Antidepressant blues

SSRIs impair the brain’s reward learning system, new research finds. Celeste McGovern looks at safe ways to get off antidepressants and alternative treatments

Psychiatry is in crisis. Among the problems plaguing the profession are soaring mental health statistics, patient recovery rates that have flatlined for decades, and a growing stack of evidence that the primary tools of the trade psychoactive drugs including super-selling antidepressants don’t work so well and are linked to an expanding litany of damaging side-effects that are increasingly hard to ignore.

Depression remains the number one cause of disability in the United States, as it is across the Western world. Younger adults and adolescents are most affected, and increasingly at younger ages; suicide is now the second leading cause of death for youths aged 10 to 19. Mental illness is the leading cause of disability in children, outpacing physical disabilities like cerebral palsy or Down syndrome. A staggering 2.7 million American children ages 3–17 received a depression diagnosis in 2016–2019.

By far the biggest consumers of antidepressants are women, however. More than 17 percent of American women had taken antidepressants in the past month in 2015–2018, according to the CDC, and for women over the age of 60, that number rose to nearly one in four (24.3 percent).

Doctors used to prescribe antidepressants for people with rare “melancholia” back in the 1960s and ’70s, but the old drugs, like tricyclics, had grim side-effects and their use was limited.

In the late ’80s, a new line of antidepressants called SSRIs (selective serotonin reuptake inhibitors) was approved by the US Food and Drug Administration. SSRIs block the reuptake of the chemical messenger serotonin into neurons and thereby are believed to make more serotonin available to improve transmission of messages between neurons.