<p>Contrary to another post here, in my opinion and also that of an increasing majority of researchers studying this field, SSRIs and the so called 'antidepressant' drugs cause great harm.</p>

<p><a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0016605/" rel="nofollow noreferrer">Firstly here is a list of common side effects</a>: Insomnia (which is common in depression anyway), increased anxiousness, feeling sick, indigestion, diarrhea or constipation, loss of appetite, fluctuations in weight, dizziness, blurred vision, dry mouth, excessive sweating, headaches, reduced sex drive, difficulty achieving orgasm, erectile dysfunction.</p>

<p>None of these are good effects which is why we don't give them to people who are 'healthy'. More importantly the devastating effect these side effects can have on a patients life could potentially be far more harmful than before the drug was taken, for example increased marital problems. <a href="http://onlinelibrary.wiley.com/doi/10.1002/wps.20243/epdf" rel="nofollow noreferrer">According to Joanna Moncrieff these effects compound depression</a>, and more importantly disturb the chemical balance in the the brain, and as a result compound or cause the very symptoms they are meant to cure. Central to this notion and the question presented here, the <a href="http://static1.1.sqspcdn.com/static/f/1072889/14891065/1320009670867/antidep+El-Mallakh-tardivedysphoriadarticle1.pdf?token=hutRTG7dlk%2FYnSaPYE%2ByIwui0N0%3D" rel="nofollow noreferrer">long-term use of SSRIs may causes</a> what we call <a href="http://static1.1.sqspcdn.com/static/f/1072889/15035221/1320787504360/Antidep+SSRI+apathy+syndrome+Barnhart+2004.pdf?token=PvfA9yIzcniAVQQ0GX103SflLMw%3D" rel="nofollow noreferrer">'serotonin induced apathy'</a>, in other words, <a href="http://static1.1.sqspcdn.com/static/f/1072889/14891065/1320009670867/antidep+El-Mallakh-tardivedysphoriadarticle1.pdf?token=o1qgiD6AzDspO64UTISKzRIfK74%3D" rel="nofollow noreferrer">after initial positive effect of SSRIs (quiet possibly short-term placebo effect), patients become indifferent to their environments</a>. Furthermore Long-term use of SSRIs leads to abnormal brain neurogenesis not seen in non-depressed samples, <a href="http://www.sciencedirect.com/science/article/pii/S0006322306005816" rel="nofollow noreferrer">this is often taken to as proof of how SSRIs exert there action</a>, or rather it was before 2008 (see below meta analysis). However it seems that this neurogenesis is less likely to be positive considering the negative effects and lack of efficacy SSRIs display.</p>

<p>The long-term use of SSRIs often leads to the development of apathy, which utimatley will lead many patients back into depression. The rate of relapse in people taking 'anti-depressants' <a href="http://static1.1.sqspcdn.com/static/f/1072889/14890979/1320009370450/antidep+Andrews+etal+drug+exposure+raises+greater+relapse+risk.pdf?token=hVNkhJbAIf35F%2F2jY01Idyhb5LU%3D" rel="nofollow noreferrer">is >40% while patients with placebo is roughly 24%</a>. If that isn't bad enough at a <a href="http://static1.1.sqspcdn.com/static/f/1072889/14890821/1320008484347/antidep+2010+MN+rept+depressed+chronic+ill+20101.pdf?token=WubXGUFWo9AaPJiz2933Azu7aS0%3D" rel="nofollow noreferrer">12 month follow up only &lt;5% of patients are in remission</a> for their depression. Why might this be? Well <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050045" rel="nofollow noreferrer">a 2008 meta-analysis by Kirsch et al found that all 'anti-depressants' are below clinical levels of acceptance</a>, in other words no more effective than placebo. However it should be noted that in severe depression SSRIs are useful only!</p>

