Adverse effects from taking antidepressants are more common and serious for the elderly because they have more fragile health and take more medications.

A new review of recent medical literature on antidepressant use by older people with depression revealed no clear evidence of benefit, while adverse effects were found to be especially common and problematic. Alternative treatments for depression were advised.

The review was conducted to provide an overview of studies from the past decade of the benefit and harms of treatment of older persons with selective serotonin reuptake inhibitor (SSRI) antidepressants. The studies under review comprised depressed patients aged 55 and older who were taking SSRI antidepressants in comparison to control groups receiving placebos.

As reported in Mental Health Science, the evidence indicated that antidepressants have little, if any, benefit over placebos in this age group. There was even less evidence of depression remission.

“The evidence of the benefits of antidepressants in the elderly was weak and alternative treatments are advised,” wrote study author Michael Hvidberg, Ph.D., of the psychology department at the University of York in the U.K.

In the U.S., 15.6 million Americans aged 60 and older are prescribed antidepressants – that’s one of every five (19%), with one in four (24%) of them women.

The evidence of the benefits of antidepressants in the elderly was weak and alternative treatments are advised.”
— Michael Hvidberg, Ph.D., Department of Psychology, University of York, U.K.

Adverse effects from taking the drugs are common and more serious among the elderly because they have more fragile health, deal with more medical issues, and take more medications. “Treatment with antidepressants may lead to more [adverse events] due to polypharmacy and age-related physiological changes,” Hvidberg writes, advising other treatment instead of the drugs.

Side effects of taking antidepressants include weight gain, nausea, insomnia, agitation, emotional blunting, sexual dysfunction, and even deepening depression. Psychiatrist Peter Breggin, M.D., describes antidepressants as neurotoxic because they harm and disrupt the functions of the brain and can cause abnormal thinking and behaviors, including anxiety, aggressiveness, loss of judgment, impulsivity, and mania, which can lead to violence and suicide.

Discontinuing antidepressants can bring on withdrawal symptoms, including electric shock-like sensations (“brain zaps” and “body zaps”), muscle spasms and tremors, hallucinations, confusion, irritability, and mania. One study found that more than half (56%) of people attempting to come off antidepressants experience withdrawal symptoms, with nearly half (46%) of them describing those symptoms as severe.

The new study’s finding of no clear benefit to patients from antidepressants is consistent with the results of a 2022 study, which found no clinically significant difference in measures of depression symptoms between adults treated with antidepressants and those taking placebos, whether over a shorter or longer time frame and regardless of the depression severity of the study participants.

Because the drugs have no strong evidence of benefit to patients, but carry the risks of significant side effects, researchers in another recent study advised primary care physicians not to prescribe antidepressants to depressed patients initially, but instead to recommend alternative approaches for treatment.  Similar guidance was issued in 2021 by the London-based National Institute for Health and Care Excellence, the organization that develops standards for health care practices in England.

One alternative approach to depression that has been repeatedly validated as effective in research studies is exercise. The results of one new study found that even exercise below levels of physical activity commonly recommended in health guidelines resulted in significant antidepressant benefits for older adults.

More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a chemical imbalance in the brain – had no scientific basis.  The study investigated whether evidence supported the theory that a low level of the brain chemical serotonin causes depression.

“The serotonin theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression,” the researchers wrote. “Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the use of antidepressants.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.