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Do Antidepressants Permanently Alter Brain Chemistry

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What Side Effects Can Antidepressants Cause

How do antidepressants work? – Neil R. Jeyasingam

Every antidepressant has possible side effects. These vary between the different types of antidepressant, and between each individual drug. This page covers:

Some of the side effects listed below are quite common, but others are rare. You may not experience many of these effects. You may also experience some side effects when you first start taking antidepressants, but feel them less after a few weeks.

It’s up to you to decide whether or not the antidepressant has more benefits for you than any negative side effects. Your doctor should be able to help you with this decision. Our pages on coping with side effects and receiving the right medication may also help.

You can also find out about the side effects for individual antidepressants from the British National Formulary A-Z list of drugs. Or you can speak to your doctor or pharmacist with any questions or concerns you have about side effects.

“It took me a long time to take an SSRI, mainly as I was terrified of the side effects listed, but my doctor finally convinced me that my depression was much worse .”

Can Antidepressants Stop Working

If your antidepressant is no longer working as well as it did when you first started taking it, you could have developed a tolerance for the drug. Some people refer to this as antidepressant “poop-out,” although the medical term is tachyphylaxis. It has not been determined how many people taking antidepressants experience this phenomenon, but studies show rates ranging from 9% to 57%.

While no one knows for sure why this decrease in effectiveness occurs, one theory suggests that receptors in the brain become less sensitive to the medication. Other culprits include:

  • Age
  • Alternative or cooccurring mental health diagnosis
  • Drug interactions
  • Stress

How Hard Is It To Stop Antidepressants

New research suggests antidepressant withdrawal symptoms might be more common, more severe and longer lasting than previously realized

Vol. 51, No. 3

Monitor on Psychology51

Prozac, the first selective serotonin reuptake inhibitor approved in the United States, burst onto the scene in 1987. Three decades later, the drug and its eventual competitors have transformed the treatment of depression and anxiety. According to the latest data available, nearly 13% of people age 12 and older in the United States have taken an antidepressant medication in the past month .

But what happens when people want to stop taking these medications? The thinking in the medical community was that patients could wean off these drugs with minor side effects, but anecdotally, many patients have reported troubling mental and physical withdrawal symptoms that last for months or even years. Finding a lack of support from prescribers as they figure out how to stop the drugs, many people have turned to online forums for advicewhere some report theyve resorted to opening pill capsules to remove a few beads, in a DIY effort to reduce their dosages more gradually.

Now, new research backs up the idea that for many people, antidepressant withdrawal might be a bigger problem than most have realized.

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Why Is Zoloft Prescribed

Traditional western medicine, sadly, has not particularly focused on overall, long-term health. Rather, doctors are pressured to find a quick fix for the problem at hand and move on to the next patient. This is what makes the most money for the drug companies, medical complexes, and doctors themselves. Actually, physicians are legally obligated to obtain informed consent before treatment is given, except when the patient is incapacitated and someone else may need to be called on to give full informed consent.21

Unfortunately, if this trend continues, less and less information can be disclosed during primary visits. This means that a significant number of patients on Zoloft are not adequately informed about the drugs side effects and withdrawal symptoms, as well as alternative non-drug-based solutions, as stipulated in the medical-legal literature on informed consent, and havent been empowered to make the best-educated decisions about their own health and safety.

How Long Does It Take To Recover From Ssris

Alter Chemistry Do Antidepressants Brain Permanently

Did you know that roughly one in ten Americans takes an antidepressant, according to Harvard Health? In fact, antidepressants are the third-most common medications prescribed to people in the U.S..

Selective serotonin reuptake inhibitors are a popularly prescribed type of antidepressant drug. They are widely prescribed because they tend to be effective for reducing depression, anxiety, and other mood disorders without many side effects. Common types of SSRIs include citalopram , paroxetine , sertraline , and escitalopram .

Although these drugs may not cure depression, they can reduce the conditions symptoms. Unfortunately, though, when people attempt to stop using these drugs, especially after theyve been taking them at higher doses, they can experience some difficult side effects.

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How To Manage Long

Antidepressants, specifically SSRIs which are considered the most tolerable and are therefore the most prescribed, are generally safe to take long-term.

The long-term effects discussed above may only occur for a small number of people and the medication itself should disclose a list of possible side effects.

In order to manage or prevent any of the long-term negative effects from happening, there are some ways to help:

Do you need mental health help?

Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/

1-800-273-8255

References

Petersen, A. . New Concerns Emerge About Long-Term Antidepressant Use.

How Do They Work

In a general guide to antidepressants, youll find antidepressants affect our brains neurotransmission.

Neurotransmission takes place when tiny chemical messengers, called neurotransmitters, travel through a neuron into the synaptic cleft. The synaptic cleft is the space of limbo between 2 different neurons.

Once a neurotransmitter is in the cleft, its waiting to be taken up by a receptor.

