Can Antidepressants Make You Feel Worse

Can Antidepressants Make You Feel Worse Depression Treatment Medication Print Can Antidepressants Make You Feel Worse? By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial policy Nancy Schimelpfening Medically reviewed by Medically reviewed by Steven Gans, MD on May 11, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 04, 2020 Depression Overview Types Symptoms Causes & Risk Factors Diagnosis Treatment Coping ADA & Your Rights Depression in Kids Rob Julia Campbell/Stocksy United While antidepressants are quite effective at relieving depression,?? it is possible that some patientsâ€"in particular, young peopleâ€"may temporarily feel worse when they first begin taking an antidepressant or when they make changes in their dosage. Black Box Warning In October 2004, the U.S. Federal Drug Administration (FDA) issued what is known as a black-box warning?? stating that certain antidepressants, when used in young people 24 years old and under, could increase their risk for suicidal thoughts and behaviors. However, the FDA noted that there was no association found between antidepressant use and suicidal thoughts and behaviors in adults over the age of 24. In addition, antidepressants actually appeared to reduce the risk in adults aged 65 and older. This black box warning,?? which is the most serious type of warning that can be issued regarding a prescription medication, was ordered following a thorough review of all available clinical trials, including unpublished ones, regarding the use of antidepressants in children and adolescents. The study?? included a total of 24 short-term trials of nine different antidepressants used in over 4,400 child and adolescent patients. In addition, there were 295 short-term trials of 11 different antidepressants involving 77,000 adult patients. While the risk of suicidality varied between drugs, the pattern of seeing increased suicidality in young people remained true for almost all drugs studied. It should be noted that no suicides actually occurred among the young people studied. Although there were some suicides among the adults studied, the numbers were too few for any conclusions to be drawn about whether the antidepressants used were a causal factor. It must be borne in mind that depression is also a known risk factor for suicide and cannot be ruled out in these cases. The black box warning further suggests that patients of all ages should be monitored closely when they begin treatment with an antidepressant. They should be watched for any signs of worsening depression, increased suicidality, or changes in behavior. In addition, families and other caregivers should be instructed to contact the patients physician or another appropriate medical professional in the event that any problems occur. What to Watch For In particular, the FDA recommends that a healthcare provider be contacted if youâ€"or a person who you are caring forâ€"experience any of the following:?? Thoughts of suicide or deathSuicide attemptsNew or worsening depressionNew or worsening anxietyNew or worsening irritabilityFeelings of agitation or restlessnessPanic attacksProblems with sleepingAggression, anger or violenceImpulsivenessExtreme increases in activity or talking (signs of mania)Any other unusual changes in mood or behavior While a black box warning might cause some to feel concerned, they should be aware that the benefits to be obtained from treating depression with an antidepressant greatly outweigh the risks in the majority of cases. Untreated depression is quite serious and is much more likely to lead to suicide than is an antidepressant. The warning is simply provided so that people can be aware of this potential effect and take appropriate measures to get help if they do begin to feel worse.