What do antidepressants do to someone who is not depressed?


In this article we will be discussing the various impacts antidepressants can have on someone who is not depressed. 

We will take a closer look at the use and overprescription of antidepressants as a pharmacological treatment and how you can use antidepressants safely. 

What do antidepressants do to someone who is not depressed?

Recent research in the past decade has found that there is some significant impact of antidepressants on the brain architecture. 

According to one study on female primates- a sample of depressed and non depressed primates- results showed that use of SSRI antidepressants can alter brain architecture if used by those who are not really depressed.

Other than the impact of antidepressants on the brain structure, other effects that it can have on a person who is not depressed include the side effects that antidepressants have on a person such as:

  • Headache
  • Agitation
  • Nausea or vomiting
  • Sleeplessness
  • Drowsiness
  • Reduced sex drive
  • Dry mouth
  • Weight gain

Use and Over-prescription of Antidepressants

Alexandra Sifferlin for Time explored the use and over-prescription of antidepressants over a conversation with the researcher of a study on primary care physicians in Quebec  that looked over 10 years’ worth of electronic medical records for antidepressant prescriptions.

The study reviewed over 100,000 prescriptions for antidepressants by almost 160 doctors in an attempt to understand the frequency with which physicians prescribed antidepressants for nondepressive conditions.

The study was an attempt to bridge the gap of research related to the temporal trends in antidepressant prescriptions which is clearly on the rise in countries like the US and the UK.

The study found that 45% of the prescriptions were for a disorder that was not depression rather they were for anxiety, panic, pain, and insomnia. 

They also found that physicians prescribe the drugs for off-label conditions such as migraine, symptoms of menopause, attention-deficit/hyperactivity disorder, and digestive system disorders where antidepressants were not supported by research as affected treatments. ’

As to why doctors are prescribing depression medications for other ailments, the researchers suspect that it could be a last resort desperation for treatment as most of the conditions do not have an exact effective pharmacological treatment.

Considering that these doctors in Quebec are prescribing medication for depression on people who are not depressed, the question of what happens to healthy individuals on anti-depressants is an important issue to look into because these drugs alter brain chemistry.

What are the structural changes in the brain caused by antidepressants?

Ever since the 1950s ever since the discovery of monoamine-oxidase inhibitors and a tricyclic antidepressant, there has been a long debate in the medical industry about the effect of antidepressants on a person.

Now, the use of drugs for depression is seen as fairly advantageous by the medical community with the most common treatments for depression include drugs under the types such as:

  • Selective serotonin reuptake inhibitors (SSRIs) 
  • Serotonin-noradrenaline reuptake inhibitors (SNRIs)
  • Noradrenaline and specific serotonergic antidepressants (NASSAs) 
  • Tricyclic antidepressants (TCAs) 
  • Serotonin antagonists and reuptake inhibitors (SARIs)

Each type of antidepressant has been found to be effective depending on individual cases however, they also come with various side effects that impact a person’s physiology and lifestyle. 

However, it is the first time that a research has been done that clearly indicates that widely used antidepressant drugs may cause changes in brain structure and function if used to treat a healthy brain with no depressive condition. 

For this study, 42 female monkeys were trained and given the drug Sertraline commonly known as Zoloft in an attempt to understand the long term effect of the drug on neural structures in depressed and nondepressed female non-human primates. 

The reason the primates were used is because depressed primates tend to show similar brain activities and structural differences-such as reduction in the hippocampus-to that of the human brain and the drug used was an SSRI, a selective serotonin reuptake inhibitor.

The subjects were given the drug and the control group a placebo for 18 months, the MRI imaging taken after the 18 months revealed differences in the structural physiology of the brain. 

In depressed monkeys, the volume of the Anterior cingulate cortex, the part that controls and regulates moods had increased while in the non-depressed monkeys, it decreased including a reduction in the hippocampus that controlled memory.

Jill Margo For Medunsw.com noted the comments of the researchers that said that other antidepressants, because they work with similar mechanisms are also likely to have the same effect. 

She also noted that this finding should not cause alarm to people who have been prescribed antidepressants but this findings of the study should garner a prevailing sense of caution about the subtle changes these drugs have on the brain within the medical field when using the drug as an off label treatment. 

