Do Antidepressants Work for Treating Depression?

It's normal to feel down sometimes. Situational changes and stress can cause temporary periods of sadness and lack of interest in normal activities, but for people with major depression these symptoms are a daily experience. More than 20 million people suffer from depression in the United States alone, and for them, the feelings of sadness and loss of pleasure in living don't go away. They frequently suffer from feelings of worthlessness and have physical symptoms such as difficulty sleeping and weight loss.

Antidepressants are the Most Common Treatment for Depression

When these symptoms become so painful that a depressed person sees their doctor, there's a good chance their doctor will give them an antidepressant medication. Antidepressants are some of the most commonly prescribed medications on the market. They're used not only to treat depression but off-label to treat other conditions as well. But recently they've come under increasing scrutiny and some experts question whether antidepressants work for treating depression at all.

And there's the issue of side-effects. Antidepressants have a variety of side-effects including a dry mouth, loss of sex drive, weight gain and anxiety to more serious ones. People taking antidepressants are at greater risk of suicide for a few weeks after starting an antidepressant medication.

Do Antidepressants Work?

Even for people that can tolerate the side effects, antidepressants don't offer a magical cure for symptoms of depression. According to an analysis of 6 randomized placebo-controlled trials carried out by researchers at the University of Pennsylvania, antidepressants were either ineffective or only marginally effective for treating mild to moderate depression. Antidepressants do show benefits for people suffering from severe depression, but the overwhelming majority of people being treated for depression aren't severely depressed.

Still, there are people with symptoms of depression who feel better once they started taking an antidepressant medication. Whether or not this is a placebo effect isn't clear. Just as concerning are the side effects of these medications. The Women's Health Initiative study showed that post-menopausal women who took antidepressants were at higher risk for stroke and had a slightly greater risk of dying prematurely from all causes.

Another study carried out at Emory University found that middle-aged men who took antidepressants had blood vessel walls that were 5% thicker than those that didn't. This thickening is a risk factor for both stroke and heart attack. Antidepressants work by altering levels of neurotransmitter such as serotonin. Serotonin can also affect the function of blood vessels, which may explain why antidepressants increase the risk of stroke and heart attack.

The Bottom Line?

Antidepressants may have a place for treating severe depression, but the risks and side effects of these medications may outweigh the benefits for people with milder symptoms. This clearly shows that alternatives to prescription antidepressants are needed. Hopefully, there will be more focus on studying alternative treatments such as acupuncture, meditation and hypnosis in the future.

Medscape.com. "Antidepressants May Only Be Effective in Treatment of the Severest Depression"

WebMD. "Antidepressants May Raise Stroke Risk"

Emory University Cardiology Blog. "Study: Antidepressants can thicken arteries and lead to heart disease"