Content updated from previous publish date.
Americans are the unhappiest they have been in over 50 years. Because of this, it’s not surprising that antidepressants are some of the most common medications used in the United States. And the number of people taking them is on this rise. During the pandemic, the number of new prescriptions for antidepressants spiked by close to 19%, based on a 2020 report. In 2021, statistics show that the number of prescriptions for antidepressants topped 337 million.
In 2021, the number of prescriptions for antidepressants topped 337 million. Share on X
When prescribed appropriately based on findings from a comprehensive evaluation that includes brain imaging, these medications can be helpful as a part of a treatment program for some people suffering from depression. But they don’t help everyone. In fact, they can make some people worse. Here’s why.
THE PROBLEMS WITH ANTIDEPRESSANTS
Most prescriptions for antidepressants are doled out after brief office visits with healthcare providers who do not look at the brain or consider any biological information. It’s like they are throwing darts in the dark at the problem. This diagnostic and treatment paradigm isn’t working.
In a large study in Health Technology Assessment, researchers found that over 50% of depressed people failed to reach full remission of their symptoms after taking antidepressants. And for one-third of people, remission continued to elude them after 4 courses of medication. One review in Evidence-Based Mental Health found that except for people with severe depressive disorder, antidepressants worked no better than placebos. These are depressing statistics.
For some people, antidepressant medication comes with unwanted side effects, including:
- Weight gain
- Fatigue
- Nausea
- Lower sex drive
- Difficulty achieving orgasm
- Heightened anxiety
- Trouble sleeping or insomnia
- Headaches
- Restlessness or agitation
- Constipation
- Diarrhea
- Dry mouth
- Dizziness
- Blurry vision
- Tremors
Even worse, lawsuits have claimed that the antidepressant medication Prozac caused violence or suicidal thoughts and behaviors. Virtually all antidepressants have black box warnings, which, in simple terms means the FDA cautions patients in the strongest terms to pay close attention to potentially extremely harmful or dangerous threats to their health.
In addition to these risks, antidepressants can change how you feel in ways you didn’t expect. Antidepressant medication is intended to decrease negative emotions. However, according to an Oxford University study, the majority of selective serotonin reuptake inhibitors (SSRIs)—the most commonly prescribed type of antidepressants—effectively dampen all emotions, including love, happiness, and joy. In this study, participants reported feeling distant from their surroundings, and they no longer cared as much about important aspects of their everyday lives. They said it seemed like their personalities had changed.
These are serious downsides.
NOT ALL DEPRESSED PEOPLE ARE THE SAME
One of the reasons why antidepressant medication has such a high failure rate is that depression isn’t a single or simple disorder. Brain SPECT imaging studies at Amen Clinics have helped identify 7 types of depression, and each type requires a different treatment plan. Giving everyone with depression the same treatment will never work, and it can make some people worse.
For example, many practitioners prescribe SSRIs (such as Prozac, Zoloft, and Lexapro) as a first line of defense for patients who say they feel depressed. But these antidepressants don’t work for all 7 types of depression, and they exacerbate symptoms for several subtypes of the condition.
A pair of 2019 studies in Nature Human Behavior and The American Journal of Psychiatry suggests that brain imaging may help predict which antidepressants will work best for individuals.
Another reason why treatment failures are so high is that depression is not a disease; it’s a symptom similar to the way chest pain is a symptom. It doesn’t indicate what’s causing it. Chest pain can be caused by many different things. It’s the same with depression. Many factors contribute to depressive symptoms, including some biological issues that aren’t resolved by antidepressants. For instance, depression has been associated with:
- Head injuries
- Heart disease and low blood flow
- Chronic pain
- Inflammation
- Exposure to toxins(such as mold)
- Lyme disease and other infections
- Hormonal imbalances
- Obesity
- Poor diet
- Chronic insomnia
In some people, addressing these underlying issues can be critical in overcoming sadness or low moods.
ANTIDEPRESSANTS AREN’T THE ONLY OPTION
If you’re struggling with depression, medications should not be the first or only thing you do to help your brain and your mind. To overcome depressive symptoms, think about using all the tools available, and focus first on the least toxic, most effective solutions. These may include:
- Nutritional supplements (Did you know that 20 studies have shown that saffron is more effective than a placebo and equal to the antidepressants Prozac, Zoloft, Effexor, and imipramine for depression?)
