While the drugs are widely used, a new study sheds light on how little is known about their long-term benefits.
Antidepressants are one of the most commonly prescribed drugs in the world, but we are still developing our understanding of how they work. Overall, this study is reassuring. On average, people who are receiving antidepressants in UK primary care are benefiting, even if the benefit is more for anxiety symptoms than depressive symptoms.
From expanding minds to healing brains.
For some they are lifesavers, for others ineffective and even addictive. Our special report looks at why even experts disagree on antidepressants, and what the real truth is.
Exercise can be a very effective way to treat depression. So why don’t American doctors prescribe it?
It’s also not yet clear whether ketamine is a real antidepressant or just triggers a feeling of euphoria. But the FDA said the medical need for another option for patients with depression justified the approval. We’re sure to learn more now that patients will have the opportunity to try it.
I am not suggesting that antidepressants do not work. I am suggesting that they are given a precedence in our thinking about mental health that they do not deserve.
But even if they do, they're not our biggest concern.
Antidepressants do work—but the best you may never have heard of.
People who are eligible for AARP memberships, teenagers, and even pets, make up the fastest growing demographics of those who are consuming cannabidiol or CBD.
“Psychiatry has known for quite some time that the ‘serotonin theory’ of depression, the notion that too little of the brain chemical can be a cause of depression, a decades-old hypothesis and deeply entrenched trope in society that helped promote a class of antidepressants taken by millions of Canadians, is wrong, says Montreal psychiatrist Dr. Joel Paris.
Experts recommend people stay on antidepressants for four to nine months after remission, but some keep taking them for years.
Mustering solid evidence, two researchers have denounced the standard psychiatric guidelines for how best to wean patients from depression medications.
The drugs have helped millions of people ease depression and anxiety, and are widely regarded as milestones in psychiatric treatment. Many, perhaps most, people stop the medications without significant trouble. But the rise in longtime use is also the result of an unanticipated and growing problem: Many who try to quit say they cannot because of withdrawal symptoms they were never warned about.
More Americans are taking antidepressants for longer. But doctors say patients should weigh the pros and cons amid new research on risks.
Psychiatrists have known for decades that the etiology of depression and other mood disorders cannot be explained solely in terms of a single neurotransmitter—whether serotonin, norepinephrine, or some other biogenic amine.
The ketamine-like spray offers hope for people with treatment-resistant depression.
Doctors used to believe depression was norepinephrine or serotonin deficiency. We now view depression as the inability of the limbic system to be modulated by the neurotransmitters.
Antidepressant medications target this problem by increasing the ability of these molecules that deal with our emotions, motivations and memory to do what they need to do.
We offer, and are offered, drugs as the first, and often last, recourse. This approach is only having modest results. When I took chemical antidepressants, after a brief burst of relief, I remained depressed, and I thought there was something wrong with me.I learned in my research that many researchers have examined the data on antidepressants and come to very different conclusions about their effectiveness. But it’s hard not to conclude, looking at the evidence as a whole, that they are at best a partial solution.
There’s no one-pill-fits-all solution if you and your doctor decide you need to be on an antidepressant. Here are the most common types of medication that help lift your mood.
Antidepressants have been in the news recently. The general feeling seems to be that although they are being overused and may have some unpleasant side effects, they certainly ‘work,’ at least in some people (1).
So what is the evidence that antidepressants ‘work’? If you compare them with a dummy tablet or placebo in a randomised trial, scores on rating scales that are meant to measure depression sometimes go down a few points more in people taking antidepressants compared to people on placebo. But what does this mean? Well, firstly, the differences are small.
There are medications that help people feel better a lot faster than today’s antidepressant pills. And feeling better sooner means that people can take helpful actions sooner, developing helpful habits for long-lasting change and lifting themselves out depression. And there are other medications that might not work any faster, but have antidepressant effects without some of the most troubling side effects associated with medications like Zoloft (sertraline) or Paxil (paroxetine).
Antidepressant drugs are as controversial as they are popular. And, boy, are they popular. As many as 1 in 10 Americans is on some form of antidepressant medication. Now a new study suggests that while the drugs benefit severely depressed people, they have a "nonexistent to negligible" impact on patients with milder, run-of-the-mill blues.
Uncovering the secret life of antidepressants could open up a host of new treatments.
Antidepressants are some of the most commonly prescribed medications and the UK is the sixth biggest consumer of antidepressants in the world. Only in the last few months has the drug binding site been discovered. This begs the question “so how do they work?”
I was an emotionally and physically paralysed version of the person that I used to be. Without medical intervention, I would still be that person today.
Unfortunately, antidepressants take at least a month to start working. Good patient education about the delayed onset of effect and close monitoring of the patient during this initial period is extremely important. Patients can become hopeless if they expect the drug to start working right away.
Your doctor can give you the medical facts, the ins and outs of being medicated, but there are always some persistent fears. Medication is one of a variety of options you can use to combat depression, but here are some of the pros, cons, and full-blown myths of taking antidepressants.
The heart of the controversy is the placebo effect – the well-evidenced phenomena of experiencing benefits because the user believes the benefit is coming. In clinical trials for antidepressants, the question is what percentage of users will experience real benefits versus those believing they’re experiencing benefits from a placebo.
Most striking is the fact that antidepressants are being prescribed even to people who don't meet the official psychiatric criteria for depression.
What Should You Do? Think twice, be skeptical, and question a simplistic diagnosis you might receive after discussing your condition for a short time with a rushed practitioner. If each person takes a stand, is willing to engage in therapies beyond drug-taking, we might actually have a responsible and informed public confronting an increasingly powerful medical-pharmalogical establishment. Drugs may not be the answer for you, and now it turns out that some drugs may not be the answer for almost anyone.
