Q&A: when to take an antidepressant; what's really in Ozempic; risks of fish oil supplements; & is Ozempic right for me

Happy Memorial Day 🇺🇸

ICYMI 👉

• My Favorite Things at the Pharmacy

• Why Taylor Swift is Good for Your Health

• Are You Getting Enough Rest?

---

The first question (on antidepressants) is free for all subscribers. Questions 2-4 (on what's really in Ozempic; risks of taking fish oil; & is Ozempic right for me) are for paid subscribers only.

If you would like a paid subscription but it’s not in your budget (or if you are a family member, friend, or patient who should be getting it free!), please message me directly. ❤️

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

---

QUESTION #1: ANTIDEPRESSANTS

I’ve been in therapy for 6 months and I almost think it makes me feel worse to talk about my problems. I know you are a big believer in therapy but how do you know when it is time to take medication for depression?

- KL

Dear KL,

I’ve heard this before! Therapy can be transformative; it also can do more harm than good (as I wrote about here). Medication for depression isn’t the same thing as a “cure” for depression, however, when prescribed appropriately—and in combination with other treatment modalities like therapy, meditation, and appropriate cognitive and behavioral changes—antidepressants have been shown to help reduce suffering and improve quality of life.

In other words, medication is simply another tool in the toolbox to treat depressive disorders. Examples are SSRIs (i.e. Prozac, Lexapro, and Zoloft), SNRIs (i.e. Effexor, Cymbalta), and dopamine/norepinephrine reuptake inhibitors (i.e. Wellbutrin).

For my patients with depression, I try to reframe the question “Should I be on medication?” to “What might help me the most with my particular symptoms of depression?” For example, a patient whose mood drops during the winter months might benefit from outdoor exercise, more time with friends, and sitting under a sunlamp each morning. (Of course that person might benefit from medication, too.) A patient whose depression flares every weekend after binge drinking might benefit more from a trial of abstinence than from medication. (Of course, that person might need both!)

In fact, I commonly see patients who are valiantly “doing the work” and resistant to medication—but whose therapy or habit changes would likely pay off with appropriate chemical support.

The bottom line: There is no medication—or prescribed set of tools—that applies to every person’s mood issues, which is why it’s essential to work with a provider who is knowledgeable about pharmacology, knows you well, and is someone who you can trust with your whole self. I hope that helps!

Photo by Diego PH on Unsplash

---

If you like what you are reading, hit the ❤️ button on this post so more people can discover my writing on Substack! 🙏

---

QUESTION #2: WHAT’S REALLY IN OZEMPIC

I was a victim of the fen-phen diet drug in the 90s - l lost a ton of weight and gained it all back and then some - and now I am spooked about Ozempic. Do we really know what’s in it? And how it actually works?

- Leslie

Hi Leslie,