Guest Column: Rebuttal to Gatekeepers to Pharmaceuticals

Jane H. Feldman, MD

Disclosures
In This Article

Safety and Side Effects

The general issue of safety is also of some concern. While contemporary antidepressant medications are certainly considerably safer than their predecessors, they are not without side effects and dangers. To say that they have little to no need for professional monitoring may be overstating their safety. Although extremely unusual, medications in this group have been known to cause akathisia, seizures, priapism, liver problems, and other rare but serious side effects. Even the more common side effects, such as gastrointestinal disturbance and sexual dysfunction, can often be attenuated if not ameliorated by physician intervention. Perhaps even more troubling is the issue of the patient making the wrong diagnosis of themselves. If they feel and think that they have a diagnosis of unipolar depression but actually have bipolar depression, the potential exacerbation of that illness by over-the-counter treatment with antidepressants could cause more harm than good. While it is true that seasoned clinicians often make this error, a professional certainly has a better chance of not making it.

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