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Taking Antidepressants Without Depression | Banyan Mental Health

Antidepressants are prescription drugs used to relieve symptoms of depression, social anxiety disorder, seasonal affective disorder (SAD), and dysthymia. These medications aim to correct the chemical imbalance that’s believed to contribute to changes in mood and behavior. First developed in the 1950s, anti-depression medications have become more popular within the last few decades. But while these medications are effective in treating people with depression, today we’re going to look at the effects of taking antidepressants when not depressed.


How Do Antidepressants Work for Depression?

Depression, or major depressive disorder, is a common and serious medical illness characterized by persistently depressed mood and loss of interest in activities significant enough to cause substantial impairment in day-to-day life. Because of their symptoms, people with depression may struggle to get out of bed in the mornings, and simple tasks like brushing their hair or changing their clothes can be draining.

Antidepressants reduce symptoms of depression by balancing chemicals in the brain called neurotransmitters, which affect mood and emotions, particularly dopamine and serotonin. These depression medications can improve your mood, concentration, sleep, and increase your appetite.

For people with depression, antidepressants can help jump-start their moods and give them the boost they need to manage their symptoms and complete their daily tasks and responsibilities. Depression medication can also encourage these individuals to do the things they enjoy again, and make better choices for themselves, contributing to an overall improved sense of being.

What Are the Effects of Taking Antidepressants Without Depression?

Research shows that taking antidepressants if you’re not depressed can alter brain function and structure, particularly the medication Zoloft. While the effects of depression medications – such as improved mood and emotion – are advantageous for people with depression, these drugs are designed to regulate a chemical imbalance.


Changes in Brain Volume

So, what happens when someone without a chemical imbalance takes these medications? According to a 2015 study, taking antidepressants when not depressed can reduce the volume of two important brain regions.

The first is the anterior cingulate cortex, which is the area of the brain that controls and regulates mood. The other is the hippocampus, which is where the registration and consolidation of memory occur. The researchers noted that people with depression had previously been shown to have smaller volumes in these brain regions compared to people who did not have depression.1

Additionally, both brain regions are interconnected with other areas of the brain and play critical roles in functions like memory, learning, spatial navigation, will, motivation, and emotion, all of which can be compromised by major depressive disorder. 1


Serotonin Syndrome

Another possible adverse effect of taking an antidepressant when not depressed is serotonin syndrome. Most antidepressants boost mood and reduce depression symptoms by elevating serotonin levels in the brain. Although this is beneficial for someone who’s depressed, for someone who does not have depression, taking antidepressant medication can cause serotonin to build up in the body, resulting in serotonin syndrome.


When serotonin levels are too high, the person may experience symptoms like:


  • Agitation or restlessness
  • Confusion
  • Rapid heart rate and high blood pressure
  • Muscle rigidity
  • Excessive sweating
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles
  • Diarrhea
  • Headache
  • Shivering
  • Goosebumps
  • Fever
  • Irregular heartbeat

In serious cases, this condition can be life-threatening, producing symptoms such as seizures and loss of consciousness. If you recognize any of these signs in yourself or someone else, seek medical attention immediately.


Increased Risk of Dependence and Addiction

Another possible risk of using antidepressants without depression is dependence. Drug dependence occurs when someone is unable to function normally without a particular drug or alcohol. Antidepressant dependence can occur in patients who take high doses for long periods, as well as in people who take these medications without prescriptions or to get high.

Although antidepressants don’t necessarily produce a high as heroin or cocaine do, people may still abuse them by taking them in higher doses than prescribed, or with other sedatives like alcohol, opioids, or benzos to exacerbate their effects. A person who’s physically dependent on depression medication may also experience a variety of uncomfortable symptoms called withdrawals when they reduce or cease their use.

If you’ve been taking antidepressants for more than four months or have abused them for long periods, do not attempt to quit using them without professional help. Our residential mental health program in Boca offers dual diagnosis treatment, during which patients with co-occurring addictions and mental disorders will receive care to address both conditions. Our specialists at Banyan Treatment Centers can assist you with the detox and recovery process.


