by Alicia M Prater PhD

Created on: January 12, 2009

Anti-depressants are not always necessary, either because they will not help the underlying issue or because medication is not the best choice in a particular circumstance. Depression is often misdiagnosed. Various research studies estimating the number of people suffering from depression, nearly 30% of the population, are flawed. Much depression will be relatively mild and can pass within a matter of months, yet according to some estimates millions of people are prescribed antidepressants for several years or more. The Bristol-Myers Squibb-funded education program created to be used by family doctors to diagnose patients is a simple screening test made up of a checklist of questions. Researchers from Monash Medical Center in Melbourne, Australia, examined the screening test and pointed to major problems. The researchers found the test to be so broad that it classifies 49% of people as having a mental disorder, half of those having a "level 1" disorder, the most serious. According to their calculation, most of the people diagnosed by the test likely did not have a mental disorder at all.

Though there is more than one type of antidepressant, the most common are SSRIs. Selective serotonin reuptake inhibitors (SSRIs) have been on the market as antidepressants for almost 20 years. This category of pharmaceuticals includes Lilly's Prozac, generic name fluoxetine; GlaxoSmithKline's Paxil, generic name paroxetine; Pfizer's Zoloft, generic name setraline; and Bristol-Myers Squibb's Serzone, generic name nefazodone.

Side Effects To Be Considered

Squibb took Serzone off the market in May 2004 over concerns of hepatitis and liver failure, as well as being linked to at least 20 patient deaths, though the generic form is still available amidst pending lawsuits. The other three drugs have side effects involving sexual dysfunction, and 25% of patients on Paxil report withdrawal symptoms. There is also a high rate of relapse, approximately 40%, once the medications are discontinued; it is advised that patients taper off taking the prescription drugs due to the side effects of ceasing cold turkey.

The most troublesome side effect of the SSRIs still on the market is an increase in suicidal tendencies in children and adolescents with major depressive disorder. Reported in the August/September 2007 edition of Scientific American Mind, a 2007 study found that the risk of increased suicidal thoughts due to the medication was present up to the age of 24. The risk usually occurred in

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