Can Anti depressants work for prolonged periods?
Anti depressants can work for prolonged periods and often sufferers of depression use antidepressants for long durations. Most of the clinicians are aware of the short term disturbances caused by antidepressants. They effectively discuss these with their patients. But many doctors are not aware of the side effects of long term usage of these medications. Often, the long term side effects are misunderstood. Doctors think the long term side effects to be the symptoms of depression itself.
Side effects of antidepressants that work for prolonged periods
- Prolonged usage of anti depressant may cause mood and anxiety disturbances.
- Sufferers of bipolar disorder experienced drug induced switching and cycling.
- The longer the duration of medicine the more are the chances of a relapse. In some cases long term medication changes the chemical composition of the body thus reducing its effectiveness to the drug. The same medicine will then have to be given in higher doses to be effective. These changes might bring about a relapse of the depression.
- Long term usage of SSRI brings about weight gain of 3 to 4 kg which can be easily managed by exercise and diet.
- Another long term side effect is sexual dysfunction which might be caused by the medicine or the depression itself. Before prescribing medicines for sexual dysfunction the doctor should rule out primary sexual dysfunction that is caused independent of anti depressants. Drug induced sexual dysfunction might set right within six months of usage. Effective sexual antidotes are available for patients on antidepressants.
- Insomnia is the long term side effects of anti depressants. Patients who use tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) are often faced with the problem of sleeplessness over a long term period. Doctors either consider a reduction in the dosage or an altogether switch in the medicine. Decreasing the dosage or shifting to a different timing for the dose can be resorted to if the doctor and patient do not wish to change medicines.
Withdrawing the drug after prolonged usage
Medications have to be gradually withdrawn after long term usage. Reduction should begin by 25% a month. And if symptoms reoccur during reduction then mood stabilizers should be used rather than switching back to the medicine.
As explained, withdrawing the drug after long usage leads to withdrawal symptoms. But these symptoms cannot be linked to the withdrawal symptoms of alcohol. The mechanism involved in the tolerance development is different in these cases. It’s possible to avoid withdrawal symptoms by reducing the antibiotics slowly or by tapering off the medicine.
A contradictory view
However majority of the doctors are of the opinion that people who use antidepressants for a long term fare better. A doctor conducting randomized trials of 31 people out of 4400 patients came to the conclusion that those who prolonged the duration of the treatment and took antidepressants for more than a year exhibited lesser signs of a relapse.