Contact Us for Depression Treatment

Depression is a serious mental health disorder that can significantly impact a person’s life and even lead to suicide if left untreated. Fortunately, Banyan offers depression treatment among a variety of other programs at our Boca Raton facility to teach patients how to manage their symptoms.

Whether it’s depression, anxiety, OCD, or any other mental health disorder, we can help. Call Banyan Treatment Centers today at 888-280-4763 to learn how to get started in our PHP mental health program.

Related Reading: 

Signs of High-Functioning Depression

Can You Overdose on Antidepressants? Source: 

Science Daily - Common antidepressant may change brain differently in depressed and non-depressed people

Why Aren’t My Antidepressants Working?

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If you feel like your antidepressant has stopped working, you're not alone. It's common for a medication that once worked wonders to become ineffective, especially if you've been taking it for a long time. Symptoms return for up to 33% of people using antidepressants — it's called breakthrough depression.

"Usually an antidepressant that's worked for a patient will keep working," says Paul Nestadt, M.D., psychiatrist and co-director of the Jack and Mary McGlasson Anxiety Disorders Clinic at Johns Hopkins. "But sometimes, a new episode of depression might come up that's not as responsive to that medication, or the medication might just stop working altogether."

What causes depression medications to stop working?

Multiple factors can change the way your body responds to an antidepressant, including:

  • Drug or alcohol use. Illicit drug use and alcohol can cause strong mood changes, which can make antidepressants ineffective.
  • Pregnancy. Your body's weight and blood volume increase when you're pregnant. Talk to your doctor about taking antidepressants while pregnant, and about potentially adjusting your dosage to continue relieving symptoms.
  • New stressors. A new stressful situation at home or work can result in a mood response for which the antidepressant can't compensate.
  • Other medications. Interactions between antidepressants and medications for other health conditions can affect how well an antidepressant works.

Most often, though, antidepressants stop working for what seems to be no reason. "There's no good research that shows why a medication may stop working for someone," says Nestadt. "I think it's less an issue of building up tolerance and more likely constantly changing stressors and factors in the brain."

When to See a Doctor

If your depression symptoms return for more than a few days, it's time to see your doctor. But even if you feel like your antidepressant isn't working, it's important to keep taking it until your doctor advises otherwise. You may need a dosage increase or a slow tapering off process. With many antidepressant medications, stopping their use too quickly can cause withdrawal effects such as:

  • Headaches
  • Nausea
  • Diarrhea or constipation
  • Greater anxiety
  • Suicidal thoughts

Early warning signs of breakthrough depression are the symptoms you typically experience when an episode of depression is coming on, says Nestadt. Depression symptoms vary from person to person, but signs include:

  • Low mood
  • Changes in sleep or appetite
  • Decreased socializing
  • Loss of interest in previously enjoyable activities

If your symptoms return, don't worry — adjusting the dose or switching to another antidepressant often solves the problem. (Note: If you have self-harm or suicidal thoughts, see your doctor immediately, call 911 or go to an emergency room.)

Changing Your Depression Medications

If you and your doctor have ruled out factors that could interfere with your current medication, your doctor may increase the dosage, switch you to another antidepressant or recommend you take an additional medication. Drug therapies that treat depression include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRI drugs are the most commonly prescribed antidepressants and are often considered the first line of defense against depression. They increase your brain's level of a neurotransmitter (a chemical that transfers messages from brain cell to brain cell) called serotonin. This neurotransmitter is associated with feeling happy and content. SSRI side effects tend to be mild, and depression symptoms improve significantly for about 60% of people with moderate to severe depression.

Selective Serotonin Noradrenaline Reuptake Inhibitors (SSNRIs)

Both SSNRI and SSRI medications affect serotonin levels, but SSNRI drugs also impact the level of norepinephrine, another neurotransmitter that may affect mood. This type of medication is helpful for those who have extreme fatigue associated with depression, or who have had side effects or poor response to SSRI drugs.

