Can Anti-depressants Make a Healthy Person Happier?

Can anti-depressants make a healthy person happier?

Do anti-depressants make a healthy person happier?

Check out this answer from Consensus:

While antidepressants can influence emotional processing in healthy individuals, their primary therapeutic benefits are observed in patients with depression or physical illnesses. The use of antidepressants in healthy people to enhance happiness is not supported by the current evidence and may carry unnecessary risks.

 

Antidepressants are primarily used to treat depression and other mood disorders, but their effects on healthy individuals have also been a subject of research. This article explores whether antidepressants can enhance the mood of those without depression.

The Effects of Antidepressants on Emotional Processing

A study on the selective serotonin reuptake inhibitor (SSRI) citalopram showed that short-term treatment increased amygdala activation to happy faces in healthy volunteers, without altering mood or anxiety levels1. This suggests that antidepressants may modulate the processing of positive emotional stimuli in the absence of mood disorders.

Antidepressants and Neural Responses in Depression

In contrast to their effects on healthy individuals, antidepressants have been shown to correct impairments in the neural processing of happy facial expressions in patients with major depression2. After treatment with fluoxetine, patients exhibited increased activation in brain regions associated with affective facial processing, which correlated with symptomatic improvement.

Neuropsychological Mechanisms Underlying Antidepressant Effects

A systematic meta-analysis of neuroimaging studies revealed that antidepressants increase brain activity in response to positive emotions and decrease activity to negative emotions in both patients with mood disorders and healthy volunteers3. However, the effects differed between the two groups, with antidepressants increasing engagement of emotion regulation regions in patients, while decreasing responses to positive emotions in healthy volunteers.

The Debate on Antidepressant Efficacy and Harm

While some argue that antidepressants may cause more harm than good, citing side effects and small drug-placebo differences4, others emphasize the importance of antidepressants in treating depression, highlighting their role in reducing suicide rates and improving quality of life4.

Antidepressants for Major Depressive Disorder

A review of the evidence on antidepressants for major depressive disorder concluded that their benefits seem minimal and may not outweigh the harmful effects5. This suggests that the use of antidepressants in healthy individuals could be even more questionable.

Antidepressants’ Impact on Emotion Recognition in Depressed Patients

Research indicates that antidepressants can alter emotional processing in depressed patients, with increased recognition of positive emotions correlating with clinical improvement6. This effect is similar to that observed in healthy volunteers, although the clinical implications are different.

Antidepressants and Sleep

Antidepressants also affect sleep patterns, particularly REM sleep, in both healthy individuals and depressed patients7. These changes can be beneficial or detrimental depending on the specific sleep issues present.

Antidepressants in Physically Ill Patients with Depression

Finally, a review of antidepressants in physically ill patients with depression found that they are effective in treating depression in this population8. This underscores the therapeutic role of antidepressants in those with comorbid physical illnesses, rather than in healthy individuals.

 

Can anti-depressants make a healthy person happier?

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.

 

Can anti-depressants make a healthy person happier?

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].

 

Can anti-depressants make a healthy person happier?

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.

 

Can anti-depressants 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.

 

Can anti-depressants make a healthy person happier?

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

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