Long-Term Antidepressant Use and 8 Potential Risks

According to the CDC, nearly 13% of people 12 years or older reported taking antidepressants in the last month. Of that group, 60% have been taking them for two years or more, while 14% have been taking them for more than 10 years.

Antidepressants have a long history of benefits, such as:

  • Providing symptom relief for depression and other disorders
  • Improving quality of life
  • Reducing suicide risk

However, there are also a number of risks associated with antidepressant medications, especially when you take them long-term. Here are eight to be aware of:

1. Weight Gain and Metabolic Effects

One of the most significant long-term side effects is weight gain. 65% of patients had complaints about their weight increase. Weight gain and metabolic changes, such as increased blood sugar levels, can increase the risk of conditions like diabetes.

2. Sexual Dysfunction

A decreased sex drive or libido, struggles to achieve an orgasm, and erectile dysfunction (for males) are just a few of the sexual side effects of antidepressants. In this study, nearly 72% of patients experienced sexual problems, and 64% reported commonly failing to reach climax.

3. Drop in Bone Health

Research is ongoing on the potential links between long-term antidepressant use and decreased bone density. However, this study found links between antidepressant use and cortical bone, contributing to more pelvis fractures in patients using antidepressants. Decreased bone health can contribute to fractures and osteoporosis, especially in our aging population.

4. Increased Bleeding

This study also points out an increased risk of bleeding with long-term antidepressant use. You could have a bleed in your digestive tract or a brain bleed, which could lead to a stroke or seizure. Any bleeding internally is potentially life-threatening, especially if not diagnosed quickly.

While some research points to concurrent alcohol use turning this risk into a reality, the risk is there, especially if you do not follow the dietary stipulations your provider gives you. If your provider gives you a list of things not to eat and drink, always ask why and what could happen if you don’t follow the instructions so you know what you are risking.

5. Pregnancy Complications

Many antidepressants are not safe for pregnancy and breastfeeding, or researchers cannot rule out the risk. These could be anything from preterm birth to withdrawal symptoms or neonatal abstinence syndrome (NAS). With long-term antidepressant use, it may impact your plans to conceive or increase risks with an unplanned pregnancy.

6. Dulled Feelings

45-65% of respondents in this study on long-term antidepressants reported feeling emotionally numb, not feeling like themselves, and reduced positive feelings. 36% reported caring less about others. While antidepressants can take away the negative feelings, they can also take away the positive feelings as well.

7. Dependence and Withdrawal

Antidepressants, like any drug, can lead to physical dependence. Abruptly stopping medication can result in withdrawal symptoms. These can include: dizziness, nausea, headaches, mood swings, anxiety, pain, heart palpitations, insomnia, and brain zaps. These zaps are electric shock sensations from the brain resetting after antidepressants. There’s even antidepressant discontinuation syndrome. 73% of patients reported withdrawal as a common adverse effect of long-term antidepressant use.

8. Risk of Suicide

36% of patients reported suicidality as a common side effect. While antidepressants reduce the risk of suicide, they can also increase the risk of suicidal thoughts or behaviors. Typically, this risk diminishes over time, but it can reemerge if you suddenly stop taking your medication, you’re not following the directions, or you become tolerant to your medication dose.

The Importance of Tapering

Drugs can change your brain in reversible and irreversible ways. The longer you are on a medication, the longer it will take for everything to recalibrate to your new normal. If you are trying to reduce or go off your antidepressant medication altogether, especially if you have been on it for a long time, it’s crucial to taper off it slowly. You must work with your provider with a plan to prevent serious side effects.

Antidepressants play a vital role in treating depression. However, there are several potential long-term risks you should hear about from your provider. Maintain open communication to hear about all your clinical depression treatment options and weigh the benefits against the risks. Don’t forget it’s never a bad idea to explore complementary or alternative depression treatments. The journey to mental well-being is deeply personal. What works well for others may not necessarily be the optimal choice for you. Embracing this individualized approach ensures that your treatment aligns with your specific circumstances and preferences.