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What if the very medications designed to lift the fog of depression were quietly contributing to another devastating mental decline? Over the past few decades, antidepressant prescriptions have skyrocketed, particularly among older adults and women. But behind the promise of serotonin-boosting relief lurks a concerning question: could these pills be silently increasing the risk of cognitive decline? A Canadian researcher, determined to uncover the truth, sifted through mountains of data—and what he found may make you think twice before reaching for that prescription.
Key Takeaways
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Antidepressants, particularly SSRIs, may offer little benefit beyond placebo effects for most patients, only showing slight improvements in those with severe depression.
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Studies indicate that prolonged antidepressant use could more than double the risk of dementia, with younger individuals facing an even greater risk.
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Non-pharmaceutical alternatives such as exercise and meditation may not only be effective in treating depression but also offer cognitive benefits without the associated risks.
Could Your Antidepressants Be Harming Your Brain?
The number of people prescribed one particular class of medication climbed by 64% in the US between 1999 and 2014. These days, one person out of every five over-60s takes these meds, with women being twice as likely to rely on them as men. The drugs I’m talking about are supposed to relieve depression. A Canadian scientist concerned these drugs could be linked to dementia, rifled through the research to find some answers. His findings are disturbing. . .
Most Popular Depression Drugs Don't Work
Over a decade ago, a group of psychologists from England reviewed data on 47 clinical trials of people taking the six most widely prescribed antidepressants approved between 1987 and 1999. Five of these were selective serotonin reuptake inhibitors (SSRIs). The first of them to be introduced was fluoxetine – more familiar by its brand name Prozac. Introduced in 1986, it became such a sensation it gave rise to a novel called Prozac Nation and a non-fiction book called Listening to Prozac, in which the author seemed to think the drug was the best thing since the invention of the wheel. Now there are many SSRIs. They all increase levels of the mood-controlling chemical serotonin in the brain. The group of English psychologists concluded these drugs don’t benefit most patients very much. It seems they only help people with the severest symptoms, and even then the benefit is only due, they write, "to a decrease in responsiveness to placebo, rather than an increase in responsiveness to medication." In other words, in these trials, a control group of severely depressed people on placebo reported less benefit than did mildly depressed people on placebo. (Makes sense – an imaginary drug is more likely to be helpful if there isn’t much wrong with you.) However, among people who were getting an SSRI, there was no difference in response between the mildly and severely depressed. And in both groups the benefit was small. Lead researcher Professor Irving Kirsch said, "Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients." Prof. Kirsch’s advice was not heeded. Over the next ten years, the number of prescriptions written for antidepressants in England doubled. If these drugs weren't harmful, it wouldn't be such a concern. But as Dr. Darrell Mousseau, a Professor with the Department of Psychiatry at the University of Saskatchewan, found out, they're not entirely safe.
Dementia Link is "Biologically Plausible"
To see if antidepressant use is tied in with cognitive impairment or dementia, Dr. Mousseau and his colleagues checked over 4000 articles before finding just five trials that met their exacting standards. Even so, these included more than 1.5 million people. The studies encompassed people taking several different types of antidepressants, not just SSRIs. The researchers found that taking antidepressant drugs more than doubled the risk of either cognitive decline or dementia, including Alzheimer's. For those aged under 65, the risk tripled. The strongest risk was for those taking SSRIs. The lowest is for people prescribed older types of antidepressants. I want to stress that the study can only demonstrate an association, not cause and effect. It does not identify a mechanism by which the drugs increase dementia risk. It also wasn't possible to determine either the dosage people were taking or how long they had been prescribed the drugs. But even with these limitations, the researchers say the link is "biologically plausible" and should be taken seriously.
Handed Out Like Antibiotics
Canadians are among the highest users of antidepressants worldwide, and while Dr. Mousseau accepts that the drugs benefit some people, he is alarmed at the way doctors dish them out for "sadness," insomnia, pain, hot flashes, and other non-depression-related problems. Even the very young and very old receive prescriptions. "They're almost becoming the antibiotic of this century," he complains. "'If you've got a disease, take an SSRI. It's going to help you in one way, shape or form.'" And we all know the problems that indiscriminate use of antibiotics has led to. The Canadian group is not the only research team to find a link between depression drugs and dementia. A similar study was published last year by scientists from Taiwan. They condensed 754 studies down to five, four of which were different from the ones included by Dr. Mousseau's team. They concluded that "antidepressant use is significantly associated with an increased risk of developing dementia. Therefore, we suggest physicians to carefully prescribe antidepressants, especially in elder patients."
Get Rid of Depression without Drugs
An excellent alternative to these drugs is regular exercise. Research suggests this may be a more effective treatment for mild depression than antidepressants because it can boost levels of serotonin. On top of that, exercise induces structural and functional changes in the brain which benefit both cognitive functioning and wellbeing, and is one of the best things we can do to reduce the risk of dementia. Another option I strongly recommend is meditation. There are a variety of different methods of meditation, and myriad teachers who will show you how.
Summary
Antidepressant prescriptions have surged over the past few decades, particularly among seniors and women. However, research indicates that these medications may not provide significant benefits for most patients and could be associated with a higher risk of cognitive decline and dementia. A Canadian scientist’s review of over 1.5 million patients found that those taking antidepressants were more than twice as likely to experience dementia, with the risk tripling for those under 65. Despite these alarming findings, prescriptions for antidepressants continue to rise. Experts urge caution, advocating for alternative treatments such as exercise and meditation, which may offer effective and safer solutions for managing depression.
Frequently Asked Questions
Do antidepressants really work?
Research suggests that antidepressants may only provide minimal benefits, primarily in cases of severe depression, and could largely rely on placebo effects.How are antidepressants linked to dementia?
Studies have found an association between long-term antidepressant use and an increased risk of cognitive decline, particularly among older adults.Are all antidepressants equally risky?
The highest risk appears to be associated with SSRIs, though other types of antidepressants may also carry some level of risk.What are some natural alternatives to antidepressants?
Exercise, meditation, cognitive therapy, and lifestyle changes have been shown to improve mood and mental health without the risks associated with medication.Should I stop taking my antidepressants?
Never stop taking prescribed medication without consulting a healthcare professional. If you have concerns, discuss alternative treatment options with your doctor.- Winerman, L. (2017, November). By the numbers: Antidepressant use on the rise. Monitor on Psychology, 48(10), 120.
- Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS medicine, 5(2), e45.
- Moraros, J., Nwankwo, C., Patten, S. B., & Mousseau, D. D. (2017). The association of antidepressant drug usage with cognitive impairment or dementia, including Alzheimer disease: A systematic review and meta-analysis. Depression and anxiety, 34(3), 217–226.
- Kirkey, S. (2017, January 4). Antidepressants may be doubling risk of Alzheimer's and other dementias, study suggests. National Post.
- Wang, Y. C., Tai, P. A., Poly, T. N., Islam, M. M., Yang, H. C., Wu, C. C., & Li, Y. J. (2018). Increased Risk of Dementia in Patients with Antidepressants: A Meta-Analysis of Observational Studies. Behavioural neurology, 2018, 5315098.