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I found two articles that mention that taking SSRI for depression can actually make the depression worse.

Is this true? Can Tardive Dysphoria (delayed depression) be caused by SSRI?

They seem pretty convincing and I can't find anything against it but if it's true, it basically means that depression treatment is going back to the 60's before SSRI were invented.

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  • $\begingroup$ Just an assumption, it seems if a neurotransmitter removal mechanism is inhibited, probably there will be a product inhibition in the upstream processes such as release and biosynthesis. imo a better strategy could be using a stimulator that enhance biosynthesis as well as release process. The reuptake process will then adjust itself. $\endgroup$ – Always Confused Sep 10 at 14:46
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Contrary to another post here, in my opinion and also that of an increasing majority of researchers studying this field, SSRIs and the so called 'antidepressant' drugs cause great harm.

Firstly here is a list of common side effects: Insomnia (which is common in depression anyway), increased anxiousness, feeling sick, indigestion, diarrhea or constipation, loss of appetite, fluctuations in weight, dizziness, blurred vision, dry mouth, excessive sweating, headaches, reduced sex drive, difficulty achieving orgasm, erectile dysfunction.

None of these are good effects which is why we don't give them to people who are 'healthy'. More importantly the devastating effect these side effects can have on a patients life could potentially be far more harmful than before the drug was taken, for example increased marital problems. According to Joanna Moncrieff these effects compound depression, and more importantly disturb the chemical balance in the the brain, and as a result compound or cause the very symptoms they are meant to cure. Central to this notion and the question presented here, the long-term use of SSRIs may causes what we call 'serotonin induced apathy', in other words, after initial positive effect of SSRIs (quiet possibly short-term placebo effect), patients become indifferent to their environments. Furthermore Long-term use of SSRIs leads to abnormal brain neurogenesis not seen in non-depressed samples, this is often taken to as proof of how SSRIs exert there action, or rather it was before 2008 (see below meta analysis). However it seems that this neurogenesis is less likely to be positive considering the negative effects and lack of efficacy SSRIs display.

The long-term use of SSRIs often leads to the development of apathy, which utimatley will lead many patients back into depression. The rate of relapse in people taking 'anti-depressants' is >40% while patients with placebo is roughly 24%. If that isn't bad enough at a 12 month follow up only <5% of patients are in remission for their depression. Why might this be? Well a 2008 meta-analysis by Kirsch et al found that all 'anti-depressants' are below clinical levels of acceptance, in other words no more effective than placebo. However it should be noted that in severe depression SSRIs are useful only!

The reason anti-depressants such as SSRIs are ineffective is because of the simplistic approach taken to treatment with these drugs. The brain is not some 'big bag of chemicals', neurons are not purely serotonergic in fact they often release multiple NTs. And crucially serotonin NT is used throughout the central nervous system, for more than mood regulation. The fact that SSRIs do not work over the long-term tells us the serotonin theory of depression is wrong. Perhaps more importantly roughly 10% of people in the UK are on 'anti-depressants', we can talk about over medicalisation of mental health, but the reality is large amounts of people are taking these drugs for large amounts of time (9-12 months recommend). This is not helped by the fact that governments are more interested in investing in cheap medical 'cures' than long-term methods with greater efficacy that cost more.

Sorry its so long, and I'm sorry its so short there is so much to say about how SSRIs don't work and how bad they are regarding people thinking they are getting effective cures, along with the neuroscience and discussions on publication bias. Its a fascinating topic, thanks for the question.

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  • $\begingroup$ "SSRIs and the so called 'antidepressant' drugs cause great harm." They may cause some harm to some people, but this claims that they cause great harm to all who take them. This is not the case. $\endgroup$ – Chris Rogers Sep 10 at 10:14
  • $\begingroup$ Personally i am under medical supervision and i have to take SSRI maintenance dose since doctors ordered it and the permission to start or stop a medication is under sole control of the doctors. Interestingly SSRIs make me very much sleepy and tired though not as much as antipsychotics. $\endgroup$ – Always Confused Sep 10 at 14:50
  • $\begingroup$ @Chris Rogers Antidepressants do cause great harm as I have pointed out, the side effect list alone shows that they cause harm. In addition tranquillising patients is IMO fine for the short term, but an ineffective long term strategy. This is where a large amount of harm comes from because you cannot think and act as well on SSRIs etc as off them, which effects much of patients lives. Furthermore the evidence shows that for the majority of patients on them they are largely ineffective. So yes they do not harm to all but they are used in such a way as to harm the majority. $\endgroup$ – Comte Sep 11 at 22:56
  • $\begingroup$ @Comte - The side effects list covers what can occur, not necessarily will occur. As for harm in that list, insomnia is a bit of a contentious effect as (pointed out by you) depression can cause insomnia. Diarrhoea or constipation could cause issues, but there are antidiarrhoeals and laxatives. Headaches can be helped with paracetamol or similar, and the rest of the list are not harms, although I concur that some can add to the depression. $\endgroup$ – Chris Rogers Sep 12 at 10:47
  • $\begingroup$ Also, antidepressants don’t tranquillize people like you suggest in your last comment. Tranquillizers tranquilize people, antidepressants are prescribed to alleviate the effects of depression in order for you to be able to function better. $\endgroup$ – Chris Rogers Sep 12 at 10:50
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In general no SSRIs lasts long enough as an effective treatment for most patients to cause long term harm. Most of the time people are only on them for weeks or months before many of their symptoms are reduced. If someone remains on antidepressants for long term treatment for something like OCD intrusive thoughts or major depression it is possibility for the medicine to harm the nervous system. This is unlikely though because SSRIs are not that effective and most of the time they have to cycled to another kind of medicine for most diseases as the diseases adapt to the medication. The meds stop working and the doctor and patient must switch to another type.

Yes Tardive Dysphoria does really happen and its happened to me but no its not a big deal nor is it life altering. No we are not going back to the 60s. As there are other options in treatments. Doctors have known that inappropriate dosages or incorrect medications do cause depression. Sometimes more of the same SSRI will fix the problem. The antipsychotics and antidepressants have long since been known to sometimes have inverse effects on some patients. This is the reason why abilify though it be the latest and greatest antipsychotic is not necessarily the medicine of choice because of it high probability to induce psychosis. Thats because there are 8 genes responsible for the schizo type psychosis and how each person responds to medication varies based on their gene and biology. Likewise also for depression a much less understood condition the person's biology is going to determine their response to medication and final treatment.

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    $\begingroup$ Welcome to cogsci.SE! This answer could be improved by citing sources. (E.g., "Most of the time people are only on [SSRIs] for weeks or months"--where is this information coming from?) $\endgroup$ – Krysta Oct 22 '14 at 12:40
  • $\begingroup$ @Krysta yes it would be nice to make a citation but it is impossible with the 2 link burden $\endgroup$ – user6939 Oct 22 '14 at 14:08
  • $\begingroup$ patient.co.uk/health/depression-leaflet $\endgroup$ – user6939 Oct 22 '14 at 14:10
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    $\begingroup$ @timmy26 I wasn't laughing at you, I was laughing at the apparent contradiction: you rhetorically said that it's comparable to proving "water is wet", which implies you don't think proof is necessary - and that no proof necessary means the claim is well substantiated. My apologies. However, academic papers can be reviews of many decades of research too, so they don't necessarily need to present a narrow scope. $\endgroup$ – user6682 Oct 23 '14 at 18:06
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    $\begingroup$ @timmy26 Besides, a medical website that can't back up its claims with sources (i.e. papers) is worthless. $\endgroup$ – user6682 Oct 23 '14 at 18:07

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