Are Antidepressants as Effective as Previously Thought? Mixed Research on Psychoactive Drugs
The use of antidepressants is increasing worldwide. This is to deal with growing rates of depression and anxiety. But it has been proven that depression is not caused by reduced levels of serotonin in the brain – so why do doctors keep prescribing them? There is very mixed evidence on antidepressants. It seems as though there is not a set opinion on their consumption in the medical field, yet prescriptions are increasing. Have antidepressants become a quick solution for a long-term problem, and what are the long-term effects of taking psychoactive drugs?
Antidepressants are medications used to treat mental health disorders, primarily anxiety or depression related. However, antidepressants can have various side effects such as an increased risk of suicide, nausea or fatigue. Similarly, different antidepressants work better for different people – taking one type of antidepressant is not guaranteed to work for you. In contrast, 69% of patients should start to show relief from their symptoms after two therapy sessions with the UK’s National Health System. So why would doctors still choose to prescribe antidepressants?
A recent survey of over 30,000 people in the US showed that one in six took antidepressants. However, only 10% of the participants were in therapy. Why were patients allowed to take psychoactive drugs on a daily basis, but not see a psychotherapist?
The Serotonin Hypothesis
The serotonin hypothesis was the theory that antidepressants were developed from. This theory suggested that depression was caused by low levels of serotonin in the brain. As a result, antidepressants like SSRIs (selective serotonin reuptake inhibitors: the most popular type of antidepressant) were developed in the 1980s. Many drug companies marketed SSRIs as antidepressants; however, no researcher could back up this claim. Serotonin is involved in mood regulation, but there was no evidence that depression was caused by low serotonin levels.
Today, it is well known that the serotonin hypothesis doesn’t explain how depression forms. However, the use of antidepressants has increased nearly two and a half times in 18 European countries since 2000.
“It’s not an evidence-based statement to say that depression is caused by low serotonin; if we were more honest and transparent with patients, we should tell them that an antidepressant might have some use in numbing their symptoms, but it’s extremely unlikely that it will be the solution or cure for their problem”
– Dr Mark Harowitz, psychiatrist and researcher
Antidepressants: Mixed Research
The evidence of antidepressants is very mixed. A recent umbrella review from 2022 examined decades worth of data about people taking antidepressants. In this study, there was no evidence found that serotonin levels are linked to depression. However, a meta-analysis from 2018 showed that all 21 antidepressants are more effective than placebos. This raises questions on the use of antidepressants: what do we know?
Similarly, the research on antidepressants and teenager’s brains are mixed. Some research has shown that SSRIs have no developmental effect on the adolescent brain. However, other research found that SSRI treatment enlarged the middle frontal gyrus, prefrontal cortex and orbitofrontal cortex. These areas help with attention, memory, emotions and decision making – areas that are very important during puberty. Why are children being prescribed antidepressants when their brains are still developing?
If there is not a set opinion in science on whether antidepressants have bad effects with long-term use, why keep prescribing them?
Why Are Antidepressants Still Prescribed?
Of course, antidepressants can be prescribed to people suffering from moderate or severe depression, as well as anxiety-related disorders. However, the World Health Organization has called for more mental health facilities and services around the world. This is because over one billion people are now living with a mental health disorder. These disorders are highly prevalent in all countries, and are the second biggest reason for long-term disability.
Even in high income countries, only 50% of affected individuals receive care for their disorder. For example, Irish waiting lists for seeing a therapist are at least 6 months. As a result, over 37,000 antidepressants were prescribed to people under eighteen in the first 9 months of 2024. Due to a lack of financing for mental health facilities or community-based access, doctors might have to turn to prescribing antidepressants, even when the illness is mild.
“Are people becoming more depressed, or simply more comfortable about seeking treatment? It may be that the availability of new, more effective antidepressant drugs has played a part, or that doctors, following clinical guidelines, feel more willing to prescribe antidepressants.”
– Future Care Capital Insight
Similarly, antidepressants have been used for long-term treatment of mental illnesses. For a long time, it was thought that they were good for preventing a relapse of mental illness. Some studies do point towards antidepressants having better effects than placebo drugs on preventing relapse and recurrence of depression. However, this was generally only found in the first six months after a depressive episode, and not for all patients.
Many people might be afraid to stop taking antidepressants because they are afraid of relapse – but the research is still mixed, and it looks like the chances of relapse are smaller than previously thought.
Antidepressants: What To Know
Although this is not a medical journal, it is important to know the facts: antidepressants can relieve symptoms, but they are not a long-term solution. Therapy and regular exercise are the best solutions, but they are not accessible for everyone. There isn’t even a set opinion on antidepressants in the medical field, there is mixed research on them. Doctors might sometimes prescribe them because of the lack of mental health facilities worldwide.
Highlight Image:
@ Towfiqu barbhuiya via Unsplash
