What Are the Negative Effects of Antidepressants? | Chris Kresser
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Negative Effects of Antidepressants: Is There a Dark Side?

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Reviewed by Vanessa Wong, MD

Here’s a stunning fact about how common antidepressant drugs are: One in eight Americans, ages 12 and older, take an antidepressant, and the numbers seem to be on the rise. (1) These pharmaceuticals are prescribed not only for depression, but also for anxiety, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and even for off-label uses. (2)

negative effects of antidepressants
Antidepressants can cause negative side effects, and they may not always be effective at alleviating depression. iStock/kieferpix

Despite the widespread use of these prescription drugs (globally, this is a $14 billion business), antidepressants can have potentially negative effects on your health. (3) While they are life-saving for some, for others these medications can trigger side effects and symptoms that can disrupt normal routines, or they may be ineffective at alleviating depression. Keep reading to find out more about potential issues with antidepressants and learn how the Functional Medicine approach to psychiatry can help.

Antidepressants are life-saving for some; for others, they can cause negative side effects or fail to alleviate symptoms of depression. Check out this article for an updated look at antidepressants. #functionalmedicine #wellness #chriskresser

What Really Causes Depression (and What’s Wrong with the Chemical Imbalance Theory)?

Conventional medicine and the pharmaceutical companies have long maintained that depression is caused by an imbalance in brain chemicals. That’s why antidepressant meds are formulated to manipulate the levels of neurotransmitters in the brain. There are several classes of these drugs, including:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants
  • Monoamine oxidase inhibitors (MAOIs)
  • Atypical antidepressants

However, depression isn’t adequately characterized by “low serotonin” or “low epinephrine.” In fact, only about 25 percent of people diagnosed with depression have abnormally low levels of these neurotransmitters, while some have very high levels of them. (4) Although these facts don’t rule out chemical imbalance as a factor in depression, they do suggest that it’s not the only one. 

In reality, depression may be a symptom of one or more underlying issues. I discussed in a previous article how inflammation may be at the root of many cases of depression, (5) but other causes of mental health issues can include:

Any treatment plan that fails to address these underlying causes isn’t likely to be effective for someone who is suffering from depression. That’s why it’s so important to move beyond the default chemical imbalance explanation and understand what’s really driving the condition.

Antidepressants May Not Be as Effective as You Might Think

Important disclaimer: If you are currently taking an antidepressant, do not stop abruptly and do not taper off the meds without the guidance and support of your healthcare providers. I’ll discuss more about how to taper off of medication below, but it is crucial that you do not undertake any steps without consulting closely with your doctor.

Given the hype surrounding antidepressants, you may be surprised to learn initial treatment is effective at mitigating symptoms only about half the time. (12) Even after trying several treatments, up to 30 percent of those with depression never achieve remission. (13)

While a large meta-analysis published in 2018 in the prestigious journal, The Lancet, states that all antidepressants perform significantly better than placebo, (14) critics have pointed out that these differences are small and not clinically relevant. (15) The majority of high-quality research studies have shown that SSRIs have no benefit over placebo for mild and moderate depression. (16, 17, 18, 19)

One Problem: Clinical Trial Groups Are Not Representative of Real-World People

One major issue with the research on antidepressant efficacy is the selection process of clinical trial group participants. Because the selection process is not standardized or subject to any federal guidelines, patients with milder forms of depression, chronic depression, or other psychiatric or medical conditions in addition to short-term depression are excluded from studies. (20) In some cases, less than 20 percent of people who apply to be part of an antidepressant efficacy trial do not meet the requirements, meaning that study groups are not representative of a real-world population. (21)

Here is why such exclusions matter: In a normal, clinical setting, many patients with depression have other illnesses, such as diabetes, chronic fatigue syndrome, or irritable bowel syndrome. It’s not unusual for them to have anxiety and insomnia, as well. In fact, it’s quite possible that a person with depression might be suffering from other conditions that are either contributing to or caused by their illness. 

One study looked at the efficacy of antidepressants in those who did not meet phase III inclusion criteria (phase III clinical trials include and exclude participants based on stringent criteria that would actually exclude the majority of people who take the drugs in real life). Among participants who would not qualify under phase III criteria, researchers found that their outcomes were, unsurprisingly, much worse than those who did qualify for the trials. (22)

It’s important to note the wide variability in individual response to antidepressants. SSRIs and other antidepressants can be game changers for many people, but the reported average response rate in clinical trials won’t shed any light on how one person reacts to a medication versus another individual. However, what’s clear is that these drugs are not a panacea for global mental illness, and that this is a complex topic.

Two Drug-Free Treatments That Can Be as Effective as or More Effective Than Antidepressants

Another important detail to note is that non-pharmaceutical treatments can be as effective or even more effective than antidepressants. Evidence shows promising results for psychotherapy and exercise as effective interventions.

1. Psychotherapy

Substantial evidence demonstrates that psychotherapies, like cognitive-behavioral therapy (CBT), are just as effective as antidepressants for long-term maintenance, for first-line treatment, and even for treatment-resistant depression. (23, 24, 25, 26, 27) In some cases, psychotherapy has actually outperformed antidepressants or added additional benefit to medication. (28, 29, 30)

CBT also might reduce the risk of depression relapse, which is very common. (31, 32) If you’ve had depression once, your risk of developing depression again is about 50 percent. If you’ve had two episodes, you’re 80 percent likely to relapse. (33, 34)

CBT may offer unique skills for preventing relapse. As one review from 2017 states: (35)

“Residual symptoms and relapse risk would decrease if patients in partial or full remission can learn, first, to be more aware of negative thoughts and feelings at times of potential relapse/recurrence, and, second, to respond to those thoughts and feelings in ways that allow them to disengage from ruminative depressive processing.”

