Denial or stigma keep many adults from getting help for depression

Philip Copitch, Ph.D. - Author of Change: How to bring real change to your life: The psychology and secrets of highly effective people

A study published in the journal JAMA Internal Medicine (8/2016) notes that:

Despite recent increased use of antidepressants in the United States, concerns persist that many adults with depression do not receive treatment, whereas others receive treatments that do not match their level of illness severity.

The study screened 46,000 Americans for depression finding that about 8 percent showed diagnosable symptoms. On follow-up, only 1 in 3 were getting treatment. 

The reasons for the gap in treatment were complicated. Some respondents avoided care because of stigma or denial. Others had limited access and/or lack of insurance. 

The researchers point out:

…critical treatment gaps persist, especially for racial / ethnic minorities, low income individuals, less educated adults, and uninsured people.

Read the study

Antidepressant drugs and drug-induced liver injury

Philip Copitch, Ph.D.

Author of Change: How to bring real change to your life: The psychology and secrets of highly effective people

The American Journal of Psychiatry reports

December 2013, researchers reported in The American Journal of Psychiatry that common antidepressant drugs can cause liver damage in humans. Drug-induced liver injury (DILI) was found in 0.05-3.0% of those taking antidepressants.

The researchers did a PubMed review from 1965 to the present, and reported that all antidepressants can induce hepatotoxicity (liver cell damage or destruction), especially in elderly patients or patients taking multiple prescription medications. This chemically driven cell damage was found to be unrelated to drug dosage and generally occurred between several days and 6 months of starting the medication. 

The antidepressants associated with greater risks of damaging the liver are:

• iproniazid
• nefazodone
• phenelzine
• imipramine
• amitriptyline
• duloxetine
• bupropion
• trazodone
• tianeptine
• agomelatine

The antidepressants that seem to have the least potential  to damage the liver are 

• citalopram
• escitalopram
• paroxetine
• fluvoxamine

The researchers conclude:

Although an infrequent event, DILI from antidepressant drugs may be irreversible, and clinicians should be aware of it.