A new study by the University of Liverpool, involving over 1800 individuals, found that an increase in suicidal thoughts and general psychological problems may be more often associated with antidepressants than commonly admitted. Although in many studies a decrease in depression in adult and geriatric patients has been seen, there is no evidence that antidepressants are ever particularly healthy for adolescents or children. This is despite them commonly being prescribed to those under 18 years of age.
The major class of antidepressant used, SSRI (selective serotonine reuptake inhibitor) is based on a highly unstable serotonine theory of depression. A recent 2014 study by Andrews et al actually seems to indicate that increasing serotonin levels can lead to increased ruminations and thus depressive thoughts.
It is also important to mention that there is a great deal of evidence relating to publcation bias (so a misrepresenting of scientific fact that makes positive results seem more frequent or significant than they actually are) in the publishing of antidepressant trials.
With new evidence showing that a worsening of depression, suicidal thoughts, and general psychiatric problems can be associated with a change in levels of chemical messengers in the brain (even those tendentially associated with happiness) isn’t particularly surprising. My lack of surprise lies in the fact that levels of particular neurotransmitters are, themselves, not alone responsible for happiness. As anyone who has ever consumed a dopamine or serotonin agonist (colloquially called “tripping”), the shift can have unreliable consequences: leading some towards euphoria, others towards panic/hopelessness or even towards a loss of their understanding of reality.
While the intake of hallucinogenic drugs causes a temporary acute change in levels of neurotransmitters (with evidenced therapeutic potential) , the chronic changes brought on by daily intake of psycho-active pills have unknown long-term effects. Each new class of anti-depressant brings with it new risks, unclear interactions with other chemicals/endogenous proteins or its relative affinity for the number of physiologically important receptors (in regard to both your cells and your symbiotic bacteria). The sheer number of factors involved in foreseeing all the possible interactions of a drug make it, at the moment, literally impossible and most testing restricts itself to phenotypically (so physically) measurable differences (e.g kidney weight, heart size, cancer rates, life expectancy etc).
Unfortunately, this ignores the fact that many endocrine disruptors (also known as xenohormones, or non-endogenous cellular messengers; which may include antidepressants) affect molecular processes that cannot always be successfully characterized unless the researchers know exactly what they are looking for. The interaction with its primary target receptors is usually clearly defined, but the number of other potential interactions is frequently unknown and never exhaustive. Problems like that seen with thalidomide continue to occur for exactly this reason.
The problem here lies in the fact that we often do not know the entirety of drug interactions (before and after metabolization) with every possible partner. Although work is being done to create libraries able to compare and search for interactions between drugs and everything it could come into contact with the patient’s body (or said patient’s symbiotic gut flora). There also exists genetic variation between individuals that make a particular drug highly dangerous for one person, while remaining harmless in another.
The importance of individual genetic predisposition, and reaction, have become a big part of the research into curing cancer. It wouldn’t be unreasonable to apply this towards the use of other medication (especially affecting something as important as our brain). Is not the mental health of our fellow citizens as important as cancer treatment? With approximately 1/6 of England taking antidepressants, and 70% of US Americans taking prescription drugs (and 13% on antidepressants), shouldn’t a higher level of safety be expected (or at least some research into long-term effects?) Are drugs really how we want to deal with general discontent or psychological problems? Although they may help some, sometimes, they should never represent the first option or primary solution.
Happiness is a difficult state to maintain, and one brought on by our thoughts, our experiences, our habits, and our choices. There are scientifically validated methods of improving your happiness, your peace of mind, and your psychological health… and they do not involve swallowing any pills or necessarily spending any money.