Tricyclic Antidepressants (TCAs)

TCA drugs increase serotonin and norepinephrine in the brain, but unlike other antidepressant types, they also block acetylcholine, a neurotransmitter associated with increased stress, anxiety and depression. You may experience more side effects with TCA medications than with SSRI or SSNRI drugs.

Monoamine Oxidase Inhibitors (MAOIs)

MAOI drugs inhibit the breakdown of dopamine, norepinephrine and serotonin, which increases their concentration in the brain. Low levels of these neurotransmitters are associated with depression and anxiety. MAOI drugs have a greater number of serious side effects. People taking them have to be mindful of the medication's interactions with certain foods and other drugs.

Bupropion

Bupropion acts on dopamine and norepinephrine. Its main advantage is that it doesn't cause troublesome side effects such as decreased libido and weight gain like other types of antidepressants do. However, it may be less helpful for depression with anxiety features.

Esketamine

This newer drug provides relief from depression symptoms within hours by increasing levels of glutamate, the most abundant neurotransmitter in the brain. Esketamine comes in a nasal spray that must be administered in a clinic because it can cause hallucinations and other sensory side effects for up to two hours after treatment. It's an effective drug for those who haven't responded to other antidepressants.

If you're experiencing breakthrough depression, it's important to consult with your doctor so you can feel better again. "It's not unusual for medications to stop working," says Nestadt. "It happens with other sorts of medical treatments as well. Sometimes your blood pressure medicine is no longer effective and it has to be switched. It's just the nature of treating illness."

Fighting depression: 10 modern drugs

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Fighting depression: 10 modern drugs

Depression is an urgent problem, the number of visits to doctors is growing every year. It can be solved by contacting a psychotherapist and taking antidepressants . These are drugs that regulate the production of hormones and biochemical processes in the body. It is strictly forbidden to prescribe them to oneself , as these are complex drugs with certain restrictions, side effects effects . The doctor must authorize their appointment and control the intake. We will tell you which of them are the most effective and common in medicine, how many they have pluses and minuses.

What is meant by

depression

Doctors have known it since ancient Greece and Egypt. Hippocrates described it as melancholy - a condition that is accompanied by anxiety, despondency, insomnia, refusal of food, irritability. Most often, the cause is childhood trauma or severe, frequent stress in adulthood. There are many provoking factors: the death of a loved one, deterioration of living conditions, alcoholism, brain diseases. Such cases are referred to as psychogenic depression.

The second type is endogenous. The problem appears not from large external shocks, but because of internal causes. A person is constantly dissatisfied with himself, subjecting himself to criticism. Many patients have panic attacks , haunted by a feeling of fear, anxiety.

How long the period of depression lasts

Many people mistake ordinary periods of low mood for depression. If they do not last long and are quickly replaced by periods of recovery, then we are not talking about a depressive state. The problem is obvious when the symptoms persist for months and dramatically change a person's life. Then you need to see a doctor.

What happens to the body

The most common theory is that there is a malfunction of neurotransmitters located in the brain. These substances transmit signals from neuron to neuron and are responsible for a person's mood. Dysfunction leads to a slowdown in the rate of this transmission and a decrease in the number of neurotransmitters themselves. Serotonin, which is called the "hormone of happiness", suffers the most. For clarity, this biochemical process can be compared, for example, with a drop in blood sugar levels in diabetes mellitus.

How is

treated depression

Depression has been treated in different ways. In the ancient world - emetics and laxatives. In the Renaissance - wine and sunbathing. In the Age of Enlightenment - external stimuli, for example, insects. The 19th century brought new recipes - in particular, a solution of camphor in tartaric acid. The treatment also included the use of drugs, which are now no longer allowed for sale, and some are recognized as narcotic.

Obviously, all these drugs had no effect on increasing the amount of serotonin. And the treatment is precisely to normalize its production. This was done after creating modern antidepressants , which have a minimum of side effects, are safe for the body and are not addictive. These are medicines, whose action is aimed specifically at balancing the disturbed balance of neurotransmitters: serotonin, norepinephrine, dopamine.

