Antidepressants are drugs prescribed by doctors to treat depression, anxiety, post-traumatic stress disorder, eating disorders, obsessive compulsive disorder and chronic pain.
In the UK, 8.32 million people are on antidepressants – worldwide this figure amounts to more than 100 million.
It is a common misconception that antidepressants can cure a 'chemical imbalance'. No chemical imbalances have been proven to exist in relation to depression or any mental disorder.
Antidepressants do not cure depressive illnesses - they only alleviate symptoms for some people by numbing emotions or by giving a temporary boost of euphoria.
About Antidepressants
Common Side Effects
More than half of patients will experience negative side effects from taking antidepressants.
According to published data, more than 50% of users experience sexual dysfunction. In men this can mean delayed ejaculation and erectile dysfunction and in women difficulties achieving orgasm. In both there can be a loss of libido.
The NHS, Mayo Clinic list other side effects as:
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agitation
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sickness
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indigestion and stomach aches
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diarrhoea, constipation
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insomnia
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headaches, joint and muscle pain
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blurring of vision
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drowsiness
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problems passing urine
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dry mouth
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weight gain
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excessive sweating
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low sex drive
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heart rhythm problems
Opinion is divided as to how well antidepressants work.
There is little data on long term outcomes as the drugs are only tested for 6-8 weeks by the pharmaceutical companies that make them.
Data on short term effectiveness is also limited because drug companies are not obliged to publish all of their trials.
In their guide to taking antidepressants The Royal College of Psychiatrists state: 'Overall research shows antidepressants help to reduce the symptoms of moderate and severe depression in adults. But different people have very different experiences with these medications.' Link
Some clinicians believe they are no more effective than a placebo.
In 2008 Dr Irving Kirsch from Harvard Medical School and a group of researchers acquired the unpublished trials for six antidepressants using the Freedom of Information Act (U.S.). They discovered that the drugs produced a small but clinically meaningless improvement in mood compared to a placebo for mild to moderate depression. Antidepressants and the Placebo Effect.
Other studies have reached a range of differing conclusions.
How Effective Are Antidepressants?
The most dangerous time for those who react adversely to antidepressants is within the first few weeks of going on them, around any change of dose (up or down), during and after withdrawal.
Extreme Reactions
Akathisia
A very common sign that someone is having a dangerous reaction to medication is that they develop a condition called akathisia.
This is a life-threatening condition that occurs in some people after starting, changing or withdrawing from psychiatric medication.
The medication attacks the nervous system creating the following symptoms:
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An intense inner restlessness with need for constant movement.
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Pacing, shuffling feet, rocking back and forth on feet.
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Foot stomping or rocking when seated.
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Inability to sleep.
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Panic attacks.
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Overwhelming sense of paranoia, terror and fear.
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Unrelenting and impulsive thoughts of violence and death.
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A feeling of wanting to rip off one's skin/escape a physical torture.
Akathisia can lead sufferers to harm or kill themselves.
With thanks to MISSD
Serotonin Syndrome
Serotonin syndrome is a potentially life threatening condition that can be triggered by a single dose of an antidepressant. Symptoms can include confusion, agitation, muscle twitching, sweating, shivering, diarrhoea, fits, unconsciousness and psychosis.
The NHS and similar websites around the world advise that if you experience any of the above symptoms of serotonin syndrome you should stop taking the medicine and seek immediate advice from your GP, specialist or emergency services.
Extreme Outcomes
Suicide
According to drug company data 1 in 100 people have a severe adverse reaction to antidepressants that results in a desire to kill themselves. Unpublished trial data puts this figure at between 2% - 5%. Other studies of healthy volunteers have shown up to 10% of people who have never had depression have become suicidal from taking an antidepressant.
Suicidal ideation (thoughts about killing yourself) can happen within just hours from people taking a single dose of an antidepressant. This is often mistaken for a sign that their depression is worsening.
Some survivors of these effects report that the desire to kill themselves stemmed from acute physical and mental agony caused by a condition called akathisia (see above)
Others report that they become confused, detached from their actions and may go into a dream-like state in which they feel compelled to harm themselves and/or others.
Homicide and Violence
There have been well documented cases of antidepressants causing homicide and violence.
Like suicide, this can be the result of akathisia or an antidepressant induced psychosis.
15 courts of law around the world have attributed homicidal behaviour to a defendant's use of antidepressants leading to acquittal or a more lenient sentence.
The legal defence in these cases is 'involuntary intoxication' or 'automatism'.
Antidepressant induced violence is not always recognised by courts. The result is that there are a number of people in prisons around the world for crimes that they, and experts, believe were caused by antidepressants.
Kurt served 24 years for killing his father after a violent reaction to Prozac.
Click here to read Kurt's story.
Long Term Risks of Antidepressants
People can suffer debilitating side effects that may continue after they stop the drug.
These include emotional bluntness, anhedonia (inability to feel pleasure), suicidal thoughts, sleep disturbances, weight gain, loss of fertility, diabetes, brain fog, persistent dizziness, visual disturbances and sexual problems.
PSSD (Post SSRI Sexual Dysfunction) is a condition where sufferers continue to have sexual dysfunction after stopping taking antidepressants and can be permanent.
Since 2019 the European Medicines Agency has required drug companies to put warnings in their patient information leaflets that sexual problems may persist after coming off antidepressants that act on the serotonin system. Sufferers report genital numbness, erectile dysfunction, inability to orgasm and emotional blunting.
"While these drugs help some people in the short term, there is growing evidence that long term use leads to worse outcomes and many patients report devastating persistent withdrawal and other negative effects"
There is now evidence that millions are trapped into taking antidepressants indefinitely because withdrawal symptoms are so severe.
According to a review of studies led by the University of Roehampton more than half (56%) of people who stopped or reduced their intake of antidepressants experienced withdrawal symptoms, with almost half of these people (46% ) reporting symptoms as severe.
These include insomnia, panic attacks, suicidal thoughts, mania, depersonalisation and depression.
In some cases reactions are so severe that patients report 'brain zaps' - these are electrical shock sensations in the brain which may extend down the body.
It can take many months or years to come off antidepressants safely.
The Royal College of Psychiatrists have published a guide - Stopping Antidepressants.
Dr. Ed White was a co-founder of this website. He suffered debilitating withdrawal effects and took his life in October 2021
Click here to read Ed's story.