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Past Article of the Month
Originally Published 07/03/2010
So You are Thinking About Antidepressants? Considerations for Making the Decision to Start Medication
By Leslie Westlund Tam, MD
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So you are thinking about antidepressants or other psychiatric medication? The decision to start medication for a mood or anxiety disorder can be difficult, especially if you are considering infertility treatment or a potential pregnancy. First, lets define a psychiatric or psychoactive drug: a female Viagra that is prescribed to alter your mental state or to treat a mental disorder. If you are struggling with such a condition and also contemplating pregnancy and/or undergoing infertility treatment, deciding to take medication for it can be overwhelming. The best way to proceed is to get a good evaluation of your condition, learn everything you can about the medication you are considering and also talk about feelings you may have about the decision with your health care professional.
Many people wonder if they suffer from depression or whether the troubles they are having are part of life. Sometimes people with anxiety or depression will be afraid that medicines prescribed may make their situation worse instead of better. Often patients see their primary care doctors or reproductive specialists, mention their symptoms, and leave with a prescription for an antidepressant or another psychoactive drug without really understanding why that particular medicine has been prescribed or what they can expect. When you think you may have an anxiety disorder or some form of depression, the best thing to do is to see a psychiatrist who can take the time to review your mental health history and make an accurate diagnosis. If you are in the midst of a reproductive event such as infertility treatment or a pregnancy, a psychiatrist who specializes in reproductive health may be your best bet. Once your condition is diagnosed, a treatment plan that considers your specific needs and goals can be developed. In general if you are having symptoms that interfere with your ability to function in any area of your life with family, at work, taking care of yourself then it is likely that you have a disorder that requires medical attention.
Ok, so lets say that you have had your symptoms diagnosed and a particular medication has been proposed. How can you and your doctor be sure it is the right course of action? When using medicines during infertility treatment or pregnancy, or whenever you are prescribed medication, it is a good idea to conduct a risk:benefit analysis. In other words, weigh the pros and cons of using the specific medicine in your particular condition. Does the medicine have an effect on your fertility? Does the medicine pose a risk to your pregnancy or your baby? Are there side effects that may or may not be tolerable? Is the risk of your untreated condition potentially harmful to you or your pregnancy? Your doctor should be able to help you make this sort of decision, considering all these factors. In addition it is important to make sure that you understand how to start and stop the medication, whether it will interact with any other medicines you may take and what to expect in terms of therapeutic or side effects. One caution: there is a lot of information available on the internet regarding these medications. To be sure that you are getting the most reliable information, make sure you are consulting sites that are reliable.
So now you have had your condition diagnosed and a treatment plan has been carefully constructed, how do you feel about taking psychoactive medication? Many patients have no experience with these medicines and may hold some beliefs about them that may or may not be true. Sometimes patients worry that medicines may have addictive potential - most psychoactive drugs do not. Some worry that taking a medicine for a mental disorder has a stigma attached. Since mental disorders such as depression and anxiety are extremely common, it is very likely that a relative, neighbor or co-worker has been prescribed similar medication! Taking medicine for a condition that is impacting your ability to function is not a sign of weakness or a failure - it can be one of the most important decisions you make to improve the quality of your life! Deciding to take any medication is a personal decision, best made with the assistance of your doctor who can help you discuss and consider the concerns you may have. I often tell my patients that whether they decide to use medicines or non-pharmacologic treatments, the important thing is that they are taking action to improve their well-being!
Since patients with infertility issues may worry about the impact of medicines during a pregnancy on their unborn child, next months article will feature an in depth look at what is known about commonly prescribed drugs on fertility and the developing fetus.
Psychoactive drugs: antidepressants, anti-anxiety medicines, anti-psychotics and mood stabilizers
Reliable websites:
www.webmd.com (general medical concerns)
www.womensmentalhealth.org (Womens Program in Psychiatry at Harvard)
www.ctispregnancy.org (information on drugs in pregnancy
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