Are the side effects of antidepressants?

Like all medications, antidepressants can also have side effects such as:

  • Headache
  • Agitation
  • Nausea or vomiting
  • Sleeplessness
  • Drowsiness
  • Reduced sex drive
  • Dry mouth
  • Weight gain

Some antidepressants are more likely to have side effects on a person than others, it has been noticed that SSRIs have fewer side effects as compared to the older antidepressants. 

These drugs affect each person differently and it is difficult to predict which side effects will impact you. However. It is also important to know various risks and effects to look out for.

The NHS highlights that antidepressants can have the following impact on a person:

  • Symptoms such as seizures linked to serotonin syndrome
  • Hyponatremia 
  • Increased risk of diabetes
  • Suicidal thoughts.

How to safely use antidepressants?

Considering that antidepressants have so many potential side effects and now that research shows that there are possible risks to your brain, here are some ways you can use these drugs safely:

  • Consult with your doctor about the side effects and have an open conversation about how you can change the doses to pne that fits you best or seek an alternative. 
  • If you are not depressed, and you find that your doctor is prescribing you an antidepressant, seek a consultation with another doctor who can give you a second opinion about your actual condition.
  • If you are depressed and this is your treatment strategy, consider therapy as well as a combination of both strategies is more likely to be effective than stand alone treatments.
  • Be consistent with your doses and do not drop the medication just because you are feeling worse or better. Consult with your doctor if you notice changes in your condition.
  • Avoid alcohol and other drugs when on this medication as it can lead to lethal side effects and make the treatment redundant. 

Talk to your doctor if you are on other medications including over-the-counter (OTC) medicines and herbal health products.

  • Be cautious and monitor your children when using antidepressants for your children or teenager as there is an increased risk of suicide in this age group. 
  • If you’re planning to get pregnant or are pregnant, talk to your doctor about the drugs which are safer related to pregnancy. 
  • If you’re planning to breastfeed or you currently breastfeed, talk to your doctor about your medicine as these drugs can also be passed on to your child through your breast milk.

References:

NHS, 2018. Side effects – Antidepressants. 1st November, 2021, [https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/side-effects/]

Willard SL, Uberseder B, Clark A, et al. Long term sertraline effects on neural structures in depressed and nondepressed adult female nonhuman primates. Neuropharmacology. 2015;99:369-378. doi:10.1016/j.neuropharm.2015.06.011

Wong J, Motulsky A, Eguale T, Buckeridge DL, Abrahamowicz M, Tamblyn R. Treatment Indications for Antidepressants Prescribed in Primary Care in Quebec, Canada, 2006-2015. JAMA. 2016;315(20):2230–2232. doi:10.1001/jama.2016.3445

Frequently asked questions related to “What do antidepressants do to someone who is not depressed?”

Can taking antidepressants when you’re not depressed make you depressed?

While it is unclear whether taking antidepressants when you are not depressed can make you depressed or not, research has found that using these drugs in healthy brains can cause a decrease in the volume of various parts  of the brain, influencing memory and mood. 

However, there is need for more research to justify what effect these changes have on a person. 

What will antidepressants do to a normal person?

Antidepressants work by balancing neurotransmitters in the brain that affect mood and emotions. 

A normal person who takes these medications will not notice any significant changes however it might help improve your mood, sleep, appetite and concentration.

Do antidepressants make you happy or not sad?

Antidepressants will not make you euphoric or extremely happy rather it will simply help relieve the symptoms of depression and associated anxiety and help you react more realistically in your emotional responses. 

Do antidepressants ruin you?

Long-term antidepressant users are at risk of the antidepressant side effects and are at risk to develop health risks if the drugs are not taken under constant guidance. Some side effects include risk of diabetes, seizures, weight gain, riskier pregnancies as well.

Does your brain go back to normal after antidepressants?

The process of healing the brain after the use of antidepressants is more complex, and it takes quite a bit longer than recovery from the acute symptoms of depression. 

If you stop taking antidepressants you might experience withdrawal symptoms and will usually take about 6 to 9 months after you are no longer symptomatically depressed for your brain to go back to normal. 

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