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Long term Rx use may make depression worse

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More and more often, many doctors and patients are thinking that long-term use of antidepressant drugs (AD) may increase the biochemical vulnerability to depression and worsen its long-term outcome and symptomatic expression. The drugs may also decrease both the likelihood of subsequent response to pharmacological treatment and the duration of symptom-free periods. A review of research literature by Giovanni Fava and Emanuella Offidani of the University of Bologna reveals potential side effects resulting from long-term treatment with antidepressant drugs.

The researchers reviewed literature identified electronically using the several databases with relevant material. They culled for information based on the following keywords: tolerance, withdrawal, sensitization, antidepressants, switching. A manual search of literature was performed looking for articles revealing paradoxical effect s of antidepressant medications. Clinical evidence has been found which indicates that even though antidepressant drugs are effective in treating depressive episodes, they are less effective when treating recurrent, long-term depression symptoms.

In some pieces of printed material, antidepressants are described as creating adverse events such as withdrawal symptoms at discontinuation, onset of tolerance and resistance phenomena and switch and cycle acceleration in bipolar patients. Unfavorable long term outcomes and counter-intuitive effects (for instance, inducing depression and the worsening of symptoms) were also reported.

When drug use is discontinued, there may be increased vulnerability to relapse. Antidepressant treatments are crucial to the treatment of major depression so the selection and length of prescription need to be carefully considered. All symptoms and reactions need to be reported and any changes in behavior discussed with a doctor.

Source: Progress in Neuro-psychopharmacology and Biological Psychiatry, MedicalNewsToday

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