What Are The Good Reasons For Taking Medication For Depression?
Let’s start with what are the not so good reasons for taking medication for depression.
The tide is turning against traditional antidepressants with some studies reporting that for up to 50% of people who take them, they just don’t work.
One study[i] published in November 2016 entitled, ‘Brain, Behaviour and Immunity’ the researchers found that between a whopping 30% and 50% of people diagnosed with depression, prescribed antidepressants didn’t work any better than a placebo.
We’ve been led to believe that depression is the result of a random imbalance of our brain chemicals and that a chemically produced pill will reverse it.
However, if that were true, we wouldn’t be witnessing the escalating rates of both depression and antidepressant use.
Because, if experiencing depression were as simple as having a brain chemical imbalance, and recovering was as simple as taking a pill to fix it, we wouldn’t be seeing the rates of depression to be rising off the scales.
So, What’s The Downside Of Taking Antidepressants?
There are two main downsides of taking antidepressants: side effects and withdrawals.
The side effects are extensive but here are the main ones:
Increased appetite and weight gain
Loss of sexual desire and other sexual problems, such as erectile dysfunction and decreased orgasm
Although they’re not addictive, (in that you don’t need to increase the dosage to get the same affect) all psychiatric medication will change the body/brain chemistry and the body will have become used to them.
Consequently, there will be some type of withdrawal effect when you stop taking them. One of the withdrawal effects is anxiety. However, if you understand that from the outset, your doctor will be able to help you be better prepared if you decide to come off the antidepressant.
I’ve personally known of people who have had to check themselves into a rehabilitation centre to receive help in weaning off antidepressants. It’s not something to go into lightly and it’s advised that medical guidance is sought before you start.
So, Why Take Medication For Depression?
For some people, when depression comes inexplicably out of the blue, descends like a black cloud and won’t shift no matter what, taking medication may be wholly appropriate.
Studies have shown that, although antidepressants may not work so well for mild depression symptoms, they work much better for those with severe depression symptoms.
Severe depression is when it’s very hard to function in daily life and it may be accompanied by self-destructive or suicidal thoughts.
One woman, Sara, 45, who shared her story with me explained:
"I was just so tired of living when there’s nothing good about my life. I kept telling myself to try harder but nothing seemed to work. The only relief I got is the thought of ending it all."
Sara went to her doctor who prescribed her with mirtazapine, an antidepressant that’s said to have been developed for medium to severe depression. (From what I’ve researched, it seems this drug seems is more tolerable to the system than other antidepressants.)
Sara suffered from ‘feeling like a zombie’ for much of the time she was taking the drug. However, it also had a ‘numbing out’ effect’.
"I’d been feeling so bad for so long that feeling nothing was better. Other antidepressants had made me feel suicidal whereas this one just knocked me out. But that was OK because I felt different which was a relief."
Although Sara had already had counselling, she’d not been able to continue. But, after taking mirtazapine for a few weeks, she was then referred for some cognitive behavioral therapy.
"It was like the drug stopped that monkey in my head trying to kill me and then I was able to get a bit more of a handle on with the rest of my life."
Sara is now undergoing twice a week therapy and making feeling more optimistic about life generally. She believes that her better mental state is somewhat due to the antidepressant that helped her,
"It wasn’t so much that the mirtazapine cured me or anything, but it shut me down emotionally with all the negative stuff I had going on in my head. Now I’ve got to learn to handle those negs without drugs which is why I got therapy. I’m not sure I’ll ever be happy but at least I’m alive."
The New Antidepressant Savior?
Traditional antidepressants have the disadvantage of inciting terrible side effects and also can take weeks to kick in. But now, there is a new kid on the block: ketamine.
You might be more familiar with this drug if you’d been offered it at a club. Its ‘street’ names include Kit Kat, Ket, Special K or Cat Killer.
Ketamine is used in hospitals as a quick and easy anaesthetic. However, for depression it appears to be something of a ‘miracle drug’ especially for people with treatment-resistant depression[ii].
Some antidepressants take weeks to work but ketamine has shown to work, by treating depressive symptoms, within hours.
Once clinic in the US, Kalypso Wellness, is offering 'ketamin infusion treatments'. Dr. Bryan Clifton from Kalypso gave an interview to the Washington Post saying,
"About 15 years ago, someone did some research as an alternative for suicidal ideation for electric shock therapy. They found that if you administer the drug in a low dose over a long period of time, then essentially you reset your brain and your central nervous system," said Dr. Clifton, "It's kind of like when your computer locks up, your cell phone locks up, and you have to shut it down and reboot it."
The treatment takes about one and a half hours to treat someone with depression and takes place within the clinic under medical supervision with the drug being administered intravenously.
"They usually feel like they're floating or relaxing, or just dozing off and feeling comfortable for the hour. Then, they stay about 20-30 minutes in the chair to make sure they are recovered appropriately." explained Dr. Clifton.
Patients are reporting effects such as:
I’m better able to manage my negative thinking
I can breathe again
Made me feel more optimistic
Slows down my brain
From the first treatment, it’s saved my life
The treatment is being hailed as the most significant mental health breakthrough in more than 50 years because it’s shown to treat the symptoms of depression within hours.
The response rate is high running at around 75%, which means that three quarters of people who are treated do well. There aren’t those kinds of positive results with any other kind of antidepressant treatment.
The drug is not approved by the FDA to be used for depression but can be prescribed by doctors as ‘off label’ use. This refers to the medication being used in a manner not specified in the FDA's approved packaging label.
Apparently, one in five written outpatient prescriptions are for off-label therapies.
If drug companies get to grips with how ketamine works for severe depression, they maybe more willing to fund trials that could test other existing pharmaceuticals with a view to manufacturing better antidepressants.
There is a rumour Johnson & Johnson are fast-tracking a new antidepressant treatment inspired by ketamine which could be ready for FDA review by 2018.
There's Hope On The Horizon
My personal view on taking medication for depression centres around the worrying fact that high numbers of depressed people seem to badly struggle with the side effects of anti depressants. Plus, the actual success rates are pitifully low.
However, in terms of people who suffer severe depression, it appears that they can be helped. As Sara said, it’s better to be alive than dead.
And perhaps with the results filtering through on the therapeutic use of ketamine, this will pave the way for drug companies to start thinking outside the box and looking at some more resultant and relevant drugs.
After all, there must be some very good reason why millions of people take (albeit illegally) this drug every Saturday night and go off to the party!
** Please remember I am not a doctor and I don’t endorse or censure any drugs. Please visit your doctor for advice.