An international debate has sparked among experts regarding the long-term health effects of patients taking antidepressants. Here's what you need to know. ebate was presented in the prominent medical journal, BMJ showed massive contrasting views on long-term effects of antidepressants

The debate was between Denmark-based researcher Peter C. Gøtzsche and London-based researcher Allan H. Young.  

Gøtzsche took the side that taking antidepressants could increase a person’s risk of dying prematurely.  He said drugs do very little for patients over a placebo and medicines should be rid altogether. He estimates are likely 15X more suicides among people taking antidepressants than reported by the FDA.

FDA issues a black box warning on antidepressants more than 10 years ago after conducting meta-analyses of hundreds of studies involving nearly 100,000 patients that showed the rate of suicidal thinking or suicidal behavior double among those taking antidepressants to 4% of patients (up from 2% of patients given a placebo)

Gøtzsche continues to argue the modest effect of antidepressants and other psychiatric drugs doesn’t justify the cost

“They’re responsible for the deaths of more than half a million people aged 65 and older each year in the Western World. (539,000 U.S. and European Union). 

Studies have shown higher mortality rates in older patients taking antipsychotic drugs (such as those used to treat schizophrenia, benzodiazepines). Prescribed to treat panic and anxiety disorders. He also suggested that discontinuing the use of almost all psychiatric drugs would lead to healthier more long lived populations.

 London-based researcher Allan H. Young said psychiatric drugs (including antidepressants) are highly investigated for safety and effectiveness and essential for treating debilitating mental illness that could shorten a person’s life expectancy. He argues that psychiatric drugs are beneficial as other treatments for common, complex medical conditions.

“More than a fifth of all health-related disability is caused by mental ill health, studies suggest, people with poor mental health often have poor physical health and poorer (long-term) outcome," said Dr. Young. He also disclosed to BMJ that he has conducted paid lectures and been on advisory boards for major companies that produce psychiatric drugs.

He also said studies show overall, taking psychiatric drugs lower mortality rates including from suicide and are crucial to consider the experience of the individual patient being treated with psychiatric drugs. He didn’t discuss antidepressants specifically.

But other physicians said those struggling with major depression could benefit from these drugs. Stark differences of opinion reflected widespread disagreement among mental health professionals over proper treatment. Leaves patients in U.S. and internationally dealing with these mental illnesses head on and struggling to make sense of all the conflicting advice.

Brings to the surface the bigger controversy regarding the use of medications and concerns over overuse and inappropriate subscribing.

Other doctors in the debate said taking any medication is not something that should be a knee jerk reaction. Other doctors also said stopping all antidepressant medication would be more harmful than good.

The risk of depression is higher than the risk of using medications appropriately

Patients with depression:

o   More likely to suffer from a heart attack or stroke

o   Some research has pointed to treating depression with antidepressants might lower cardiovascular disease risk

o   Doctors note mental health issues patients face like depression raise suicide risk

But observing link between psychiatric medications and suicidal thinking and behavior doesn’t prove the drugs lead more patients to commit suicide.

At high doses antidepressants can be associated with seizures or abnormalities in heart rhythm.

Antidepressants are also used to treat:

Smoking : treated with Wellbutrin

• Common norepinephrine and dopamine reuptake inhibitor
• Marketed as Zyban to help people stop smoking and is FDA-approved for that purpose
• Why: Smoking is a high-frequency behavior couple with oral and sensory gratification
• Aroma of burning tobacco is rewarding to those people who enjoy it
• Coupled with physiological effects of nicotine in the blood

Irritable Bowel Syndrome and bedwetting

• Tricyclic antidepressants affect multiple receptors throughout central nervous system and GI system
• Also used for bedwetting

Learning and memory

• SSRIs can be used to treat certain learning disabilities are related to learning in the brain’s upper right hemisphere
• Area associated with visuospatial skills, direction and attention

Sleep

• Trazodone can be used
• Low doses can induce sleep
• Most often prescribed off-label for insomnia
• Unlike other sleep aids, it’s not a benzodiazepine or narcotic
  • Therefore it’s not addictive or habit-forming

Pain

• Antidepressants can be used to treat chronic pain, headaches, nerve pin, fibromyalgia
• Medications include tricyclic antidepressants
• A class of medications that affect brain chemicals called serotonin and norepinephrine