Will you’re gonna wanna take antidepressants forever?

The short answer is not necessarily, but it’s complicated.

“We made it all about brain function, and we focused heavily on antidepressants as the primary intervention.

However, there is evidence coming to light that depression is more complex than that.”

At a Glance

So, what role should antidepressants play in your treatment plan?

What other options are available, and how do they compare to existing antidepressants?

Are there situations where long-term antidepressant use is the best course of action?

Antidepressants can be an effective part of a treatment plan, which may also include therapy and lifestyle changes.

Other options, like ketamine-derived medications, may also help people who have treatment-resistant depression.

Why Do We Still Use Antidepressants?

Most existing FDA-approved antidepressants are designed to either increase the availability ofserotoninornorepinephrine(or both) in the brain.

That doesnt mean that antidepressants dont work.

Part of the confusion stems from the delayed response to the standard antidepressants that work by changingneurotransmitterlevels.

Some researchers have explained this delayed response as aplacebo effector just a general numbing of emotions.

Instead, the benefits might come from changes to brain circuitry.

The human brain is plastic, meaning it constantly adapts to its changing environment and circumstances.

It develops new connections and capabilities in response to changing demands.

This kind of adaptation is meant to be protective: your brain is becominghypervigilantto possible threats.

But it can contribute to the sense of hopelessness, helplessness, and general discontent associated with depression.

This suggests thatSSRIs and SNRIsmight be helping to correct those stress-induced adaptations in the brain.

“Conventional antidepressants change only positive processing of incoming information,” researchers explained.

That’s where some of the newer antidepressants derived from ketamine might be able to help.

In other words, stressful or traumatic memories might become less distressing and painful to remember.

The data supports these claims.

For people with chronic or severe depression, medication may be needed on a long-term basis.

In these cases, antidepressants are often taken indefinitely.

That is, in part, because depression is not an illness that can be cured.

“But for some people, remission may not be possible,” Dr. Hong explained.

“In these cases, the focus shifts to symptom management.

Even if symptoms can’t be eliminated entirely, they can usually be significantly reduced with treatment.”

Even if you do need lifelong treatment, it may not necessarily need to involve antidepressants.

ComorbidADHDor other psychiatric or neurological conditions aren’t the only ones that can make depression harder to treat.

Of those whose symptoms did relapse, some were able to manage the symptoms without taking medication again.

It is important to note, however, that depression tends to be not just episodic, but recurrent.

So if someone has suffered a depressive episode, there is a significant risk for recurrence.

Less life-threatening side effects of long-term use includeemotional numbing, weight gain, and sexual side effects.

As worrying as those risks might sound, antidepressants are still generally considered safe.

Danielle Zito, a board-certified psychiatric nurse and mental health advisor at Illuminate Labs.

About 20% of patients develop discontinuation syndrome after abruptly stopping medication.

Symptoms can include nausea, insomnia, headaches, and sensory disturbances, among others.

What Does All of This Mean for People With Depression?

Ketamine-derived drugs are showing promise but might not offer the lasting results people with chronic depression need.

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