Answers About Antidepressants

Last night we invited your questions in response to our coverage of antidepressants and the risk of suicide. We received hundreds of questions from viewers, and while we can't answer them all, ABC's Medical Editor Dr. Tim Johnson has worked to answer some of them as best he can. Check out his answers below.

Question: How long can someone stay on Paxil, years? Then how does one get off the medication? (from Cindy R. in Tampa, Fla.)

Answer: Only your doctor can tell you how long to stay on a medication. Some patients stay on antidepressants for years, as long as the drugs continue to help and don't cause troublesome side effects. Paroxetine (sold as Paxil) can have side effects, such as dizziness, confusion, unusual dreams or feeling "drugged." You should talk to your doctor about any and all side effects you experience while taking the drug, and your doctor may or may not decide to take you off the drug because of those side effects.

If you do stop taking the medication, a doctor will typically suggest taking smaller and smaller doses, until you aren't taking anything at all. If you suddenly stop taking paroxetine, you may experience withdrawal symptoms such as depression or anxiety. Again, tell your doctor if you experience any of these symptoms when your dose of paroxetine is decreased.

For more information on Paxil and its side effects, check out http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a698032.html#how

Question: My impression of antidepressants is that they're basically a crapshoot -- odds are you'll feel even worse and have to switch a couple of times before you feel better. Do you think science will ever progress enough that a blood test can determine the right medicine and its dosage? (from Ron B. in Erie, Penn.)

Answer: Unfortunately, even scientists are stymied by antidepressants and the way they work. The brain is a very complicated organ, so it isn't always easy to treat with medication. Most antidepressants take about a month to "kick in" -- and that month can be a critical period of adjustment. But the drugs do help a lot of people feel better, even though it can sometimes be hard to find the drug that works best.

There actually is a test, called the CYP450 test, that can basically tell whether or not a drug might "work" with your metabolism. But the test can't tell you whether that drug will alleviate depression, and it only works for certain drugs. It's possible that someday, scientists will find a more exact test, but we may have a long way to go before then.

Question: My wife is taking Lexapro after her first pregnancy to help with feelings of depression. We are ready to have another child and I am worried that this drug could affect her next pregnancy. Is it OK for her to be taking this drug while she is pregnant? (From Jeff S. in Kinston, N.C.)

Answer: That's actually a tricky issue -- something that your wife definitely needs to discuss with her doctor. Taking antidepressants during pregnancy could pose risks for your baby, but stopping may pose risks for your wife. Some antidepressants have not been linked to increased birth defects -- including fluoxetine (Prozac, Sarafem, others), sertraline (Zoloft) and bupropion (Wellbutrin) -- but scientists are still looking.

As far as Lexapro goes, here's what the experts say about that:

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