Antidepressant Response Danger

New research helps explain a paradoxical effect of certain antidepressants; they may actually worsen symptoms before helping patients feel better. Many people do not tolerate antidepressants and suffer side effects including extreme mood swings, agitation and suicidal thoughts. This can make these medications dangerous for some individuals.

Selective serotonin reuptake inhibitors (SSRI) affect the brain chemicals serotonin and glutamate differently. While the antidepressant drugs increase serotonin for motivation, they suppress glutamate for pleasure, which is why it can take several weeks for depression symptoms to subside.

SSRIs are the most widely prescribed class of antidepressant drugs. They work by gradually increasing levels of a brain chemical called serotonin. While this boost in serotonin occurs within minutes to hours after an SSRI is taken, patients usually have to take the medication for weeks before experiencing any relief of symptoms. During this delay, the drug may actually aggravate depression, in some cases even increasing the risk for suicide.

Researchers and clinicians have been puzzled by this, but Adrian Fischer of Otto-von-Guericke University in Germany, and his colleagues, now point to evidence from recent studies showing that serotonin neurons transmit a dual signal that consists of the release of serotonin as well as glutamate, another brain chemical. The investigators claim that SSRIs may affect these two components of the dual signal in different ways, which is what causes these side effects.

Fischer said:

“While the serotonergic component is immediately amplified following SSRI administration, the glutamate component is acutely suppressed and is only normalized after several days of drug treatment. These differential time courses may help to explain the paradox of acute versus chronic SSRI effects.”

The discovery of the dual signal helps explain why the delayed onset of clinical efficacy that’s seen with SSRIs is not evident with other antidepressant drugs that instead target glutamate receptors. Learning how medications affect the brain can lend support for improved evidence based therapies for depression.

If you are thinking of using antidepressants, seek out the counsel of a good psychiatrist and address all your options. There are many.