![]() Don't figure that SSRIs are magic bullets - or that they are the only option. His advice for people taking SSRIs: Monitor your symptoms, and work with your doctor to address each one. "One medication may not always do the trick," he says. Sleep medication or treatments like cognitive behavioral therapy can get the insomnia under control. The insomnia is particularly troubling, McClintock says, because lack of sleep can lead to more clinical depression - and because insomnia can be treated. Those included new bouts of insomnia and a lack of interest in daily activities. In addition, people said that new problems cropped up while they were taking the antidepressant. Surprisingly, a lack of sex drive wasn't on the list, even though it's a common side effect of SSRIs. Almost all of the people said they continued to have problems with insomnia, with 81 percent reporting being unable to sleep in the middle of the night, 71 percent reporting sad mood, and 40 percent reported a decreased lack of interest in activities. But what's striking about this new study is that many of the people taking the antidepressant continue to struggle with symptoms that can make life miserable, especially insomnia. Indeed, in this study the participants' suicidal thoughts decreased by more than half while taking Celexa, as did their negative self-image, and feeling of being slowed down. In 2004, the Food and Drug Administration made drugmakers add a black-box safety warning, the strongest type available, to SSRIs, saying that taking them could increase a person's thoughts of suicide. "That's counter to popular belief that treatment with an SSRI increases suicidal ideation." "We were surprised to see that thoughts of suicide didn't emerge," Shawn McClintock, a psychiatrist who led the study, tells Shots. The researchers wanted to find out which symptoms were persisting, and which were popping up for the first time while taking the drug. Those people said they got better, but also still had symptoms of depression. ![]() ![]() (Citalopram is in the same family of antidepressants called SSRIs that was pioneered by Prozac.) They looked at 428 people who took the antidepressant citalopram (brand name Celexa) for 12 weeks. Bupropion prolongs REM sleep latency and increases REM density (a measure of the number of eye movements in the period) and activity during the first REM sleep period (Ott et al., 2004). To find out just how bad this problem is, researchers at the University of Texas Southwestern Medical Center in Dallas combed through data from the STAR*D trial, one of the biggest studies ever done on depression treatments. Bupropion may reduce REM less than other antidepressants. Those symptoms can make life miserable, and raise the risk of descending back into depression. About half of people who take antidepressants say that they feel better, yet many of them still struggle with symptoms of depression, including insomnia and difficulty thinking.
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