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This is not directly related to the post. But gauging that this topic will attract readers knowledgable about antidepressants, I figured I might get an illuminating response.

I often read that a side-effect of a antidepressant is heightened suicidal feelings. That completely mystifies me. Isnt it exactly what it is supposed to be working against ?

3 comments

Antidepressants motivate people to improve their lives.

One obvious way to do this is suicide. If your every moment of existence is painful, suicide is an immediate improvement.

It's the motivational aspect that seems to increase suicide - motivation turns people's lethargic depression into a more active form of depression where they find the will to carry out their desires.

A common desire among the depressed is the desire for death. Your typical depressed person however is too depressed to even exert the energy or thinking necessary to end his life.

Ah! it makes more sense now. Thanks

This may be one explanation of the phenomena but there are others.

For example, some anti-depressants disrupt REM sleep, creating a phenomena akin to a waking dream and thus making individuals less sensitive to finality of their actions.

http://en.wikipedia.org/wiki/Antidepressant#REM_Sleep

Also, the most dangerous time for suicide for a person on anti-depressant is when they suddenly stop taking them - as happened to a good friend of mine. It is hardly the motivational quality that gets people going at that point.

Edit: suicidal AND homicidal feelings are "rare" but all-too-common responses to anti-depressants and especially to withdrawal from anti-depressants. I've had friends who had both responses in fashions that are at least very unexpected. Anyone with loved-ones taking such drugs, be on your guard.

Seconding the sentiments on withdrawal. I went off Citalopram cold turkey due to an incompetent doctor (who incidentally had not informed me that it was a dependency forming drug). I have never, ever felt that shit in my entire life, and hope I never do again.

If you ever launch into a profanity-laden tirade at the top of your lungs in public because a car was inching forwards at a red light, you might also be going through withdrawal.

Tip for those who want to avoid this: Fluoxetine. Switch to it before quitting, it has a really long half-life so you can just stop taking it, and the levels in your body slowly tail off. Much nicer.

Speaking as someone who has been on a couple... they change everything. You think differently, about different things. For the most part I would summarise the changes as less emotional, cooler, more patient, slower to anger, but lots of the changes seemed completely random. If you randomly change someone's thoughts, they might think about suicide less often, or they may think about it more often. That's just my guess, which judging by this article is about as good as anything right now.

> Isnt it exactly what it is supposed to be working against ?

Not really. Depression and suicidal tendencies are two separate things. Anti-depressants treat depression, they aren't designed to reduce the risk of suicide.

This article might be interesting for you: http://www.scientificamerican.com/blog/post.cfm?id=being-sui...

> “Concluding simply that depression causes suicide and leaving it at that may be inadequate for several reasons,” he writes. “It is abundantly clear that most depressed people do not attempt suicide and that not all suicide attempters are clinically depressed.”

> I often read that a side-effect of a antidepressant is heightened suicidal feelings. That completely mystifies me. Isnt it exactly what it is supposed to be working against ?

That's ironic, but not odd. For example, treatments for stomach discomfort can have side effects that include... stomach discomfort.

Chemicals affect different people differently. Some people react in the opposite way than others.