On social media, influencers tout them as lifestyle medications that can turn around your life. But Health Secretary Robert F. Kennedy Jr. has branded SSRIs\u2014or selective serotonin reuptake inhibitors, the most common class of antidepressants\u2014as more addictive than heroin and linked them to violent episodes such as a recent church shooting in Minnesota.<\/p>\n
He\u2019s said the government is launching studies to look at whether the medications are being overprescribed to adolescents and contributing to violence.<\/p>\n
What is the reality about antidepressants? Here are some answers.<\/p>\n
My father passed away, and I\u2019ve been sad for weeks. Should I ask a doctor for an antidepressant?<\/p>\n
Most likely, no. Antidepressants are typically prescribed for people with major depressive disorder.<\/p>\n
\u201cThe diagnosis is really more than just transient sadness and the normal expected grief from the loss of a family member,” says Dr. Sanjay Mathew, president-elect of the Anxiety and Depression Association of America.<\/p>\n
Depression also comes with anhedonia, or the inability to experience pleasure in activities or social situations that were once enjoyable.<\/p>\n
A diagnosis typically involves having an array of symptoms. These can manifest with things like low energy, difficulty concentrating or changes in sleeping and eating patterns.<\/p>\n
Doctors look for symptoms that impact people for most of the day for at least two weeks.<\/p>\n
\u201cWe look for a cluster of symptoms,” says Dr. Aniruddha Deka, an assistant professor of psychiatry at Rush University in Chicago. \u201cWhen we have enough of these symptoms and they are affecting functioning, we diagnose.”<\/p>\n
Are antidepressants addictive?<\/p>\n
No. Doctors say antidepressants\u2014SSRIs as well as other classes\u2014show none of the telltale signs of addictive substances.<\/p>\n
\u201cAddiction involves craving a substance, feeling kind of high or intoxicated on something and compulsively using it despite negative consequences,” says Deka.<\/p>\n
With antidepressants, people have a physical adaptation to the medication as the serotonin signaling in their body changes.<\/p>\n
\u201cI\u2019ve never in my career seen someone compulsively seek out antidepressants,” says Dr. Eric Lenze, head of the psychiatry department at Washington University School of Medicine in St. Louis.<\/p>\n
What\u2019s confusing is that people who stop taking antidepressants can experience flulike withdrawal symptoms as the body adjusts to the absence of the medication, says Lenze. One unusual symptom is ear zaps, or the sensation of an electrical zap behind one\u2019s ear.<\/p>\n
Other withdrawal symptoms can include dizziness, fatigue, anxiety, insomnia, agitation and gastrointestinal side effects.<\/p>\n
\u201cAddiction is a very different thing than simply the fact that if you stop taking the medication you may have some withdrawal symptoms or you might relapse,” says Lenze.<\/p>\n
How many people experience withdrawal symptoms varies. One recent study analyzing data from more than 20,000 patients across nearly 80 studies concluded that about 15% of people had withdrawal symptoms when discontinuing an antidepressant. Severe symptoms were experienced by only 3% of people.<\/p>\n
How long should someone take an antidepressant?<\/p>\n
The length of time someone takes an antidepressant depends on if it\u2019s his or her first episode or not, says Deka.<\/p>\n
\u201cRecurrences tend to predict further recurrences,” he says.<\/p>\n
The risk of recurrence is about 50% after one episode of depression. That jumps to 70% after two or more episodes and 90% after three episodes.<\/p>\n
Depression in most people is a chronic or recurrent illness, says Lenze. \u201cIn a way it\u2019s like hypertension,” he says. \u201cIf you take blood-pressure medicine and your blood pressure normalizes then that\u2019s a sign that the medication is working. But if you stop it, your blood pressure will go back up.”<\/p>\n
If it\u2019s a first episode, doctors will typically recommend tapering off an antidepressant after six to 12 months from remission of symptoms.<\/p>\n
\u201cWe don\u2019t necessarily want people to be on the drugs indefinitely if they don\u2019t need it,” says Mathew.<\/p>\n
If someone is still going through a hard time or has had episodes before, he may be advised to stay on the medication, Deka says. People with severe cases that resulted in hospitalization or thoughts of suicide may also stay on the medications.<\/p>\n
\u201cIt could be more than two years depending on the situation,” says Deka.<\/p>\n
Always consult a medical professional if you\u2019re looking to stop taking an antidepressant. Doctors say it\u2019s best to taper off gradually.<\/p>\n
Most people can taper off an antidepressant in two weeks to two months. Generally, people taking a higher dose of an antidepressant, or who have been taking one for a long time, may take longer to come off them.<\/p>\n
What are the side effects of antidepressants?<\/p>\n
Common short-term side effects for SSRIs include gastrointestinal ones like nausea or feelings of anxiety. Longer-term ones can include sexual dysfunction and weight changes.<\/p>\n
Medications commonly used in conjunction with antidepressants\u2014such as Abilify and Vraylar\u2014also can have metabolic side effects, such as changes in cholesterol and blood-sugar levels. In rare cases people can develop movement disorders such as uncontrollable neurological movements. \u201cMost of the side effects are reversible upon discontinuation,” says Mathew.<\/p>\n
Can they cause violence?<\/p>\n
There is no solid research linking antidepressants to violent behavior, doctors say.<\/p>\n
Deka says it\u2019s difficult to separate medication effects from underlying illness, and people may be struggling because their condition isn\u2019t controlled, not because the drug causes violence.<\/p>\n
There are modest risks for taking antidepressants over a lifetime, says Lenze, such as bleeding because some inhibit platelet function.<\/p>\n
But for most people the risks of taking an antidepressant are less than the risk of a relapse of depression, he notes.<\/p>\n
So while there can be unpleasant side effects or withdrawal symptoms, antidepressants don\u2019t pose a risk for addiction like opioids or even stimulants. But they also aren\u2019t a cure-all, even if they can serve an important purpose for getting through challenging times in life.<\/p>\n
Write to Sumathi Reddy at Sumathi.Reddy@wsj.com<\/p>\n","protected":false},"excerpt":{"rendered":"On social media, influencers tout them as lifestyle medications that can turn around your life. But Health Secretary…\n","protected":false},"author":2,"featured_media":257081,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[44],"tags":[13883,106706,102,55649,1906,6623,106705,56,54,55,51077],"class_list":{"0":"post-257080","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-antidepressants","9":"tag-antidepressants-medication-effects","10":"tag-health","11":"tag-major-depressive-disorder","12":"tag-mental-health","13":"tag-mentalhealth","14":"tag-selective-serotonin-reuptake-inhibitors","15":"tag-uk","16":"tag-united-kingdom","17":"tag-unitedkingdom","18":"tag-withdrawal-symptoms"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/257080","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=257080"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/257080\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/257081"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=257080"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=257080"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=257080"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}