The travel of neurotransmitters is what affects our moods and emotions. Three major neurotransmitters include norepinephrine, dopamine, and serotonin.

  • Norepinephrine is used in regulating motivation, heart rate, and cognition
  • Dopamine affects our experience of pleasure, arousal, and decision-making
  • Serotonin affects mood regulation and our feelings of happiness and appetite

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How Long Do They Take To Work

Everyone is different when it comes to seeing improvements on SSRIs. But people typically start noticing positive changes after about 4 to 6 weeks of treatment. It can take several months to feel the full effect of the medication.

But if youâre not feeling any improvements after about 6 to 8 weeks, talk to your doctor about trying another treatment or adjusting your dosage.

Antidepressants And Your Brain

How Do Antidepressants And Antipsychotic Drugs Change Your Brain? with Robert Whitaker

Before delving into the research, let’s look at how antidepressants work. Antidepressants come in several forms. The major ones are:

  • Monoamine oxidase inhibitors
  • Selective serotonin reuptake inhibitors
  • Serotonin-norepinephrine reuptake inhibitors
  • Tricyclics

In your brain, informationincluding emotionmoves from one neuron to another via chemical messengers called neurotransmitters. Think of neurotransmitters as mailbox keys. Each one unlocks certain receptors on neurons in order to allow the message to keep traveling.

With many of these conditions or diseases, something is wrong with the brain’s neurotransmitters . Sometimes, there’s just not enough of one or more of the neurotransmitters. In other cases, the brain doesn’t use neurotransmitters efficiently, or the problem could lie with the receptors. There’s either no key for the lock, the key isn’t used properly, or the lock is broken.

Regardless of the cause of the problem, the result is the same: neurotransmitter dysregulation. The mail isn’t getting to the right mailbox, so messages aren’t being delivered.

Antidepressants change how neurotransmitters function, making more available so that when a message comes along, it can be properly delivered. This is achieved by slowing down a process called reuptake, which is essentially a clean-up or recycling process.

Once the messages are flowing more as they should, your brain works better and the symptoms related to the slow-down diminish or go away.

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Ways To Help Patients Discontinue Antidepressants

  • Stay current on the research so you can speak knowledgeably about medication-related questions and concerns.
  • Help patients clarify their goals for stopping medications.
  • Help patients track and measure withdrawal symptoms and any related mood or behavior changes.
  • Help patients recognize signs and symptoms of returning depression or anxiety.
  • Encourage patients to self-advocate and share their concerns with their prescribers.
  • Consult with prescribers, with patient consent, to coordinate patient care.
  • Provide psychological therapies to help patients manage specific withdrawal symptoms, such as fatigue, insomnia or mood changes.
  • Advice From The Harvard Health Watch

    If youre thinking about stopping antidepressants, you should go step-by-step, and consider the following:

    Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off it. If youve had three or more recurrences of depression, make that at least two years.

    Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether to stop using them. Before discontinuing, you should feel confident that youre functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge. Dont try to quit while youre under stress or undergoing a significant change in your life, such as a new job or an illness.

    Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant youre taking, how long youve been on it, your current dose, and any symptoms you had during previous medication changes. Its also a good idea to keep a mood calendar on which you record your mood on a daily basis.

    For More Information

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    How Do You Get Off Zoloft

    Medication tapering is the most effective system for getting off of Zoloft. Tapering involves moving from your prescribed dose, slowly down the dosage ladder and down to zero, or at least to the lowest tolerable dose possible.

    In our Zoloft tapering program, we help you to take the correct doses of your medication and ensure that you wean your body off of it safely. As the drug leaves your system and your body begins to readjust, you may experience some uncomfortable symptoms. Our holistic, inpatient treatment programs are here to help. As you begin to holistically detox your body from the SSRI, we will provide you with a gentle and supportive community. Holistic mental health practices such as the ones listed above can help support your body and mind during this time and give you a solid foundation on which to build your drug-free life.

    Are There Alternatives To Zoloft

    How Do Antidepressants Affect the Brain?

    Many doctors would suggest that the only alternatives to Zoloft are other similar SSRIs. These other alternatives, such as Lexapro, Celexa, Prozac, etc., have many of the same side effects and concerns that come with using Zoloft.

    Fortunately, there are natural and holistic healing alternatives that do not have the dangerous side effects and withdrawal symptoms that Zoloft and other SSRIs can create. Here at ATMC, we provide the following holistic programs that can act as an effective replacement for mental health prescriptions:

    • Yoga
    • Counseling services
    • Equine therapy

    We have seen our clients achieve immense success from safe tapering and replacing their Zoloft prescription with a combination of the above therapies. While gently tapering off their prescription under our supervision, we watch our clients blossom, as these natural and holistic practices support their bodies natural rhythms, and free them from debilitating medication side effects.