2. Exercise

Exercise may be powerful for preventing and alleviating depression. Exercise has mood-boosting effects and can decrease inflammation, improve vagal tone, and modulate neurotransmitters, all of which can help decrease depressive symptoms. (36, 37)

Although not all studies are in agreement, (38) many clinical trials and meta-analyses have determined that exercise can be helpful as an adjunct to antidepressants, or even by itself. (39, 40, 41, 42) Of note, people who already have depression may not have enough motivation and energy to start an exercise regimen, especially on their own. However, perhaps surprisingly, drop-out rates among those who participate in exercise groups generally aren’t higher than drop-out rates for other types of treatments. (43) As exercise boasts numerous health benefits beyond mood improvement, it’s worth considering.

Negative Side Effects of Antidepressants

Side effects are quite common for people who take antidepressants. More than half of those beginning an antidepressant have one of the more common side effects: (44)

  • Nausea
  • Decreased libido (very common, especially among men: up to 40 percent taking antidepressants experience this side effect)
  • Tiredness and/or insomnia
  • Dry mouth
  • Constipation
  • Dizziness
  • Anxiety
  • Weight gain
  • Sweating

While some of the side effects listed above are manageable and won’t cause serious or long-term health complications, others, such as weight gain or anxiety, may—especially if they persist.

Jitteriness Syndrome, Anxiety, and Akathisia

In the first few months of beginning an antidepressant, “jitteriness syndrome” and anxiety are common side effects. Up to one in four people will experience jitteriness syndrome, and studies have reported a wide range of anxiety incidence related to beginning antidepressants, from 4 to 65 percent. (45) Frequently, those who show anxiety are then prescribed another medication, like a benzodiazepine, with its own risks.

In rare cases, a particular type of severe agitation called akathisia may occur. (46) Akathisia has been shown to increase aggression, violent behavior, and suicide.

Suicide

In 2004, the U.S. Food and Drug Administration (FDA) issued a black-box warning that antidepressants may increase suicidal ideation and attempts in children. A couple years later, they extended the warning to include those up to age 25 and also stated that patients of all ages should be monitored for suicidal ideation, plans, and/or attempts. (47)

The studies surrounding suicide and antidepressants are mixed. Some studies have shown higher suicidal behavior in adults and children (48, 49, 50, 51), while others haven’t. (52, 53) Published FDA investigations state that those under age 25 taking antidepressants have about twice the rate of suicidal behavior compared to those taking placebo. (54, 55) SSRI users might be more at risk than users of other classes of antidepressants, and suicide risk seems highest in the first month starting and stopping the meds. (59)

In general, post-2000 studies show lower rates of suicide among antidepressant trials, despite the fact that suicides have increased since then. (60) Some claim that the earlier studies were flawed or that suicidal ideation is better monitored during trials, but others say that the lower rates in recent studies are due to “enhanced screening procedures and effective exclusion of suicidal patients in clinical trials for depression.” (61) To me, that explanation is far from reassuring. The fact remains that individuals who are actually suicidal will be prescribed antidepressants, but robust studies looking at the efficacy of meds in this population just don’t exist.

Other Side Effects

Other side effects can occur with antidepressants, though some still aren’t well-characterized and many are rare: (62, 63, 64, 65)

  • Numbness or anti-motivational syndrome
  • Interactions with other drugs (ibuprofen and SSRIs don’t mix, for example) (66)
  • Depletion of beneficial gut bacteria (antidepressants have antimicrobial properties)
  • Osteoporosis
  • Cardiovascular issues
  • Personality changes
  • Gastrointestinal symptoms including diarrhea, gastrointestinal bleeding, and dyspepsia (for which antacids may be prescribed)
  • Birth defects
  • Liver injury (very rare)
As with any medication, adequate risks/benefits must be taken into consideration. Even when experiencing side effects, stopping antidepressants needs to be done under the guidance of a healthcare provider.

Weaning off Antidepressants Is Difficult

Antidepressants were intended for short-term treatment of depression, but in actuality, people are taking them continuously for years on end. Half of American antidepressant users have been on them for more than five years, though long-term data on effectiveness and safety are sparse. (67) A review of 14 studies on long-term depression treatment indicated that patients who were treated with drugs fared no better than those who weren’t treated with drugs long-term. (68) In another study of people with depression and on antidepressants for over two years, the patients who did not take drugs after remission had a lower rate of remission compared to those who did. (69)

A big reason that people stay on antidepressants long-term is simply this: Withdrawal symptoms make it very difficult to stop. In a systematic review of patients trying to wean off antidepressants, 46 percent of the participants described withdrawal effects as “severe.” (70) Common withdrawal symptoms include:

  • Dizziness
  • Fatigue
  • Irritability
  • Confusion
  • Insomnia
  • Relapse of depression

Slowly Tapering off Antidepressants Is More Successful Than Current Recommendations

One major problem is that patients are weaning off antidepressants too quickly—often at their doctors’ orders. The prevailing recommendation is to wean off completely in a period of two to four weeks. (71) However, evidence demonstrates that decreasing the dose over a much longer period of time results in much lower rates of side effects and results in more consistent levels of neurotransmitters, as imaged by positron emission tomography scans. (72) Several studies have shown the benefits of tapering more slowly (73, 74, 75) including one study that found that patients who slowly came off an SSRI over an average of 38 weeks had only a 6 percent chance of withdrawal syndrome, compared to a 78 percent chance in the group who stopped quickly. (75)

Tapering slowly may take longer, but it’s much more likely to be effective. (76)

The Functional Psychiatry Solution

Do antidepressants have a place in treating depression? As I said above, for some people, they can be game changers. But they don’t work for everyone, and they will not address any underlying issues that are causing or contributing to depressive symptoms.

A better approach to depression and other mental health issues is the functional psychiatry solution, which treats the root cause of a disorder rather than masking symptoms with prescription drugs.

Using a holistic approach, a functional psychiatry approach to depression may involve interventions such as:

  • Metabolic testing
  • Psychotherapy
  • Dietary interventions
  • Stress management
  • And more

By addressing the true underlying causes of depression, the functional psychiatry approach can improve long-term outcomes for people with depression, giving them relief from their symptoms without the addition of any negative effects of antidepressants. 

