Long-term use of psychiatric drugs may cause permanent brain damage, which has been most clearly documented for antipsychotics [20, 21]. Animal studies have shown that prenatal exposure to psychiatric drugs can lead to altered physiology and behaviour later in life [22, 23].
Some believe it is unlikely that antidepressants cause any permanent changes to brain chemistry in the long term. The evidence seems to indicate that these medications cause brain changes that only persist while the medication is being taken or in the weeks following withdrawal.
The report points out that antidepressant discontinuation syndrome (ADS) can manifest itself as flulike symptoms, insomnia, nausea, imbalance, sensory disturbances often described as electric shocks or “brain zaps,” and hyperarousal.
In studies on adults with moderate or severe depression, 40–60% report improvements within 6–8 weeks. Those who wish to come off antidepressants because they feel better should ideally wait for at least 6–9 months after complete symptom remission before stopping their medication.
Do I have to take antidepressants forever is a question that some ask as they struggle with depression. This is one of the more common myths associated with the condition. You do not need to take antidepressants forever nor do you need to get a prescription from a counselor or therapist.
And, since depression is often a long-term disease, people needs long-term treatments for it. “There are clear differences between a healthy brain and a depressed brain,” Dr. Katz says. “And the exciting thing is, when you treat that depression effectively, the brain goes back to looking like a healthy brain.”
Clinicians usually recommend that people continue taking antidepressants for about six months after they begin feeling better. Although it is tempting to stop taking the medication as soon as you feel better, abruptly stopping will greatly increase your risk of relapse.
The researchers found that, once pre-existing risk factors had been taken into account, long-term antidepressant use was associated with an increased risk of coronary heart disease, and an increased risk of death from cardiovascular disease and from any cause.
For most people, antidepressants are the main cause of emotional blunting. In most cases, feelings of numbness go away when you stop taking the antidepressant that is causing you to feel this way. If you feel emotionally numb, it's important to tell your doctor.
Tranquilizers, antidepressants, some blood pressure drugs, and other medications can affect memory, usually by causing sedation or confusion. That can make it difficult to pay close attention to new things. Talk to your doctor or pharmacist if you suspect that a new medication is taking the edge off your memory.
Depression is correlated with atrophy of neurons in the cortical and limbic brain regions that control mood and emotion. Antidepressant therapy can exhibit effects on neuroplasticity and reverse the neuroanatomical changes found in depressed patients.
Even if you experience brain zaps after you stop taking antidepressants, the problem shouldn't last too long. While some patients have reported experiencing brain zaps for years, Dr. Barnett explained, "I would say [for] the vast majority of people, they typically resolve within a month."
When treatment is eventually stopped, there will be fewer receptors than before and a short-term deficiency of serotonin activity. The body will typically correct this, but there will be a period of adjustment until the system normalizes.
Generally speaking, SSRIs and SNRIs are well-tolerated by most people. They also have good evidence supporting their long-term safety. Older antidepressants, like TCAs and MAOIs, tend to cause more side effects.
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.
The good news is these cognitive symptoms tend to improve with treatment. The bad news is they usually don't disappear. In one study, patients suffering from depression reported cognitive problems 94 percent of the time; that percentage decreased to 44 percent after most symptoms of depression had abated.
Pharmacological (e.g., antidepressant medications) and nonpharmacological interventions (cognitive-behavioral therapy, exercise) may reverse stress-induced damage in the brain.
Brain fog can be caused by anxiety, depression, and other medical conditions. Prolonged cognitive decline can create difficulties with daily functioning, working, and schooling. Hormonal changes and brain inflammation can increase brain fog symptoms.
The NICE guidelines for treating depression recommend that doctors offer you a type of talking therapy or counselling. This will often be cognitive behavioural therapy (CBT). Therapy may be offered instead of antidepressants, or in addition to them.
Around 60% of people respond by about two months to the drugs with about a 50% reduction in their symptoms - an improvement in mood, better sleep and so on. But, he said, “about 80% of people stop antidepressants within a month”.
Taking medicine for your depression can help you get your life back to normal, especially if you also get counselling. But if your symptoms are mild, lifestyle changes and counselling may be all you need. You don't need to be ashamed about taking antidepressants.