Antidepressants and the chemical imbalance theory

According to antidepressant manufacturers depression is caused by chemical imbalances in the brain. As per the chemical imbalance theory, when there is a shortage of the chemical serotonin in the brain, depression occurs.

Prescription medications such as Zoloft and Paxil aim to increase serotonin levels and bring them back to normal.

However till date there is no way to measure serotonin levels in the brain to determine what is normal and even whether depression medication brings these levels back to normal.

Antidepressants increase serotonin levels but it is not known that depression is caused due to low serotonin levels. Studies have also shown that lowering serotonin levels does not always lower moods. Moreover even though antidepressants can raise serotonin levels in a few hours, it takes a few weeks before any depression symptoms are relieved. This strongly suggests that depression is not due to low serotonin.

Types of antidepressants

Antidepressants generally belong to medications known as selective serotonin reuptake inhibitors (SSRIs). The main function of these medications is to increase serotonin levels. SSRIs include commonly known prescription medications such as Prosac, Zoloft, Paxil, Luvox, Lexapro and Celexa.

There are also Atypical antidepressants which affect other brain chemicals such as dopamine and norepinephrine. They may or may not also target serotonin. Medications such as Cymbalta, Remeron, Effexor, Wellbutrin fall in this category.

There are also Tricyclic antidepressants and MAOIs (monoamine oxidase inhibitors) which are older classes of antidepressants with more severe side effects and are generally prescribed after the newer antidepressants have failed.

Side effects of antidepressants

Brain chemicals such as serotonin affect not only moods but other bodily functions such as pain, sleep and digestion. As a result when antidepressants target serotonin, other functions get affected as well causing side effects such as

• Nausea and dizziness
• Sleeplessness and Excessive sleepiness
• Anxiety and Agitation
• Lowered libido
• Dizziness
• Headaches
• Weight gain or loss
• Trembling
• Sweating
• Tiredness
• Dry mouth
• Diarrhea
• Constipation
• Blurred vision

For those over 65, antidepressant increase the risk of falls and fractures and can also cause bone depletion. In some people, antidepressant can increase depression and also increase the risk of suicide especially in the first 2 months of treatment.

People on antidepressants should be closely monitored for any signs of:

• suicidal thoughts
• Hyperactivity
• Worse depression
• Hostile angry behaviour
• Risky behaviour
• Sleep difficulties

It is also important to note that antidepressants have very unpleasant withdrawal symptoms. These symptoms include

• Crying spells
• Aches and pains
• Anxiety, agitation
• Depression, mood swings
• Flu-like symptoms
• Irritability
• aggression
• Sleeplessness
• Nightmares
• Nausea and vomiting
• Dizziness, loss of coordination
• Stomach cramping and pain
• Electric shock sensations
• Trembling, muscle spasms

These symptoms known as antidepressant discontinuation syndrome can cause people to revert back to taking antidepressants. It is therefore advisable to slowly reduce dosage instead of stopping medication suddenly. Going off of antidepressants can take several months and should be under a doctor's supervision.

Effectiveness of antidepressants

According to testimony given in the fall of 2004 to the Congressional Energy and Commerce Committee, about half of all studies of anti-depressants have not shown in adults that the SSRI drugs are significantly more effective than a placebo alone. Even worse, insignificant results were found in two thirds of the studies in which children were given anti-depressants and compared to children given a placebo.

A major government study released in 2006 showed that less than 50 percent of people become symptom-free on antidepressants, even after trying two different medications. Furthermore, many who do respond to medication slip back into major depression within a short while, despite sticking with drug treatment.

According to a report published in the Jan. 17 issue of the New England Journal of Medicine, the makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness.

New research pointing to causes of depression

Studies now show that serotonin may not be the only cause of depression. Other biological factors such as inflammation, high stress hormones, lowered immunity, nutritional deficiency and shrinking brain cells may also be the cause. Social factors such as low self-esteem, poor diet, unsocial lifestyle, lack of exercise also contribute to depression.

Depression Treatment Options

Therapy and other self-help methods of treating depression can be just as effective as antidepressants without the side effects.
Read more on natural depression remedies
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References:

Pubmed.org

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