Depression has become one of the most talked about medical conditions that affect many of us. The way depression is treated and addressed has been a hot topic of conversation recently. It has become one major health issue that dominates the mainstream media. The use of antidepressants is also highly buzzed about. Does it work though?
Are antidepressants safe and do they really work on you? This is something that has been widely discussed by doctors and researchers in recent years. This worldwide debate on the topic of antidepressants has been fairly recent when British author Johann Hari released his book, Lost Connections: Uncovering the Real Causes of Depression — and the Unexpected Solutions.
Hari had been using antidepressants for about 13 years, something that began when he was just a teenager. Through his new book, he aims to unravel the answers to some of the questions that have been eating his head on the topic of antidepressants for years. He especially wants to know what caused his depression and why his antidepressants have not yet cured the depression?
Lost Connections was started as a fanfare of endorsements from famous faces like musicians Elton John and Brian Eno, political activist Naomi Klein, and even Hillary Clinton. This led to one important question being asked: "Is everything we know about depression wrong?" There was a need for radical solutions. This soon caused a lot of controversy on the topic of depression.
Lost Connections was swarmed with a number of claims that antidepressants are majorly ineffective, that this uselessness has been smartly covered up by the pharmaceutical industry with all credit to the regulatory systems, and also the physiological mechanisms that most times suggested triggering depression which cannot be laid out with evidence.
"Telling people, as I was told by my doctor, that depression is caused by a problem in your brain is, firstly, untrue," Hari explains as he talks to the press about his understandings of depression. Still, there are so many unanswered questions as to why antidepressants fail to work on some people. So is there any explanation as to how or why this could be?
Since he has experienced depression and antidepressants first had, he has a lot to say. "[A]nd," Hari also states, "it is also really problematic because it cuts people off from finding the real causes of their depression and anxiety. We've been telling ourselves this chemical story for 35 years and every year depression and anxiety gets worse."
Claims like these have definitely alarmed health professionals and journalists alike. They have made them more aware and as concerned as ever after the book was released. There was also a push, in the mental health patients community to stop using their medication without the consultation of an expert. It was truly a stepping stone for the people affected by depression to make anew.
In the meantime, some others became even more concerned about the impact the claims made by Hari could have. His thoughts about antidepressants that "between 65 and 80 percent of people on antidepressants are depressed again within a year" has especially provoked thoughts of those people involved with depression to think a little deeper.
Even if Lost Connections has sparked a lot of controversies definitely struck a populist nerve, there was a lot of criticism regarding Hari's words. People were very quick to talk about the fact that this was just his second major work after publishing a huge plagiarism scandal regarding his work back in 2011. He had to keep away from the public for some time when this happened.
This ongoing discussion began to grow even more. It was splattered all across social media and in several editorial columns as it is an issue that thousands of people deal with every day. After waiting for 6 long years, the systematic review which weighed the usefulness of antidepressants titled The Lancet was finally published.
This was a review that collected all of the scientific data, ones that have both been published and unpublished that the staff from Oxford University in the United Kingdom could gather. This extensive research was an analysis that has been assessed ever so carefully so that it could hopefully turn out to be the final verdict of the highly heated antidepressant controversy.
For example, Prof. Carmine Pariante who works as a spokesperson for the Royal College of Psychiatrists in the U.K. released a statement regarding this review, "This meta-analysis finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression."
"Importantly," Prof. Pariante goes on saying, "the paper analyzes unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the clinical usefulness of these drugs is not affected by pharma-sponsored spin." The review concluded that even though the effects of the 21 antidepressants are short-lived and temporary, it still had an impact on the adults using it.
The effectiveness of the drugs varied from one another. Paroxetine (Paxil, Brisdelle, Pexeva), agomelatine (Valdoxan), escitalopram (Lexapro), mirtazapine (Remeron), and sertraline (Zoloft) had a very high response rate with a lower dropout rate. Since depression is present in over 350 million people, the need for clarification has become more crucial than ever. In America, the monetary burden of depression has amounted to be around $210 billion per year.
Majority of the antidepressants studied were from the kind of drugs called selective serotonin reuptake inhibitors (SSRIs). The notion of how antidepressants work is that they boost serotonin levels, even though this is yet to be confirmed. Even the levels of the neurotransmitter serotonin are known to be raised even though there has not been any concrete proof regarding this claim.
Serotonin is credited for maintaining mood balance, appetite, and motor, cognitive, and autonomic functions. Following the 1980s, low serotonin levels were blamed as sole reasons for depression. Johann Hari and others have put out words that go against this notion. In the year 2015, Medical News Today had reported on an editorial that was printed in The BMJ by an SSRIs critic named Prof. David Healy who debated that depression is a result of low levels of serotonin and that SSRIs increases the serotonin levels is a pharmaceutical myth.
The researchers from Oxford then made an argument that a more updated research work and better antidepressants are needed. They also stated that since the effect of antidepressants cannot be specified, there is a need for a more specialized drug. Because of the meager amount of knowledge about antidepressants, a heavy risk in the health of depressed people exists. Hence, the production for better and long-lasting drugs have to happen soon.
The MNT has made a recent discovery about antidepressants being able to raise the risk of mortality. These research works have suggested that these drugs increase the risk of premature death. This was a study made by the McMaster University in Ontario, Canada, who came up with a meta-analysis of 16 studies regarding a total number of about 375,000 participants which pointed towards a 33 percent higher risk of premature death with people using antidepressants.
Moreover, people who use antidepressants were discovered to have a 14 percent better chance of having a stroke, heart attack, or other cardiovascular events. The meta-analysis failed to find the difference between the outcomes of people taking SSRIs and those using tricyclics, an older form of antidepressants. But researchers could not conclude whether antidepressants resulted in premature death or not. Marta Maslej the lead author stated that "Antidepressants disrupt the functioning of monoamines (important biochemicals such as serotonin and dopamine), and these monoamines have important functions not only in the brain but all over the body."
"For example," she went on saying, "serotonin affects growth, reproduction, digestion, immune function, and many other processes, and it is found in almost every major organ. Disrupting the functioning of serotonin can, therefore, have different adverse effects, which can contribute to a risk of death in many different ways." All of the researches have somewhat the same conclusion, that if you use antidepressants, you should always consult your doctors when or if you feel there are side-effects.