- Eating anti-inflammatory mood foods that fight depression
- Exercising (a wealth of studies show that physical activity has antidepressant effects, plus it boosts blood flow)
- Healing any underlying brain injuries
- Balancing hormones
- Making sleep a priority
- Tackling negative thinking habits
- Eliminating exposure to toxins
- Learning strategies to cope with chronic pain
- Testing for and treating any infections
Depending on your individual needs, medication may be necessary in addition to these other solutions. Getting a brain scan to more accurately diagnose your subtype of depression can be very helpful in determining which antidepressant is most likely to work for you. And follow-up brain imaging can show how well treatment is working and if any adjustments are needed.
Depression, anxiety, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
I am very interested in this theory as I have been on this roller coaster of antidepressants for almost 30 years. Last year I ended up in the hospital and received 14 ECT treatments.
The question is how can and ordinary, middle income person afford your clinic/program? None are close so there is the expense of travel plus the charges incurred. Any suggestions?
Thank you,
Vicki
Comment by Vicki — June 18, 2018 @ 4:11 AM
Hello Vicki, we can have a Care Coordinator reach out to you via email to discuss options for treatment further. Thank you for reaching out to us.
Comment by Amen Clinics — June 18, 2018 @ 10:34 AM
Very compelling information. My adult son is severely compromised and unable to sustain meaningful employment. He lives with me and has constant suicidal ideations. He begs for help yet declines tradional treatment options because medications have done more harm than good. Your program would be a possible beacon of hope but is cost prohibitive. Are there any other options at all. We are desperate.
Comment by Elizabeth — June 18, 2018 @ 11:04 AM
I have emailed you several times requesting information on the procedure and cost of admitting my grandson to your clinic. He has, beginning at age 8, had several head injuries. He has been diagnosed recently (at the age of 37) as bi-polar. He was prescribed invega (the shot that supposedly last a month) and is not taking seroquel and lamictal. Nothing seems to relieve his depression and anxiety. The seroquel does help him sleep, but he says he feels ‘weighed down’ when he wakes up. He has no insurance and is unable to work (since about April 2018) I am able to help his to some extent, but I have already spent fully half of my savings. I’m willing to spend the other half if he can get some real help. He is going to apply for disability if he can get up enough energy to drive to the nearest town with a social security office. Can you please respond?
Comment by Jane Wright — June 18, 2018 @ 12:02 PM
Hello Jane, thank you for reaching out and letting us know. We will have a Care Coordinator reach out to you right away via email. Our direct line is 888-288-9834.
Comment by Amen Clinics — June 18, 2018 @ 2:48 PM
Hello Elizabeth, thank you for reaching out to us. We’d be happy to have a Care Coordinator reach out to you to discuss your son’s symptoms in more detail and offer treatment options for you.
Comment by Amen Clinics — June 18, 2018 @ 2:49 PM
I am feeling neglected and rejected in the cycle of care treatment (variety of meds to function). I want to wake up and live my best quality of life now.
I attended a talk seminar a couple of months ago with Dr Amen.
I need to know the best method of discontinuing cymbalta welbutrin gabapentin respiratdone and armodofinal as a way of functioning.
Comment by Arnetha Booth — August 27, 2018 @ 8:31 AM
I never felt deep depression until I started on lexapro for anxiety/unrelenting panic. I believe it saved my life at the time…but long term, the depression and lack of feelings set in. I understand why people commit suicide while on these drugs or while coming off them.
Luckily, I knew enough about these meds to direct myself. Unfortunately, many of the people who prescribe these drugs don’t know enough about mental health and the follow up is poor. Thank you Amen Clinics. You are a beacon in the night.
Comment by Elizabeth Smith — January 7, 2019 @ 4:47 AM
If I didn’t take my medications I wouldn’t have got through 45 yrs in a clinical / management role as a nurse with only one period of time off work for 8 weeks. The stresses etc that really tipped me over the edge resulted from both work and home pressures.
