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NEW ANTIDEPRESSANT

A new antidepressant has just been approved by the FDA, but it did so with little fanfare, and at a time when antidepressants are under fire for allegedly triggering some to commit suicide.
The drug is called cymbalta, it works differently from other antidepressants in that most act on only one brain hormone. This one acts on two. But while most of the 19 million depressed Americans could benefit, is it possible its activity could lead certain individuals to harm them?

Dr. Gilda Carle is a psychotherapist who questions whether we really need another antidepressant on the market. “In our culture we are choosing to put on band aids rather than choosing to get inside our heads and find out what’s really wrong and as a result we are solving no problems.”
Yet, cymbalta has been pitched as a medication that can treat both the psychological and the physical aspects of depression.
Eli Lilly, the maker of cymbalta, says that because the drug works on two chemical messengers, serotonin and norepinephrine, it is more likely to relieve also the physical signs of depression, such as back and shoulder pain.
The drug will compete directly with effexor, Wyeth's drug that targets the same neurotransmitters. Lilly has priced the drug at an average wholesale price of $2.85 a tablet, roughly equivalent to effexor.
Cymbalta comes in a capsule and can be taken once a day. The recommended daily dose is 60 milligrams.
The approval comes at a time when there is great scrutiny of antidepressants in general.
Cymbalta was linked to the suicide of a 19 year old student who was in perfect health and who had no mental disorder, and was not suicidal. She was a volunteer in a clinical trial, receiving the drug in high doses.
Today, the FDA concluded that the drug did not trigger the teenager’s suicide.
Many experts believe antidepressants on a whole are safe.
Dr. Norman Sussman, a psychiatrist at the NYU School of Medicine, says, “It’s hard to separate the cause and effect from coincidence.// I would imagine in my experience there are some patients when they start taking antidepressants they do experience an increase in thinking about suicide but it’s extremely rare and unfortunate. That’s the stuff that makes it into the front pages of the newspapers and it scares people away.”
In studies, the most common side effects of the drug were mild and not severe. Still, there are lingering questions as to whether certain individuals, especially younger patients, carry genes that put them are at risk when taking certain antidepressants.
“Naturally during the teenage years there are ups and downs highs and lows, hormonal controls are out of wack very often and we’re finding very often more and more that these kids feel blue and lonely and upset for the simplest things and they tend to exaggerate,” states Dr. Carle.
“I have not seen any significant risk of people wanting to become suicidal if anything it’s only when the drugs don’t work when people become suicidal,” Dr. Sussman adds.
The most common side effects of cymbalta are headache, nausea, changes in appetite and sleep problems. Antidepressants for the most part are extremely well tolerated.

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