Millions of people rely on anti depressants to help them to combat the crippling symptoms of depression, in some cases dealing with side effects such as headaches, insomnia and sexual disfunction in order to remain on medication. But now, a study concludes that antidepressants might actually increase the probability of future relapses..

The news comes as a result of a meta-analysis carried out by evolutionary psychologist Paul Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour. His findings suggest that people who have not taken medication for depression are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.

The work analysed the results of dozens of previously published studies comparing outcomes for patients who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment. Paul believes that anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new episodes.

This same problem was recently highlighted by John Horgan in an article for Scientific American. He claims that the effect has left his friend unable to stop taking the drugs:

One chronically depressed friend has tried, unsuccessfully, to stop taking his medications, but he experienced a surge of depression worse than the one that led him to seek treatment. He accepts that he will probably need to take antidepressants for the rest of his life.

Of course, public suspicion of anti-depressants is not a new thing. The complex nature of the diagnosis and treatment of neurological conditions, coupled with a realtively poor understanding of how the drugs affect the brain, means that some will always be suspicious. The means by which drug companies get their drugs approved doesn’t help matters either, as the New York Times reports:

As a condition for drug approval, the F.D.A. requires drug companies to demonstrate a medicine’s efficacy in at least two trials. Trials in which neither the new drug nor an older, established drug is distinguishable from a placebo are deemed “failed” and are disregarded or weighed lightly in the evaluation. Consequently, companies rushing to get medications to market have had an incentive to run quick, sloppy trials.

Often subjects who don’t really have depression are included — and (no surprise) weeks down the road they are not depressed. People may exaggerate their symptoms to get free care or incentive payments offered in trials. Other, perfectly honest subjects participate when they are at their worst and then spontaneously return to their usual, lower, level of depression.

This improvement may have nothing to do with faith in dummy pills; it is an artifact of the recruitment process. Still, the recoveries are called “placebo responses,” and in the F.D.A. data they have been steadily on the rise. In some studies, 40 percent of subjects not receiving medication get better.

Of course, the influence of anti-depressants isn’t all negative. They have been shown to be effective at preserving memory and brain function in stroke victims, and whether they’re chemically effective or not, they bring relief to many people suffering from a horrible and debilitating condition. As Peter Kramer, a clinical professor at Brown University points out:

It is dangerous for the press to hammer away at the theme that antidepressants are placebos. They’re not. To give the impression that they are is to cause needless suffering.

The question is, are we still doing our best to treat complex neurological conditions such as depression, even though care is necessarily slow, expensive and unpredictable, or are we becoming too quick to see medication as a quick fix? The brain is still relatively poorly understood as far as treatment and care are concerned, if that is to change, patient care, not patient turnover, needs to be the driving force behind treatment.

Source : Science Daily,