Prescription

If a healthy person takes antidepressants , there will be no effect . For a depressed patient, taking them will help:

  • improve psychological state;
  • get rid of irritability;
  • panic fear;
  • increase mental and physical activity;
  • overcome the dreary mood.

Psychiatrists prescribe antidepressants for chronic back pain, headaches. And also with irritable bowel syndrome, incontinence and other cases when the body stops producing its own painkillers. Medication helps restore pain suppression mechanisms.

These drugs can only be taken with a doctor's prescription, as many of them are strong stimulants. Self-administration may cost dearly - the condition may worsen. Only a doctor will correctly calculate how many medicines to take per day. In parallel with the treatment by a psychiatrist, a neurologist, a consultation of a psychotherapist is required.

Precautions

  • Prescribed drug start drinking from a small dose - the first couple of days they take a quarter of a tablet. Gradually increase the dose to normal. So the body adapts better. Finish the course by reducing the dose.
  • The first effect of appears only 2 weeks after the start of administration. Sustained action - after six months. All this time, you need to take remedy, without making passes, breaks.

  • Products are not combined with melatonin, St. John's wort, products and dietary supplements based on sibutramine, 5-HTP. Their combination can raise serotonin to dangerous levels. Also, you can not combine them with monoamine oxidase inhibitors, for example, Cipralex. When writing a prescription, the doctor takes these points into account.

  • Drinking antidepressants is better in parallel with visits to a psychotherapist. If the drugs normalize the biochemical processes in the body, then this doctor will help normalize the psychological state after depression.

The best antidepressants

In medicine, they have long argued that some drugs give only a placebo effect. The purpose of the study was to find out which of them are the most effective and valid . The project involved 116 thousand patients, and its results were published by the authoritative edition of the Lancet. We offer a list of the best.

1. Agomelatine

New generation drug. Agomelatine is used for severe depressive disorders, high levels of anxiety. Enhances the release of dopamine and norepinephrine, stimulates melatonin receptors. The standard therapeutic dose is 25-50 mg 1 time / day. Helps to restore the normal structure of sleep, get rid of anxiety and panic attacks attacks

Pros

+ Does not adversely affect attention and memory.

+ No lethargy during the day.

+ No sexual deviations.

+ No relation to blood pressure.

+ Do not reduce dosage upon discontinuation.

Cons

— In 1-10% of cases, increased sweating, diarrhea, constipation.

- Possible increased fatigue, drowsiness.

- There are no evidence-based safety studies in people with renal or hepatic insufficiency, therefore, such patients are advised to refrain from taking drugs with active ingredient agomelatine.

2. Amitriptyline

Tricyclic antidepressant. Moreover, the World Health Organization considers Amitriptyline the most reliable in this group. The standard dose is 200-250 mg / day. The action is to block the reuptake of neurotransmitters. A good remedy for moderate to severe disorders of the endogenous type. Additionally, it has a sedative and hypnotic effect. Effective in the treatment of neuropathic pain, for the prevention of migraine.

Pluses

+ Preparations with active ingredient amitriptyline are inexpensive.

+ High reliability, minimum side effects.

+ Relatively safe during breastfeeding.

Cons

- Possible side effect in the form of blurred vision, dry mouth.

- Lowering blood pressure.

- Some patients experience constipation.

- Drowsiness.

3. Escitalopram

It belongs to the group of modern serotonin reuptake inhibitors (SSRIs). Most often, it is recommended to take for anxiety, panic attacks. It is taken once, the standard dose is 10 mg per day. Escitalopram has a milder effect and is prescribed to patients for whom tricyclic drugs are contraindicated.

Pluses

+ Lasting effect comes after 3 months.

+ Indicated for patients with disorders of the cardiovascular system.

+ Soft action.

Cons

- In some patients, the functions of the gastrointestinal tract are disturbed, which is most often expressed in diarrhea.