<p>The reason anti-depressants such as SSRIs are ineffective is because of the simplistic approach taken  to treatment with these drugs. The brain is not some 'big bag of chemicals', neurons  are not purely serotonergic <a href="http://www.ncbi.nlm.nih.gov/books/NBK10818/" rel="nofollow noreferrer">in fact they often release multiple NTs</a>. And crucially serotonin NT is used throughout the central nervous system, for more than mood regulation. The fact that SSRIs do not work over the long-term tells us the serotonin theory of depression is wrong. Perhaps more importantly roughly 10% of people in the UK are on 'anti-depressants', we can talk about over medicalisation of mental health, but the reality is large amounts of people are taking these drugs for large amounts of time (<a href="http://www.who.int/mental_health/mhgap/evidence/depression/q2/en/" rel="nofollow noreferrer">9-12 months recommend</a>). This is not helped by the fact that governments are more interested in investing in <a href="http://cep.lse.ac.uk/pubs/download/special/depressionreport.pdf" rel="nofollow noreferrer">cheap medical 'cures' than long-term methods with greater efficacy that cost more</a>.</p>

<p>Sorry its so long, and I'm sorry its so short there is so much to say about how SSRIs don't work and how bad they are regarding people thinking they are getting effective cures, along with the neuroscience and discussions on publication bias. Its a fascinating topic, thanks for the question.</p>

CC BY-SA 4.0
2019-09-10T10:14:58.447Z
*"SSRIs and the so called 'antidepressant' drugs cause great harm."* They **may** cause **some** harm to **some** people, but this claims that they cause **great** harm to **all** who take them. This is not the case.
Chris Rogers
CC BY-SA 4.0
2019-09-11T22:56:58.143Z
@Chris Rogers Antidepressants do cause great harm as I have pointed out, the side effect list alone shows that they cause harm. In addition tranquillising patients is IMO fine for the short term, but an ineffective long term strategy. This is where a large amount of harm comes from because you cannot think and act as well on SSRIs etc as off them, which effects much of patients lives. Furthermore the evidence shows that for the majority of patients on them they are largely ineffective. So yes they do not harm to all but they are used in such a way as to harm the majority.
Comte
CC BY-SA 4.0
2019-09-12T10:47:52.137Z
@Comte - The side effects list covers what **can** occur, not necessarily **will** occur. As for harm in that list, insomnia is a bit of a contentious effect as (pointed out by you) depression can cause insomnia. Diarrhoea or constipation could cause issues, but there are antidiarrhoeals and laxatives. Headaches can be helped with paracetamol or similar, and the rest of the list are not harms, although I concur that some can add to the depression.
Chris Rogers
CC BY-SA 4.0
2019-09-12T10:50:46.763Z
Also, antidepressants don’t tranquillize people like you suggest in your last comment. Tranquillizers tranquilize people, antidepressants are prescribed to alleviate the effects of depression in order for you to be able to function better.
Chris Rogers
CC BY-SA 4.0
2019-09-12T10:56:58.953Z
Oh and depression can cause loss of appetite, and increase in appetite (comfort eating etc.) which in turn can lead to fluctuations in weight, also listed in the side effects list, so that can be contentious as to whether it is the antidepressants or the depression causing it.
Chris Rogers
CC BY-SA 4.0
2019-09-13T11:30:13.447Z
@Chris Rogers Anything that causes adverse side effects can be deemed harmful, hence antidepressants not being available without prescription. Taking additional drugs adds to harm not reduces it, particularly over a prolonged period. For instance impact on the liver, kidneys etc. I’m really not sure where to start with these other statements as they suggest a lack of knowledge regarding drugs termed ‘antidepressants’, and brain function i.e. memory. That is not to say they do not have their place in short-term intervention. But one should not be ignorant of the reasons patients abandon them.
Comte
CC BY-SA 4.0
2019-09-13T12:01:29.867Z
@Chris Rodgers my main point is that antidepressants are being used widely despite the fact they are not particularly effective. I would also suggest reading ‘methological flaws, conflicts of interest, scientific fallicies: implications for evaluation of antidepressants’ efficacy and harm. Hengartner 2017
Comte
CC BY-SA 4.0
2016-03-03T13:32:34.403Z
2019-09-09T16:51:55.090Z
2019-09-09T16:51:55.090Z
Comte
<p>I found two articles that mention that taking SSRI for depression can actually make the depression worse.</p>

