Antidepressant Medication Increases Relapse Rates

Antidepressants are commonly used to treat depression and in the short term, can be effective for many people. However, they are far from perfect and there are several studies highlighting their potential dangers in the long term.

In a paper published in the journal, Frontiers in Psychology, researchers demonstrated that depressed individuals who use antidepressants are much more likely to suffer a depressive relapse than those who use no medication at all [1].

In fact, patients who have used antidepressant medications had almost twice the risk of suffering from a future depressive episode. This conclusion was based on a ‘meta-analysis’ of studies. A meta-analysis basically relies on statistical analyses from several research studies. This makes the conclusions of a meta-analysis stronger than those from a single study.

The research group found that people who have not been taking any medication have a 25 per cent chance of relapsing, compared to 42 per cent for those who have taken and then gone off an antidepressant.

According to the lead author Dr Paul Andrews, antidepressants may interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters which are associated with mood. Once people stop their medication the brain can overcorrect which triggers a new depressive episode.

In addition to this, the problem with the sole reliance on antidepressants to treat depression is that it does not necessarily treat the underlying causes. Depression is not simply due to deficiencies in neurotransmitters such as serotonin. There are several lifestyle, psychological, social, biological and environmental factors that can affect mood. For mood improvements to maintain in the long term the underlying causes need to be identified and corrected.

For example, high stress, a poor diet, nutritional deficiencies, lack of exercise and poor sleep can all affect mood. Interestingly, all of these can also affect serotonin levels in the brain.

Recent studies have confirmed that eating a healthy diet can protect against depression. In particular, a Mediterranean-diet comprising lots of vegetables, fish, olive oil, seeds and nuts can improve mood [2]. There have also been studies showing that spices such as saffron and curcumin (from turmeric) can have brain-protective and mood-lifting effects. Saffron, in particular, has been shown to be as effective as antidepressants for the treatment of depression (in the short term) [3].

While we do not recommend people stop their antidepressant medication without consulting their doctor first, this study highlights that to improve mood and effectively overcome depression in the long term, a reliance solely on antidepressant medication is not an effective approach over the long term.

References

[1] Andrews, P.W. et al Blue again: perturbational effects of antidepressants suggest monoaminergic homeostasis in major depression. Front Psychol. 2011 Jul 7;2:159. pubmed link

[2] Rahe, C. Dietary patterns and the risk of depression in adults: a systematic review of observational studies. Eur J Nutr. 2014 Jun;53(4):997-1013. pubmed link

[3] Lopresti, A.L. & Drummond P.D. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol. 2014 Nov;29(6):517-27. journal link