666 Comments

Join the conversation

  1. It has been two years since I stopped taking SSRIs/SNRIs. I still have not had a full night sleep in all that time, average five hours. As a result in the past year I have now developed a dependency on benzos and the withdrawal is hell, and it will take me one full year to go off them if i even can. As a result of going off antidepressants I had a manic episode and was wrongly diagnosed bipolar. I’ve been suicidal for over a year now because of the torture my body and mind has been under thanks to psychiatrists tossing me around on different meds. I don’t know if I’ll ever recover. I can’t feel happiness anymore, everything is just flat. My body is in shambles. Here is the kicker. I was prescribed them in middle school because I was having trouble making new friends.

    Antidepressants do not fix chemical imbalances, they cause chemical imbalances.

    • I would agree that anti-depressants cause chemical imbalances. I won’t go into all the details of my own history with them, but I ended with Lexapro, which I took for two and a half years, though the last six months I spent tapering off slowly, once I’d found a tapering schedule slow enough to avoid the worst of the withdrawal symptoms.
      That was a little over five years ago. In December of 2008, I thought I was finally free of Lexapro and of all the antidepressants I’d taken (however briefly), which include Effexor XR, Zoloft and Celexa, as well as the aforementioned Lexapro.
      Five years later, though, I still get strange sensations in my head followed by an intense and overwhelming need to cry–about nothing, or at least nothing specific. Strange neurological symptoms come and go every time I come down with a fever.
      My husband thinks I’m depressed, and the neurologist chalked everything up to that, too, though I’m not suicidal and never have been. I don’t want to die. What helped me to get off anti-depressants for good was anger, which, for me, was stronger than the apathy caused by the Lexapro.
      I can understand why some get suicidal, though, while taking these drugs. They made it a lot easier to believe things that might have pushed me over the edge, if I hadn’t been angry enough to fight back.
      Anger has a dark side, too, of course. But not one that any drug can treat. I believe the same is true of genuine depression and anxiety. Drugs only make it hard to get to the bottom of what’s causing the depression. It’s like a fireman who goes into a burning building with people trapped in it, turns off the fire alarm and then walks away, saying, “Problem solved.”
      I don’t know if you experienced the same thing while taking anti-depressants, but I felt as though I were being slowly erased, and that the drug itself was saying, “What I’m erasing–what I’m taking away from you–isn’t worth saving, anyway. You aren’t worth saving.” Maybe I’m just projecting messages from other sources, but those words were never easier to believe than when I was taking Lexapro.
      I knew even then, though, that it was a lie. Someone knows we’re worth saving.

  2. SSRI medicine is trouble. Before you take it get a written guarantee from the Doctor you won’t do anything stupid.
    These bloody things are trouble.

  3. Momster and Defiaz,

    I can completely empathize with both of your stories as my experience has been much the same. Im a 51 year old American male, long-time, happily married father of two wonderful, healthy teens (boy and girl). Was first prescribed anti D’s 30 years ago to help remedy a paralyzing, incapacitating depression resulting from the ending of a long-term (6 years) relationship, my first “real” love, although as I subsequently have realized, a deeply dependent, ultimately quite unhealthy encounter. Alas, I was very young; we live, grow, and learn, and hopefully actualize and improve with age and experience.

    Unfortunately today, after 30 years on and off numerous psych meds (anti D’s, mostly Effexor and some SSRIs, several “mood stabilizers”, stimulants, and some others), I find myself cognitively very diminished, disabled from working, with horrifically poor recall memory spanning the entire three decades I was “medicated” for what has been a rather chronic, recurring series of depressions, brief recoveries and relapses. I feel I was duped by the largely uninformed psych MD community. I’m neither bitter nor angry, just extraordinarily challenged simply trying to function somewhat productively in my current role as father and house husband. I too was once a very sharp, highly educated, motivated and articulate professional (banking and finance) with a rewarding career where I felt valuable, productive, and was a caring colleague and mentor to many. Sadly, over the past eight years, my mental abilities, judgement, reliable motivation and energy, and recall memory have all rather steadily and sharply diminished leaving me frustrated, increasingly apathetic, definitely un-employable, with a virtual inability to experience or feel any real joy.

    Finally awakening to the developing truth that it has been the drugs, and not some underlying illness or “chemical imbalance” that perpetuated and worsened my mood instability and cognitive decline, I began slowly weaning myself from all psychotropic agents about six months ago (four drugs at the time), and am now only taking a small (25 mg) dose of Effexor. I desperately hope to be off this last remnant within a couple of weeks. As everyone here who has withdrawn from these chemicals can attest, my withdrawal over the preceding six months or so has been horrific: wild mood swings, extreme lethargy, periods of irrational anger, debilitating depression, chronic insomnia and/or sleep interruptions, apathy, days spent unshowered, incapacitated in bed, occasional suicidal ruminations, etc. Essentially, symptoms that resemble extreme depression, yet this time, I finally understand, this isnt the re-emergence of illness – it’s simply my brain and body’s trying to recover and heal itself from the damage brought on by chronic administration of virtually toxic chemicals over many years.

    As we are all “seekers” and pursuers of knowlege regarding our mental health, I now spend time researching what, if anything, I might do to try to heal my brain and salvage what remains or enhance what I might restore.

    Best to everyone who has taken time to post here.