- Anxiety may increase during the first 2 weeks, therefore it is recommended to start treatment with low doses and gradually increase them.

- Contraindicated in pregnancy and lactation.

4. Mirtazapine

A drug of the tetracyclic group. Mirtazapine - good stimulant for anxious depressions, has a moderate sedative effect. The average amount is 30 mg / day, it must be consumed once. Usually it is prescribed to patients who lose interest in life, cease to experience joy, pleasure. Effective in the correction of sleep, in particular, early awakenings.

Pros

+ Earlier onset of action than SSRIs (1 week).

+ Works well with most general medicines.

+ Full effect in 4 weeks.

+ Does not affect sexual function.

Cons

- The active substance mirtazapine is contraindicated in diabetes mellitus, arterial hypotension, increased intraocular pressure.

— During the appointment, you must drive carefully and engage in potentially hazardous types of work.

- 18% of patients experience drowsiness, 15% dry mouth, 5% weight loss. Other side effects occur in 1-3% of cases.

5. Paroxetine

Belongs to the SSRI group, is used most often for severe anxiety, panic, social phobia, nightmares, stress after trauma. Paroxetine can resolve the problems of anxious depression, anxiety-phobic disorders. Take once a day at a dose of 20 mg.

Pros

+ The most powerful stimulant among SSRIs.

+ Anxiety and insomnia pass quickly.

+ Minimal side effects in the form of vomiting, diarrhea.

+ Suitable for patients with cardiovascular problems.

Cons

— Not suitable for patients with severe motor, mental inhibition.

- Reduces libido.

- Harmful to the fetus when taken during pregnancy.

6. Fluoxetine

One of the most commonly used antidepressants in the SSRI group. Known as Prozac. Fluoxetine is also known as a good mood stimulant. Patients have a feeling of fear, tension, anxiety, gloomy dislike for others. Depending on the indications, the average daily dose is 20-60 mg.

Pluses

+ There is practically no effect on the work of the heart.

+ Does not cause sedation.

+ Effective for patients with motor retardation and excessive daytime sleepiness.

Cons

- May cause weight loss.

— Hypoglycemia is possible in diabetes mellitus.

- Contraindicated in severe renal impairment.

7. Fluvoxamine

Another SSRI drug. Fluvoxamine is similar to Prozac Fluoxetine but is fast acting and may cost cheaper. The effect is in a more active slowing down of the reuptake of serotonin by neurons. It is indicated for depression of various origins, as well as obsessive-compulsive disorders. The average daily dose is 100 mg.

Pros

+ Lower price than traditional Prozac.

+ Faster action than him.

+ Relatively minor side effects (diarrhea, dry mouth, drowsiness).

Cons

- Contraindicated in diabetes.

- Pregnant women - with caution, lactation - prohibited.

- Causes nausea in some patients.

8. Sertraline

One of the widely used and universal drugs of the SSRI group. They treat almost any depressive condition, panic disorder, social phobia. However, in severe clinical cases, sertraline may not be effective enough. The standard dose is 50 mg/day.

Pros

+ No cardiotoxicity.

+ The patient's psychomotor activity does not change.

+ Does not increase body weight.

+ Combines well with other groups of antidepressants.

Cons

— In the first 2 weeks there may be problems with sleep, diarrhea.

- Side effects of a sexual nature.

- Contraindicated in pregnant women.

9. Escitalopram

The drug is classified as an SSRI. Its difference is in its effectiveness in depression, which is accompanied by involuntary movements (tic, tremor, chewing, smacking). Escitalopram is prescribed to patients with panic, anxiety, phobias, obsessive thoughts or actions. The daily dose is 20 mg.

Pluses

+ Effective in tardive dyskinesia.

+ One of the most powerful SSRIs.

+ More pronounced thymoleptic effect (improvement of mood) compared to many antidepressants of the same group.

Cons

- In some patients, anxiety increases within 2 weeks after starting treatment.

