A talk on “Antidepressant Use and Suicide” was organized by the Vocational School of Health Services. At the event, where Dr. Sultan Mehtap Büyüker, Head of the Pharmacy Services Program, participated as a speaker, the discussion focused on antidepressant use, poisonings, and the evaluation of suicide from a forensic toxicology perspective. Büyüker emphasized the critical importance of the correct treatment method in depression therapy, stating, “When determining the diagnosis and treatment scheme, particular attention should be paid to applying personalized treatment.”
“Depression is not as simple as we use it in daily conversation”
Büyüker stated that the term “I am depressed” is sometimes used by everyone, but the situation is not that simple. Büyüker said; “From time to time, we use the term 'I am depressed' quite often, but the scope of the matter is actually not that simple. Depression is a process in daily life where problems such as not enjoying life, deep despair, sadness, losing your normal daily energy, appetite disorders, and sleep disorders emerge. However, if this process prolongs, we call it depression. If the process has extended for weeks, months, or years, and as a result, the final stage of depression, which we call the person disconnecting from life and an increased tendency to end their life, we define this as severe depression.”
“Depression can result from many different causes”
Addressing the causes of depression, Büyüker said; “If we look at the factors causing depression, we can talk about genetic, biochemical, hormonal, and psychosocial factors. Genetic factors include having a history of psychiatric illness in the family, predisposition, the effect of monoamine oxidase A enzyme, and the presence of brain-derived neurotrophic factor gene polymorphism. Additionally, biochemical neurotransmitters, the limbic system, and hormonal factors such as the decrease of estrogen during menopause or its increase in early periods, along with changes in oxytocin and endorphin levels, as well as the psychosocial factors we monitor most closely, can all contribute. These can include marriage and relationships, difficult living conditions, the death of a loved one or a severe illness of one of your relatives, accidents and disasters, economic problems, certain legal troubles, sexual and physical abuse, and other severe illnesses.”
“Choosing the right antidepressant is the most important step in depression treatment”
Büyüker emphasized the critical importance of the correct treatment method in depression therapy, stating; “When determining the diagnosis and treatment scheme, particular attention should be paid to applying personalized treatment. Here, drug interactions are very important; a person with depression may also be a diabetic patient. They may have hypertension or epilepsy. These medications can interact with many other drugs and toxic effects can occur. Therefore, in drug selection, it is necessary to consider the person's underlying diseases.” She continued: “Again, selecting the correct antidepressant and the right dose is extremely important. All of these need to be evaluated, but the application of psychotherapy along with depression treatment is highly effective.”
“The public should be informed about antidepressant use”
Büyüker discussed the results of their study on antidepressant use, highlighting the increase in antidepressant consumption in Turkey over the years; “Looking at the results in Turkey, antidepressant sales were 14 million 238 thousand boxes in 2003, while reports show they rose to 48 million 226 thousand 609 boxes in 2017. This represents an increase of 338%. Similarly, poisoning reports increased from 18 thousand 841 in 2000 to 217 thousand 331 in 2018. When we make a comparison, while the population increased by 1.2 times from 2000 to 2018, poisoning reports increased by 11.5 times. We also compared Turkey with other countries; the results show that Turkey has a lower suicide rate. However, we found that the crude suicide rate showed an increase of more than 300%.” Finally, she stressed the importance of informing the public and healthcare personnel about rational drug use and antidepressant use, urging people not to resort to medication at the slightest unhappiness, stating, “we need to show sensitivity to our mental health, both for ourselves and for our environment.”