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    Ventricles And Cerebrospinal Fluid

    A vast majority of studies has shown larger volume of third , lateral ventricles and CSF in patients with depressive disorder, whereas some others found preserved size . A recent meta-analysis reported a trend of enlargement of CSF among patients with depression, but remarked the heterogeneity across studies .

    Golomb Remains Convinced That Lower Cholesterol Can Cause Behavioural Changes In Both Men And Women

    There was even a potential mechanism: lowering the animals cholesterol seemed to affect their levels of serotonin, an important brain chemical thought to be involved in regulating mood and social behaviour in animals. Even fruit flies start fighting if you mess up their serotonin levels, but it also has some unpleasant effects in people studies have linked it to violence, impulsivity, suicide and murder.

    If statins were affecting peoples brains, this was likely to be a direct consequence of their ability to lower cholesterol.

    Since then, more direct evidence has emerged. Several studies have supported a potential link between irritability and statins, including a randomised controlled trial the gold-standard of scientific research that Golomb led, involving more than 1,000 people. It found that the drug increased aggression in post-menopausal women though, oddly, not in men.

    In 2018, a study uncovered the same effect in fish. Giving statins to Nile tilapia made them more confrontational and crucially altered the levels of serotonin in their brains. This suggests that the mechanism that links cholesterol and violence may have been around for millions of years.

    Fruit flies become more aggressive when their serotonin levels become mixed up, research has shown

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    Results: Grey Matter Connectivity Changes As A Result Of The Ssri

    Researchers were able to create connection maps in 3-D that showed the degree of interconnectivity within grey matter. They noticed that when more serotonin was present in the brain as a result of SSRI administration, changes in connectivity were noticeable. Although this finding isnt too surprising, what took researchers by surprise was the fact that other areas of the brain such as the cerebellum and thalamus exhibited different activity.

    The results of the study showed that taking an SSRI essentially reduces the amount of neural connectivity within the brain with the notable exception of two specific parts: the cerebellum and the thalamus. The team of researchers observed decrease in connectivity throughout most areas of the brain. However, they did find that in the cerebellum and thalamus, the opposite effect occurred and connectivity actually increased.

    • Reduced connectivity: Taking an SSRI was found to reduce internal connectivity in most areas of the brain.
    • Increased connectivity: Despite reducing activity in most of the brain, taking an SSRI also resulted in increased connectivity in the cerebellum and thalamus.

    This finding suggests that those who respond best to SSRIs may exhibit over-connectivity among certain brain regions. Over and under connectivity within the brain can be associated with various mental illnesses such as autism.

    Antidepressants Reorganize Brains Functional Connectivity

    Dr. Joe Q& A – Antidepressants

    The study author Julia Sacher stated that what they had observed among individuals with no prior antidepressant treatment is likely a marker of brain reorganization. Researchers believe that these findings could be beneficial in that brain scans may be used in the future to assess how well someone will respond to an SSRI treatment. It is also thought to be beneficial in understanding brain scan changes among those who fail to experience relief in depressive symptoms after theyve been taking an SSRI.

    Sacher was quoted as saying, It was interesting to see two patterns that seemed to go in the opposite direction. She continued by stating, What was really surprising was that the entire brain would light up after only three hours. They didnt expect that to happen. A majority of people who take antidepressants dont notice changes in their mood until theyve been on a medication for a few weeks.

    This finding also supports my idea that individuals who are very self-aware may notice changes in thinking, feeling, and side effects within the first day of taking their antidepressant. Since this study only documented changes in brain scans immediately after taking the drug, it is thought that further changes could happen over the course of long-term treatment. It is speculated that synapse remodeling may take place as serotonin levels increase and influence neighboring cells.

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    Do Antidepressants Affect Memory

    Tranquilizers, antidepressants, some blood pressure drugs, and other medications can affect memory, usually by causing sedation or confusion. That can make it difficult to pay close attention to new things. Talk to your doctor or pharmacist if you suspect that a new medication is taking the edge off your memory.

    Drug Effects In Clinical Trials

    RCTs of antidepressants report that drug-treated trial participants show greater improvement on rating scale scores than placebo-treated participants. However, this difference was shown to be small in recent meta-analysesabout two points on the Hamilton Rating Scale for Depression, or small differences in improvement rates . Drug-induced effects could account for this difference in several ways. In the Hamilton Rating Scale for Depression, for example, three items on sleep, two on anxiety and one on agitation can score up to 16 points . On these items, any drug with sedative effects would be likely to outperform placebo.

    In addition, because inert placebos create nowhere near the range and intensity of effects that active drugs produce, RCTs of psychotropic drugs that use inert placebos are not truly blinded . In that case, outcomes for people on antidepressants are likely to be subject to amplified expectations compared with those on inert placebo . This placebo amplification might be exacerbated in people who have taken antidepressants before and have not responded negatively modern trials are likely to select such patients above others .

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