Doing Life Together

pill-1884775_1920People who struggle with depression often go to their primary care doctor and are placed on antidepressants. In some cases, a formal evaluation of depression is not even conducted. But even when a patient is determined to be depressed, the cost and benefits of being on a medication should always be discussed.  The U.S. Centers for Disease Control estimates that 1 in 11 or 1 in 14 people meet criteria for clinical depression. That is a lot of people! And a lot of people want to know if antidepressants are safe.

If you Google safety of antidepressants, you will get general information saying they are relatively safe with certain exceptions. But it is important to also know that there are newer studies being done to assess the safety and effectiveness of antidepressants. And 2 of those studies do question our current thinking.

We know most medications have side effects and have the potential to create medical complications. But the common  thinking is that antidepressant drugs are safe and effective, yet recent research questions both of those claims. One large antidepressant effectiveness trial concluded that antidepressants failed to sustain positive effects in the majority of people who took them. This is important because while antidepressants can improve the quality of some peoples’ lives and help with severe depression, we need to better understand if taking a medication is having the desired effect.

According to Medscape, an estimated one in 10 people use antidepressants.  We know how these drugs affect the brain, but less is know about how they impact the body. A new study published  in Psychotherapy and Psychosomatics concludes that antidepressants are not safe for the general population, but less harmful for cardiovascular patients. The reason for less harm in cardiovascular patients has to do with the anticlotting properties antidepressants have that help treat cardiovascular disease. When looking at the general population, the reviewers of several studies found that antidepressants increased risk of mortality and cardiovascular events in those patients who used antidepressants. Now, they do note that people who take antidepressants tell to be ill and ill patients do have higher risks for mortality. This could be a confounding variable in the study.

Both of these studies are important and need to be replicated by other researchers given all the people currently taking antidepressants. Please note: I am not suggesting you stop taking your antidepressants, but rather evaluate with your physician as to whether or not you are improving on your medications and ask about long term side effects so you can make an informed decision about your treatment. Also ask if there are other ways apart from medication to treat depression that have been determined to be effective. Clinical depression can be debilitating and people need help to improve their functioning and engage in everyday life. So the message here is have a thoughtful conversation with your doctor and tell him or her about this on-going research.



Pigotta, E.,  Leventhalb, Altera. A.G. &  J Borenb, J. Efficacy and Effectiveness of Antidepressants: Current Status of Research. Psych other Psychosom 2010;79:267–279

Maslej M, M, Bolker B, M, Russell M, J, Eaton K, Durisko Z, Hollon S, D, Swanson G, M, Thomson Jr. J, A, Mulsant B, H, Andrews P, W, The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. Psychother Psychosom 2017;86:268-282

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