    • Thanks for your comment, Craig. I hope you can recover your former self. I am continuing my quest to understand and resist the effects of sugar and I am finding some interesting things. I suspect yeast overgrowth has played a role in all of the things I’ve experienced. You might find it interesting to read about this — there are lots of useful websites that summarize the medical literature pretty well and Chris K has some other posts on it too. If the pharmacological industry has something to answer for, it seems likely it’ll be minor in comparison to what the food industry has known — and suppressed — for 40 years. I see more and more in the mainstream media about the effects on human physiology of increasing sugar consumption in a single generation by 3 or 4 fold and these effects were foretold in 1971 to industry insiders! CBC did a great mini-documetary on this that you can find on the web. It’s shocking, but also inspiring. It’s heartening how quickly one’s body responds to reduced sugar consumption. I don’t think it’s too late to turn things around even with years of ‘abuse,’ and it’s certainly not too late to help our kids. Good luck!

    • Craig, and all others,
      I could hug you if I could reach you. This is my story almost exactly. I was a highly trained medical professional who absolutely loved my job. Several years of ER and ICU work led me to being trained as a medevac helicopter flight nurse with field surgeon skills. As you can imagine, we were constantly practicing and maintaining our medical skills as we never knew what we would be called to respond to. I loved, loved, loved my job and felt like my life was accomplishing something meaningful. I also have 3 wonderful intelligent, and loving adult children and a whole passel of grand kids. My life has not been all peaches and cream and I have had my full share of bumps in the road. About 8 yrs ago in my early 50s, the job, the bumps, menopause and a few medical problems all caught up with me and I had a “breakdown”. One of my daughters found me curled up on the sofa after 3 days of not sleeping, eating, or drinking. I was tachycardic, dehydrated etc. They took me for help and I ended up on meds. After rotating through the system, and a number of drugs, for several years, I ended up on Lexapro and Klonopin. I was better in some ways, and was functional and could work, so I thought all was well. Began having increasing pain in joints and felt all foggy and weepy. For the first time I thought of ending it all but couldn’t do that to my family. Got worse and worse, and my co workers covered for my short comings. I was having cognitive issues and my balance and agility were failing. I finally gave up the battle 2 years ago, thinking that I was too old, and retired early before I lost what was left of my dignity. Scared to death to try another job as I didn’t trust myself physically or mentally. Always in a fog. Couldn’t remember even the most mundane things. After 1 yr of getting worse, ( Anger, weeping, scared of riding in a car, anxiety over everything, burning in my throat and chest, mad, mad, mad at God, and many others) I started to try to figure all this out. Being the highly educated medical professional that I am you would think that I would have thought of this before. Duh. This stuff screws with your most basic instincts. None of my docs helped. I had one ortho doc tell me that I was a walkie/ talkie and should get back to work. I forgot to mention that my unsteady gate led me to fall down a stairway and I had some orthopedic injuries that I neglected to get treated for a few weeks. My back mostly. I had a pain management doc write in my chart that I was faking my discomfort. Well I showed them. I just up and grew a tumor in my L/S spine. Thank God it is benign, but getting worse. Prob surgery soon. But any way, this affirmation that I did have something wrong with me gave me the courage to decide that I could come off these drugs. It has been 2+ months of SSRI free after 5 month taper. Taper wasn”t too bad but wowsie after the last pill fragment. I am now over the worst of all that, but I, like others have what I call leftover stuff. Like you, my intelligence quotient has declined by a mile. I remain timid, angry, weepy, and somewhat agoraphobic. My sleep sucks without chemical help. I carry the diagnostic labels of A/D and PTSD because of the horrific things I saw and did during my 35 yr history of nursing. I guess you can only see so many hundred people die before it kicks your ass. Any way, this all relates to your story because I am very resentful of the fact that I still have all this knowledge and experience inside me to help people with and a few more years in which to do it and this poison has robbed me of that ability. I am proud of the fact that I got off the Lexapro finally, and now I am working on the Klonopin. I am now 61 yrs old and some days I feel like 100. I honestly don’t know how young folks with family and jobs and kids are able to overcome this. My most humble praise to those that are in that position. Even though I am still mad at God, I still talk to him and ask for his help daily and I will include all of you in my prayers. One day, no, one minute at a time.

  4. Hello, I very much enjoyed this post. What was the date it was posted? I would like to quote you in research assignment I am doing but I cannot find the date this was posted.

  5. I have been suffering from anxiety and depression for the past six years. My first experience came out of nowhere in the middle of an April, but now it occurs every time I go back to work after summer and winter break. (I am a teacher). It first starts with anxiety which causes me to wake up early in the morning and not being able to go back to sleep. It soon gets so frustrating that it turns into full on depression/helplessness. I was orginally on citalopram and it kept reoccurring s then I switched to venlafaxine. I was on 75mg and now I’m on 150mg. Currently the anxiety/depression after returning from winter break is worse than it has ever been and I don’t know what to do. I have done counseling and all that, but it keeps coming back year after year. I have even considered changing careers, but I really don’t want to do that. Any advice would be great! Thanks!!

    • Hi Matt,
      I try to be cautious about offering specific advice other than telling my personal story, however I would offer this to you to consider for yourself. In my weaning off Paxil/Prozac, after very long-term use I found that high doses of fish oil is very helpful in alleviating anxiety symptoms. There are also many more natural supplements/herbs that you could try: melatonin and others. Some people try 5-HTP when trying to wean off SSRI’s and seems to help them somewhat. I also found out through much therapy and study of psychology that the human psyche is immensely complex and perhaps the depression is your deeper psyche trying to tell you something related to your deepest thoughts; i.e. needs, fears, often related to childhood experiences. Personally, I have had to radically rethink many choices I’ve made in my life that led up to my depression. Additionally, and I know this is foreign to many western minds, for me by far the greatest impact (for the positive) on my mental health has been my spiritual pursuit and coming to an understanding/knowledge of a “higher power” and the great love available to me if I seek it; a journey which I would not have endeavored upon but for my struggle with depression/anxiety. Prayers and positive thoughts for you and your journey friend. CSC

      • A word of warning. It is dangerous to mix 5-HTP with any residual SSRI in your system. I accidentally sent myself into a (thankfully mild) case of serotonin syndrome, which if more powerful can be deadly.