— Gastrointestinal disorders, insomnia, agitation are possible.

— Use during pregnancy only in extreme cases, incompatible with feeding.

10. Venlafaxine

Belongs to the SNRI group. In addition to blocking the reuptake of serotonin, venlafaxine has a similar effect on another neurotransmitter, norepinephrine. The medicine is prescribed for depressive conditions of various origins, social phobias, anxiety, panic. Usually take 150 mg per day.

Pros

+ Better tolerated by patients than most tricyclics.

+ More pronounced effect than classic SSRIs.

+ Fewer contraindications.

Cons

- Traditional side effects of most antidepressants: nausea, drowsiness, dry mouth, diarrhea or constipation.

- May increase eye pressure.

- The most severe withdrawal syndrome among antidepressant drugs.

This list is not to be used as a recommendation. In any case, consult your doctor before purchasing. Be healthy!

do they help, treat or relieve symptoms, are they addictive, do they make you gain weight

Daniil Davydov

medical journalist

Author profile

human.

At the same time, many myths surround the cures for this disease. Antidepressants are accused of ineffectiveness and severe side effects, but often the problem is not with the drugs themselves, but with their misuse.

We collected 8 myths about antidepressants and found out how close they are to the truth.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Myth 1

Antidepressants almost never help

Most likely, this myth arose due to the fact that antidepressants do not work in all patients - so even some doctors and scientists doubt their effectiveness. However, antidepressants cannot be called ineffective, there are just important nuances in the use of these drugs.

Antidepressants are a class of drugs that normalize the level of neurotransmitters, that is, chemicals that help nerve cells in the brain exchange information.

What are Antidepressants - International Drug Database RxLis

What Medications Help Clinical Depression in Adults - International Primer for Physicians UpToDate

How Antidepressants Help Pain - Mayo Clinic Bulletin

All Antidepressants Used to Treat Depression in Adults , work - The Lancet

Who antidepressants help and who don't - clinical guidelines for British doctorsPDF, 141 KB

These medicines help people whose problems are due to a deficiency or excess of neurotransmitters. Antidepressants reduce symptoms of depression, obsessive-compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder, and bipolar affective disorder.

There is evidence that antidepressants are effective for chronic pain. Antidepressants increase the amount of neurotransmitters in the spinal cord, which reduces pain signals.

Most specialists have no doubts that antidepressants work. For example, according to the British Royal College of Psychiatry, 50-65% of people with depression who take antidepressants feel better - compared with 25-30% of those who take a placebo.

However, there are situations where the benefit of antidepressants is questionable. For example, antidepressants are good for treating moderate to severe depression, but do not work well for people with mild depression - psychotherapy is more suitable for them.

And there are situations when these medicines were prescribed by mistake. Then antidepressants really won't help.

When antidepressants don't help

Sergey Divisenko

psychotherapist

There are three cases when antidepressants most often cause problems.

The antidepressant didn't work because the doctor prescribed the wrong dose. The minimum doses of these drugs do not help in half of the cases. Then competent doctors increase the doses to those recommended in clinical guidelines, while illiterate ones refuse them.

Sometimes, in order for antidepressants to work, they need to be augmented—i.e., enhanced—with other classes of drugs. For example, second-generation antipsychotics, or normothymics, that is, drugs that stabilize mood. If this is not done, the person taking antidepressants will not feel relief.

The antidepressant didn't work because the doctor misdiagnosed and was trying to treat a condition that these drugs don't work for. To help a person, one had to either use other drugs or use non-drug methods of treatment: for example, psychotherapy, transcranial stimulation, or electroconvulsive therapy.

For example, in bipolar disorder, symptoms can be very similar to depression or anxiety. But with bipolar disorder, antidepressants help only if they are used together with other drugs - mood stabilizers. By themselves, they will either work for a short time, or they will not work, or they can cause a phase inversion - that is, a person will switch from a depressive phase to a manic one.

