HEALTH NEWS

Study Title:

SSRI Antidepressants Do More Harm than Good

Study Abstract

Antidepressant medications are the first-line treatment for people meeting current diagnostic criteria for major depressive disorder. Most antidepressants are designed to perturb the mechanisms that regulate the neurotransmitter serotonin – an evolutionarily ancient biochemical found in plants, animals, and fungi. Many adaptive processes evolved to be regulated by serotonin, including emotion, development, neuronal growth and death, platelet activation and the clotting process, attention, electrolyte balance, and reproduction. It is a principle of evolutionary medicine that the disruption of evolved adaptations will degrade biological functioning. Because serotonin regulates many adaptive processes, antidepressants could have many adverse health effects. For instance, while antidepressants are modestly effective in reducing depressive symptoms, they increase the brain’s susceptibility to future episodes after they have been discontinued. Contrary to a widely held belief in psychiatry, studies that purport to show that antidepressants promote neurogenesis are flawed because they all use a method that cannot, by itself, distinguish between neurogenesis and neuronal death. In fact, antidepressants cause neuronal damage and mature neurons to revert to an immature state, both of which may explain why antidepressants also cause neurons to undergo apoptosis (programmed death). Antidepressants can also cause developmental problems, they have adverse effects on sexual and romantic life, and they increase the risk of hyponatremia (low sodium in the blood plasma), bleeding, stroke, and death in the elderly. Our review supports the conclusion that antidepressants generally do more harm than good by disrupting a number of adaptive processes regulated by serotonin. However, there may be specific conditions for which their use is warranted (e.g., cancer, recovery from stroke). We conclude that altered informed consent practices and greater caution in the prescription of antidepressants are warranted.

From press release:

Commonly prescribed anti-depressants appear to be doing patients more harm than good, say researchers who have published a paper examining the impact of the medications on the entire body.


"We need to be much more cautious about the widespread use of these drugs," says Paul Andrews, an evolutionary biologist at McMaster University and lead author of the article, published recently in the online journal Frontiers in Psychology.

"It's important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they're safe and effective."

Andrews and his colleagues examined previous patient studies into the effects of anti-depressants and determined that the benefits of most anti-depressants, even taken at their best, compare poorly to the risks, which include premature death in elderly patients.

Anti-depressants are designed to relieve the symptoms of depression by increasing the levels of serotonin in the brain, where it regulates mood. The vast majority of serotonin that the body produces, though, is used for other purposes, including digestion, forming blood clots at wound sites, reproduction and development.

What the researchers found is that anti-depressants have negative health effects on all processes normally regulated by serotonin.

The findings include these elevated risks:
•developmental problems in infants
•problems with sexual stimulation and function and sperm development in adults
•digestive problems such as diarrhea, constipation, indigestion and bloating
•abnormal bleeding and stroke in the elderly

The authors reviewed three recent studies showing that elderly anti-depressant users are more likely to die than non-users, even after taking other important variables into account. The higher death rates indicate that the overall effect of these drugs on the body is more harmful than beneficial.

"Serotonin is an ancient chemical. It's intimately regulating many different processes, and when you interfere with these things you can expect, from an evolutionary perspective, that it's going to cause some harm," Andrews says.

Millions of people are prescribed anti-depressants every year, and while the conclusions may seem surprising, Andrews says much of the evidence has long been apparent and available.

"The thing that's been missing in the debates about anti-depressants is an overall assessment of all these negative effects relative to their potential beneficial effects," he says. "Most of this evidence has been out there for years and nobody has been looking at this basic issue."

In previous research, Andrews and his colleagues had questioned the effectiveness of anti-depressants even for their prescribed function, finding that patients were more likely to suffer relapse after going off their medications as their brains worked to re-establish equilibrium.

With even the intended function of anti-depressants in question, Andrews says it is important to look critically at their continuing use.

"It could change the way we think about such major pharmaceutical drugs," he says. "You've got a minimal benefit, a laundry list of negative effects -- some small, some rare and some not so rare. The issue is: does the list of negative effects outweigh the minimal benefit?"

Study Information

Paul W. Andrews, J. Anderson Thomson Jr., Ananda Amstadter and Michael C. Neale.
Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good
Frontiers in Evolutionary Psychiatry
2012 April
McMaster University, Hamilton, ON, Canada and University of Virginia, Charlottesville, VA, USA.