- The Washington Times - Friday, February 21, 2020

Health researchers are warning against using antidepressants long term, which can lead to physical dependence.

They also recommend patients who have taken the medications for years to consider weaning off them, according to a study released this week.

An estimated 17.3 million adults in the U.S., or about 7%, had at least one major depressive episode in 2017, according to the National Institute of Mental Health.

Since patients who are physically dependent are likely to face difficult and even dangerous withdrawal symptoms, the researchers suggest users taper off the medications under the guidance of a physician, noting that stopping medication outright is “almost never advisable.”

“I understand that many people feel safe in that their depression or anxiety is continuously managed by medication. However, these are mind-altering drugs and were never intended as a permanent solution,” said Mireille Rizkalla, lead author of the study and assistant professor at Midwestern University Chicago College of Osteopathic Medicine.

The study, published in the Journal of the American Osteopathic Association on Thursday, said one-fourth of people taking antidepressants have been using them for a decade or more, citing a recent report from the Centers for Disease Control and Prevention.

“I think we have a real problem with patient care management, when it comes to prescribing antidepressants,” Dr. Rizkalla said. “We tend to put patients on an [antidepressant] and more or less forget about them.”

Patients who stop taking their medication often experience Antidepressant Discontinuation Syndrome, which can cause flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances and hyperarousal.

Antidepressants also could cause more severe symptoms such as cognitive impairment and psychosis.

However, patients who stop taking antidepressants risk a gradual worsening or relapse of depression, anxiety and suicidal thoughts.

“Once the patient’s depression or anxiety has been resolved, the physician should guide them toward discontinuation, while providing nonpharmacologic treatments to help them maintain their mental health,” Dr. Rizkalla said.

While antidepressants are relatively safe, she said they still come with side effects such as emotional numbing, weight gain and sexual dysfunction. The evidence for antidepressant risks is based on short-term use, she said, noting there are no sufficient long-term studies that look at the neurologic effects of taking them for decades.

Antidepressants are commonly used to help treat depression, but many of them also are used to manage other conditions such as OCD, generalized anxiety, eating disorders and chronic pain syndrome.

That widespread use may lead doctors to overestimate the potential benefits of antidepressants while overlooking the side effects, the study says.

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