  6. Hi Chris, I would love your thoughts on this…
    I developed hypothyroidism a few months post partum and since have never had relief from symptoms. I believe I was becoming toxic on levothyroxine and now cant even seem to take 1/2 grain nature thyroid or 5mcg T3 on its own! I am now wondering if sertraline caused my thyroid disease!? I started Sertraline in March 2012 and was on it for around 8 weeks. This is when my thryoid tests showed I had SHOT into hypothyroidism. I think there is a connection!? 20/12/11 results – TSH 0.2 and FT4 18, 06/03/13 – TSH 1.2 FT4 20.9, 10/05/12 – TSH 123, FT4 5.0, I hadn’t started any thryoid medication prior to these blood tests! Please tell me your thoughts. Many Thanks, LA

    • Lee-Anne, or anyone else in this situation…Low-thyroid function (hypothyroidism) can and does definitely induce depression. It slows down all of the body’s biochemical activities, including the production and release of serotonin. If a small dose of T3 or of natural desiccated thyroid (NDT, of which your Nature-Throid is an example) doesn’t help but rather, makes things worse, try checking your ferritin level, your vitamin D level, and your cortisol level. Any or all of these, if low in the range, can hamper the effectiveness of even the best thyrod medications. Alhough I’m not wild about the attitude of the website, “Stop the Thyroid Madness” website (and book, avail. through Amazon or the website) offers a great deal of useful and true information on thyroid diagnosis and treatment, including for what to do if it’s not working. Make sure to check your adrenal glands, which often “tank” along with the thyroid especially with a stressful situation. There is info there on adrenals.

      All the best to you!

  7. I was on a variety of anti depressents and anti psychotics for about six years, in hindsight I realise now that I probably never needed them to begin with.. they’ve pretty much ruined my life. They were all heavily sedating as I suffer from anxiety, they would knock me out at night… and my body seemed to rely on them to put me to sleep instead of sleeping naturally.. because now I’ve lost the ability to sleep naturally, my sleep when off drugs is all over the place and has remained that way for the three years since I stopped my meds, I’m so tired all the time I can’t function properly. I’ve also lost most of my emotions, it’s like my serotonin receptors were fried (much like someone who abuses ecstasy) and they no longer absorb the chemical, I’ve seemingly lost the ability to feel happiness.. I don’t bother going out or doing much anymore because I simply don’t get anything from doing much anymore.. It’s also had a horrible effect on my stomach & bowels, (ibs type symptoms)… the worst part about all of it is it did NOTHING to change or help my anxiety.

    I’m hoping some of the damage can be undone in time but it’s looking less and less likely. I don’t doubt that there are people who genuinely need these drugs, people with legit chemical imbalances in the brain.. as I’ve seen some people get a lot better with them but I do think they are WAY over prescribed.. medication was the very first thing given to me when I sought treatment for my anxiety, really it should’ve been the LAST thing they gave to me if everything else didn’t work, it should be the LAST resort not the FIRST… ahh well :(.

  8. It’s very thought-provoking to read the entire series of posts here and it seems to me that all of the perspectives offered could be correct simultaneously. For some people, particularly with heritable bipolar disorder, psychoactive drugs offer their only opportunity for a fulfilling life. But for many others who were prescribed with SSRI’s to cope with what might have been short-term and adaptive depression following life stressors, it seems they actually risked –or are now risking — long-term damage by taking these drugs.

    I believe I am on the cusp of that effect myself. I was prescribed with Zoloft following the end of my first marriage. If I had pushed through that era with therapy, more careful attention to diet and exercise, and reduced work expectations, I believe I would have emerged on the other side as the same person with a few more life skills.

    But instead, I emerged with a heightened tendency to feeling anxious and stressed, wondering why in a new, happy marriage with thriving kids, a nice home, and a good job I still felt kind of numb much of the time. My GP prescribed a return to Zoloft and a psychologist discovered underlying ADD. I was referred to a psychiatrist who prescribed Adderall based on the same short, ,self-reporting questionnaire by the WHO I’d found on the web. Even for this young (so recently-trained) psychiatrist, that is the extent of the diagnostic expertise.

    I’ve been on them both for about 5 years and I am gradually realizing some uncomfortable truths. Mainly, I am not the same person I was. I do not think as clearly, I do not feel as much empathy as i once did for others or enjoy anything (including sex) as much as i used to. My poor memory is worsening steadily, I am much quicker to anger, and I am prone to sugar binges in the evening, something i did not used to do. Together, These lessen the enjoyment I used to derive from exercise, creating cascading feedback loops that probably involve every physiological system in my body. I have the first signs of liver disease (probably from long-term use of allergy medication) and heart problems. I am not yet 50.

    I am not a medical professional, but I do have access to and read the primary medical iterature. I know quite a bit about behavior and I use multi-variate statistics regularly. I know how hard it is to demonstrate causation, even correlation, when there are many interacting variables at play, especially if some go unmeasured. I have witnessed the powerful influences of industry on government in issues of public policy. I also know the extent to which all western doctors are rewarded for memorizing and asserting as undergrads to get into medical school. I have realized that most clinical doctors of every sort have virtually no training in hypothesis testing and have something approaching disdain for alternative explanations. I see the way conventional medical treatments atomize the body into seemingly-independent parts and how little communication there is among the professions treating a single individual. And I see how resistant we all are to complexity and change as human traits that are almost universal.

    When I put all these things together, it seems inevitable that much of what is already clear will take decades to synthesize and communicate to GP’s, let alone the public. Zoe is quite right about that. Meanwhile, I will be weaning myself off the drugs — all of them — and learning as much as i can about nutrition and lifestyle changes that might treat the actual underlying causes my increasing tendency to depression, despite having had what others considered to be an extremely happy and positive disposition. Sugar is my first topic of intense research. I will do more to resist the chronic, but largely unnecessary, work stressors and extra hours. And I will try to help others do the same, especially my kids.

