Ask the Pharmacist: Antidepressants require close monitoring

Q: My 16-year-old daughter has been taking an antidepressant drug for depression for 10 months. She was doing better and enjoying life but in the past few weeks her sadness has set back in. She isolates herself and I hear her crying all the time. She’s irritable and refuses to participate in family activities. Her doctor wants to increase her drug dosage again. Do you think this will help? — K.T., Sacramento, Calif.

A: It’s hard to say; this might work for a short time. Generally speaking, however, the higher the dosage, the greater her risk for side effects such as insomnia, headache, dizziness, low appetite and confusion.

I’m not a psychiatrist, but it’s clear that the doctor thinks your daughter is slipping backward, so he’s prescribing a higher dosage again. This may very well be the case, but I have to warn you that this change in your daughter’s behavior could be due to her medication, not a relapse into depression. I say that because antidepressants have been linked to suicidal thoughts (and yes, suicide!) in children and teens, although it’s unusual.

The U.S. Food and Drug Administration requires that antidepressant drugs carry a special ‘black box’ warning about the danger. Some of the signs and symptoms to watch out for include worsening depression, anger and thoughts or talk of suicide.

I offer natural ways to ease depression, as well as safety tips if you take prescribed antidepressants in Chapter 5 of my book, The 24-Hour Pharmacist. As a caring mom, you need to ask your daughter whether or not she’s experimenting with other drugs like alcohol or cocaine — another reason for emotional disorders. Combining these substances with antidepressants is extremely dangerous.

Learn more about her lifestyle (could she be pregnant?) and also talk to her doctor(s). Finally, consider the following safe and natural remedies to take with her medication: essential fatty acids, magnesium chelate, B-complex, vitamin C, Panax ginseng and green tea.

Q: I’ve been having hot flashes so I bought a cream containing “wild yam” extract from a health food store to help balance my hormones, particularly progesterone. Will this do the trick? — T.E., Los Angeles, Calif.

A: No, that would not be my pick. The theory that wild yam converts to progesterone in the body is not bullet-proof. It sounds good, especially when you hear someone explain the biochemical reasoning, but according to some leading hormone gurus, wild yam extract is not the same as pure progesterone itself.

Diosgenin (found in wild yam) has some activity in the body, and under strict laboratory conditions, along with solvents, it can convert itself into some steroid hormones. These lab solvents are not found in a woman’s body, however — see why I like USP pure progesterone better than wild yam extract? Because when you buy progesterone, you get progesterone. Period.

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