When the idea that selective serotonin re-uptake inhibitors (SSRIs) might make people feel suicidal first started to be discussed by people like David Healy, I admit I was sceptical. It didn’t seem to me the drugs had much effect at all, and I couldn’t understand how a chemical substance could produce a specific thought. Since that time, however, the evidence has accumulated, and moreover, it is clear that the suicidal thoughts and behaviours usually occur in the context of a state of intense tension and agitation that the drugs seem to precipitate in some individuals, especially the young.
I think antidepressants are a useful technology that has helped a lot of people. I'm glad we have them. But I'm definitely sympathetic to the view that they are overprescribed.
Do antidepressants work? The notion that they don’t—that Prozac, Lexapro and other drugs are little more than placebos with side effects—has become mainstream. “Antidepressant Lift May Be All in Your Head,” a typical headline reads, atop an article citing research from medical journals. With as many as one in eight American adults now taking an antidepressant, the stakes are high.
Among 14 antidepressants, only fluoxetine—Prozac—is more effective than a placebo.
So it looks like the fluoxetine is most effective when combined with corticosterone, or exposure to stress. This becomes important when you take into account that 80% of people diagnosed with major depressive disorder report symptoms after a significant life stress.
A study of nearly 65,000 women finds a link between taking certain antidepressants during pregnancy and teen depression.
Are we using good scientific evidence to make decisions about keeping these young people on antidepressants? Or are we inadvertently teaching future generations to view themselves as too fragile to cope with the adversity that life invariably brings?
Twenty-three years after Listening to Prozac, Peter Kramer comes to the drug’s defense. Antidepressants work—not all the time, and not for all people, but in lots of ways for lots of people.
Although these drugs are generally considered to be safe by the media and amongst medical professionals and patients, a close look at the evidence suggests otherwise. Antidepressants have serious and potentially fatal adverse effects, cause potentially permanent brain damage, increase the risk of suicide and violent behavior in both children and adults, and increase the frequency and chronicity of depression.
An in-depth analysis of clinical trials reveals widespread underreporting of negative side effects, including suicide attempts and aggressive behavior.
There is a myth that SSRIs and related drugs treat severe depression. This comes from the trial data that shows that in people whose rating scale scores are little worse than many of us might have on a Monday morning, it is not possible to show any budge in the rating scale score.
“The message for patients with mild to moderate depression is ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake depression—whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.’”
Researchers are seeking clues in the brain for hints on who is most likely to suffer a relapse of depression, information that could help doctors decide who needs the medication long-term.
Despite our ambivalence, sales of psychiatric drugs amounted to more than seventy billion dollars in 2010. They have become yet another commodity that consumers have learned to live with or even enjoy, like S.U.V.s or Cheetos.
Yet the psychiatric-drug industry is in trouble.
The conventional wisdom is that antidepressant medications are effective and safe. However, the scientific literature shows that the conventional wisdom is flawed. While all prescription medications have side effects, antidepressant medications appear to do more harm than good as treatments for depression.
New insights into how selective serotonin reuptake inhibitors work suggest they reverse inhibited nerve regeneration and connectivity that may underlie depression.
Psychiatric medications are prescribed to treat the symptoms of mental health disorders. They can stabilize symptoms and prevent relapse. They work by affecting neurotransmitters in the brain. Serotonin is involved in mood, appetite, sensory perception, and pain pathways. Norepinephrine is part of the fight-or-flight response and regulates blood pressure and calmness. Dopamine produces feelings of pleasure when released by the brain reward system.
One in ten Americans takes an antidepressant, including almost one in four women in their 40s and 50s. Women are twice as likely to develop depression as men.
A brain scan could help objectively identify who will benefit, and who won't.
Did you know that antidepressants are commonly prescribed for things other than depression and antipsychotics and commonly prescribed for things other than psychosis?
But from this latest analysis, we can conclude something interesting. The fact that the placebo effect diminishes in the most severely depressed patients, but that the drugs continue to show the same level of efficacy, suggests that they do have some effects of their own. To me, that’s the real news from this study.
Antidepressants work. They work modestly well to treat garden-variety depression. They work better in conjunction with CBT and other psychotherapies, light therapy, and exercise. Combined treatment is best, as the overall efficacy and remission rates remain rather poor for any single treatment of depression.
In general, there are 2 major mechanisms of action for antidepressants medication: enzyme deactivation (MAOIs) and reuptake inhibition (most other antidepressants).
Each of these drugs may be known by several different names, which we have listed below under the Generic name and Trade names (UK) columns.
Our current antidepressants are thus best conceived not as medical breakthroughs but as technological breakthroughs. They are chemical tools that have allowed us early glimpses into our brains and into the biology of one of the most mysterious diseases known to humans.
If someone is not helped or reacts poorly to SSRIs or SSNRIs, they can be prescribed other antidepressants that have been on the market much longer. These drugs are generally not considered first-line because of side effects. One exception is the atypical antidepressant, bupropion (Wellbutrin), which is prescribed to 14% of patients with depression, according to data provided by IQVIA. There has also been recent interest in using ketamine, a hallucinatory drug, to treat depression.
The backlash against antidepressants results from a suspicion of medicine, and misunderstands the very nature of depression.
Peer support for tapering and withdrawal syndrome.
Atypical antidepressants are antidepressants that don’t fall under any of the 4 main classes of antidepressants. They’re most often prescribed if you’ve tried other types of antidepressants, and they didn’t work for you. But they can also be used as a first-line treatment, depending on your symptoms and whether you are experiencing other mental health conditions in addition to depression.