Do Antidepressants Work?


Anti-depressants are chemicals designed to inhibit or accelerate neurotransmitter substances in our bodies. They stabilise these chemicals in order to alleviate symptoms of depression caused by an imbalance of certain substances.

   For example:

  • Low levels of serotonin mean the brain is not sufficiently stimulated leading to dampened moods.

  • Low levels of dopamine lead to a depletion of our innate ‘drive for pleasure’ which leads to depressive thoughts.

  • Low levels of norepinephrine mean that our bodies do not process and respond to stress effectively leading to anxiety.

   Here are some examples of drug therapies:

1) SSRIs – ‘selection serotonin reuptake inhibitors’ e.g. ‘Prozac’

   Seratonin is released into the synapse from one neuron in order to target receptor cells (receptor sites) on a receiving neuron after which they are reabsorbed by the initial neuron. SSRIs inhibit this reabsorption and thus increases serotonin levels in the synapses between neurons.

2) Tri-cyclics e.g. domipranine (‘Anafaril’)

   Block the transporter mechanism that reabsorbs serotonin and noradrenaline into the presynaptic cell after it has fired.

    A meta-analysis by The Royal College of Psychiatrists has supposedly confirmed the benefits of these (and similar) antidepressants against neurotransmitter imbalances. Data had been collected from 522 clinical trials of 116,477 people.

   The main researchers (inc. Dr Andrea Cipriani) found 21 common anti-depressants were all more effective at reducing symptoms of acute depression than dummy pills but also that there were huge differences in effectiveness between different drugs.

   This study has shown that drug therapies are a very acceptable option for anyone suffering from depression. It is important to reduce the stigma of taking medication for mental illness as the benefits are obvious. Antidepressants have been proven to reduce anxiety, improve moods, increase motivation and alertness.

   However, it is also important to realise that antidepressants are only part of recovery- there are many other forms of therapy available that are just as beneficial, such as psychotherapy, cognitive behavioural therapy etc. It is necessary that we are not too reductionist and realise that mental illness is the product of a myriad of things- including external/environmental factors that drugs cannot control. For this reason, it is important that we do not put all our faith in these drug treatments. There are proven side effects that may counteract the benefits. That being said, we must trust valid research and trust the professionals.

The most effective:

  • agomelatine

  • amitriptyline

  • escitalopram

  • mirtazapine

  • paroxetine

The least effective:

  • fluoxetine

  • fluvoxamine

  • reboxetine

  • trazodone

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