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Dr. Bob is Robert Hsiung, MD,
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Posted by herpills on December 8, 2009, at 18:44:37
Interesting article. Thoughts? herpills
Copyright © 2009, The Los Angeles TimesA study finds steep drops in neuroticism and increases in extroversion among patients taking Paxil. Such traits had been believed to shift very little over a lifetime.
By Melissa Healy
December 8, 2009
Antidepressant medications taken by roughly 7% of American adults cause profound personality changes in many patients with depression, far beyond simply lifting the veil of sadness, a study has found.Researchers saw strong drops in neuroticism and increases in extroversion in patients taking antidepressants, two of five traits thought to define personality and shape a person's day-to-day thoughts and behavior. The findings are striking, researchers said, because psychologists have long thought that such fundamental traits are moorings of an adult's personality that shift very little over a lifetime.
The medications would seem to relieve depression by chemically altering brain processes that spawn negative thoughts rather than just alleviating symptoms associated with a depressed state, said Northwestern University psychologist Tony Z. Tang, the lead author of the study.
The findings, published in the journal Archives of General Psychiatry and funded by the National Institute of Mental Health, could have significant implications for depression treatment, researchers not connected with the study said.
It is unclear how long-lasting the changes in personality are, the authors said. But the study found that patients whose personalities shifted the most were less likely to relapse. And they said that monitoring those altered traits could be a useful, early gauge of whether a medication is working and how probable a recurrence would be.
The findings are likely to rekindle debate on the impact and effectiveness of selective serotonin reuptake inhibitors, or SSRIs, on which Americans spent $9.6 billion last year alone. SSRIs increase the availability of serotonin, a key brain chemical, low levels of which are linked to depression.
The trial involved 240 adults with moderate to severe depression. Of those, 120 were given the selective serotonin reuptake inhibitor paroxetine (Paxil) for 16 weeks. Another 60 received cognitive therapy but no medication for 16 weeks, and 60 others were given a placebo alone for eight weeks.
All subjects who reported improvements in their depression in response to psychotherapy or medication were followed for a year.
Patients who received paroxetine were more likely to have their symptoms ease than patients in the other two groups, and they showed more dramatic personality changes.
Those given placebo pills reported early improvements in their depressive symptoms almost as great as those reported by those on medication, but their underlying personalities "didn't budge," said Northwestern's Tang. And their relief from depressive symptoms was briefer and more muted than the improvement of those on medication or cognitive therapy. They were given the antidepressant if their condition failed to improve after eight weeks.
That finding "pokes a hole" in the charges of many critics that SSRIs are little more effective at treating depression than sugar pills, said UCLA psychiatrist Andrew Leuchter.
Still, several researchers not involved in the study cautioned that the findings might prompt greater use of medications for which U.S. physicians already write 164.2 million prescriptions a year. For insurers and healthcare policymakers wary of the high cost of psychotherapy, the study might make the drugs look like a better value.
That would be a mistake, said University of Illinois psychologist Brent Roberts. Not all depressed patients respond to SSRIs so favorably. "And it would be foolish to base policy on the findings of one study," he said.
Other studies will be necessary before the cost-effectiveness of different treatments can be established, Roberts added.
The personality changes in the study were striking, researchers said. While adults typically become slightly less neurotic with age, it is a gradual change. In the study, experimental subjects who responded to SSRI treatment changed roughly twice as much on the neuroticism scale as most adults do in a lifetime. And they did so in eight weeks.
"That is a dramatic change," said Robert McCrae, a leading researcher on personality, now retired. "If you were these patients or someone in their family, you'd notice a difference."
The study also suggests a new measure to identify people at risk of developing depression and to predict who would benefit most from a particular medication or therapy. Doctors could refer to a personality inventory that would measure a patient's "big five" traits -- neuroticism and extroversion, as well as agreeableness, conscientiousness and openness -- to test a patient's early response to a drug or psychotherapy.
Such a tool could improve the trial-and-error method of prescribing that is common in the treatment of depression, UCLA's Leuchter said.
To drive down the rate of relapse in depression, Tang said, psychiatrists should focus on helping patients achieve fundamental personality changes and not just recover from a current episode of depression. Roughly half of those treated successfully for the disorder can be expected to suffer a recurrence in the following year.
"They should be thinking how to prevent relapse -- not just about short-term recovery, which we're pretty good at -- as soon as the patient walks through their door," Tang said.
