Yes, people can be on antidepressants long-term, even for life, especially with severe or recurrent depression, though many can stop safely after a period, with the decision depending on individual circumstances, symptom history, and doctor consultation, as some face relapse risk, while others find indefinite use best for managing chronic conditions or preventing severe episodes. While medication helps manage symptoms for some, the goal is often symptom remission, but lifelong treatment might be needed for symptom management if remission isn't possible.
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.
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 you take antidepressants for a long time (several years or more) you may be at an increased risk of type 2 diabetes. This is more likely if you are over the age of 30 and are taking either SSRI or tricyclic antidepressants.
In time, the brain returns to a normal state after stopping antidepressants. If depressive symptoms do arise and gradually worsen, it's best to consult a psychiatrist or doctor if they don't improve within a few weeks or if they become severe.
Suicidal feelings
There is a possibility that taking an antidepressant could make you feel suicidal. It may happen even if you didn't experience suicidal feelings before. This side effect is mainly with SSRI antidepressants. But it is a risk with all antidepressants.
Most people can gradually stop taking their antidepressants over a few weeks or months, by taking smaller doses and then stopping completely. This is called 'tapering'. This can reduce the risk of you getting withdrawal symptoms, or mean that any symptoms you have are less severe.
Avoid driving or operating machinery. Avoid caffeine, tobacco and alcohol. Drink plenty of fluids. Take your antidepressant at bedtime if your doctor approves.
SSRIs are the most commonly prescribed type of antidepressant. This is because they're effective and well-tolerated with mild side effects for many people. With many SSRIs available as generic products, they also tend to be more affordable. SNRIs and bupropion are also common choices for similar reasons.
Some antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can cause short-term memory problems in certain individuals. Research shows that many people experience these side effects only while taking the medication, and the memory issues often go away when the treatment is adjusted or stopped.
Being on medication, particularly if the dose is too high, can dull your senses, making it difficult to think clearly or concentrate effectively. Getting off of antidepressants or reducing your dose can help you feel sharper and more alert in both your personal life as well as in your professional life.
The typical length of treatment is 6 to 12 months, but some people may stay on antidepressants for much longer.
Fluoxetine Capsules or Tablets (Depression/Mood Disorders) Fluoxetine is a medication that treats depression, anxiety, obsessive-compulsive disorder and eating disorders. It increases the amount of the hormone serotonin in your brain to help regulate your mood. The brand name of this medication is Prozac®.
Selective serotonin reuptake inhibitors (SSRIs).
Health care providers often start by prescribing an SSRI . These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants.
There's good news for people with severe treatment-resistant depression: Esketamine is a groundbreaking therapy that can provide relief from major depression within hours.
Chocolate, red wine, and antidepressants. Along with many beers, aged cheeses, processed meats, and smoked fish, chocolate and red wine contain an amino acid derivative called tyramine. Mixing tyramine with monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine can cause unsafe spikes in blood pressure.
Sarris et al. found that omega-3 significantly reduces depressive symptom when added to antidepressants. Omega-3 augments antidepressant efficacy by promoting modulation, reuptake, degradation, and synthesis of norepinephrine, dopamine, and serotonin—all of which are targeted in depression treatment.
If you eat lots of processed meat, fried food, refined cereals, candy, pastries, and high-fat dairy products, you're more likely to be anxious and depressed. A diet full of whole fiber-rich grains, fruits, vegetables, and fish can help keep you on a more even keel.
After discontinuing antidepressants, the brain undergoes a readjustment period as neurotransmitter levels and receptor sensitivity gradually return to their pre-treatment state.
The hardest antidepressants to come off are typically those with short half-lives, meaning they leave the body quickly, leading to more intense withdrawal (discontinuation syndrome); prominent examples include Paroxetine (Paxil), Venlafaxine (Effexor), and Fluvoxamine (Luvox), with Venlafaxine often cited for particularly severe withdrawal. In contrast, Fluoxetine (Prozac), with its long half-life, is generally considered the easiest to stop due to its gradual exit from the body.
What are the alternatives to antidepressants?
Antidepressants are not usually recommended for children and young people under 18. In rare cases, they can cause thoughts about suicide and self-harm in this age group. There are concerns that some antidepressants can also affect brain development in children and young people.
Antidepressants are thought to work by increasing neurotransmitters like serotonin and noradrenaline. These are chemicals in the brain which can improve mood and emotion. But this process isn't fully understood. Increasing levels of neurotransmitters can also disrupt pain signals sent by nerves.
Long-Term Treatment – For those with severe, recurrent depression or treatment-resistant depression, antidepressants may be used for several years or indefinitely. The decision to remain on long-term medication depends on how well the medication controls symptoms and the patient's mental health history.
One of the widely-reported side effects of SSRIs is 'blunting', where patients report feeling emotionally dull and no longer finding things as pleasurable as they used to. Between 40-60% of patients taking SSRIs are believed to experience this side effect.