    Like other things that were once promoted for their widespread benefits, such as tobacco, asbestos, DDT, and aspartame, many lives will likely be lost before the skeptics are quieted. What a pity is is that society must relearn that precautionary principle again and again.

    Thank you, Chris, for initiating this blog and everyone else for your additions. It was over this breakfast read and in the writing of my own response that I came to this decision. I wish you all health and happiness.

  9. Well having been depressed.
    Having taken all sorts of anti depressants and personally felt their changes.
    I would say for the most part they do not work.
    If they did the severity of my depression would not have increased while taking prescribed medication.
    So I saw no benefits at all.

    I also read recently a study involving mice and rats showing the long term effects of a certain anti depressant had both a positive and negative effect when taken for a long time during adolescence
    Making the rats and mice more resilient towards depression but more vulnerable toward stress and fear.

    My personal experience obviously may not translate to the whole human population.

  10. Hey Chris, maybe you can point me in the right direction. Five months ago, I took Celexa for three days straight, and immediately had a major crisis, something went terribly wrong. My PA told me to stop taking the pills right away, but maybe I should have gone to the emergency room instead. My life has seriously been hell ever since I took Celexa—I never knew what real depression was until I had this experience—I am now horribly depressed, but even worse, I’ve experienced severe memory loss (immediately and ever since), along with a wide range of other problems needless to say. Actually it now seems as though I’m mentally challenged… for real, it’s very upsetting… I have become antisocial and frightened with continuous suicidal thinking. I used to be smart and sharp, energetic and passionate. Now there is nothing, no emotion. I can’t laugh or cry anymore. And I have headaches and a constant sharp pain in my head. What happened? I have always been a stressed and anxious person, with what I thought was slight depression; but I’ve always been positive, and never a poor-me type of person, which is why I’m so scared now, I’m totally desperate; I guess my mind is not as strong as I thought. Should I see a neurologist and have an MRI, EEG or some other test done? Will they think I’m crazy? lol… I saw a counselor for two months but it didn’t help. I have seen psychiatrists who want me to take SSRIs, but I’m hesitant because I don’t think they know what the fuck they are doing, and I don’t want to make this worse… it’s obvious that the medical world doesn’t have the right standards in place to deal with this kind of thing, so I’m very scared that my personality has been permanently altered in such a negative way. Is there anything that I can do? Does modern medicine know how to handle these situations? Does anybody know? – Thanks, Chris G.

    • Chris G. —
      I can understand exactly where you are and your fear is valid. My first suggestion, aside from meds, is to seek counseling; either group or solo. If you don’t feel comfortable with the group or the solo provider, look elsewhere…don’t settle. Do research on depression and NEVER be afraid to question doctors or therapists. I’ve been on meds for 18 years and I KNOW I was treated incorrectly. I questioned my pshyc once after he prescribed a med that my insurance company called and quegtionef me as to the reason it was prescribed. I called and left him a message about the insurance question and was VERY surprised how quickly he called me back. At my next appointment he told me he would no longer treat me because I was a liability. If that doesn’t speak volumes I don’t know what does. Long story short, after finding a new doctor, I was taken off some meds and dosages were reduced on others. Just NEVER SETTLE!!! Research!!!

  11. My partner is concerned that I have personality changes whenever I go back onto anti-depressants. I am an alcoholic, my trigger being depression. I have been to rehab several times and I come out a changed man but after being back on anti-depressants I apparently have become acutely insensitive, “invincible”, have no fear of consequences, take risks and avoid all natural emotions required for a healthy relationship. This causes conflict in my life and I end up breaking down and drinking again anyway. I get chronic psychosomatic pains too. Is there really permanent brain damage from being on anti-depressants, mirtazapine specifically? How does one live without them?

  12. Chris, with this subject I believe you are opening a pandoras box. I’m a normal guy who experienced some marital troubles in my life, like a lot of people. I began to drink to numb away the problem. When I relized it was consuming me I went for help, in a rehab. Although when I was there, I was told I was not an alcoholic but depressed. I was prescribed anti- depression meds. This is where my nightmare really began. I am hypersensitive to medication. The meds they prescribed acted as if I was striped of my emotional governor. The result landed me in prison. I have through family and doctors been told to write a book about my experiences. but the evidence of the harmfulness of these meds are overwhelming. Especially in the returning military vets. who are given these same meds. Their suicide rate climbs daily. I am trying to find help putting my book together. Again it becomes overwhelming of all the info I have uncovered! Every time I mention it to someone, they have a story of someone they know that has been affected/effected by this. I would like to share my story to help people so they don’t repeat what happened to me. If you can contact me and or help me with this, either with info or connections to further my quest I would be very grateful ! Thank You!

  13. I’m sorry but this has to be the most irresponsible piece of “journalism” I have ever read. First of all, you have absolutely no empirical evidence backing up your claims, just a few citations sprinkled here and there to make it appear as if the author did some research.( ie:”thousands of excess suicides”? Come on. Where’s your citation on that number?) Mental illnesses are physical illnesses, just like AIDS, cancer or rheumatoid arthritis. I don’t know why that is so hard for some people to comprehend. Would you be so irresponsible as some of the commenters here as to tell young cancer patients to stay away from “evil” cancer drugs and use only natural therapy/spiritual guidance to treat their illness? It sounds as ridiculous as saying miasma (bad air) caused the black plague in the middle ages or that disease is caused by the devil. (I don’t know…maybe that’s what some of the commenters here believe?) It’s fine if you don’t want to take anti depressants yourself or you don’t want your kid taking anti depressants. That’s your decision. They don’t work for everyone. And there are not perfect. But for some of us, they are literal lifesavers. I have been on several over the years along with mood stabilizers, long term, and I am perfectly healthy, no brittle bones, gastrointestinal bleeding or Parkinson’s, but I have survived anorexia nervosa (72 pounds when hospitalized), have had no further suicide attempts and am able to live a relatively normal life with bipolar disorder, a disease that has been in my family for generations and has killed several family members who went untreated. I’m sorry if my tone is a little angry, but I don’t want to see a kid who needs help for depression be influenced by a very one-sided argument. Giving your opinion is fine, but please don’t present it as fact.

