The Depressing Effects Of Antidepressants

SSRIs (Selective Serotonin Reuptake Inhibitors) are the most common and generally considered the safest antidepressants. They work by preventing the reuptake of serotonin, thereby increasing the amount of serotonin in the brain. They are considered the safest for having the most favorable side effect profile compared to other antidepressants. They are considered first line treatment for severe and or persistent depression, other psychological conditions such as anxiety disorders, bipolar disorder, PTSD and more. They are considered immediately necessary and effective for treating severe depression especially but how truly effective and safe are they? 

The time it takes for SSRIs to start working is 2 to 4 weeks. It is considered that SSRIs are immediately necessary for the severely depressed, as severe depression can compel one to commit suicide, yet they do not work immediately. This is because the brain tries to recalibrate serotonin levels by producing less of it.  If it can take nearly a month to start working, why should it be treated as first line intervention? When it finally does take effect, how effective is it? How significantly does it improve symptoms?

According to the National Library of Medicine, in multiple studies comparing a placebo to antidepressants, it found that 20 to 40% of people taking the placebo reported improvement in their symptoms and 40 to 60% of people taking the antidepressants reported improvements in their symptoms. Simply believing that their placebo pills will help causes a reduction in symptoms, yet for the actual SSRI antidepressants this also only comes to a 20 percent increase in improvement. If depression can be life threatening, why is this rate of improvement accepted as adequate? Furthermore, alongside this rate of improvement, what kind of side effect profile do SSRIs have? 

According to a study done by the National Library of Medicine, out of 401 patients taking antidepressants, 86% experienced at least one side effect and 55% experienced multiple bothersome side effects. These side effects, according to The National Library of Medicine and NHS, include feeling agitated, shaky, or anxious (yet antidepressants are prescribed to treat anxiety disorders), feeling sick, digestive issues such as indigestion, stomachaches, diarrhea, constipation (SSRIs are also used to treat digestive disorders), loss of appetite, insomnia (sleep deprivation increases risk of depression), or exhaustion (exhaustion is one of the symptoms of depression), headaches, loss of libido or other sexual issues. These symptoms usually improve after a few weeks of use, but for many they persist. These symptoms, even if they usually recede, make remission of depression more difficult. These symptoms, so commonly experienced, put users at even greater risk for suicide. Why should people be prescribed SSRIs when these drugs can not only negatively impact their quality of life but worsen the symptoms of their depression? Long term use of SSRIs are also linked to diabetes and cataracts. Rarer side effects of SSRIs include serotonin syndrome, Hyponatremia, and increased suicidal ideation. All these side effects and risks point not only to the lack of effectiveness of SSRIs but to the toxicity of the drugs as well. The toxicity of SSRIs is especially concerning considering  as much as 90 percent of the body’s serotonin is produced in the gut. 

Enterochromaffin cells are responsible for producing as much as 90 percent of the body’s serotonin (other cells in our gut, and microbes also play a major role). The side effect profile of SSRIs point to the concerning toxicity of SSRIs because SSRIs are just like other pharmaceuticals. They have an antimicrobial effect on the gut microbiome. They also, by damaging the gut, disrupt the gut brain axis (the gut brain connection). The brain’s balance of serotonin is directly connected to the gut’s health and this proves that in order to treat depression effectively, supporting the gut’s health should be paramount. 

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