Frequently Asked Questions
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Do I have to take Depression medications for the rest of my life?
Usually not. However, that answer highly depends on many factors:

  • Age of Onset—the earlier the onset, the longer the time to take them.
  • Course Progression—the longer you are symptom free between Depression episodes, the less need for meds on the long run.
  • Family History in first degree—speaks towards need for such for a long time.
  • Co-morbidity and other conditions such as anxiety or constant worry, speaks towards the ongoing need.
So, for how long do you propose to take an antidepressant?
At least one year, but this varies depending on many factors.
I had one bout of Depression Episode, what are my chances of having another one?
  • One bout of depression episode in the past, recurrence rate is about 50% in your life time.
  • Two bouts, recurrence rate is 70 % in your lifetime.
  • Three bouts of depression, recurrence rate is >90% (almost 100%) if your life time.

To sum it up, if one had between 2-3 bouts of Depression you stand a minimum 70% recurrence rate. That would affirm staying on meds for many years.

Do depression medications cause organ damage?
They are relatively safe and do not cause organ damage, unless pregnant. They are now warning against all causing fetal anomalies.
What if I had side effects?
In most cases, with newer meds there are generally mild to no side effects. If you can tolerate some such as nausea, most side effects are well tolerated along with dose titration over time.
What about sexual side effects with depression medications?
Yes, common especially with Paxil, this is very common. Do not be shy to alert your doctor and ask for a change in medication. Wellbuterin is an option to discuss.
What about weight gain with depression medications?
Common with Paxil too. Wellbuterin is an option to discuss.
I used to take depression meds and go to sleep, now can I take them and stay awake?
We ask patients to start meds at night time but as time goes (where receptors and synapses become saturated with the given medication), it is not uncommon to switch to day time as long as there is no daytime sedation.
What is so good about Cymbalta?
Cymbalta is a newer antidepressant that was approved by the FDA for treating Major Depression and Generalized Anxiety and most recently Fibromyalgia. Fibromyalgia is known to cause Chronic Fatigue, Poor concentration and Chronic Pain Syndrome. Cymbalta is not as commonly known to cause sexual side effects or weight gain.
What is Abilify?
It is an antipsychotic and used as an add-on for partially resolving signs and symptoms of depression. I would not advise to keep taking it for a long time as it has a potential for late, abnormal muscle movement known as Tardive Dyskinesia/TD. I would avoid it in diabetics as TD has a tendency to be more common with diabetics and females.
I cannot focus at work or at my studies?
Were you ever diagnosed with Attention Deficit Disorder/ADD? If so, it is always a good idea to try antidepressants first and then try the older class of ADD meds if ineffective. If you have not, then make sure to rule out you do not suffer from Depression or Anxiety Disorder. Get a Professional Psychiatric Evaluation.
I am afraid that if I inquire about his/her suicidal thinking, that will lead him/her to do it?
Seriously suicidal patients feel more relief and better understood when asked about it? No evidence that inquiring about suicide ever led to doing it.
I do not want to take depression meds, are there alternative solutions?
  • One: you are not suffering that much.
  • Two: Think about using the Tanscranial Magnetic Stimulator (TMS). Expensive, but insurance does not want to pay, and there are no current studies supporting how long TMS improvement will last.
  • Three: make sure that you are not abusing any drugs or alcohol?
Can Marijunana/THC help Depression and Anxiety?
Even though THC might cause immediate relief, over time THC worsens Depression, builds chronic Amotivational Syndrome, and worsens libido especially is men (hypogonadism). It also causes a voracious appetite which could lead to a remarkable increase in weight. For Anxiety, THC worsens it. In addition it can cause hallucinations or paranoia.
What is the Gateway Drug? What does that mean?
It is THC. Over time a THC user, may use it more frequently and may turn into an abuser. This builds tolerance. As tolerance builds, more is needed to get the same prior THC effect. This can open the door to invite other drugs, such as Opiates, Morphine, Heroin etc. Can be dangerous, and it can take few months/years to get a very destructive point.