What are the long term effects of anti-depressants?
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Summary
10 papers analyzed
Some studies suggest long-term antidepressant use may worsen depression and increase relapse risk, while other studies highlight their beneficial effects in reducing relapse and managing depressive episodes, though they may also cause cognitive, physical side effects, and weight gain.
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Introduction
The long-term effects of antidepressants have been a subject of considerable research and debate. While these medications are effective in treating acute depressive episodes, their prolonged use may lead to various side effects and complications. This synthesis aims to present the key insights from multiple research papers on the long-term effects of antidepressants.
Key Insights
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Worsening of Depression and Sensitization:
- Long-term use of antidepressants may worsen the course of depression, potentially leading to increased biochemical vulnerability and symptomatic expression .
- Antidepressants can induce paradoxical effects, such as depression-inducing symptoms and symptomatic worsening in some patients .
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Tolerance and Resistance:
- Patients may develop tolerance to the effects of antidepressants over time, leading to decreased efficacy and the need for higher doses .
- Resistance to the same antidepressant upon rechallenge has been observed in some cases .
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Withdrawal and Relapse:
- Discontinuation of antidepressants can lead to withdrawal syndromes and increased vulnerability to relapse due to the oppositional model of tolerance .
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Physical and Cognitive Side Effects:
- Long-term antidepressant use is associated with physical side effects such as weight gain, sleep disturbances, and fatigue .
- Cognitive side effects, including apathy, inattentiveness, and mental slowing, are frequently reported by patients on long-term antidepressant therapy.
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Impact on Balance and Motor Functions:
- Tricyclic antidepressants (TCAs) have been shown to impair balance, motor coordination, and postural reflexes, while selective serotonin reuptake inhibitors (SSRIs) do not show this effect.
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Driving Performance:
- Depressed patients on long-term SSRI or serotonin and noradrenaline reuptake inhibitor (SNRI) treatment exhibit impaired driving performance, likely due to residual depressive symptoms rather than the medication itself.
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Neuroendocrine and Biochemical Changes:
- Long-term antidepressant use affects the regulation of the hypothalamic-pituitary-adrenocortical axis and alters neurotransmitter systems, which may contribute to their long-term effects.
Conclusion
The long-term use of antidepressants is associated with a range of effects, including potential worsening of depression, development of tolerance and resistance, withdrawal symptoms, and various physical and cognitive side effects. While these medications are crucial for treating major depressive episodes, their prolonged use requires careful consideration and monitoring to balance their benefits and risks.
Sources and full results
Most relevant research papers on this topic
9
[Long-term clinical effects of antidepressive agents].
9
1 Citations
1995
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