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Can antidepressant use spur financial flights of fancy?

Millions who suffer from severe depression, anxiety or bipolar disorder find relief with antidepressants. Yet while these medications can dramatically improve the way patients feel and function, they may also cause an unexpected and financially devastating reaction: irrational shopping sprees, atypical gambling jaunts and reckless investment decisions.

The Centers for Disease Control and Prevention reports that about 11% of people in the U.S. age 12 or older are currently prescribed antidepressants. If you or a loved one is among them, be alert to unusually compulsive or risky financial behavior -- and know what preventive steps to take if the urge is coming on.

Meds affect financial choices

The number of antidepressants on the market today is vast, from selective serotonin reuptake inhibitors (SSRIs) with such trade names as Lexapro, Prozac, Paxil and Zoloft, to serotonin-norepinephrine reuptake inhibitors (SNRIs) including Effexor and Cymbalta.

According to San Diego psychiatrist David Reiss, any antidepressant and stimulant can trigger hypomania, a psychological state of euphoria. And while a patient may experience positive effects such as being confident, creative and outgoing, antidepressants can also contribute to extremely poor financial judgment.  Reiss sees many patients through the California Workers Compensation system who have experienced depression due to their injuries and are treated with antidepressants. Among this group, he has noticed a spike in gambling.

"I am now much more aware to listen for and more closely ask how they are spending their time," says Reiss. "Perhaps 20% of the time, people who are limited in their activity by physical impairment and finances will tell me that they go once a week or once a month to local casinos," he says. As a result, they can't meet their expenses and assume losses that their disability income cannot support.

Many are surprised by what they've done after the euphoria passes -- and are shocked and dismayed when they see their credit card bills. "This often triggers guilt and depression," says Reiss.

Grandiose self-perception is also a feature of hypomania, and it, too, can lead to daredevil actions. "They think they can walk into a casino and win a million dollars," says Soroya Bacchus, a Los Angeles psychiatrist. "When you're hypomanic, you can do a lot of things mere mortals can't. Or you think you can, anyway."

Shopping till they drop

In addition to prompting unrealistic and obsessive betting, hypomania also may result in "unrestrained buying sprees" and "foolish business investments," according to the Diagnostic and Statistical Manual of Mental Disorders.

That was true for Wendy Honeycutt of Bellevue, Texas. She had been prescribed antidepressants after a series of tragic events, including the death of her young son. While medicated, she began to spend and charge recklessly.

"My needs were being met by grabbing a credit card," says Honeycutt. "I ended up with closets full of crap. When you're on those drugs, you don't care. They cause you to be selfish. It doesn't allow you to see yourself though a proper perspective. . . . I would order stuff on eBay and Amazon, and days later it came in the mail, and I didn't remember buying it. By the time it came I didn't want it anymore."

When Honeycutt stopped taking her medication, she was nearly $25,000 in debt.

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