    • My comments of warning to others regarding these drugs are based upon hard-earned life experience…now going on approx. 22 years of SSRI use and almost 30 years of struggle with anxiety/depression. I feel it is my responsibility to inform others and possibly prevent another bright, inquisitive (but struggling) young person from falling into the trap I fell into..and having a life before A.D.s in sharp contrast to their life after A.D.s. I know intimately how crippling depression and other mental/emotional stuggles can be in life. My point is that life is not always easy and can be an unbelievable struggle for some…but one should be fully informed as to the end result of long-term SSRI use. INFORMED CONSENT. If one is struggling so much that they agree to the brain-damaging effects of long-term SSRI use, then that is your right…but why do the pharmeceutical companies not disclose the entire TRUTH to the consumer so that the consumer can weigh the risk/benefit for themselves?? Perhaps because they know that few people would touch SSRI’s (short term or long term) if they knew the risks(i.e.testimonies like mine and many others). But looking back through history, their is a universal law at work: the truth will eventually surface, even if it takes decades or longer.
      CSC

    • Your and your family history suggests that either you are one of the very few people I the population with a genuine mental illness for which you really do need the meds, or that you have all been victims of the same fraud as the rest of us, but you believe that the pills, which studies have shown are of little use in all but the very extreme cases but regularly cause mania and other worse conditions. No need to cite sources here, there are a great many if you look, but start by reading rxrisk.org, Irving Kirsch, Peter Breggin, Joanna Moncrieff, David Healy, and many many more, rather than the clincial trials funded by drug companies which are rigged and they have been caught covering up the truth.

    • I have been through numerous antidepressants.Prozac is what was first giving to me at age 16.I am now 34. I have started to feel and realize that antidepressants have taken a toll on my well being.my mental and physical health is painful.and my children, I wastold by 3 different docs that antidepressants won’t harm my children..omg they were wrong.what can I do now?my mental being? Alot of what you are saying is true…I have experienced nothing but p

    • I have been on celexa and Wellbutrin for over 20 years now. It saved me from a very hard life and I have grown into a very successful person. Going from screaming and yelling at everyone, crying for days, not being able to go in any crowd to a successful manager, mother of 3 beautiful children and run 1/2 marathons in my spare time. I know a lot had bad side effects of these drugs but I am the best person I have ever been on these. I tried to go off a couple of times because I was listening to others saying I shouldn’t be on them. Well let’s just say that I will never go off them again. And I should finish by saying husband and I have been together over 25 years and he is so grateful to the pills because without them we would not have made it.

  14. I love this article and am always looking for ways to naturally heal the body. I suffered from horrible depression and went on many meds…some made me manic, other like lexapro were HELL to come off of. I had serious mood swings and would go from 1-10 like that. I have talked to a lot of people who experienced similar things.

    What struck me in this article was the loss of motivation because of these drugs. This is something I have been experiencing since being on wellbutrin. I thought it was just me but all my motivation to do ANYTHING has disappeared. I am a college student and before going on the drug was hyped about school and now the desire is there but it isn’t as intense as it once was.

    My feeling is that these drugs should only be used short term and that CBT should be used in conjunction with the drugs.

    • As someone who has suffered from depression and been on a few different anti-depressants, I would have to say that the need for an antidepressant is up to the individual. I would also have to say that there is some truth to what Chris is saying. I once heard that a doctor is guessing 40% of the time when making a diagnosis. As someone who does my own research, and believes in homeopathy, I believe people should rely more on themselves than the medical community. Depression is caused by many things and deciding to take an antidepressant is up to the individual. Clinical depression is a chemical imbalance in the brain and there are a variety of ways to treat that and medicine is one of the ways. All prescribed medicines have side affects, no question. So any individual needing help with depression should decide for themselves on the best course of action to take to get them where they need to be. Sometimes the prescribed medicine gets the brain issue corrected faster and easier than the other ways and people need that. But many of us should look at using an antidepressant as a short term solution while we also invest in natural and healthy ways to balance ourselves out for inner peace and happiness.

  15. For the young people who have posted, please take this article and my personal life experience while on these drugs to heart (see my earlier posts)! Try to wean off of these drugs (slowly and in a controlled, managed manner, WITH SUPPORT). You must do WHATEVER is required: long term therapy, life changes, spiritual pursuits; in order to cope with life and live without the mind-numbing, and ultimately brain damaging, effects of these drugs. I have had to learn the hard way and I now see it as one of my major life purposes to inform others of what I now KNOW. I was a high-achieving student in a difficult graduate program and after succumbing to the belief that my brain was “chemically imbalanced” I lost years of my life and nearly ended up homeless, all because of 18 years of antidepressant use. Looking back I pray that I had someone to warn me and I can see that life is sometimes incredibly hard, but worth the fight. You can do it, but you MUST persevere and find the long-term solution, not the quick-fix.
    God bless you and I pray you heed the advice of one who has gone before you.
    CSC

    • Thank you for your effort. I have been using paxil for nearly one year. It affects my short term memory terribly. I would rather cease using those after seeing so many people have the same symtomp.

  16. Dear Chris, I have been on Strattera for ADHD for a year. I am now coming off it due to the many side effects and am experiencing terrifying memory problems akin to dementia. My short term memory is completely malfunctioning. Within minutes of a conversation I can’t recall even the topic let alone details such as names. Long term memory is also afftected. I can forget what film I saw at the cinema the night before and even names of best friends and work colleagues. I’m incredibly frightened this is permanent. Do you think a year is long enough to cause permanent damage or is it a withdrawal symptom? Prior to the medicine I was high achieving and had excelled academically (I got into Cambridge to read English). Other withdrawal symptoms are tearfulness and anxiety (both significantly exacerbated by the memory issues). Thank you so much.

