Patient Misconceptions with Antidepressant Therapy
Patient misconceptions with antidepressant therapy is very common. Antidepressant therapy can be life changing for patients, but we have to remember that their are very critical education points that we need to help coach them on. Here’s a list of a few patient misconceptions with antidepressant therapy that I’ve seen patients have.
Patient Misconception With Antidepressant Therapy #1 – Onset of Action
The biggest mistake that I see patients make with antidepressants is that they do not recognize that these medications take a while to work. Understandably, patients who are depressed want their problems fixed right away. Unfortunately, the patient may be weeks away from benefit.
Patient Misconception #2 – Adverse Effects
The question I’ve been asked most often by patients is will the medication make me feel like a zombie (or something similar to that effect). The feeling of being a zombie, is incredibly rare. There are some antidepressants that are more sedating than others. A few examples of more sedating antidepressants include mirtazapine, paroxetine, and trazodone. Notably, trazodone is not often used for depression, but more for insomnia because of this adverse effect. If you are looking for more information on SSRI adverse effects, you can listen to this podcast.
Patient Misconception #3 – Lifelong Therapy
Another common misconception is that the patient believes they will have to be on the medication long term. While there are many patients that long term antidepressant therapy is necessary, there are some patients who may be able to discontinue therapy eventually. One really important education point for those seeking to try to get off of an antidepressant is to speak with their pharmacist/primary provider before doing so. Discontinuation syndrome is a real problem and overlaps with symptoms of worsening depression. As long as there aren’t any significant adverse effects, tapering off of the antidepressant slowly over time is important to try to avoid discontinuation syndrome.
Patient Misconception #4 – PRN
This misconception ties into the fact that these medications take a while to work. I’ve had patients make the mistake of taking these medications on an as needed basis. This is obviously not how these medications work and could lead to patients feeling frustrated that it didn’t help their mood when they took it.
Patient Misconception #5 – Medication is a Sign of Weakness
There are a significant number of patients who think that depression in general is a sign of weakness or a character flaw or other misconceptions. In my experience, I’ve found that geriatric patients tend to have a more closed view on mental health issues and are often reluctant to initiate antidepressant therapy. It is really important to try to figure out why they are against it if it is deemed that an antidepressant would be appropriate and helpful for them.
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