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The Real Effectiveness of Antidepressants
Antidepressants have been prescribed for treating depression for several decades. But the real facts behind these medications may shock you. Find out more about how antidepressants work and what they really do below.
According to the National Institute for Mental Health, about 254 million antidepressant prescriptions are prescribed annually, costing about $10 billion dollars per year. Research from the Center for Disease Control shows that in a given year, up to 18 percent of adults and 11 percent of teens report feeling depressed.
Americans today are feeling more depressed than ever. Anxiety disorders and a variety of other mental health issues are occurring more each day. This causes many Americans to turn to the use of antidepressants and other medications to try to feel better, but recent studies show that antidepressants may not be the best option for all forms of depression. Find out more below.
Antidepressants usually work by either blocking neurotransmitters from absorbing into the brain’s nerve cells or by boosting the absorption of certain chemicals. Reuptake inhibitors are the most common form of antidepressant, which keep the neurotransmitters in the gap between the nerves. This theoretically improves communication between the nerve cells and strengthens the circuits in the brain that regulate mood.
In practice, however, researchers are unable to clearly identify any specific link between chemicals balances in the brain and mood. Most antidepressants manufactured today are a sort of “shot in the dark” treatment methods that have been shown to be somewhat effective in reducing depressive symptoms. Antidepressants are classified into three groups based on the type of neurotransmitter they alter:
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. These antidepressants work to boost serotonin levels in the brain. Common brands are Zoloft, Symbyax, Celexa, Paxil, Prozac, and Lexapro.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer form of antidepressant. They block the reuptake of serotonin and norepinephrine. Common brand names are Cymbalta, Khadeza, Pristiq, and Effexor.
Norepinephrine and dopamine reuptake inhibitors (NDRIs) work differently by blocking the reuptake of dopamine and norepinephrine. Currently, only one brand uses this formula- Wellbutrin.
A few decades ago, it was thought that antidepressants were highly effective at reducing depression. However, recent studies have uncovered data that questions the effectiveness of the medication. A study published in the “Journal of the American Medical Association” in January of 2010 uncovered data that showed that antidepressants were no more effective for mild and moderate depression than placebo pills. The study did find that antidepressants were more effective than placebo for patients with severe depression and for those with chronic depression.
An in-depth review of the study from “Time” Magazine uncovered further complications that make the role of antidepressant medication even more complicated. According to Time’s research, only 1/3 of patients are helped by the first medication they try. Many patients can recover fully through talk therapy or without any other help at all. Up to 14 percent of patients will have extremely dangerous reactions to a medication that they try- with the most serious complication resulting in suicide. The authors concluded that treating depression medically is a complicated issue that requires time and effort to find the right solution for each patient.
Another study conducted by researchers at the University of California in 2010 examined the effectiveness of Prozac or Effexor versus a placebo pill. This study was designed to identify patients that might be at risk for developing serious side effects to antidepressants. The researchers found that individuals most likely to develop serious side effects had dramatic drops in midline/right frontal (MRF) area brain activity. The placebo group had a slight rise in brain activity in this area.
The researchers hope that this data will make side effects from antidepressants less common, since it is possible to detect future problems within 48 hours of taking antidepressants using the study method. Overall, a study from the University of California in 2000 found that the effectiveness rating for selective serotonin reuptake inhibitors is up to 55 percent at 10 weeks.
A review on several of the top antidepressant treatments in 2005 found that the most effective antidepressants are Zoloft and Effexor. Another reason why the effectiveness rating for most antidepressants is so low is due to the original purpose for antidepressant medication.
A Neuroscience conference from 2009 identified the original purpose of antidepressants as a treatment for stress. The drugs were used to manipulate the behavior of stressed animals, and it was theorized that they could also help humans with depression (which is true for some antidepressants about half the time). However, chronic stress does not alter the balance of chemicals in the brain the same way that depression does, which is likely why antidepressants are at most, 55 percent effective.
The trouble with antidepressants is mainly the high risk for side effects. As the information uncovered by Time shows, up to 14 percent of patients will experience dangerous side effects, while many others will experience the less-dangerous side effects.
It is up to each individual to determine if they need to go the medical route or the natural route for treating depression. Some individuals find that using both medical and natural methods work together in harmony to relieve depressive symptoms. The above data shows that in mild to moderate cases, antidepressants should not be the first line of treatment.
The high likelihood of seeing serious side effects combined with the low effectiveness rating for treating milder forms of depression mean that you are better off trying natural methods and behavioral therapy rather than using medication to solve the problem. For severe or chronic depression, however, studies do show effectiveness with antidepressants up to around 55 percent.
