Before considering antidepressant medication, you probably want to know if they can help. Can antidepressants really ease or cure depression?
Well, effectiveness is not the biggest issue concerning antidepressant medication. Antidepressants can definitely ease depression. To be cured with pills alone is less common, but it happens. And sometimes, they save lives.
About 50% of people report a 50% or more reduction of their symptoms with medication (SSRIs). As a comparison, 25-30% of people will have similar results using placebo pills.
That’s actually not bad.
And if you combine your medication with psychotherapy or tDCS, your chances of improving increase even more.
So, what’s the catch?
Actually, there are several. That doesn’t necessarily mean you should stay away from antidepressants. However, it’s important to be well informed before starting the treatment.
Here are 6 common problems with antidepressants you should know about:
1. Emotional blunting
About 30-50% of people who take antidepressants experience emotional blunting – feeling numb or dull, as if nothing is truly important. This side effect can easily be mistaken for depression.
2. Tolerance
Antidepressants are designed for short-term use. When effective, they improve your depression within 4-8 weeks.
You are supposed to slowly come off the medication about 6 months to 1 year after it starts working (by carefully tapering the dose in agreement with your doctor). However, some patients are prescribed the same antidepressant for several years, which can be harmful to receptors in the brain, making them less responsive to the medication.
Even when used correctly, 25% of people build up tolerance to antidepressants over time.
3. Withdrawal
Both doctors and patients sometimes mistake withdrawal for depression. In some cases, patients keep taking antidepressants for years and years, thinking they are unable to cope without them. Every time they try to quit, they feel awful.
When lowering their dose, about 50-60% of people experience some of these withdrawal symptoms:
- Confusion
- Stomach upsets
- Flu-like symptoms
- Sweating
- Anxiety
- Dizziness
- Sleeping problems
- Nightmares
- Brain zaps (feeling as if there’s an electric shock in your head)
- Irritability
4. Unexpected drug interactions
Even though doctors prescribe medications with well-known side effect profiles, it’s not possible for mental health professionals to precisely predict how two different drugs interact with each other.
Dr Russ Altman found that mixing Pravastatin/Pravachol (a drug for high cholesterol) and Paroxetine/Paxil (an antidepressant) created a completely unexpected and unhealthy spike in glucose levels. High glucose levels are associated with diabetes and damage to organs and tissue.
If you’re currently taking another form of medication, you may want to consider a medication-free treatment for your depression.
5. Finding the right pill
There are many types of antidepressants and even more brands. Unfortunately, there’s no way of knowing for sure which medication will work for you or give you the most tolerable side effects.
Medical research shows us what works in general, for large groups of people. It can’t tell us which drug will work for any one individual.
To complicate things further, different types of antidepressants have different side effect profiles. But a particular antidepressant doesn’t cause the same side effects in all people.
So, doctor’s need more than one medication to choose from when prescribing antidepressants. If one doesn’t work, perhaps another one will. And considering that it takes 4-8 weeks for an antidepressant to take effect, finding the right one can become a lengthy project. And you may experience uncomfortable side effects in the process.
6. Side effects
This is perhaps the most well-known problem with antidepressants. As many as 70-80% of people stop their treatment early because of intolerable side effects.
Here are some of the common ones:
- Profuse sweating
- Weight gain
- Diminished sexual interest, desire, performance and satisfaction
- Insomnia
- Sleepiness during the day
- Restlessness
- Headaches
- Joint pain and muscle pain
- Muscle spasms/twitching
- Dry mouth
- Skin rashes
- Dizziness
- Nausea
- Constipation
- Diarrhea
In conclusion
Antidepressants work and they do save lives. However, it’s important to be well informed about tolerance, withdrawal, drug interactions and side effects before starting treatment.
Read more about 14 therapies to treat depression.
Hope this helps.