Copyright © 2009, The Los Angeles Times
Posted by Phillipa on December 8, 2009, at 21:09:27
In reply to Antidepressants linked to major personality change, posted by herpills on December 8, 2009, at 18:44:37
For me the relief of anxiety is the key irreguardless of the method. First I was solo benzos and three beers at night to relax but stopped the beer in nursing school. I never took an ad first being l0mg of paxil til my thyroid became low. And with that higher anxiety. Three months laying in a hammock before it worked or my brain got used to it. I continued on the benzos and beer. When I stopped drinking I became depressed with worse anxiety and remain that way but also have had and may still have some lyme's disease in me. So I don't feel SSRI's changed my personality or worrying. I am outgoing with strangers even when anxious and no longer drink.And it was much longer before the l0mg of paxil allowed me to get back to work. Forgot lopressor 25mg was added for three weeks before the paxil to help with anxiety. Phillipa
Posted by floatingbridge on December 8, 2009, at 22:30:15
In reply to Antidepressants linked to major personality change, posted by herpills on December 8, 2009, at 18:44:37
> To drive down the rate of relapse in depression, Tang said, psychiatrists should focus on helping patients achieve fundamental personality changes and not just recover from a current episode of depression. Roughly half of those treated successfully for the disorder can be expected to suffer a recurrence in the following year.
>
> "They should be thinking how to prevent relapse -- not just about short-term recovery, which we're pretty good at -- as soon as the patient walks through their door," Tang said.
>Yes. New diagnostic tools and psychiatrists more thoroughly educated in various therapies to assess who may benefit from therapy in conjunction w/ meds.
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Posted by bleauberry on December 9, 2009, at 17:44:55
In reply to Antidepressants linked to major personality change, posted by herpills on December 8, 2009, at 18:44:37
Antidepressants linked to major personality change
As in loss of interest in God, loss of interest in lifelong hobbies, loss of caring for family members, increase of "me" first the other fellow second attitudes (should be God first, the other fellow second, myself last), noninterest in things everyone else is interested in, suddenly being outgoing and energetic when your whole life you were naturally quiet and reserved? And so on.
For sure ADs can change personality. For the better and the worse. One can reach remission but also become a totally different person...maybe in a good way and maybe in a bad way. Different for sure.
ADs completely obliterated my depression for some years. But it was strange, because I had also become a considerably different person while on those drugs. An excellent worker, high achiever, but very poor with friends, family, and social activities. I was different. Not the same.
A few people however do find the remission that returns themselves to the orignals they were.
I don't think this study even mentioned the common thing we see here all the time...
the apathetic motivationless emotional lebotomy effect...no depression, but no spark either. That's a pretty significant personality change that happens a lot. No mention of it by the researchers however.
Posted by manic666 on December 10, 2009, at 4:24:08
In reply to Re: Antidepressants linked to major personality change, posted by bleauberry on December 9, 2009, at 17:44:55
when depressed you dont have a personality.. so ocourse you change thats the hold idea.I would sooner be some over the top nutter// the dragging my feet like a dead man all day.
Posted by RSidney on December 10, 2009, at 10:29:18
In reply to Re: Antidepressants linked to major personality change » herpills, posted by Phillipa on December 8, 2009, at 21:09:27
Phillipa - is Paxil helping with your anxiety? Is is suppose to be a "calming" type drug as compared to Effexor, etc which I think are considered more activating.
Like I said, I am considering going back on Celexa to deal with my anxiety, but if Paxil is better I may suggest that to my PDOC?Thanks in advance for your diligence on this board!
Posted by manic666 on December 10, 2009, at 12:42:42
In reply to Re: Antidepressants linked to major personality ch » herpills, posted by floatingbridge on December 8, 2009, at 22:30:15
if a major depressive attack drag,s your hole person to depths of mental pain,you tend not to come of your meds when in remmision.So your never going to be the same person.Once you have suffered a few attacks, it pretty unlikely your going to be the same ever again.come off meds your just waiting for the next attack .stay on them all be a lower dose you may get a little longer.i used to hate all meds an come off at the first sign of remmision.Not anymore
Posted by Phillipa on December 10, 2009, at 19:12:25
In reply to Re: Antidepressants linked to major personality change, posted by RSidney on December 10, 2009, at 10:29:18
Unfortunately I discontinued paxil many years ago but my diagnosis has always been Gad. Still take low dose luvox and some benzo. Never felt leaden and dragging my feet so guess not really depressed maybe more bored and dysthymic? All I know is no ad and took all the SSRI's SNRI's cymbalta last for 60 days and nothing. So went back to 50mg of luvox. No side effects from it? Phillipa ps thanks for the compliment!!!
Posted by RSidney on December 11, 2009, at 17:48:19
In reply to Re: Antidepressants linked to major personality change » RSidney, posted by Phillipa on December 10, 2009, at 19:12:25
Luvox is suppose to be a very "calming" AD and is very popular in Europe as I understand.
One doctor wanted to put me on Luvox, but it is poorly metabolized by the P450 2D6 enzyme.
Posted by Phillipa on December 11, 2009, at 21:33:45
In reply to Re: Antidepressants linked to major personality change, posted by RSidney on December 11, 2009, at 17:48:19
Maybe that's why I tolerate it and not the others? Phillipa
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