Are antidepressants being overused?
On the one hand, popular antidepressants like Prozac can effectively alleviate depression in many people with depressive symptoms – and are widely prescribed (15). But the truth is that antidepressants don’t work on everyone (1), and their effects are not guaranteed to last (2). After all, no singular method of treatment – antidepressants, psychotherapy, or otherwise – can simultaneously address all of the complex, potential causes of depression, like genetics, traumatic events, malnutrition, hormonal imbalance, and even changes in season (3):
Luckily, researchers have been working to discover more treatment options for depression that may supplement and/or replace antidepressants for patients for whom typical drugs are ineffective. One recent study, for instance, has confirmed the effectiveness of anti-inflammatory drugs in treating depression.
The Study: Anti-inflammatory Drugs Alleviate Depression
A 2017 study conducted by the Department of Psychiatry in Cambridge has found that anti-inflammatory medicine may alleviate the symptoms of depression (4).
The researchers took their cue from previous studies, which found that patients with depression tend to experience inflammation (5). Indeed, patients with depression may have higher amounts of cytokines – a type of inflammation-causing proteins – in their blood (6, 7).
Accordingly, the Cambridge researchers set out to see if people with inflammatory autoimmune diseases, like rheumatoid arthritis, felt less depressive symptoms when they took anti-inflammatory, anti-cytokine drugs for their autoimmune diseases (4). After reviewing the effects of anti-cytokine drugs on 5063 patients in over 20 studies, the research team concluded that the use of anti-inflammatory drugs was associated with less depressive symptoms.
“About a third of patients who are resistant to antidepressants show evidence of inflammation,” confirmed Dr. Khandaker, an investigator in this study (8). “So, anti-inflammatory treatments could be relevant for a large number of people who suffer from depression. […] It’s possible that in the future we would use anti-inflammatory drugs in psychiatry for certain patients with depression.”
The Problem with Antidepressants
Currently, a vast majority of antidepressants treat depression by altering the amount of neurotransmitters – like serotonin, norepinephrine, and dopamine – in the brain. Some of the most popular antidepressants on the market include selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft, which raise the amount of serotonin in the brain (9). In this way, antidepressant treatments subscribe to the “serotonin theory” – a system of theories originating from the 1950s which propose that low levels of serotonin are to blame for depression (10).
However, the serotonin theory has lost scientific credibility over the years, as researchers have found little evidence to support it. Namely, there is little evidence that low serotonin levels necessarily cause depressive symptoms (10, 11). In fact, researchers who depleted serotonin in healthy participants (without histories of depression) found that these individuals did not develop any depressive symptoms as a result (11).
So do antidepressants even work? Yes – but only for some people, like those whose depression is associated with a notable chemical imbalance in the brain (12). A study from 2008 found that only 38 out of 74 studies conducted on 12 different antidepressants had found these drugs to be significantly effective (13). In another 2008 review, antidepressants proved to be more effective than placebo – or, “fake pills” – in only 20 out of 46 trials (14).
Yet, antidepressants continue to be doled out to the public much too often and much too quickly as a “one-size-fits-all” solution for depression. According to the National Institute of Mental Health, antidepressants remain the second most commonly prescribed medication in the US, with over 254 million prescriptions written for them – and $10 billion spent on them – every year (15).
The good news about the Cambridge study, then, is that its findings may help reduce inappropriate uses of traditional antidepressants by introducing more diverse, alternative treatment options for patients with depression. Indeed, patients with depression associated with non-neurotransmitter-related issues, like inflammation, may soon have more effective treatment options for depression – and no longer have to suffer the many negative side effects of traditional antidepressants, like indigestion, headaches, anxiety, confusion, insomnia, and suicidal thoughts (16).
So what should you do about depression?
The first step to treating any mental health issue should be consultation with a medical professional. If you start to experience symptoms of depression, make sure to consult with a professional to determine the root cause(s) of your condition and treat them appropriately.
However, there are also a few fundamental lifestyle changes you could make at home to naturally reduce inflammation and alleviate symptoms of depression. Try out the tips below, in consultation with your doctor:
- Walk, run, or jog for 30 minutes a day. Even moderate levels of physical activity will help reduce the risk of developing depression, major chronic diseases, and stress (17).
- Cut down on added sugar. Sweet foods and beverages with added sugar have been associated with risk of depression (18). Eat less processed foods, as they tend to be high in added sugar (19) – and reduce the amount of added sugar you use in cooking by two-thirds. Alternatively, try using natural sweeteners, like honey or stevia, instead of artificial ones, like white table sugar.
- Eat fresh, natural, inflammation-fighting foods. Get enough healthy fats, like avocado, olive oil, and salmon, as well as fresh fruits and vegetables rich with zinc and B-vitamins, like pomegranates, bananas, and spinach (20).
- Drink more coffee and less alcohol. Feel free to drink up to 4 cups of coffee a day to reduce your risk of depression (21). You should, however, consume less alcohol, as heavier consumption has been linked with a higher risk of depression (22).
- Aim to get 7 hours of sleep every night. Sleep deficiency could lead to neurotransmitter problems and depression (23).
- Practice meditation and open-minded thinking. Meditation and mindful thinking have been proven to lower negative psychological stress (24).
- Surround yourself with friends and family. A strong, positive social network can increase mental wellness (25).
- Cultivate a sense of purpose. Finding a sense of purpose through spirituality or setting meaningful goals can help alleviate depressive symptoms and increase life satisfaction (26).
Disclaimer:
Please consult a physician before beginning any treatment program or making any adjustment to your health care, diet, and/or lifestyle.
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