#Antidepressants

A newly published review in JAMA Psychiatry has sparked controversy among mental health experts, raising concerns that it significantly underestimates the risks faced by long-term users of antidepressants when they attempt to discontinue their medication. The debate centers on the review’s focus on short-term, industry-funded studies and has important implications for millions worldwide, including a growing cohort of patients in Thailand who rely on antidepressant therapy.

Antidepressant withdrawal — the range of physical and psychological symptoms experienced when stopping or reducing dosage — has come under increased scrutiny as more people use these medications for extended periods. While previous medical guidelines, such as those from the UK’s National Institute for Health and Care Excellence (NICE), described withdrawal as “brief and mild,” recent scrutiny has revealed a more complex picture, particularly for long-term users. The new JAMA Psychiatry review, authored in part by academics with ties to pharmaceutical companies, concludes that withdrawal symptoms from antidepressants are generally not clinically significant for most users, especially those on the medication for only eight to twelve weeks. Its analysis, based on eleven trials — the vast majority of which involved short-term use — found slightly more withdrawal symptoms in those stopping antidepressants than in placebo groups, but the authors attribute much of this to the “nocebo effect” (the power of negative expectations to trigger adverse symptoms) rather than to withdrawal itself.

A newly published article is reigniting debate around the roots of depression, presenting fresh analysis and decades of scientific evidence that question the long-standing view that depression is primarily a biological illness requiring medical treatment. The piece asserts that psychological, not biological, factors may lie at the heart of depression—a claim with profound implications for how the disorder is diagnosed and treated globally and in Thailand.

For years, the mainstream belief—widely propagated by medical authorities and reinforced by pharmaceutical marketing—has been that depression is caused by chemical imbalances in the brain and should be approached like other physical illnesses. This perspective shifted in the 1980s, coinciding with the publication of the American Psychiatric Association’s DSM-III manual and the widespread introduction of antidepressant medications, especially selective serotonin reuptake inhibitors (SSRIs). However, the article cautions that this medicalization of depression is not firmly founded on scientific evidence and may be failing patients worldwide (madinamerica.com).

A newly published study by University College London (UCL) researchers reveals that individuals who have taken antidepressants for more than two years are vastly more likely to suffer severe and long-lasting withdrawal symptoms when discontinuing the medication, compared to those prescribed antidepressants for less than six months. The findings, which come at a critical time as antidepressant prescriptions have soared worldwide, suggest that the duration of use is a key driver for withdrawal difficulty, potentially prompting a significant shift in how these medications are prescribed and managed both globally and in Thailand.

A groundbreaking new study from researchers at Imperial College London suggests that the psychedelic compound psilocybin may enhance or preserve depressed patients’ emotional reactions to music, while the commonly prescribed antidepressant escitalopram—an SSRI—can dull these emotions, even though both drugs produce similar clinical improvements in depressive symptoms. The findings, published in Molecular Psychiatry and highlighted by Medical Xpress, provide fresh evidence that psilocybin’s effects on emotional processing could have significant implications for the future of mental health treatment, especially in cultures—such as Thailand’s—where music is integral to social and spiritual life (medicalxpress.com).

A widely-prescribed antidepressant may significantly shorten lifespan—by up to six years—according to recent findings circulated by the international medical community. The claim, based on a new research review highlighted by several medical news outlets and summarized in a viral Yahoo Lifestyle article, is igniting debate among doctors, mental health professionals, and patients in Thailand and around the world over the safety and prescription practices of this common medication.

The backdrop of this news is the widespread and growing use of antidepressant drugs, especially selective serotonin reuptake inhibitors (SSRIs), which include widely-recognized names such as sertraline, fluoxetine, and paroxetine. With depression and anxiety rates rising globally—including in Thailand, where mental health awareness has increased sharply in the aftermath of the Covid-19 pandemic—these medications are standard tools for primary care doctors and psychiatrists alike [World Health Organization].

The latest in-depth investigations by international psychiatrists and psychologists are prompting a global rethink over the widespread use and perceived efficacy of antidepressants, especially in the United States, where such medications have become almost ubiquitous for treating depression, anxiety, and insomnia. New findings sharply question the central assumptions about how these drugs work, their long-term benefits, and the risks they carry—a discussion that resonates far beyond America’s borders, including in Thailand, as local mental health practices continue to evolve.

A deeply personal story recently published in the Daily Mail, titled “I almost ended my life on antidepressants, ditching them saved me,” has struck a chord with readers who are questioning the impact of long-term antidepressant use and the consequences of withdrawal. This article arrives at a time of intensifying scientific scrutiny and public debate, as researchers worldwide uncover mounting evidence that discontinuing antidepressant medications can result in a complex and sometimes debilitating set of symptoms—findings that are directly relevant to an increasing number of Thai people prescribed these medicines for depression and anxiety.

A new study from Sweden is making waves in both the scientific community and among environmental advocates, revealing that anxiety medications commonly used by humans can fundamentally alter the behavior of salmon exposed to these drugs. When traces of clobazam, a prescription drug used to treat anxiety, were introduced to farm-raised salmon, the fish began to display markedly bolder behaviors than their untreated peers. While the consequences might initially appear positive—bolder salmon migrated to the sea more quickly—the broader implications point to serious ecological risks (Newser).

In a world where mental health awareness is gaining momentum, understanding depression—its symptoms and treatments—remains crucial. Depression, clinically known as major depressive disorder, profoundly affects how individuals feel, think, and manage day-to-day activities, according to recent insights from the National Institutes of Health (NIH). The article by Hannah Yasharoff for USA Today highlights the pervasive impact of depression and the advances in treating this complex condition.

Depression is characterized by a myriad of symptoms, including fatigue, concentration difficulties, irritability, changes in appetite, sleep disturbances, social withdrawal, and physical complaints such as unexplained headaches or digestive issues. Psychiatrist Dr. Judith Joseph, in her conversation with USA Today, underscores the importance of recognizing these symptoms which can vary across individuals.