Ask the Experts: Can Anti-depressants Make a Healthy Person Happier?

We asked five psychiatry, neuroscience, and pharmacology experts if antidepressants can make a healthy person—someone without clinical depression—happier. Their answers reveal an important distinction between treating illness and enhancing well-being. From clinical researchers to neuroscientists, these experts weigh in on whether medications designed to treat depression could boost mood in those without a diagnosed condition. The evidence may challenge popular assumptions about these widely prescribed medications.

Michael E Thase has answered Unlikely

An expert from Perelman School of Medicine in Psychiatry

The short answer is no – an antidepressant won’t enhance a healthy and reasonably happy person (i.e., someone who is not suffering from a problem that the antidepressant might treat). However, lots of people who consider themselves to be “normal” do have sufficient signs and symptoms of common problems with mood or anxiety or related disorders and might actually gain benefit from taking an antidepressant. This includes milder conditions in the psychiatric realm, such as persistent minor depression (formerly called dysthymic disorder), cylcothymia (a condition related to bipolar affective disorder, but with milder mood swings), attention deficit disorder, binge eating disorder and certain kinds of insomnia, as well as conditions typically seen by internists and other primary care providers, such as fibromyalgia and irritable bowel syndrome. Other “normal” maladies, such a premature ejaculation and cigarette smoking, are sometimes treated effectively with medications originally approved to treat depression.

It should be noted when a course of antidepressant therapy has a remarkably good outcome, the formerly symptomatic person may feel “good as new” or even “better than ever.” This doesn’t mean the illness has been cured, however, because the antidepressant only suppresses illness activity and doesn’t “cure” the underlying condition. The decision to stop an effective course of antidepressant should be carefully thought out and done with awareness that relapse is possible, particularly within the first 6 months of stopping the medication.

Importantly, the beneficial effects of antidepressants generally take several weeks or even a month or two to be evident and they generally don’t work on the spot or when taken “as needed” (prn). They can have side effects – including rare ones that can be severe – and should not be taken unless there is good reason to believe that the chance of benefit outweighs the likely risks. This is why a prescription is still required – they are not available over the counter – and follow-up with a healthcare provider is a standard of practice.

J M Witkin has answered Likely

An expert from Indiana University Medical Center in Pharmacology

‘Happier’ is not a technical term and, as everyone is aware, happiness is tough to measure. That being said, millions of physically healthy people suffer from major depressive disorder (MDD) and related depressive syndromes. The disorder is also highly prevalent in people with other diseases (e.g., diabetes). Antidepressant drugs are approved by the U.S. Food and Drug Administration for reliving symptoms of depression. Thus, antidepressant have been proven by controlled clinical studies to help people be interested and excited about life events that made them ‘happy’ before they developed MDD. For many people these drugs can also help reduce stress-related behaviors and reduce anxiety. Both of these drug effects on behavior are often subtle and do not occur in all patients (the right drug for the right patient is often required). When they work, they have remarkable effects in individuals that are beneficial (‘happiness producing’?) in patients and in the those people with whom they interact. [I am a Ph.D. research scientist, not a physician and my words here should not be a recommendation to take or not to take any medications].

Christopher A Lowry has answered Unlikely

An expert from University of Colorado Boulder in Neuroscience

Can antidepressants make a healthy person happier? This is unlikely. Even in persons with a diagnosis of major depressive disorder (MDD), the effects sizes for improvement in depressive symptoms are estimated to be 0.2-0.3 (i.e., a small effect size). However, the science of measuring “happiness” is in its infancy, and few if any controlled studies have been done to test if antidepressants can make a healthy person happier.

Domenico De Berardis has answered Extremely Unlikely

An expert from National Health Service in Psychiatry, Psychopathology

Antidepressants may improve depressive symptoms in moderate-to-severe depression. The effects on healthy people are generally negligible. Moreover, their use in such people may expose them to the risk of adverse effects.

Ivor Ebenezer has answered Extremely Unlikely

An expert from University of Portsmouth in Neuroscience

Happiness is not a psychiatric term like depression and is therefore difficult to define in scientific terms. The term is very subjective and can vary from person to person. Nevertheless, most people understand happiness to mean one or more of the following: contentment, satisfaction, joy, a feeling of well being, positive emotions, pleasure or fulfilment. On the other hand depression is usually associated with low mood, loss of interest in most activities, inability to feel pleasure, reduced energy, pessimistic thoughts, suicidal ideas, changes in sleep patterns, loss of appetite, and cognitive symptoms, such as difficulty in focusing attention or deficits in memory recall (1). Antidepressant drugs act to reduce the symptoms of depression by increasing central neurotransmitters, such as noradrenaline (norepinephrine) and 5-hydroxytryptamine (serotonin) (1). All the antidepressants that are used clinically have side effects that range from mild to life threatening and include sedation, anticholinergic effects, sexual dysfunction, gastrointestinal dysfunction, sleep disturbances, suicidal thoughts, serotonin syndrome, postural hypotension, and cardiovascular problems. (1). There is no evidence in the medical literature that people who do not have depression will benefit from taking antidepressants and feel “happier” by doing so. In fact, they may feel worse as they may display some of the the side effects that are associated with these drugs. Interestingly, low doses of the tricyclic antidepressant, amitriptyline, have been prescribed to treat certain types of clinical pain in non depressed individuals or non-depressed individuals with sleeping disorders and some complain of side effects, such as apathy and “lack of motivation” to achieve goals. There are people who have highly stressful jobs and who take SSRI (Specific Serotonin Reuptake Inhibitors) antidepressant, such as fluoxetine (prozac), as a lifestyle drug to help them cope. They feel that without the drug, they would find it difficult to meet the demands of their jobs. However, these are anecdotal views and many people who take such agents will experience short term and long term adverse effects that may sometime include psychotic episodes (1). There is also evidence from animal studies that antidepressant can produce changes in brain architecture. For example, experiments carried out in non-depressed primates have revealed that chronic exposure to an SSRI (sertraline) produced  a decrease in the volume of the anterior cingulate cortex (an area of the brain involved in mood) and the hippocampus (an area of the brain involved in memory). By contrast, chronic treatment with the antidepressant in primates that were assessed as being depressed produced an increase in the volume of the anterior cingulate cortex (2). 

In summary, the use of antidepressants in healthy people will not make them happier. These agents may cause a variety of adverse effects that range from mild to severe and long term use may cause changes in brain architecture that may adversely affect mood and memory function.

(1) Ebenezer, I.S. (2015) Neuropsychopharmacology and Therapeutics, (Affective Disorders 1: Depression, Chapter 6, pp 147-193) John Wiley and Sons, Chichester, U.K. 

(2) Willard, S.L. et al. (2015) Long Term Effects Of Sertraline on Neural Structures in Depressed and Nondepressed Adult Female Nonhuman Primates. Neuropharmacology, 99, 369-378

Verdict: Most Experts Say Antidepressants Won’t Make Healthy People Happier.

The experts have spoken: four of the five specialists consider it unlikely or extremely unlikely that antidepressants would make a healthy person happier. They emphasize that these medications are designed to treat specific conditions, not enhance normal mood states. Most note that healthy individuals taking antidepressants would likely experience side effects without meaningful benefits. One expert dissents, suggesting these medications may help some physically healthy people who might have subclinical symptoms or related conditions that could respond to treatment.

Find more research on psychopharmacology, mood enhancement, and mental health on Consensus, or explore the related questions below to dive deeper!