Antidepressant Withdrawal

Many medical professionals agree that short-term use (no longer than one year) of antidepressants is often successful in treating episodes of depression. But without a plan to gradually taper off of them, patients may find their brain chemistry in disarray.

For many people suffering from anxiety and depression, antidepressants may seem to be the best drug for the job. In addition to their efficacy, antidepressants are legal and easy to qualify for. But many are not aware of the repercussions of long-term use. Tardive dysphoria is the brain’s process of “canceling out” its own serotonin production in response to extra serotonin produced by the antidepressant. As the brain neutralizes serotonin levels, the user responds to the medication’s effects less and less over time.

Dr. Giovanni Fava, a professor of clinical psychology and psychiatry, calls this paradoxical phenomenon the oppositional model of tolerance in his study “The mechanisms of tolerance in antidepressant action.” In this study, Dr. Fava examines the function of antidepressants over time, pointing out that prolonged use can yield unfavorable outcomes:

“Clinical evidence has been found indicating that even though antidepressant drugs are effective in treating depressive episodes, they are less efficacious in recurrent depression and in preventing relapse. In some cases, antidepressants have been described inducing adverse events such as withdrawal symptoms at discontinuation, onset of tolerance and resistance phenomena and switch and cycle acceleration in bipolar patients.”

According to Fava and other psychiatric researchers, extended use of antidepressants can actually worsen depression symptoms. In a study conducted by Dr. El-Mallakh, subjects who had used antidepressants for longer periods of time were more likely to relapse into episodes of depression. The trial began in the early 1990s, when the rate of treatment-resistant depression was at about 10-15%. By 2006, that figure increased to 30-50%, suggesting that antidepressants do in fact lose their efficacy over time.

Many medical professionals agree that short-term use (no longer than one year) of antidepressants is often successful in treating episodes of depression. But without a plan to gradually taper off of them, patients may find their brain chemistry in disarray.

For information about the addictive properties of anti-anxiety medication, see our article on Benzodiazepine Addiction.

Resources:

• http://www.ncbi.nlm.nih.gov/pubmed/21459521
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911177/
• http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria
• http://www.madnessradio.net/files/tardivedysphoriadarticle.pdf
• http://www.healthcentral.com/depression/c/4182/141813/antidepressant
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