Are Antidepressants for Life?

Have you been taking antidepressants for a long time? Did you stop taking them but had to go back to them because of a relapse? There are many people who fear the effects of continually taking these drugs. What does science say about the subject? We're going to explore.

Written and verified by the psychologist Valeria Sabater.

Last update: 15 June, 2023

Are antidepressants for life? The answer is no. But, where did this myth come from? When it comes to mental health and depressive disorders, there are certain nuances that tend to change everything.

Some patients who are prescribed psychotropic drugs continue with them for two years or more. These drugs work by generating changes in the brain which rid the sufferer of many of the symptoms that reinforce depression. However, by themselves, they don’t resolve the conflicts on which the disorder might be based.

As a matter of fact, multidisciplinary intervention is important. It needs to include therapy that restores stability to the patient, helped by the antidepressants. To make an analogy, imagine a rocket. A launch vehicle will help it take off (the antidepressants) but its engine also needs to have been repaired (the therapy to restore autonomy to the patient).

What does science say?

When an antidepressant is first prescribed, the patient usually takes it for at least four to six months. After this period, the doctor will schedule the withdrawal and follow-up plan. At least, this is the ideal situation. But, each patient has their own personal circumstances that health professionals must attend to and supervise.

The main mechanism of action of most antidepressants is an increase in the availability of serotonin or norepinephrine. However, a study conducted by University College, London (UK) in 2022, claims that there’s insufficient evidence to confirm the idea that depression is due to a deficit of these neurotransmitters.

This would suggest that the approach to treating depressive disorders shouldn’t only be based on psychoactive drugs and that more strategies are needed.

1. Each patient has their own needs

The ultimate goal is for patients to eventually stop using antidepressants. To do this, they must fulfill a series of conditions. But, the moment must be chosen well because a relapse could provoke even deeper despair.

A large-scale study conducted by the University of North Carolina (USA) reported that only a third of those who consume antidepressants recover completely in a few months. The rest get a little better but need more time to experience their full effects.

It’s also common to see patients who’ve been consuming different types of antidepressants for several years because they haven’t yet found one that suits them.

2. Relapses are frequent

When estimating the duration of pharmacological intervention for depression, certain dangers must be considered. The most important is probably relapse. Research conducted by the University of Minnesota (USA) claims that at least 50 percent of patients who recover from a first depression suffer a relapse. They add that 80 percent of those who suffer two relapses will be at risk of a third.

In too many cases, a withdrawal of consumption is scheduled, to later be needed again. In order to avoid the most adverse effects of relapse, it’s extremely important that the patient is aware of this possibility and that they’re prepared to deal with the situation when the medication is withdrawn, should it occur.

It’s preferable that the patient anticipate the need for this kind of emotional management when they’re feeling well than when they start to decline when everything might seem dark. Talking about it is helpful. It should be noted that the tendency to relapse often has a genetic basis.

3. Taking antidepressants for life

There are multiple variables that mean antidepressant treatment may be prolonged. For instance, if a patient has suffered between two or three episodes of major depression (the most severe form), doctors may recommend continuing this treatment for a long time. It could last for years. Here are some more contributory factors:

• Periodic relapses.
• Incorrect diagnoses and ineffective therapeutic approaches.
• A history of relatives with mental illnesses.
• Opting only for antidepressants and not undertaking psychological therapy.
• Stressful experiences. For example, ongoing challenges, adversities, and sleeping problems.
• Not finding a suitable antidepressant. In fact, some patients spend years trying different kinds.
• Other clinical comorbidities.

The health risks of taking antidepressants for life

The long-term prescription of antidepressants isn’t without risk. The same happens with other drugs that are consumed for years. Fortunately, today, antidepressants tend to have fewer side effects. Moreover, doctors will always try to guide the patient. For example, they may suggest they progressively withdraw from taking them or substitute them with gentler drugs.

Antidepressants become less effective over time. Therefore, other options should be considered, according to the patient’s particular needs. The University of Auckland (New Zealand), studied the effects of prolonged administration of anti-depressants. They’re as follows:

• Fatigue.
• Suicidal ideation.
• Weight gain.
• Sexual dysfunction.
• Social disconnection
• Risk of suffering from diabetes.
• Emotional numbness.
• Gastrointestinal disorders.
• The patient feels that they’ve become addicted.
• They feel restricted in the experience of positive emotions.

The medical condition of each patient can cause extended administration to have certain effects. The most obvious symptom is that the depressive symptoms intensify. This can lead the patient to reinforce the idea that they should continue using the drugs. However, what they really need is another therapeutic approach.

How to avoid chronic consumption of antidepressants

As we said at the beginning, antidepressants aren’t for life. But, each individual has their own needs and requires a personally tailored approach. This can sometimes mean that patients spend several years consuming this kind of medication.

If you want to avoid this situation, psychological therapy and lifestyle changes are the answer. In fact, you should only take antidepressants if your doctor recommends it. Because, while these drugs are effective, they only address the symptom, never the root of the problem. This is why psychological help is so important.

At present, cognitive therapy for depression based on mindfulness is the most effective in avoiding relapses. A study conducted by Dr. John D. Teasdale and colleagues from the University of Oxford (UK) highlights the benefits of this approach. Indeed, without a doubt, asking for expert help is always the way to go.