The Mighty Logo

Why Your Antidepressants May Stop Working

The most helpful emails in health
Browse our free newsletters

Editor's Note

Please see a doctor before starting or stopping a medication.

From what I’ve read in Facebook support groups — and noticed from my own experience — the effects of antidepressants don’t always last as long as we might want.

I took my first antidepressant when I was only diagnosed with unipolar depression, so it seemed like a good choice. It was what is called a “tricyclic” antidepressant because of its chemical structure. Many people complained of the side effects.

Tricyclics were about all the medical community had to offer until 1987, when Prozac hit the market, followed by its cousins Zoloft and Paxil. All of these were classified as SSRI drugs, ones that selectively acted on the neurochemical serotonin in the brain, rather than a wide variety of brain chemicals as the tricyclics had.

Since then we have listened to Prozac, talked back to Prozac and have been referred to as a Prozac Nation. Prozac has been hailed as a “miracle drug,” damned as a gateway to violence or suicide and prescribed in phenomenal amounts.

And Prozac has helped me. After about six weeks on it, when the drug started to kick in, I was on a sailing trip. One of the crew said I was the passenger most at peace with myself that he knew. It was a revelation to me and a new way of thinking of myself.

Prozac changed my life — possibly saved it. And then, not so much. I moved on to other medications.

Major Study Finds Antidepressants Work, But May Have Limitations,” by Brigit Katz, published on The, validates my perception. Her article states, “A meta-analysis [or study of studies] of existing trials suggests that the drugs are mostly effective on a short-term basis for patients suffering from acute depression.” Katz’s article also cites articles in the New York Times and The Lancet that report similar findings.

The Lancet study found that 21 commonly prescribed antidepressants were more effective than placebos in reducing depressive symptoms during the first eight weeks of treatment. Katz commented on this saying, “The new analysis suggests, however, that the efficacy of the drugs may be limited… For one thing, the benefits applied in the short-term, and only to patients who are suffering from acute major depression.” 

The Smithsonian article and the studies conclude that while the study shows antidepressants are more effective than placebos, media reports claiming they “work” and “people should take them” may not be completely accurate.

This hearkens back to a pet peeve of mine: that headline writers — who are almost never the authors of the articles — do a poor job of summarizing articles in favor of more definitive or appealing descriptions of the text. At any rate, the meta-analysis bears out my experience. Although I was bipolar two, my disorder first manifested as major depression. I got relief from Prozac, results that later diminished. Since my proper diagnosis I have found more relief from a combination of an SSRI, an anticonvulsant medication often used for bipolar disorder, and an atypical antipsychotic also useful for bipolar as well as schizophrenia. Even though I do not have seizures or schizophrenia, these medications work for me and have not worn off for several years now.

So, what’s the takeaway from all this? I think it is that, if your medication for bipolar or depression seems to be “wearing off,” your perception may indeed be valid. But that’s no reason to give up on psychotropics altogether. People and their disorders differ in ways we just don’t know. You can ask your doctor to try a different medication or combination of medications that may work better for you.

The benefits of medication for psychiatric disorders do not simply go away just because the effect of one does.

Unsplash photo via Rawpixel

Originally published: August 11, 2018
Want more of The Mighty?
You can find even more stories on our Home page. There, you’ll also find thoughts and questions by our community.
Take Me Home