Why Antidepressants Don’t Work

By Michael A. Smith, MD

Depression is a serious mood disorder that affects millions of people every year. In some cases, the cause is something that happens in life — like the death of a loved one, a divorce, or illness. But in a majority of cases, we don’t know why depression develops.

And this is where a huge drug market comes into play — the antidepressants. Big Pharma believes that their drugs are the cure-all for depression and all of its potential consequences. But here’s an interesting fact: Less than 50% of patients prescribed antidepressants actually get better.1

That means that more than half of the people taking one of these so-called “cure-all drugs” are still left suffering from this debilitating mood disorder. In baseball batting 500 is considered a success, but when it comes to treating depression, we think this is completely unacceptable.

Conventional Medicine’s Failed Approach to Depression

Antidepressants for the most part work by preventing the removal of one neurotransmitter from the brain — serotonin, the “feel-good” neurotransmitter. Studies have shown that higher brain serotonin is associated with a sense of well-being and low levels are associated with depression.

So naturally, Big Pharma focuses on serotonin. But their approach fails for two big reasons:

  1. The most popular class of antidepressants does not increase serotonin production. The drugs only prevent its removal from the synaptic cleft — the space between two brain cells. Do you see the problem? If depression is associated with low serotonin, simply preventing its removal doesn’t address the deficiency.

    After taking the drugs, you still have low serotonin. It just hangs around between brain cells longer. This may help a little, but it doesn’t correct the serotonin deficiency.

  2. The “one mechanism” approach fails to recognize the complexity of the brain itself. There are probably several neurotransmitters involved, working within several brain centers to produce mood.
So what would be a more effective treatment approach for depression? We believe a more holistic approach using nutrition is necessary.

Brain Food for Treating Depression

Successfully treating depression is possible if you feed your brain the nutrients it needs to function properly. Here’s what we suggest:

  1. Optimize vitamin D — Studies show that low levels of vitamin D are associated with depression.2 So take vitamin D daily. Most people will need between 5,000 and 8,000 units a day of vitamin D3 to reach optimal blood levels.

  2. Take B vitamins — The research is inconclusive, but B vitamins seem to help certain populations, like preventing depression in patients who have suffered a stroke.3

  3. Supplement with Omega-3 fats — Omega-3 fats are essential to brain health, including mood. Although most of the clinical studies are small, omega-3 oils have shown benefit in treating depression.4
A holistic approach is the only strategy that makes sense when it comes to treating depression. Big Pharma just needs to accept the fact that the brain is way too complex for a one-mechanism approach to any disease.

Do you battle with depression? Have you tried antidepressants? Please share your experience in the comments!

  1. Nature. 2011 Nov 15;479(7373):278.
  2. Psychiatry Res. 2011 Dec 30;190(2-3):221-5.
  3. Ann Neurol. 2010 Oct;68(4):503-10.
  4. J Clin Psychiatry. 2009 Dec;70(12):1636-44.


Anonymous said...

For many years I struggled with inherited depression. I heard repeatedly the importance of B vitamins, but they never helped much. It finally occured to me that perhaps I inherited problems with B vitamin metabolism. I switched to more usable forms of all the B vitamins, so I didn't have to convert them. This helped a lot. Probiotics, which help your body perform key chemical reactions in the gut, and phosphatidylserine were also very beneficial.

Anonymous said...

I take venlafaxine since 2001. It helps both depression and anxiety. Sometimes I have bouts of severe depression, but I don't want to increase my dose. My LLMD says it interferes with his treatment for my chronic, late-stage Lyme disease. Phenibut helps depression and anxiety. I don't think that clinical depression and anxiety can be cured. Drugs aren't the answer. I want to get off of Venlafaxine for its serious side effects; ditto the omeprazole I'm taking. Drug cos. downplay those.

Mark said...

Anti-depressants *may* work on *some* individuals with a chemical imbalance, yet, anti-depressants do not work on individuals with a structural form of depression.

Anniebird said...

Depressed for 20 years. Off and on anti depressants. Now happy and off them for 10. Employed and sustain all your recommendations, lots of work on healthy gut. Daily yoga, happy thoughts.

SmartEaters said...

This is a helpful and accurate piece.

The serotonin hypothesis is already a defunct and discredited one, already now accepted as nonsense by those in the know, as for example with the cholesterol hypothesis of heart diseaase.

There are 2 principal difficultis involved with treating depression in a more "natural", nutritionally focused way:

One is that depression is really an umbrella term and you could find 10 folk depressed for each of 10 different underlying reasons. Certainly deficiencies in B vits, vit D and omega 3s may be associated with depression: however. there are very many other possibilities also. Some of these other issues are discussed in a piece on nutrition and depression accesible just now on the home page of smarteaters.org

The other difficulty is the inherent compliance issues: those very people who might most need and most benefit from applying major challenging dietary changes, being depressed, are often very unwilling or unable to do so. It's a Catch 22: depression can't be beaten without a fight and most depressed people don't have much energy for any kind of a contest. Unfortunately the other modalities that really help such as Yoga also take time and effort to bear fruit and so are often overlooked.

The solution? Ultimatley it's about properly targetted supplemental assistance whilst dietary upgrade is searched for over time. He who is not spiralling downwards, is in fact spiralling upwards ...

Anonymous said...

I see this all the time in my job, of 22 yrs as a pharmacy tech. People have been on antidepressants for years with no real improvement in their symptoms. You really do have to treat the cause of the depression. For me I have struggled with it for years, starting when my father was murdered. 27 years later, I still find that it is my diet, mind focus and spirit that helps me most. All the meds and supplements are just a band-aid for me.

Life Extension said...

Anonymous, thank you for sharing your story with us. And we want you to know that you're absolutely correct. Diet plays a MAJOR role for most people.

Richard J. Metzner, MD said...

With all due respect to Dr. Smith and those who commented favorably, there are so many medically inaccurate statements in this piece that I wrote a response to it on the website: DepressionConsultant.com called "Misinformation about Antidepressants on the Internet." Life Extension responded within three hours of my posting it that they "completely agree." I hope you'll take a look to find out why.

Ellen Sweet Moss said...

I also disagree ....Antidepressants have saved my life. My son however can not seem to find one that lasts.

Bob Fiddaman said...

"Anti-depressants *may* work on *some* individuals with a chemical imbalance"

Complete nonsense. The chemical imbalance idea was put forward by the pharmaceutical industry, it was a scaremongering tactic designed to make people believe they had an illness that could be treated.

In fact, there is no scientific evidence that a chemical imbalance exists. Once taking these powerful group of drugs is the only time you can see a change to the chemicals.

Write to any pharmaceutical company and ask for evidence of the chemical imbalance...they will not be able to provide it to you because it simply never existed. It was a marketing tactic that duped patients and medical professionals.

Some of the comments we here are along the lines of 'antidepressants saved my life' - How can we be sure this is the case? How do we know that this wasn't merely a placebo effect?

Anonymous said...

Alcohol is the key for me. Self medicated with booze for years. Stopped drinking and feel LOADS better.

Life Extension said...

Anonymous - We're glad you stopped drinking alcohol and that you're feeling much better!

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