Centre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal
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Ask the expert

The antidepressants I take have taken away my strong creative side; should I stop taking them?

Antidepressants can be very useful. Sometimes they're necessary. Sometimes they're not. It would be irresponsible to say that a person should or should not take the medication without knowing the background history. Some people taking antidepressants report feeling less bothered by things, therefore they're less depressed and anxious. However, some people report a sense of numbness. They feel as if the antidepressants take a little bit of spice away from them. Only a small percentage of people tend to feel that way. Like all medications, you have to balance between what it brings to you and what it costs you.

Take, for example, a patient who was a very successful and creative musician. He suffered from bipolar depression and needed a mood stabilizer. When he stopped taking his medication, he had a manic episode and ended up in rural Quebec, naked in the streets, and was picked up by the police. In such a case, not taking his medication was not an option. He needed it to function normally. The medication did affect his creative side, but that certainly was a small price to pay for what it brought him. So the answer to your question is: it depends on how much it helps you and how necessary it is. Sometimes, a different medication can bring the same benefits and have fewer side effects. (Mimi Israël, MD) The question as to whether your creative side gets you into trouble should be answered by you. However, it's important to share your hypothesis with the professionals that treat you because they may have interesting answers as well.

If depression is partly due to brain chemistry, do people need to take medication their entire lives?

Brain chemistry can, in my opinion, also change with psychotherapy. But the patient must undergo psychotherapy on a regular and intense basis, and it must lead to the anticipated outcome. In the case of obsessive-compulsive disorder, data clearly show the effects on the brain before and after cognitive behavioural therapy. Certain people are more sensitive to psychotherapy, while others need medication. Maybe in 20 years we will discover who is more likely to respond to a given treatment and therapies will be personalized. For the moment, I believe that if the condition is serious, a combination of the two is the best solution.
- Johanne Renaud, MD, Mini-Psych School 2010

Can women continue taking antidepressants while pregnant?

Women in this situation need a specialized program to make sure they have the right medication. Gynecologists and obstetricians are more informed than they used to be, and the CHU Saint-Justine has a specialized centre that provides information on medication for the best treatment plan. Of course, it is always best not to take any medication when pregnant. However, if a woman is going through a depressive episode, she will still need treatment. Although there are risks, some medications are indeed allowed during pregnancy, but these risks are very low compared to symptoms of depression and suicidal thoughts. Again, any woman in this situation has to be followed after pregnancy, as the post-partum period is also a high-risk period. It’s better to have support and to talk about your condition with your physician both during pregnancy and after the child is born.
-Johanne Renaud, MD, Mini-Psych School 2012

How long does it take to treat depression?

When treating depression with an antidepressant, the patient starts at the lowest dosage to adjust to the side effects. The dosage is then optimized to initiate a response. It takes three weeks after the first week to see some improvement. If the person tolerates the medication, then approximately 6 to 12 months of treatment is required to make sure the person is feeling better. After this period, the antidepressant is decreased in the same increments as in the beginning. The person is then monitored to see if the previous symptoms return. If not, the medication is decreased and then ceased. Patients still have to be followed to ensure they don’t have another episode. Depression can be a chronic illness, but symptoms can be prevented with psychotherapy.
-Johanne Renaud, MD, Mini-Psych School 2012

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