But 21 mths ago I went over the edge when my daughter committed suicide. I am a lot better now, but have mood swings downwards that sometimes scare me. I have professional support. But it’s so hard.
I now don’t work through choice, but I know there would have been much difficulty trying to work for the first yr after my daughters death. It’s very paralysing.
Comment by Barb — January 7, 2019 @ 5:52 AM
Hi integrative drs can do a gut neurotransmitter test for about $150 to see what supplements would be best for him. I did that and also read Dr Amens book about ADD-Change your Brain and that helped me tweak supplements. I finally went to the Amen clinic for a partial SPECT scan to save money and find specific arcs that would suit me so now I know what specific prescriptions are best for me if I can’t afford my supplements.
Comment by Lauren — January 7, 2019 @ 6:10 AM
Hi,
I’ve had severe depression for 25 years and am now on disability because no meds work for me any more or the side effects are unbearable. I want to come to the clinic but since you dont take insurance im unable to. Do you give people like myself any help?? What I receive from disability is next to nothing so im unable to pay anything but i do have medicare.
Thanks,
Carolyn
Comment by Carolyn — January 7, 2019 @ 6:59 AM
I have suffered from Depression for a number of years now. I have taken a number of drugs and have no relief. I also had electro convulsive therapy and nothing seems to work. On top of that of that I have Gran Mal seizures which are controlled. Do I have any options or is my life essentially over.
Comment by Eva Bell — January 7, 2019 @ 8:59 AM
why do you not take medicare and supplemental INs. like Blue Cross / Shield? Why NOT?! Then why not enable other mental health providers to have access to copy your info and non profit it to the middle and lower classes? Help us out here!
You live well enough Dr. Amen now enable all to have access to your methods
Comment by brad — January 8, 2019 @ 1:44 AM
I find life for many very sad. Medicine alone is never the answer. Unfortunately tracking down good help is very difficult to find. So easy yet so difficult to find many that suffer are given advise that does not fit them, medication that works for a while then does not. Therapy that quits when their hour is up. Promises that do not last and suffering that never goes away. What is needed. Good diagnostic evaliluations. Good resources with treatment centers that will work. Jobs that make an individual feel worthwhile Test that give answers to good treatment and follow up. Should not be so hard to find the help that so many are looking for. Promises to help with failure to do so. The world has become a very greedy world. We need resources for those crying out for help not bandaids that do not cure the problem and hope for the help that is so desperately needed.
Comment by Rosalie — January 21, 2019 @ 4:53 AM
After being harmed by the medical professionals attempting to treat my anxiety and mood as well as depersonalization, this article is very interesting to me. If only normal everyday people could afford the treatment you provide at your clinics we might see more mentally healthy people in the world. Thanks for all the articles you do publish though, i get alot from them.
Comment by Michelle — March 15, 2023 @ 7:23 AM
Is it contraindicated to take ashwaganda if you have Hashimoto’s?
Comment by Shannon Wessel-Calbrix — March 15, 2023 @ 8:55 AM
I believe that antidepressants are way over-prescribed, especially to people with dysthymic depression, or just mild anxiety. Just about everyone I know is on some type of psychotropic drug, and very few of them are actually clinically depressed. That's why the drugs do not work for them. Their symptoms may be based on a situational condition, to which no drugs can change. You also fail to mention that there is a genetic test that can be taken to discern what category of antidepressants may be best suited for an individual. It is cheaper than getting a SPEC scan of the brain. I took this test and discovered that I was most likely to respond to the tricyclic antidepressants. So I was started on one, and had far superior results than I ever had on any SSRI or SNRI. Thought it is worth mentioning. Thank you.
Comment by Stephanie — March 15, 2023 @ 1:34 PM
I wish your clinic was here in the UK! I've struggled with mental health as far back as I can remember, so from being very small which seems to have caused other health struggles. It's annoying that anti-depressants are the first things that Dr's pump you with, without internal scans first…
Comment by Mel — March 15, 2023 @ 1:51 PM
What’s the dangers of getting off 30 years of mostly lexapro for good??
Comment by Paul — March 15, 2023 @ 3:06 PM
Excellent information!
Comment by Doug Morris — May 16, 2023 @ 12:52 PM