Depression affects more of us than ever, but are antidepressants always the way to go? For some, the side effects may outweigh any benefits.
More than 300 million of us are living with depression around the world according to the World Health Organization (WHO), with New Zealand ranking in the top 10 most depressed countries. WHO this year named failing to seek treatment for depression as the leading cause of ill health and disability worldwide, yet antidepressant use has more than doubled since the turn of the century. Some researchers are now questioning whether the drugs are the best path to happiness. Every person reacts slightly differently to antidepressants, and studies consistently show that a significant proportion of people who take them experience side effects, some of which are so severe that they opt to stop taking them.
Last year, a study by the University of Auckland’s School of Psychology of 180 New Zealanders who had used antidepressants over the previous three to 15 years found the majority suffered adverse effects, including sexual problems such as low libido and failure to reach orgasm (65-72 per cent), weight gain (65 per cent) and feeling emotionally numb (65 per cent). Between 36 and 57 per cent of respondents reported feeling these side effects at either a moderate or severe level. However, the majority also reported that the antidepressants did improve their depression.
A University of Liverpool study in 2014, also of New Zealanders, found that 62 per cent of the 1829 antidepressant takers queried experienced sexual difficulties and 60 per cent reported feeling emotionally numb. “We need to be much more cautious about the widespread use of these drugs,” warns associate professor Paul Andrews, an evolutionary biologist at McMaster University in Canada who researches depression and the impact of antidepressants on the entire body – not just the brain. “It’s important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they’re safe and effective.”
Antidepressants are designed to increase the levels of serotonin in the brain where it is used to regulate mood, but Andrews and his colleagues are concerned because the majority of serotonin the body produces is actually used elsewhere – for digestion, to form blood clots, and for reproduction and development. Andrews’s research has found that antidepressants can negatively affect all the body’s processes that are regulated by serotonin. “The thing that’s been missing in the debates about antidepressants is an overall assessment of all these negative effects relative to their potential beneficial effects,” he explains. “The issue is: does the list of negative effects outweigh the minimal benefit?”
IN THE SYSTEM
“Most serotonin is actually in the gut, which can account for some of the digestive effects of antidepressants,” says fellow McMaster University researcher, Marta Masle. Nausea, constipation, indigestion, bloating and diarrhoea are common side effects, along with sexual problems, cognitive issues such as agitation or anxiousness, dizziness or drowsiness and problems with sleeping, among others, she says. “Prescribers of antidepressants certainly need to carefully weigh and discuss the risks and benefits of using antidepressants with each individual patient,” Masle points out.
Because not enough research has been done into their long-term use, we don’t have enough information to assess the effects of antidepressants over time, she says. More research is needed, “particularly into how antidepressants interact with the body and not just the brain,” says Masle. Andrews also cautions that people who stop taking antidepressants may face a rebound effect, with more severe depressive episodes.
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