Our review supports the conclusion that antidepressants generally do more harm than good by disrupting a number of adaptive processes regulated by serotonin. However, there may be specific conditions for which their use is warranted (e.g., cancer, recovery from stroke).
Antidepressants can make you feel worse at first
Starting an antidepressant can't actually make your depression worse. But it can cause side effects that are very similar to depression. Antidepressants can make you feel tired, cause concentration problems, and lead to changes in sleep and appetite.
In observational studies, antidepressants have been linked to increased risk of dementia ; they may induce depressogenic effects; and the prevalence of treatment-resistant depression appears to be increasing .
Those who had used antidepressants for >3 years reported more severe side effects, including “weight gain”, “addiction”, “feeling not like myself ”, “withdrawal symptoms”, and “suicidality”, than those who had been on antidepressants for ≤2 years.
If the symptoms develop later or gradually, they may constitute a relapse of the depression. Ultimately, these withdrawal symptoms will improve with time, but they can be unpleasant for days and possibly even weeks. In time, the brain readjusts and people should experience a return to their normal state.
It may be hard to believe that antidepressants can cause depression, but it could be true. The very reason you take depression medication can sometimes make symptoms worse. Depression is a mood disorder that can cause feelings of sadness and lack of energy, among other symptoms.
Some patients taking SSRIs develop insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhea. These problems are usually temporary or mild or both.
Exercise. Research suggests that regular exercise may be a more effective treatment for mild depression than antidepressants. Exercise helps boost levels of chemicals called serotonin and dopamine in the brain, which can lift your mood.
For people with chronic or severe depression, medication may be needed on a long-term basis. In these cases, antidepressants are often taken indefinitely. That is, in part, because depression is not an illness that can be cured.
Quitting an antidepressant suddenly may cause symptoms within a day or two, such as: Anxiety. Insomnia or vivid dreams. Headaches.
People who used antidepressants had a 14% higher risk of heart attacks and strokes and a 33% greater risk of death, according to findings in a meta-analysis of 17 studies that was published in 2017 in the journal Psychotherapy and Psychosomatics.
As it is with any medication, antidepressants can have side effects, including the possibility of what is termed “emotional blunting.” According to studies, nearly half of people taking antidepressants at some point experience emotional blunting from antidepressants.
In other words, antidepressants are effective against chronic, moderate and severe depression. They don't help in mild depression. The various antidepressants have been compared in many studies. Overall, the commonly used tricyclic antidepressants (SSRIs and SNRIs) were found to be equally effective.
Although they're often used to treat anxiety, antidepressants can potentially cause anxiety, especially when people begin taking them for depression. 1 Using various strategies, it is possible to get a better handle on these anxiety symptoms.
Vitamin B-3 and Vitamin B-9 can help people with depression because B vitamins help the brain manage moods. Vitamin D, melatonin and St. John's Wort are recommended for seasonal depression. Omega-3 fatty acids, magnesium and vitamin C may also help with depression.
Natural antidepressants include SAM-e, St John's Wort, and omega-3-fatty acids, among others. If a person thinks they have symptoms of depression, they should speak to a doctor before trying any natural antidepressants.
Many people with mild to moderate depression, where sleep is adequate, can recover from depression with talk therapy and adjunctive strategies such as exercise, improved nutrition, mindfulness techniques, sunlight or light therapy, support from friends, family or a support group, and lifestyle changes.
Some people are bothered by the idea that they might not be able to beat depression without medication. They think of antidepressants as a kind of crutch, and think they would see themselves as being weak and helpless if they had to rely on them. Others question whether they really need the medication to feel better.
It's thought that antidepressants work by increasing neurotransmitters. These are chemicals in the brain like serotonin and noradrenaline. They can improve mood and emotion, although this process isn't fully understood. Increasing levels of neurotransmitters can also disrupt pain signals sent by nerves.
Although this is beneficial for someone who's depressed, for someone who does not have depression, taking antidepressant medication can cause serotonin to build up in the body, resulting in serotonin syndrome. When serotonin levels are too high, the person may experience symptoms like: Agitation or restlessness.
Take your time.
You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off it.
Brain SPECT imaging studies show that some psychiatric medications—particularly benzodiazepines, sleeping medications, and pain pills like hydrocodone and oxycodone—have a negative impact on the brain. SPECT scans reveal that they suppress brain function in many people.
Do Antidepressants Permanently Alter Brain Chemistry? Antidepressants are designed to alter brain chemistry to alleviate symptoms—thus, they do so while you are taking them. They may promote potentially beneficial structural brain changes, as well.
It's usually recommended that a course of antidepressants continues for at least 6 months after you feel better, to prevent your condition recurring when you stop. Some people with recurrent illness are advised to carry on taking medicine indefinitely.