<ul>
<li><a href="http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria">"Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria"</a> on Psychology Today.</li>
<li><a href="http://www.behaviorismandmentalhealth.com/2014/04/08/antidepressants-make-things-worse-in-the-long-term/">"Antidepressants Make Things Worse in the Long Term"</a> on the Behaviorism and Mental Health blog.</li>
</ul>

<p>Is this true? Can Tardive Dysphoria (delayed depression) be caused by SSRI?</p>

<p>They seem pretty convincing and I can't find anything against it but if it's true, it basically means that depression treatment is going back to the 60's before SSRI were invented.</p>

<psychiatry><depression><psychopharmacology>
Can SSRI make things worse in the long term or cause delayed depression?
user6935
# Can SSRI make things worse in the long term or cause delayed depression?

(Asked by: username_0 on 2014-10-20)

I found two articles that mention that taking SSRI for depression can actually make the depression worse.

* ["Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria"](http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria) on Psychology Today.
* ["Antidepressants Make Things Worse in the Long Term"](http://www.behaviorismandmentalhealth.com/2014/04/08/antidepressants-make-things-worse-in-the-long-term/) on the Behaviorism and Mental Health blog.

Is this true? Can Tardive Dysphoria (delayed depression) be caused by SSRI?

They seem pretty convincing and I can't find anything against it but if it's true, it basically means that depression treatment is going back to the 60's before SSRI were invented.

**Tags:** psychiatry, depression, psychopharmacology


---

## 1 answers

### Answer by username_1 on 2016-03-03. Score: 1

Contrary to another post here, in my opinion and also that of an increasing majority of researchers studying this field, SSRIs and the so called 'antidepressant' drugs cause great harm.

[Firstly here is a list of common side effects](http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0016605/): Insomnia (which is common in depression anyway), increased anxiousness, feeling sick, indigestion, diarrhea or constipation, loss of appetite, fluctuations in weight, dizziness, blurred vision, dry mouth, excessive sweating, headaches, reduced sex drive, difficulty achieving orgasm, erectile dysfunction.

None of these are good effects which is why we don't give them to people who are 'healthy'. More importantly the devastating effect these side effects can have on a patients life could potentially be far more harmful than before the drug was taken, for example increased marital problems. [According to Joanna Moncrieff these effects compound depression](http://onlinelibrary.wiley.com/doi/10.1002/wps.20243/epdf), and more importantly disturb the chemical balance in the the brain, and as a result compound or cause the very symptoms they are meant to cure. Central to this notion and the question presented here, the [long-term use of SSRIs may causes](http://static1.1.sqspcdn.com/static/f/1072889/14891065/1320009670867/antidep+El-Mallakh-tardivedysphoriadarticle1.pdf?token=hutRTG7dlk%2FYnSaPYE%2ByIwui0N0%3D) what we call ['serotonin induced apathy'](http://static1.1.sqspcdn.com/static/f/1072889/15035221/1320787504360/Antidep+SSRI+apathy+syndrome+Barnhart+2004.pdf?token=PvfA9yIzcniAVQQ0GX103SflLMw%3D), in other words, [after initial positive effect of SSRIs (quiet possibly short-term placebo effect), patients become indifferent to their environments](http://static1.1.sqspcdn.com/static/f/1072889/14891065/1320009670867/antidep+El-Mallakh-tardivedysphoriadarticle1.pdf?token=o1qgiD6AzDspO64UTISKzRIfK74%3D). Furthermore Long-term use of SSRIs leads to abnormal brain neurogenesis not seen in non-depressed samples, [this is often taken to as proof of how SSRIs exert there action](http://www.sciencedirect.com/science/article/pii/S0006322306005816), or rather it was before 2008 (see below meta analysis). However it seems that this neurogenesis is less likely to be positive considering the negative effects and lack of efficacy SSRIs display.

