People’s Pharmacy: Did antidepressant lead to suicidal behavior?

By Joe Graedon, M.S., and Teresa Graedon, Ph.D.

Q. I’m 48 and have battled depression for most of my life. After being on fluoxetine for several weeks, I attempted suicide. Prior to that, I remember feeling unreasonably angry and physically aggressive. I attributed that to my stressful job, and it never occurred to me that it could be from the medicine.

I was hospitalized after my suicide attempt. I didn’t know why I tried to kill myself. I was very depressed, worse even than before I was admitted, so the psychiatrist increased my dose.

I knew within a few days that the medication was making me worse! I tried explaining that to the doctor, to no avail. So, I started “cheeking” my pills and disposing of them carefully. I felt much better within a week. When I was discharged, I was off the fluoxetine.

A. Prozac (fluoxetine) was introduced in 1987. It took until 2005 for the Food and Drug Administration to require a black box suicide warning for most antidepressant drugs. Initially, it was limited to children, but in 2006, the caution was extended to cover people up to 25 years old.

The FDA urges family members to monitor patients closely for unusual changes in behavior. Symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility and aggressiveness are red flags.

Controversy remains over the risk of suicide in middle-aged adults. Your story reminds us how important it is for family and friends to be aware of potential problems associated with antidepressants.

Q. You have written about better drug prices in other countries compared to the United States. I take Trelegy for breathing problems. The price is outrageous. Where can I find information about ordering overseas to save money?

A. Trelegy Ellipta is an inhaled medication to treat chronic obstructive pulmonary disease and asthma. It won’t be available as a more affordable generic product anytime soon.

According to GoodRx.com, the average retail price for a package of 60 “blisters” is over $700. That is for two months’ supply.

PharmacyChecker.com lists prices from approved Canadian partners. For a three-month supply of brand name Trelegy, prices range from $77 to $523. The price differs depending upon where the medicine is shipped from. If it comes directly from Canada, it is pricier, but still less expensive than in the U.S.

To learn more about finding legitimate Canadian drugstores and other approaches to spending less on prescriptions, you may wish to consult our “eGuide to Saving Money on Medicines.” You will find this online resource under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. You recently wrote that “seniors with hearing loss are more vulnerable to dementia.”

I am 75 years old. When my maternal grandmother seemed to be having cognitive problems in late middle age, her doctor prescribed hearing aids. She died at age 91 of a heart ailment with no appreciable cognitive loss.

My father’s sister, 97, has worn hearing aids for about 10 years now. She is quite cogent.

I have worn hearing aids for several years. Although they aren’t perfect, hearing aids improve your quality of life. Not only do I hear better, but others aren’t frustrated by my asking them to repeat what they have said.

I wear in-ear aids because I feel more secure. Why not wear what works so that you will use them?

A. The article we cited (JAMA, Jan. 10) notes that people using hearing aids are less likely to develop dementia.

Thanks for sharing your story.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla. 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”