Here we begin our look at antidepressants with a guide to the most popular type of drug prescribed for this condition – SSRIs.
SSRIs What are they?
The most widely prescribed antidepressants in the UK are selective serotonin re-uptake inhibitors – commonly known as SSRIs. More than ten million prescriptions were filled for SSRIs in the UK in 2000.
SSRIs include Prozac, Seroxat, and Lustral. They were developed in the late 1980s and have been prescribed since the beginning of the 1990s.
Who are they suitable for?
SSRIs are mainly prescribed for depression but they can also help in other conditions such as some forms of anxiety disorder, such as obsessive compulsive disorder and some eating disorders like bulimia.
SSRIs only work on the brain chemical serotonin. They act by blocking the reabsorption of serotonin in the brain.
Dr Tony Cleare, an expert in the treatment of depression at the Institute of Psychiatry in London, says, ‘Serotonin is released by the brain and after it has been used by the cells, it is ‘recycled’. SSRIs stop the recycling process so there is more of the chemical in the brain.’
This process boosts your serotonin levels, helping to beat depression.
Dr Cleare says one reason SSRIs are so heavily prescribed is because many doctors believe they have fewer side effects compared to older antidepressant drugs and the side effects they do have are easier to live with. But this is currently an area of controversy among the medical profession.
Doctors also favour them as they do not have as many negative interactions with other drugs as the older antidepressants.
What are the side effects?
There is a huge debate currently raging over whether SSRIs can actually make depression even worse, triggering suicidal feelings.
Dr David Healy, a psycho-pharmacologist at the University of Wales College of Medicine, has highlighted the concerns about the side effects of SSRIs and the extent to which people can be addicted to them.
He has also highlighted concerns that Seroxat, an SSRI, may cause suicidal feelings, a claim denied by the manufacturers.
Dr Tony Cleare, an expert in the treatment of depression at the Institute of Psychiatry in London, says when people are depressed, they have little motivation to do anything, which also takes away the motivation to kill themselves.
Once they start taking antidepressants, they regain their motivation but may not yet have beaten the depression, leading them to commit suicide.
Experts are also divided over whether SSRIs are habit forming. The Royal College of Psychiatrists say there is no evidence that antidepressants cause dependency, but reports on SSRIs now contradict this view.
A study in the Journal of Risk and Safety in Medicine in 1998 raised a number of concerns over dependency associated with SSRIs. Dr Healy from the University of Wales College of Medicine has also found evidence in trials that non-depressed people develop withdrawal symptoms when they stop taking the drug.
A group of more than 60 people in the UK who say they have become hooked on the SSRI Prozac are now trying to decide if they can take legal action against the manufacturers. They say the pharmaceutical company failed to warn doctors that it could create dependency.
Although patient information and guidelines for taking SSRIs warn that patients may become more depressed and feel like attempting suicide at the beginning of their treatment, the mental health charity Mind feels these warnings are not adequate.
The Medicines Control Agency – the government body that makes sure all medicines on the UK market reach certain safety standards – recently said it would consider examining the issue of withdrawal symptoms ‘in the near future’.
Other side effects of SSRIs include nausea, vomiting, anorexia with weight loss, constipation nervousness, anxiety and loss of libido. Talk to your doctor if you are worried about the side effects of your treatment.