They may not be perfect but antidepressants DO save lives

As a psychiatrist, I have treated thousands of people over the past 25 years for debilitating and serious clinical depression. Time and again, I’ve seen the impact it has on their lives and their families. and I’ve seen just how positive and lifechanging antidepressants can be.

Not for every patient and not always without side-effects. But for a large number of people with serious clinical depression, I have no doubt that antidepressants work and are safe.

This depression is different from the sadness we all feel from time to time, and it’s different from mild depression or the temporary states of emotional upset that are a normal part of life and loss.

It is feeling sad all the time, for weeks or months; losing hope of getting better; battling with insomnia, loss of appetite, and fatigue; being unable to work and to have a social life; and thinking of, or planning, suicide.

antidepressants allow people with serious clinical depression to get their lives back. They have saved marriages and families, and prevented suicides.

That’s why I am so frustrated by those who argue antidepressants are a failure and don’t help most people.

That’s the view of a new book, The sedated society, serialised in the Mail, which criticises Ssris (serotonin selective re-uptake inhibitors), such as Prozac.

The critics say antidepressants don’t work for most people, can be addictive and that many patients would be better off without them.

But the problem with this argument is that it highlights potentially bad effects in a few patients without mentioning the overwhelmingly good effects in the majority of those with serious clinical depression. When used correctly, antidepressants do work, especially if prescribed with a psychological therapy.

That’s not just my view, it’s the view of the majority of the medical profession, the NHs and the leading scientific and medical organisations worldwide.

Of course, antidepressants should not be given to just anyone: there are legitimate concerns about them being doled out like aspirin for mild depression. But we have clear guidelines stating they should be given only to those with serious clinical depression, and there is evidence the guidelines are followed.

Of course, antidepressants don’t work for everyone: about one in three patients with serious clinical depression who takes them doesn’t get better.

But this doesn’t mean we should give up on them for the others; it means we should continue with our efforts to develop better antidepressants.

My own research involves developing blood tests to tell us who would benefit from antidepressants and who should use other types of drug treatments.

It’s also true antidepressants can have side-effects (there’s yet to be a drug that doesn’t), but it’s about finding the balance between good and harm.

For a few patients, antidepressant side-effects can be severe. some can experience an increased feeling of tension, agitation and restlessness, which can trigger thoughts or acts of self-harm, especially in teenagers.

Other patients experience severe side-effects at the time of stopping antidepressants.

Yet we shouldn’t forget these severe side-effects occur only in a minority, who probably have the abnormal reaction to these drugs written in their genetic make-up.

In fact, after taking antidepressants, people are ten times more likely to experience improvements than an increased risk of self-harm. The critics correctly claim we don’t really know how these drugs work. But this doesn’t mean the medicines don’t have measurable effects.

studies show us that antidepressants can increase the number of new brain cells.

We also know depressed patients have inflammation and raised levels of stress hormones; antidepressants have been shown to have a positive effect on these.

In view of this complexity, which is only just being unravelled, we understand the original idea that antidepressants ‘correct a chemical imbalance in the brain’ is an over-simplification.

The argument over the pros and cons has been clouded by the behaviour of parts of the pharmaceutical industry, with examples of inappropriate or even illegal behaviour.

It is vital regulatory authorities investigate these cases, but overall the quality of clinical trials in psychiatry is as good as in other medical specialities.

NOT all the data on anti-depressants comes from research funded directly by pharmaceutical companies. some of the largest studies have been supported by publicly funded bodies, such as the Medical Research Council.

It’s important that if you’ve been prescribed antidepressants (and have concerns about side-effects or other problems raised by the critics), you don’t just stop taking them. Please talk to your doctor.

Disclosure: Pharmaceutical companies fund less than 10 per cent of my research; 90 per cent is funded by the taxpayer.