  17. I was on Paxil for 6 years for panic disorder, it worked but dulled my senses and made me put on weight so tried to come off but symptoms persisted. Switched to citalopram and within a year noticed twitches in fingers and toes. 8 years later and I have tics all over my body – it’s hell. I went to so many specialists who said I should up my dose or try another ssri. All the time I knew they were causing the tics so I eventually weaned off. I am a husband and father of 2 young children and run my own business. My life is a living nightmare now, I am in constant pain, feel ashamed and am constantly under pressure to mask the agonizing tics. Nobody seems to have an answer and I don’t know what to do. Avoid these drugs if you possibly can.

    • I am so sorry to hear that! I experienced something similar. I was on Paxil for almost 10 years and gained almost 80 lbs. I hated myself and was more depressed than ever but at the same time, lost interest in nearly everything. I felt numb and didn’t care about things the way I should have. I finally weaned off which was awful and now, 8 years later, I am still not right. I lost the weight, rapidly, in the first 18 months but I experienced so many withdrawal symptoms. I never had twitching but I did have nightmares, horrible mood swings and the worst anxiety I’ve ever known. I still don’t leave my house much. These antidepressants are NOT good for anybody – they are a way of not dealing with the bad stuff in life, plain and simple. I am currently writing an essay for my college class and using this website as one of my sources. This man makes sense! Good luck to you and all who have gotten duped by the doctors and pharmacists throwing pills at our problems!

  18. Great post, but I have a question I’m 16 years old I I’ve been taking antidepressants since I had 15 mirtazapine for 6 months and Prozac for 3 months both medications together,and my question is if I have permanent brain damage or I did change my neurons for bad I’m very groggy with your post I have negative effects of antidepressants and I would be great full if you answer me, thaks.

    • Hi Jacob
      Have a look at this utube site below. It is a bit long, but it helps to explain how the brain works when we have experiences that cause us to be so fearful or terrified. Our mind tries to help us fight or flee the “situation”. That makes the person feel highly anxious and “out of control” when this is relentless, it wears the person down and can cause the depression.
      He explains the three different sections in our brain that are responsible for our thinking and feeling and keeping ourselves safe.
      The Neo Cortex part (thinking,imaginative and logical part), The Limbic (the feeling and emotional part)and the Reptilian part of the brain (fight or flight part of the brain).

      At the heart of all this is becoming aware of the different roles they play. Fear is fear and at any given time in your life these feelings will inevitably show up. When there are stressful life events which can put one’s resilience to the test, the brain instead of being able to logically explain and reason with the feelings, it goes straight to your limbic and reptilian parts which are activated and over ride your logical part of the brain. You just hate the feeling and it disempowers you, no matter what your logic tries to tell you. Depression/anxiety etc can occur.

      Neuro plasticity of the brain is a very encouraging thing to know and understand. A person has the chance here to turn their thinking and feelings around.

      Knowledge of how your thoughts and senses can keep you in this state is useful as it empowers you to not be tricked by past responses to stress. As well, using Imagery to tell the Neo cortex part of the brain to visualise the healing of Limbic and Reptilian part of brain can go a long way in empowering yourself to a better way of being.

      Meditation
      The reason why meditation can work is that it just gives these parts of the brain time to rest and restore. It is worthwhile persevering in the art of meditation. See it as helping your brain give it the rest it needs.

      I am not against anti depressants, but anything that will help in empowering a person to awareness is incredibly empowering and this is key to a better life

      http://m.youtube.com/watch?v=kFnLR9PLH8A&desktop_uri=%2Fwatch%3Fv%3DkFnLR9PLH8A
      Also Brene Brown – “the power of vulnerability” Tedtalk
      Plus Brene Brown – “listening to shame” (this is a positive talk). Do not let the title fool you. It’s great!

  19. Well, this article just opened my eyes on some things. I was put on Paxil when I was thirteen years old and took it for around six months (maybe longer -it’s hard to remember now, but it was at the very least 5-6 months, probably a bit longer). I went from being a healthy pre-teen/teen at a healthy weight of around 130 pounds (5’6″ tall, broader, athletic body type) to TWO HUNDRED POUNDS in a matter of MONTHS. I had NO idea that something like Paxil could have been to blame. And let me tell you, for a thirteen year old girl being that overweight is absolute HELL. I ended moving to live with a different parent ~6 months after I’d been put on Paxil and my dad promptly told me I wasn’t going to take it anymore and that was the end of that. I experienced withdrawal symptoms (though I didn’t know what withdrawal even was). It wasn’t until I was 16, almost 17 years old that through a LOT of hard work and some near-starvation weeks that I was able to go back down to a healthy weight. This makes SO much sense now… For years I’ve wondered how it was I could put on weight like that so quickly when I’d been at such a healthy weight and a mildly athletic kid (played outdoors and walked the neighborhood with my friends to get away from parents, rode my bike everywhere, etc.).

    Thanks for this article and the info! My eyes are definitely opened up now. I can’t believe that I didn’t even consider that the Paxil might have played a role… Those years are some you can’t get back either… Not bitter, but dang, if that wasn’t irresponsible to have a 13 year old put on something like that (that I honestly didn’t even need)…

  20. The problem with antidepressants is that they are Jerry rigging they are not fixing the cause. And while Jerry rigging may help symptoms in the short term it does damage in the long term. Sometimes there may be no choice but to do this in the short term because of the severity of symptoms. But the goal should be to shift to dealing with the cause and stop the Jerry rigging as soon as possible. Unfortunately because of lack of resources to focus on healing rather than medicating, some folks may be stuck with Jerry rigging via medications. Insurance will pay for pharmaceuticals for a poor person, but not a better diet or tryptophan supplementation.

    The bottom line is not whether antidepressants work. It is whether they are the best option and the answer to that is a definitive no. The reason they are so heavily relied upon is because they are lucrative.