Side effects inc. dry mouth, headaches, suicide: FDA tells drug makers to make sure.

Now for your Daily Dose of Disturbing: a recent article in the New York Times explained that the FDA is asking drug manufacturers to watch for suicide as a possible side effect in clinical trials. A little history:

The seeds for the new federal effort were planted four years ago with the discovery that antidepressants may cause some children and teenagers to become suicidal. Top agency officials at first discounted the finding but commissioned researchers from Columbia University’s department of psychiatry, led by Kelly L. Posner, to reanalyze the drugs’ clinical trials. This work caused the drug agency and its experts to view the risk as real.

This is all very unsettling to me. By the time a drug makes it to human clinical testing, we are pretty darn sure it is safe – physiologically. But then the human mind has to go and be all misunderstood by modern medicine, and bam, drugs used to treat depression are leading to suicide. How exactly does that work? Suicide’s an action, not a condition. Is the “suicidal” condition totally distinct from the depressed condition? Can the former emerge when the latter is squelched? 

This is especially scary when antidepressants may be overdiagnosed and less beneficial than supposed, as my classmate Catherine Guiles discussed in her blog.

“One lesson from pharmacology is that you can see effects on emotion and cognition without the drug entering the brain if a drug leads to peripheral changes in” other chemicals that enter the brain, said Dr. Thomas R. Insel, director of the National Institute of Mental Health.

Yikes. So everything we put in our body can affect our mood? Could the pistachio I’m struggling to open cause, through a complicated string of reactions a la Mousetrap, a chemical change that evokes a new/different mental condition?

“Distinguishing between mental problems that spring from a disease and those that result from its treatment is often difficult. For antidepressants, many researchers suggested that suicidal behaviors resulted because, as patients’ depression lifted, they suddenly had the energy to carry out previous suicidal thoughts.”

When I was 14, I went on the acne-clearing drug Accutane for five months. My skin wasn’t horrific, but I’d tried everything else and jumped at the chance to stop the oiliness once and for all. At the time, it felt like there were a lot of hoops to jump through before they’d give me the package of yellow pills – two pregnancy tests, monthly blood tests, etc. But now, from what I understand, going on Accutane is difficult, bordering on impossible (mostly due to the risk of birth defects.) But even then, in 2001, my dermatologist mentioned that some studies suggested a link between the medication and depression and even suicide.

“But really,” she said confidently, “I think it’s just that these people have had disfiguring acne their whole lives and they believe if it’s cleared up, everything will be better.” She narrowed her eyes. “And it’s not. It doesn’t.”

I got through my five months with few physical and no psychological side effects. I got an ego-boost from noticing I didn’t look like a greaseball in photos, and I haven’t given my skin much thought since then. But it was a risk then, as it is for others now. On the blog/zine Awkward is Awesome, my friend Sammy Davis is weighing the health risks of going on the drug.

And if my doctor was wrong, and the drug really can churn up a suicidal condition…well, it begs the question of what side effects outweigh a medicine’s side effects. Dry skin? Fine. Sun sensitivity? Sure thing. The possibility of destroying the very life you’re trying to better? The jury’s still in session…