Selective serotonin reuptake inhibitors, or S.S.R.I.s (the most commonly prescribed form of antidepressant) were originally studied for short-term use and were approved based on trials that lasted only a few months. But people quickly began taking the drugs for extended periods. Now patients are likely to stay on antidepressants for years, even decades. Of those who try to quit, conservative estimates suggest about one in six experiences antidepressant withdrawal, with around one in 35 having more severe symptoms. Protracted and disabling withdrawal is estimated to be far less common than that. Still, in a country where more than 30 million people take antidepressants, even relatively rare complications can affect thousands of people. (View Highlight)
For many patients, it’s clearly worth it to start on antidepressants. There’s strong evidence that antidepressants are more effective than placebo, especially for short-term use. But, as for most medications, the effectiveness of antidepressants varies from person to person. Nearly a quarter to a third of patients find their depression remarkably improved or even resolved after starting medication, but a similar proportion experience no real benefit even after trying multiple kinds of antidepressants. (View Highlight)
The public deserves advice about psychiatric medications that does not oscillate between stupor and alarmism. Antidepressants, like all medical interventions, come with benefits and trade-offs. If psychiatry refuses to engage seriously with patients’ concerns, if the mantra of “safe and effective” is all it is willing to publicly say, it will lose credibility. We cannot disregard those whose lives have been derailed by psychiatric medications. (View Highlight)