Widely prescribed anti-depressants may be doing patients more harm than good, claim scientists at McMaster University who have recently published a paper examining the impact of the treatments on the entire body in Frontiers in Evolutionary Psychology. This claim is part of an ongoing conversation in the medical community about the value of anti-depressants, a conversation which has passionate advocates on both sides.
Anti-depressants are made to reduce the symptoms of depression by boosting the levels of the neurotransmitter serotonin in the brain, where it regulates mood. Yet the authors of the paper in Frontiers in Evolutionary Psychology postulate that there’s a problem with attempting to use artificially elevated serotonin levels to improve mood. It’s that the majority of serotonin that the body produces is used not to regulate mood but rather for other purposes, including digestion, neural cell growth and death, forming blood clots at wound sites, sexual stimulation, reproduction and physical development.
What the researchers at McMaster University found is that anti-depressant use correlates with negative effects on all these processes that are normally regulated by serotonin.
It’s important to note that correlation does not equal causation – in other words, the scientists at McMaster University can’t be certain that the anti-depressants caused the noted problems, only that the problems have been seen to exist simultaneously with anti-depressant use. Though a relationship of causation between anti-depressant use and these symptoms hasn’t been conclusively proved, the researchers at McMaster University hypothesize that anti-depressants, by artificially increasing the amount of serotonin present in the body, may disrupt important bodily processes, leading to diminished overall health in patients.
The study finds the following elevated risks correlated with anti-depressant use:
- 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
- developmental problems in infants
“We need to be much more cautious about the widespread use of these drugs,” argues Paul Andrews, an evolutionary biologist at McMaster University and lead author of the research.
“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.” Indeed, the Telegraph reports that psychiatrist Dr William Shanahan, medical director at Capio Nightingale Hospital, London, is sure that anti-depressants are safe. “These drugs have their place,” says Shanahan, ”They work wonderfully for many people and lives have been transformed by them,” he says.
Andrews and his colleagues examined earlier patient studies into the effects of anti-depressants and felt that the benefits of most anti-depressants, even taken at their best, compare poorly to the correlated risks, which include premature death in elderly patients.
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, according to Andrews and his associates, 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 insists. The causal relationship that Andrews hypothesizes has, however, not yet been shown to exist.
A previous meta-study published in the Journal of the American Medical Association found that anti-depressants are safe and effective for treating anxiety, obsessive compulsive disorder, and major depressive order in children and adolescents.
The scientists at McMasters University conclude that anti-depressants may still be helpful for patients in certain conditions, but emphasize that they should be much more cautiously prescribed.
In conclusion, it’s important for us all to take a proactive approach to managing our emotional and physical health through holistic approaches like moodtraining. While medicine can be helpful in some cases, it’s no replacement for self-knowledge, focus and discipline.
image: [Steve Snodgrass]
Hi Carolyn, I like the idea of a risks/benefits approach, but I think there are a couple issues that need to be raised w the article and your interpretation of it.
Good points- First, the authors great point about the serotonergic effects through the body, this does often go un-examined. Also some great points about how medications get to be known as "safe" when the full spectrum of risk/benefit is not yet known (and cannot be known until there are large #'s or people taking the medications due to statistical power).
My main concerns, and there were a few, was their discussion of the developing brain. This would be the key point at which they could go into the literature on how severe an impact untreated depression can be on the developing brain but they fail to do so. The effects of morbidity (poor function, disability, interpersonal stressors, achievement) could have been addressed as opposed to a mortality (death), which in this population is rare. Also of note the adoelscents typically included in studies of this type exclude suicidal thinking but include depression. Therefore the typical course of depression is one of worsening depression and therefore increased suicidailty (and therefore the meds are seen as having "caused" the thinking).
I would also disagree with the last paragraph of your article, as good as it was overall. The authors did not demonstrate that antidepressants CAUSED these problems, rather found an association. Lastly, I would say that unfortunately medication is, unfortunately, at this time in our biomedical knowledge, necessary in some cases. However, in many cases, self-knowledge, focus, and discipline might have prevented the full expression of this underlying risk architecture, and that moodtraining can help with that :) That is what I would see as the role of moodtraining.
I agree the topic of risk/benefit is one that very much needs active discussion, thanks for serving it up!