The Hidden Social Impact Of Coming Off Antidepressants (M)

Turbulent emotions and social shifts—what happens when people say goodbye to antidepressants.

Turbulent emotions and social shifts—what happens when people say goodbye to antidepressants.


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Antidepressants vs. Running: Which Treats Depression Better? (M)

The 16-week study gave people the choice between group running or taking antidepressants.

The 16-week study gave people the choice between group running or taking antidepressants.


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Why Antidepressants Take 28 Days To Start Working (M)

The study may partly explain how antidepressants really work — since there is little evidence for the ‘chemical imbalance’ theory.

The study may partly explain how antidepressants really work -- since there is little evidence for the 'chemical imbalance' theory.


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Antidepressants: 7 Must-Read Studies For Patients And Psychologists

Do antidepressant do more harm than good?

Do antidepressant do more harm than good?

While people are no more depressed now than they were 20 years ago, antidepressant use has tripled in this period.

Despite the surge, relatively little is known about how they work.

There is scant evidence that they ‘correct a chemical imbalance in the brain’, as drug marketers claim.

This raises many question, including:

  • Do antidepressants do more harm than good?
  • Do they really improve people’s quality of life compared with not taking them?
  • How easy or hard is it to come off them?
  • What is the best way to quit?

Below are 7 studies from the members-only section of PsyBlog that try to answer these questions, and more:

(If you are not already, find out how to become a PsyBlog member here.)

  1. Antidepressants: Pros And Cons And How They Should Be Prescribed
  2. How Antidepressants Affect Long-Term Quality Of Life
  3. How Stopping Antidepressants Affects Relapse Risk
  4. Depression NOT Caused By Low Serotonin Levels, Large Review Finds
  5. The Real Risks Of Taking Antidepressants
  6. The Best Way To Quit Antidepressants
  7. Antidepressants Kill Positive Emotions Too: Why That’s Dangerous

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Antidepressants Have This Acute And Unexpected Side-Effect

For the first few weeks antidepressants have a strange side-effect researchers are trying to tackle.

For the first few weeks antidepressants have a strange side-effect researchers are trying to tackle.

It is popularly believed that SSRIs, like Prozac and Zoloft, only produce good feelings.

In fact, in the first few weeks of treatment, common antidepressants can cause increased anxiety and fear.

Serotonin — the neurotransmitter that is boosted by SSRIs — is even linked to suicidal thinking, especially in young people.

Research, though, could provide a clue as to how the effect can be reduced.

The serotonin-activated pathways in the brains of mice that lead to anxiety have been traced.

The circuit could be crucial to how SSRIs produce short-term anxiety.

Professor Thomas L. Kash, who led the research, said:

“The hope is that we’ll be able to identify a drug that inhibits this circuit and that people could take for just the first few weeks of SSRI use to get over that hump.

More generally, this finding gives us a deeper understanding of the brain networks that drive anxiety and fear behavior in mammals.”

Having identified the crucial circuit in the brain, the researchers moved on to trying to block it.

They were able to this with a ‘CRF blocker’, but as this research was in mice, it is not clear if the same result would be seen in humans.

Professor Kash said:

“It’s logical that it would since we know SSRIs can induce anxiety in people, and the pathways in these brain regions tend to be very similar in mice and humans.”

Professor Kash said:

“Other researchers are working to develop better CRF-inhibiting compounds, so that’s one potential direction to take, but there are others.

We’re now looking at the various proteins expressed by these BNST neurons, and we’re hoping to identify a receptor that is already targeted by established drugs.

One of them might be useful for people as they start taking SSRIs.”

The study was published in the journal Nature (Marcinkiewcz et al., 2016).

Antidepressants Kill Positive Emotions Too: Why That’s Dangerous (M)

How antidepressants affect people’s ability to enjoy activities they once found pleasurable.

How antidepressants affect people's ability to enjoy activities they once found pleasurable.