According to data from the CDC, up to two-thirds of people with depression are undiagnosed. In fact, untreated depression is one of the number one causes of suicide in the United States. Depression is more than simply feeling “blue.” Many doctors use the SIGECAPS method to identify depression, which include criteria based on sleep, interest, guilt, energy, concentration, appetite, psychomotor, and suicide. When more than four of these criteria are identified, there is a good chance the person is suffering from major depression- which could be benefited by antidepressants. For results in fewer than four categories, the depression may be milder and can be treated naturally.
The above symptoms must be noted for several weeks and not related to other mental disorders, grief, or substance abuse. The symptoms must also cause impairment in social, occupational, or other aspects of life. Never ignore any signs of suicide even if no other signs of depression are present.
Signs of suicidal intent can include:
A person’s suicide risk is higher under conditions such as:
According to studies, a person’s risk of suicide could increase once depression levels improve (but not entirely cured). This is one theory why antidepressants increase the risk of suicide. Researches theorize that an increase in energy may cause someone to carry out a suicide plan or feel more in control of the decision to end their life.
If you believe anyone around you is feeling suicidal, do not leave them alone and contact a suicide hotline or 911 immediately.
Since antidepressants are less effective than placebo pills in cases of mild and moderate depression, treating this kind of depression naturally makes the most sense. If you are feeling depressed, always consult with a medical professional right away, in case your depression is more serious than you realized. It is possible to be more depressed than you currently feel.
If your depression is diagnosed as moderate or mild, discuss your intent to use natural methods with your doctor so that the two of you can remain on the same page for treatment discussion and depression severity monitoring. You can treat mild to moderate depression naturally in 4 different ways:
Exercising naturally raises many of the chemical levels in the brain that fight depression. Both serotonin, endorphins, and dopamine levels are raised significantly after exercise-which all directly influence your mental state. Studies have shown that regular exercise (somewhere around 4 times a week for at 30 minutes a day at moderate intensity) is as effective as a treatment for depression as most antidepressants. Exercise also increases cells in the hippocampus. Some studies have linked low cell numbers in the hippocampus to depression.
The right supplements can have a powerful effect on your depression levels. A variety of herbs and supplements can increase neurotransmitter levels or function in the brain, leading to less depressive symptoms. You may find the best results with the following supplements:
L-Phenylalanine: This amino acid is used to produce neurotransmitters. A study from 1979 found that supplementing with the amino acid was more effective than tricyclic antidepressants without any side effects.
Folic Acid: Many patients with depression are deficient in folic acid (particularly women). In one study, 95 percent of women who took folic acid supplements in addition to Prozac had substantial reduction in depressive symptoms.
St John's Wort: St John’s wort is the most-studied natural treatment for depression to date. Numerous studies have found the herb to be more effective than placebo pills, and in studies comparing the herb with Prozac, Celexa, and imipramine, St. John’s wort was just as effective or more effective as these antidepressants.
Ginkgo Biloba: Ginkgo biloba is an herb used in conjunction with St. John’s wort to boost the effectiveness of the herb.
A healthy diet will not only provide the necessary nutrients to help the brain function properly, but it can also help you feel better overall and prevent depression from forming. Sugar and processed carbohydrates may be particularly bad for depression, since leptin and insulin imbalances can lead to feelings of depression. Excess sugar also suppresses the growth hormone BDNF (brain derived neurotrophic factor), which helps create healthy brain neurons and boosts memory. According to studies from the University of Helsinki, BDNF levels are often extremely low in individuals with depression.
Yes, sunlight is one of the best cures for depression. This is a widely-known fact, but still, most people do not get enough daily sun. Sunlight helps your body produce vitamin D, which boosts mood and fights depression. In fact, a study conducted by the The University of Texas Southwestern Medical Center and the Cooper Institute in 2011 found that individuals with the lowest levels of vitamin D were 11 times more likely to be depressed. Try going outside in the sun more often, and you can also take a vitamin D3 supplement to fill in any gaps.
Is there a place for antidepressants? Absolutely. Even though most antidepressants are not as effective as researchers would like, they are beneficial for treating severe depression quickly. Antidepressants could help prevent depression that would lead to suicide in cases of severe depression.
Studies show that antidepressants work in treating severe depression, which means there will always be a place for them in the health industry. However, for the millions of Americans suffering from mild or moderate depression, antidepressants are not the answer. Natural methods offer more effective treatment methods without the dangerous side effects of antidepressant pills. If you are suffering from mild or moderate depression, or simply do not want to face depression, the 4 natural methods outlined above will help you treat your depression and get you feeling your best within a few weeks.
However, before starting any treatment plan, consult with your doctor to identify the severity of your depression and to identify specific steps you should take for your individual case.
Neuroscience 2009, Chicago, IL October 17-21, 2009
LaValle JB, et al. Natural Therapeutics Pocket Guide. Hudson OH: LexiComp, Inc; 2000:441-442.
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Exulin is a natural remedy that contains clinically proven ingredients that boost serotonin levels. Exulin will help with the conversion to tryptophan into serotonin to increase mood and happiness.