Depression, and especially major depressive disorder (MDD) is typically a chronic condition—which means it requires chronic care. In recent years, this often means prescription antidepressants. However, understandably, many people want to decrease their dependency on Rx’s like antidepressants or safely stop their use (under the guidance of their doctors) entirely. The TMS Institute of Arizona may be able to help with options like transcranial magnetic stimulation (TMS) and/or Spravato.
According to a recent article published in the British Journal of Psychiatry Open, “long-term antidepressant use is tied to an increased risk of adverse outcomes, including cardiovascular disease (CVD), cerebrovascular disease (CV), coronary heart disease (CHD), and all-cause mortality.” Researchers analyzed a decade of data from UK’s Biobank, which included information on more than 220,000 adults. They looked at the odds of developing these conditions amongst those who were taking antidepressants and those who were not.
The team found that, after considering other pre-existing factors, those who took antidepressants were twice as likely to get CHD, CVD (along with CVD-related mortality), and had an increase in their all-cause mortality. They were also at a higher risk of CV. However, these figures do not tell the whole story.
Benefits of Treating Depression
On the plus side, those who used antidepressants also had a 23 percent lower risk of getting hypertension and 32 percent less likelihood to develop diabetes compared to their non-antidepressant-taking peers. However, this does not necessarily suggest that the antidepressant drugs themselves are responsible for lowering risks of hypertension and diabetes. Other factors, such as actually treating the depression (no matter the treatment) may be at play. The most common Rx antidepressants included SSRIs, trazodone, mirtazapine, duloxetine, and venlafaxine.
The lead author says,
Our message for clinicians is that prescribing of antidepressants in the long-term may not be harm-free [and] we hope that this study will help doctors and patients have more informed conversations when they weigh up the potential risks and benefits of treatments for depression.
How to Treat Depression
Antidepressants are usually the first line of treatment for depression, and these are one of the most widely prescribed drugs in the world. In fact, 70 million prescriptions are typically written every year, which is twice as many as were prescribed 10 years ago. “This striking rise in prescribing is attributed to long-term treatment rather than an increased incidence of depression,” says the researchers.
There are few studies that assess the safety of antidepressants in the long-run simply because most are short-term studies. However, since depression is strongly linked to CVD risk factors, it is paramount that long-term cardiometabolic shifts with the use of antidepressants happen soon. Other factors that may inform the results also need to be more closely examined. In this study, the researchers accounted for demographics, socioeconomic status, biochemical/anthropometric/behavioral risk factors, overall health status, and disabilities. There were roughly equal numbers of men and women in the study, but 96 percent were white. This is a glaring oversight, and studies focused on non-white participants is essential in the future.
The Dependency on Drugs
At the end of the follow-up periods (five and ten years), about 7 percent of participants had been newly prescribed antidepressants. By far, the most common Rx was SSRIs at 81 percent. Of these prescriptions, the most common drug was citalopram, which was prescribed to nearly half of the new SSRI users. At five years of use, all antidepressants were linked with an increased risk of diabetes, all-cause mortality, and CHD. Simultaneously, these users also presented with a reduced risk of diabetes at this time.
TMS is a non-invasive form of therapy that may help with a variety of mental disorders including MDD and depression. It works via a magnetic field which is created at target areas of the brain. Multiple sessions are initially needed, but impressive results have been shown to last for several months. For those who are not getting the results they want with prescriptions and want to supplement their treatment, Spravato is also available in our clinic (which works in conjunction with current prescriptions). To learn more about both of these treatments, contact the TMS Institute today by calling the office or completing the online contact form.
