If you’re suffering from major depression, antidepressant medication, used under the guidance of a mental health professional, may relieve some of your symptoms. But antidepressants aren’t a silver bullet for depression. Medication doesn’t cure the underlying problem and is rarely a long-term solution. Not only do antidepressants come with significant side effects and dangers, but recent studies have also raised questions about their effectiveness.
Learning the facts about antidepressants and weighing the benefits against the risks can help you make an i
Is depression caused by a chemical imbalance in the brain?
This information is not intended to be a substitute for medical advice. If you are taking an antidepressant, do not change your dosage without consulting your physician!
You’ve seen it in television ads, read it in newspaper articles, maybe even heard it from your doctor: depression is caused by a chemical imbalance in the brain that medication can correct. According to the chemical imbalance theory, low levels of the brain chemical serotonin lead to depression and depression medication works by bringing serotonin levels back to normal. However, the truth is that researchers know very little about how antidepressants work. There is no test that can measure the amount of serotonin in the living brain—no way to even know what a low or normal level of serotonin is, let alone show that depression medication fixes these levels.
While antidepressant drugs such as Prozac increase serotonin levels in the brain, this doesn’t mean that depression is caused by a serotonin shortage. After all, aspirin may cure a headache, but it doesn’t mean that headaches are caused by an aspirin deficiency. Furthermore, many studies contradict the chemical imbalance theory of depression. Experiments have shown that lowering people’s serotonin levels doesn’t always lower mood, nor does it worsen symptoms in people who are already depressed. And while antidepressants raise serotonin levels within hours, it takes weeks before medication is able to relieve depression. If low serotonin caused depression, there wouldn’t be this antidepressant medication lag.
When it comes to depression, serotonin doesn’t tell the whole story
Experts agree that depression involves much more than just “bad” brain chemistry. Serotonin is just one of many factors that may play a role in the disorder. New research points to other biological contributors to depression, including inflammation, elevated stress hormones, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. And these are just the biological causes of depression. Social and psychological factors—such as loneliness, lack of exercise, poor diet, and low self-esteem—also play an enormous role in depression.
Researchers agree that when depression is severe, medication can be helpful—even life–saving. However, research shows that antidepressants fall short for many people. A major government study released in 2006 showed that fewer than 50 percent of people become symptom-free on antidepressants, even after trying two different medications. Furthermore, many who do respond to medication slip back into major depression within a short while, despite sticking with drug treatment.
Other studies show that the benefits of depression medication have been exaggerated, with some researchers concluding that, when it comes to mild to moderate depression, antidepressants are only slightly more effective than placebos.
If you have severe depression that’s interfering with your ability to function, medication may be right for you. However, many people use antidepressants when therapy, exercise, or self-help strategies would work just as well or better—minus the side effects. Therapy can also help you get to the bottom of your underlying issues and develop the tools to beat depression for good.
There are many different types of drugs used in the treatment of depression, including selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Side effects are common in all antidepressants. For many people, the side effects are serious enough to make them stop taking the medication.
Side effects of SSRIs (selective serotonin reuptake inhibitors)
The most widely prescribed antidepressants come from a class of medications known as selective serotonin reuptake inhibitors (SSRIs).
Common side effects of
SSRI antidepressants:
SSRI antidepressants:
- Nausea
- Insomnia
- Anxiety
- Restlessness
- Decreased sex drive
- Dizziness
- Weight gain or loss
- Tremors
- Sweating
- Sleepiness
- Fatigue
- Dry mouth
- Diarrhea
- Constipation
- Headaches
The SSRIs include:
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
The SSRIs act on a chemical in the brain called serotonin. Serotonin helps regulate mood, but it also plays a role in digestion, pain, sleep, mental clarity, and other bodily functions. As a result, the SSRI antidepressants cause a wide range of side effects.
Common side effects include sexual problems, drowsiness, sleep difficulties, and nausea. While some side effects go away after the first few weeks of drug treatment, others persist and may even get worse.
In adults over the age of 65, SSRIs pose an additional concern. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults. The SSRIs can also cause serious withdrawal symptoms if you stop taking them abruptly.
Other antidepressant drug risk factors
Anyone who takes antidepressants can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:
- People over 65. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults.
- Pregnant women. The use of SSRI's late in pregnancy may lead to short-term withdrawal symptoms in newborns after delivery. Typical symptoms include tremor, restlessness, mild respiratory problems, and weak cry.
- Teens and adolescents. The U.S. Food and Drug Administration requires that all depression medications include a warning label about the increased risk of suicide in children and young adults.
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