The long-term use of SSRIs often leads to the development of apathy, which utimatley will lead many patients back into depression. The rate of relapse in people taking 'anti-depressants' [is >40% while patients with placebo is roughly 24%](http://static1.1.sqspcdn.com/static/f/1072889/14890979/1320009370450/antidep+Andrews+etal+drug+exposure+raises+greater+relapse+risk.pdf?token=hVNkhJbAIf35F%2F2jY01Idyhb5LU%3D). If that isn't bad enough at a [12 month follow up only <5% of patients are in remission](http://static1.1.sqspcdn.com/static/f/1072889/14890821/1320008484347/antidep+2010+MN+rept+depressed+chronic+ill+20101.pdf?token=WubXGUFWo9AaPJiz2933Azu7aS0%3D) for their depression. Why might this be? Well [a 2008 meta-analysis by Kirsch et al found that all 'anti-depressants' are below clinical levels of acceptance](http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050045), in other words no more effective than placebo. However it should be noted that in severe depression SSRIs are useful only!

The reason anti-depressants such as SSRIs are ineffective is because of the simplistic approach taken to treatment with these drugs. The brain is not some 'big bag of chemicals', neurons are not purely serotonergic [in fact they often release multiple NTs](http://www.ncbi.nlm.nih.gov/books/NBK10818/). And crucially serotonin NT is used throughout the central nervous system, for more than mood regulation. The fact that SSRIs do not work over the long-term tells us the serotonin theory of depression is wrong. Perhaps more importantly roughly 10% of people in the UK are on 'anti-depressants', we can talk about over medicalisation of mental health, but the reality is large amounts of people are taking these drugs for large amounts of time ([9-12 months recommend](http://www.who.int/mental_health/mhgap/evidence/depression/q2/en/)). This is not helped by the fact that governments are more interested in investing in [cheap medical 'cures' than long-term methods with greater efficacy that cost more](http://cep.lse.ac.uk/pubs/download/special/depressionreport.pdf).

Sorry its so long, and I'm sorry its so short there is so much to say about how SSRIs don't work and how bad they are regarding people thinking they are getting effective cures, along with the neuroscience and discussions on publication bias. Its a fascinating topic, thanks for the question.

> **Comments:**
> **username_2**: *"SSRIs and the so called 'antidepressant' drugs cause great harm."* They **may** cause **some** harm to **some** people, but this claims that they cause **great** harm to **all** who take them. This is not the case.  
> **username_1**: @username_2 Antidepressants do cause great harm as I have pointed out, the side effect list alone shows that they cause harm. In addition tranquillising patients is IMO fine for the short term, but an ineffective long term strategy. This is where a large amount of harm comes from because you cannot think and act as well on SSRIs etc as off them, which effects much of patients lives. Furthermore the evidence shows that for the majority of patients on them they are largely ineffective. So yes they do not harm to all but they are used in such a way as to harm the majority.  
> **username_2**: @username_1 - The side effects list covers what **can** occur, not necessarily **will** occur. As for harm in that list, insomnia is a bit of a contentious effect as (pointed out by you) depression can cause insomnia. Diarrhoea or constipation could cause issues, but there are antidiarrhoeals and laxatives. Headaches can be helped with paracetamol or similar, and the rest of the list are not harms, although I concur that some can add to the depression.  
> **username_2**: Also, antidepressants don’t tranquillize people like you suggest in your last comment. Tranquillizers tranquilize people, antidepressants are prescribed to alleviate the effects of depression in order for you to be able to function better.  
> **username_2**: Oh and depression can cause loss of appetite, and increase in appetite (comfort eating etc.) which in turn can lead to fluctuations in weight, also listed in the side effects list, so that can be contentious as to whether it is the antidepressants or the depression causing it.  
> **username_1**: @username_2 Anything that causes adverse side effects can be deemed harmful, hence antidepressants not being available without prescription. Taking additional drugs adds to harm not reduces it, particularly over a prolonged period. For instance impact on the liver, kidneys etc. I’m really not sure where to start with these other statements as they suggest a lack of knowledge regarding drugs termed ‘antidepressants’, and brain function i.e. memory. That is not to say they do not have their place in short-term intervention. But one should not be ignorant of the reasons patients abandon them.  
> **username_1**: @Chris Rodgers my main point is that antidepressants are being used widely despite the fact they are not particularly effective. I would also suggest reading ‘methological flaws, conflicts of interest, scientific fallicies: implications for evaluation of antidepressants’ efficacy and harm. Hengartner 2017  

---

