The drug millions of Aussies are taking - what it does for weight, sex and you!
More than 12 million anti-depressant scripts a year are prescribed in Australia - and rising. But are we taking mood-enhancing meds too far?
Next time you're at an office lunch, chances are at least one or more of the people sitting around your table are taking Zoloft, Lexapro, Prozac or one of the dozens of prescription drugs currently on the market.
These days there are "happy" pills to treat everything from that severe, can't -get-out of bed, "dark place" depression, to pre-menstrual depression, right down to anxiety, head-in-the clouds vagueness or even poor concentration.
Today anti-depressants are the number one drug Aussies are taking to help them beat their mood problems, and in turn reduce stress, work and relationship issues in their life.
According to the Australian Institute of Health and Welfare, a staggering 20.7 million prescriptions for mental health related medications were filled under the Pharmaceutical Benefits Scheme (PBS) in 2006.
Among other drugs, this included about 12.3 million antidepressant scripts and 1.8 million anti-psychotic drugs, both rapidly increasing in popularity.
Whilst anti-psychotics were once popularly perceived to be treatments for schizophrenia, in reality today they are also commonly prescribed for anxiety, severe depression and a variety of other psychological problems.
But we have to ask ourselves whether popping a pill for every modern malaise is the answer, given a recent meta-analysis of 47 studies, which showed that antidepressants were no more effective than a dummy pill.
Aussie doctors are divided over the recent research, which included the blockbuster brands Effexor, Zoloft, Cipramil, Aropax and Prozac.
Some doctors agree perhaps depression is being over medicalised.
But Professor Ian Hickie from the Brain Mind & Research Institute in Sydney, argues that medications DO have a place.
"Firstly, the people in these studies were not severely depressed patients, because severely depressed patients are excluded from trials. And for these patients we have 40 years of evidence which show antidepressants do absolutely have clear benefits."
"Secondly, the study also completely ignored the fact that suicide rates have dropped steeply in countries where antidepressants are now in widespread use.
"And thirdly, we have to remember that even mild depression causes a major increase in suicide risk.
"Seeking no treatment for any kind of depression is a bad option. Because often those people with mild depression one day go on to moderate or severe depression the next day. This does not always mean drugs, but in many cases they can help."
Professor Hickie says if you notice signs of depression in yourself or others (do the mood IQ test below) then don't delay in getting treatment.
"There is no reason to put up with untreated depression, or for people to be scared of taking a pill if they need to. People take a tablet for anything else, but there is still clearly a stigma that depression is a character flaw, or something other than a clear biochemical illness. But depression is something people can't snap out of or be jollied out of. It is an illness - a major one, that is often life-threatening."
And evidence shows drugs may also mean less chance of recurrence.
"Other studies show that people who are on depression medications for 6-12 months and recover are much less likely to have the depression recur within the next two years."
Professor Gordon Parker from the Black Dog Institute agrees the meta analysis research was flawed, because participants in clinical studies are generally only mildly depressed, did not use drugs or alcohol and didn't have suicidal thoughts.
"Psychiatrists don't see people like that in real life. It's the same flawed logic as prescribing an antibiotic for a common 24-hour cold and the results were compared with placebo treatment after a week."
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Female problem
Overall, women are about twice as likely to suffer from depression as men, and whilst antidepressants are useful, it's important to remember "they won't suit everyone."
"For many people there is an inevitable trial and error process to be worked out with your doctor. If one doesn't work well, you simply try another," says Professor Hickie.
"About 60 per cent of people overall respond well to anti-depressants. The remainder are either non-responders (the drugs simply do not ease the depression). Or else have side effects that are annoying enough to stop taking them.
"Usually these side effects include mild nausea or headache or more distressing problems like loss of interest in sex. About half of the people who get these symptoms stop taking the medications within a month. If you stick with it though, these usually subside within a few weeks.
"However about 5-10 per cent of people who take anti-depressants get severe symptoms which include severe agitation or depression that was worse than they felt before taking the medicines. This is the real problems doctors must constantly watch for."
Professor Hickie says in cases of non-responders or severe side effects psychiatrists can try other therapies or combinations of anti-depressants and other drugs.
But despite the role drugs play, he says they aren't the only cure.
"In terms of what works best, information, counselling and family support are number one, medication number two, then a range of other strategies including exercise really help.
"Generally the best results in persistent depression are when people have access to all these treatments."
Weighing it up
Many women worry about the side effect of weight gain when taking anti-depressants. But this is generally not significant (rarely more than 2 to 3kg), for the most commonly prescribed drugs, says Professor Hickie.
"In many years of clinical experience I have rarely seen people put on a great deal of weight on antidepressant drugs alone.
"And for people who are severely depressed, the thought of feeling joy and not being numb anymore greatly outweigh this."
What's Your Mood IQ?
This is the official Edinburgh Depression scale - often used on post-natally depressed mothers. Answer the following questions based on how you have felt in the past seven days.
1. I have been able to laugh and see the funny side of things
As much as I always could 0
Not quite so much now 1
Definitely not so much now 2
Not at all 3
2. I have looked forward with enjoyment to things
As much as I ever did 0
Rather less than I used to 1
Definitely less than I used to 2
Hardly at all 3
3. I have blamed myself unnecessarily when things went wrong
Yes, most of the time 3
Yes, some of the time 2
Not Very Often 1
No, Never 0
4. I have been anxious or worried for no good reason
No, not at all 0
Hardly Ever 1
Yes, sometimes 2
Yes, very often 3
5. I have felt scared or panicky for no very good reason
Yes, quite a lot 3
Yes, sometimes 2
No, not much 1
No, not at all 0
6. Things have been getting on top of me
Yes, most of the time I haven't been able to cope at all 3
Yes, sometimes I haven't been coping as well as usual 2
No, most of the time have coped quite well 1
No, I have been coping as well as ever 0
7. I have been so unhappy that I have had difficulty sleeping
Yes, most of the time 3
Yes, sometimes 2
Not very often 1
No, not at all 0
8. I have felt sad or miserable
Yes, most of the time 3
Yes, quite often 2
Not very often 1
No, not at all 0
9. I have been so unhappy that I have been crying
Yes, most of the time 3
Yes, quite often 2
Not very often 1
No, not at all 0
10. The thought of harming myself has occurred to me
Yes, quite often 3
Sometimes 2
Hardly Ever 1
Never 0
Scoring: The higher the score the more likely you are depressed. If your sore is over 12 take this test to your doctor - you may have depression.