The patient was not helped by a particular antidepressant, but another might. Antidepressants differ in the principle of action - on this basis they are divided into classes. It happens that one antidepressant does not work, but another from the same or another class helps. If the treatment does not work, you should not stop drug therapy, but continue to look for a drug that will help this particular patient.

Myth 2

Antidepressants only relieve symptoms, but do not eliminate the cause of the disorder

In most cases, this is not a myth. However, in some situations, antidepressants act on the cause of the disorder.

Depression is a heterogeneous disease. Experts identify a different number of subtypes of depression - from 4 to 12. But for our purposes, depression can be divided into two large subtypes.

American Criteria for Depressive Disorders - A Handbook for Psychiatrists DSM-5PDF, 32 MB

What Depression Is - An International Primer for Physicians UpToDate

associated with depression. Disorders that can be attributed to this group are more common.

If these causes affect a person long enough and he does not understand how to deal with them, depression may develop. In this situation, antidepressants act as drugs that alleviate the symptoms of the disease. To influence the cause of the problem, psychotherapy is needed.

Depression provoked by internal causes. Approximately 7% of people with depression have the right way of thinking, there are no internal conflicts and injuries, and there are no serious illnesses. In this situation, the cause of depression is the lack of neurotransmitters: serotonin, norepinephrine and dopamine in the synapses of brain nerve cells. In such people, the antidepressant acts precisely on the cause of the disease, that is, it corrects the production of serotonin in neuronal synapses.

Myth 3

As soon as it gets better, you can stop taking the antidepressant

This is also not exactly a myth - it would be more correct to call it a belief that is true only for some, but not for all patients with depression.

It is generally advised to continue taking antidepressants for at least six months after remission. If the duration of the disease is short, that is, the person was ill for about two weeks, then for the onset of remission, one or two months usually need to take medication. If the duration of the disease is long, from several months or years, then more time is required for the onset of remission. It’s impossible to say exactly how much: different people with depression have different recovery times.

Some people have recurrent depression. In this case, the period during which you need to take the medicine depends on how many bouts of depression have already been during your life. If more than three, it is recommended to take antidepressants for several years or for life.

Myth 4

Antidepressants cause addiction

Perhaps the roots of this myth are that some people need to take depression medication for life. And at the beginning of treatment, some patients have to increase the dose. But in fact, antidepressants do not cause either true physical or drug dependence.

True physical dependence on a drug is a situation where a person becomes so addicted to a drug that when it is withdrawn, the symptoms of the disease sharply increase. People who are dependent on the drug have to increase the dosage, otherwise the drug stops helping.

What is True Drug Addiction - Bulletin of the National Institute for the Study of Drug AbusePDF, 7 MB

What is Drug Addiction - Bulletin of the American Psychiatric Association

Drug dependence may include physical dependence on a drug. But this addiction has a unique feature. Dependence can also develop in a healthy person who used the drug not to recover, but to enjoy it. But when he tries to quit the drug, he still experiences physical suffering, which is called the withdrawal syndrome. As a result, a person is forced to look for a new dose of a drug.

Although a person who takes antidepressants to treat depression gets better, these drugs by themselves are not pleasurable or addictive. Taking them as drugs is useless.

Of all the drugs that are used in psychiatry, true physical dependence can only be caused by psychostimulants that activate mental activity and anti-anxiety, that is, benzodiazepine tranquilizers. Antidepressants are not included in this list, because there is no need to increase the dosage of correctly selected drugs from this group.

However, some people who stop taking antidepressants early sometimes experience withdrawal symptoms such as nausea, hand tremors, and some feel “shocks” in the head, similar to the sensations of an electric shock. Depressive symptoms return to patients who need to take the medicine for a very long time.

Antidepressants are sometimes abused, but they cannot cause addiction - Journal of Modern Psychiatry

To avoid unpleasant consequences, stop taking antidepressants only if the attending physician says that they are no longer needed. But even in this situation, it is necessary to cancel antidepressants slowly, that is, gradually reducing the dose. This will help avoid unpleasant side effects.

