life and a drug-induced depression can be difficult.
One reader shared her experience: “I was stopped at an intersection on an icy day waiting for a sand truck to pass when I almost pulled out in front of him–intentionally.
“When I saw the young man’s face, I said to myself, ‘I cannot do this to him.’ After the truck passed and I drove on, I wondered what in the world was going on. I was not depressed.
“When I arrived home, I was still shaken from what I had almost done. I read the daily newspaper while I ate lunch. The first article in your column that day was from a lady whose husband had committed suicide while taking Reglan.
“That was the exact same medication my doctor had prescribed for my stomach. I jumped up and emptied that bottle down the toilet and wrote on it in large letters, DO NOT TAKE AGAIN. I thank God and the lady who wrote you that letter.”
Reglan (metoclopramide) carries a warning that it can cause mental depression and suicidal ideation. Patients should always be cautioned about such a serious complication.
Sometimes a medicine is essential, and any psychological reactions it causes can be handled with another medication. But often, rather than piling one drug with potential side effects up on top of another, it makes sense to re-evaluate the original treatment. That is how a nurse reacted to a question about a teenager who became depressed while taking birth control pills:
“The 16-year-old girl in the column was smart not to want to use Paxil. It’s sad that her doctor is trying to treat that side effect with another drug instead of taking her off the Pill.
“I was given Paxil a few years ago for anxiety mixed with depression. Taking it was an awful experience. I was more anxious than I had ever been. I decided to get off it and then found out about the horrible withdrawal.
“No one had warned me about this problem. The doctor did mention I’d have to taper off, but there wasn’t even a hint how hard this is.
“I had night sweats, dizziness and electrical shock-like sensations in my extremities. I ended up taking Klonopin to help with the withdrawal.”
Antidepressants save lives. Fighting depression and preventing suicide are crucial. But the experience of these readers and countless other people demonstrate that doctors and patients must be in close communication about all medicines. When the cure starts to cause more psychological distress than it relieves, it is time to examine other options.
Our Guides to Psychological Side Effects and Antidepressant Pros & Cons describe drugs that can trigger depression or other symptoms such as nightmares, confusion or forgetfulness and discuss issues of withdrawal and interactions. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. MX-23, P. O. Box 52027, Durham, NC 27717-2027.