Antidepressants to treat grief? Psychiatry panelists with ties to drug industry say yes

[Ms. Toad]

217. That is part of how insidious it is.

That is what she suspected (although even from the beginning she realized there was some compulsion to it) - although it was so totally out of character for anything previous in her experience that incident set off red flags for me (particularly since I am a rape survivor - and she was, at the time, a counselor at the college's rape crisis center).

That incident (and several related ones ) scared her enough that she sought counseling (with my help to locate a counselor) to help her sort out making better decisions regarding risks - and has been investing more than 3 hours a week to drive to and from counseling. At that point, she associated it with living with a very severe chronic illness - she was so dead inside that the only time she felt anything was when the thrill of the risk broke through. But the more recent behavior having compulsive unprotected sex with enough men that she does not know the source or nature of her exposure to STIs - scared the crap out of her. She took herself off of celexa without even consulting me abouther suspicions (and without medical supervision because her doctor had abandoned her - but her lack of control over what was going on scared her enough that she felt she couldn't wait until her psychologist could identify someone accepting new patients and on our insurance). Once she was off it for 3 month the drive and compulsion vanished - but in the mean time it has taken more than 2 months to clean up the routine STIs and related infections, and we have to wait another for to be sure she is clean on HIV, and she has taken a medical leave from college until she gets things under her control (her decision - she called after the decision was already made).

Now that it is out of her system, she actually tracks back the thread of this particular side effect even farther than I would (to activities which seem quite within the normal college range of sexual activity from my perspective - even taking into account her personal hisotry).

Long answer - but I think it points out exactly why this needs to be carefully supervised because it is so hard to distinguish (in her case) normal young adult behavior, or increased sexual appetite because the medication treated the depression, from compulsive hypersexuality created by the celexa. In others (particularly teenagers) suicidal thoughts because of the depression are hard to distinguish from suicidal thoughts because of the medication - one reason it took so long for them to realize that depressed teens on anti-depressants were more likely to commit suicide than depressed teens not on anti-depressants.

When the medication is designed to alter how you think and feel, and the harmful side effects are alterations of how you think and feel, it isn't as easy as objectively watching your blood pressure in response to taking ibuprofen, or watching for hives in response to antibiotics.

I'm not at all critical of using anti-depressants as part of care for depression - despite how terrifying the last few months have been as a parent, it is clear to me that the depression is beyond anything which can be handled without medication. At this point, it is my daughter who is reluctant to try a different anti-depressant because of the impact celexa had on her. I am just very clear that these are not medications which should be routinely handed out by GPs like candy, as they are way too often now.