Myth 5

A person on antidepressants becomes lethargic and loses interest in life

This popular myth is based on real but outdated data.

These mental changes have been observed in patients taking first-generation tricyclic antidepressants such as amitriptyline. It has a sedative, that is, a sedative effect. A person who takes high doses of amitriptyline can indeed become sleepy and indifferent to the outside world.

Amitriptyline - Sedative - Drugs.com International Drug Database

SSRIs do not sedate - Drugs.com International Drug Database

Current second-generation antidepressants that are recommended to start treatment with, such as selective serotonin reuptake inhibitors, or SSRIs almost never cause drowsiness and apathy.

On the contrary, in most people with depression they return interest in life.

Sometimes SSRIs do cause drowsiness, but this has not yet been proven

Sergey Divisenko

psychotherapist

It is believed that in rare cases, modern antidepressants can provoke SSRI-induced apathy. But this condition is extremely rare.

And even then psychiatrists still doubt that the cause is precisely in the drugs, and not in the patient's condition. After all, some people during the time of taking antidepressants may develop other adverse mental states in which apathy occurs: for example, schizotypal disorder, which was not noticed before.

Myth 6

Antidepressants have many side effects

This is partly true: both SSRIs and antidepressants from other groups have side effects. But it is quite possible to deal with them.

At the start of treatment, when people first start taking antidepressants, many complain of increased anxiety, dry mouth, nausea, and trouble sleeping. But after a few days or weeks after the start of the course of treatment, these symptoms usually disappear. If the side effects do not stop, it makes sense to consult a doctor - he will replace the antidepressant.

Dealing with antidepressant side effects - tips from the Mayo Clinic staff

Here's what to do before the side effects go away:

  1. Take your antidepressant with meals, unless the instructions say otherwise, so the antidepressant will be less annoying stomach;
  2. put a bottle of clean water on the desktop - if your mouth is dry, you can take a sip. Unsweetened lollipops and chewing gum also help with dry mouth;
  3. Take a walk for at least half an hour before going to bed to make it easier to fall asleep. If you can’t sleep at all, you can ask your doctor to pick up sleeping pills.

The second most common side effect is an increase in anxiety at the beginning of antidepressant use. To avoid this problem, psychiatrists resort to two effective methods:

  1. titrate the dose - that is, start with the minimum dose of the antidepressant and then gradually increase it;
  2. at the beginning of the reception, sedatives - tranquilizers are prescribed together with the antidepressant.

A third common side effect of SSRIs, especially sertraline, known as Zoloft, and escitalopram, better known as Cipralex, is decreased libido. Approximately 20-30% of people taking antidepressants from this group experience a decrease in sexual desire to one degree or another. At the same time, it is difficult to say how much the drugs are to blame, because approximately 35-50% of people with depression have already experienced sexual dysfunction.

Many people with depression experience sexual dysfunction before starting antidepressants - Harvard Medical School Bulletin

Switching to another antidepressant usually helps, but many people prefer to wait until the medication can be stopped. In some cases, psychiatrists prescribe antidepressants from other groups in addition to the libido-lowering antidepressant. Sometimes it helps to regain interest in sex.

Myth 7

Weight gain due to antidepressants

This is not a myth, but a half-truth. There are both antidepressants that contribute to weight gain, and those that do not have a similar effect.

The most common complaint about weight gain during treatment is people taking the tetracyclic antidepressant mirtazapine, which actually increases appetite. Another weight gaining antidepressant is paroxetine, better known by the trade name Paxil. But "Zoloft" and "Cipralex" do not contribute to weight gain.

If a patient feels that an antidepressant is causing them to overeat, it is wise to consult a doctor and discuss a change of medication.

Myth 8

Antidepressants are expensive

True, but not for all patients. Most people can cure depression and not go broke.

Antidepressants from different groups vary greatly in price. There are both very expensive drugs and relatively low-cost drugs among them. At the same time, both of them work equally well. However, there are situations when a cheap antidepressant cannot be dispensed with.

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