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Prozac And Zoloft Worsen Anxiety: SSRI Side-Effect

SSRI antidepressants such as Prozac and Zoloft can increase anxiety in the first few weeks.

SSRI antidepressants such as Prozac and Zoloft can increase anxiety in the first few weeks.

Around 100 million people around the world take antidepressants like Prozac and Zoloft.

However, few are aware beforehand that antidepressants can worsen anxiety in the first few weeks of use.

Until recently scientists have found the side-effect mysterious.

Now, though, they have identified an anxiety circuit in the brain that responds to serotonin.

The study’s findings help underline the fact that serotonin does not just promote good feelings, despite what many think.

Professor Thomas L. Kash, who led the study, said:

“The hope is that we’ll be able to identify a drug that inhibits this circuit and that people could take for just the first few weeks of SSRI use to get over that hump.

More generally, this finding gives us a deeper understanding of the brain networks that drive anxiety and fear behavior in mammals.”

Anxiety worsened by SSRIs like Prozac And Zoloft

Studies have long suggested that serotonin can actually have negative effects on mood.

Younger people seem particularly vulnerable.

Scientists at the University of North Carolina (UNC) School of Medicine have now mapped out the pathway in the brain that is sensitive to serotonin and is linked to anxiety.

The regions of the brain are called the dorsal raphe nucleus (DRN) and the bed nucleus of the stria terminalis (BNST).

After activating these areas in mice using serotonin, the scientists observed anxiety-like behaviours.

Testing Prozac on these mice also showed that it made them more anxious.

Next the researchers hope to find a way of blocking the anxiety-inducing effects of antidepressants.

However, it will first need to be confirmed that human brains operate in a similar way to mice in this regard.

Professor Kash said:

“It’s logical that it would, since we know SSRIs can induce anxiety in people, and the pathways in these brain regions tend to be very similar in mice and humans.”

The study was published in the journal Nature (Marcinkiewcz et al., 2016).

Do Antidepressants Really Help In The Long-Term?

Study tests if antidepressants really help depressed people feel better in the long-term.

Study tests if antidepressants really help depressed people feel better in the long-term.

Over nine years, depressed people were better off if they had no treatment at all than if they took antidepressants, research finds.

In addition, depressed people that got adequate treatment without medication did better nine years later than those who got adequate treatment with medication.

It may be that taking antidepressants causes more harm than no treatment whatsoever in the long run.

These effects could be the result of many factors that others have suggested.

For example, coming off antidepressants after taking them for a time can be difficult due to withdrawal effects.

Antidepressants may also permanently change the way neurotransmitters in the brain work.

Alternatively, perhaps most of the effect of antidepressants is down to placebo.

Studies have found, for example, that the science of antidepressants is based on backward facts.

Professor Jeffrey R. Vittengl, the study’s author, writes:

“…treatment including medication may have worsened depression in the long run.

Until mechanisms of benefits and harms are better understood, these findings argue for using antidepressant medication only if short-term benefits (e.g., reducing active suicide risk) are likely to outweigh delayed consequences.”

The short-term benefits of antidepressants are well-known.

They can help people who are in crisis.

However, the studies that test the effects of antidepressants usually only follow them for a year or two.

Antidepressants don’t help much in the long-term

The study looks at how people do over 9 years.

It included data from over 15,000 people in the US.

None of them were in hospital, but around 10% had experienced a major depressive episode in a one-year period.

Around 38% of these people received no treatment for their depression.

Only 4% received adequate treatment that did not include antidepressant medication.

However, 13% received adequate treatment that included medication.

Professor Vittengl found that medication was linked to doing worse over the long run:

“This pattern suggests possible long-term iatrogenic effects of antidepressants.

For example, antidepressant medications may recruit processes that oppose and eventually overwhelm short-term benefits resulting in loss of efficacy, resistance to retreatment, paradoxical effects, and withdrawal syndromes, perhaps via disruption of homeostatic control of monoamine neurotransmitters.”

The study was published in the journal Psychotherapy and Psychosomatics (Vittengl, 2017).