Long-term antidepressant use: patient perspectives of benefits and adverse effects

Abstract

Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment. This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue.

Clinical guidelines on antidepressant withdrawal urgently need updating

“…These practices, if routinely enacted, would help partly explain why the average time a person spends taking antidepressants has doubled in the UK since the guidelines were introduced in 2004,1819 why antidepressant prescriptions are rising overall, and why patients regularly report that their withdrawal is not properly acknowledged, understood, and managed by doctors 2021. In addition, the pooled results of two recent surveys showed that under 2% of around 3000 patients were able to recall being told anything about withdrawal effects, dependence, or potential difficulties in discontinuing treatment 2223…”

Drug-free after basal exposure therapy

“…Some patients in mental health care wish to become drug-free after long-term use of psychotropic drugs (1)(2)(3). In Norway, the hospital trusts have been ordered to establish drugfree therapeutic programmes (4).…”

Is it time to end our complicity with pharmacocentricity?

“…This phenomenon is reported in the scholarly literature (Cartwright et al . ; Hall ; Ostrow et al . ; Read et al .…”