Q&A: How long do I need to keep taking my antidepressant and anxiety medication?

Question: After struggling with anxiety and depression for several years, I finally decided to see a doctor about my problem. He put me on an antidepressant, and I’m pleased to say that it’s made a noticeable improvement in my mood. Still, there’s a nagging worry at the back of my mind: will I have to take this drug for the rest of my life? Would it be dangerous to stop taking it? 

Answer: 

Anxiety and depression can have a number of complicated and interrelated causes: spiritual issues, past experiences or present conflicts, trauma, distress, broken relationships or physiological dysfunctions. If your physician has prescribed an antidepressant, he must have reasons for believing that your problem is primarily or significantly physical in nature. 

Explore your options

This is standard procedure. Physical disorders of this kind are more common than you may realize, and your doctor’s method of treatment is perfectly normal and acceptable. Still, it might be worth asking yourself if there are other dimensions to your mood disturbances that deserve a closer look. It’s often helpful to combine drug therapy with psychological counselling. If you’d like to explore this option, feel free to call Focus on the Family Canada’s counselling department. Our counsellors are available to discuss your situation with you Monday through Friday between 8 a.m. and 4 p.m. Pacific time at 1.800.661.9800. They can also supply you with a list of qualified Christian therapists practicing in your area.

In the meantime, there are some important facts and considerations you should keep in mind with regard to the purpose, function and use of prescription antidepressants.

Understanding chemical imbalances

First, while there are several physical conditions and diseases that may have a depressive effect on those who suffer with them – for example, menopause, thyroid disease, neurological disorders and certain types of cancer – the fact remains that only a small percentage of people with anxiety or depression have some other medical problem that, when treated, solves the problem. Many if not most cases appear to be linked to imbalances in chemical messengers within the brain known as neurotransmitters. When there is a disturbance involving one or more neurotransmitters, working on the issues of life or spiritual concerns may be far more difficult – like trying to swim across a lake with weighted boots clamped to your feet. Prescription antidepressants are designed to counteract this chemical imbalance in the brain. If medical evaluation suggests that a neurotransmitter problem may be playing a role in a significant mood disturbance, a trial of medication is a reasonable option.

Antidepressants are not addictive

Second, it’s important to know that antidepressants are not addictive or even habit-forming. Claims (on the Internet and elsewhere) that antidepressants are addictive are untrue, but they may be fuelled by a phenomenon known as discontinuation syndrome that occurs in some individuals when certain types of the medications are stopped suddenly. Symptoms such as vertigo, fatigue and odd "electric shock" sensations in the head may occur, and they will disappear if the medication is restarted. But unlike withdrawal symptoms induced by long-term use of narcotics, antidepressant discontinuation symptoms are by no means universal and can be avoided by gradually reducing the dose of the drug. Needless to say, changes in these medications should be made only under the supervision of the prescribing physician.

Don't expect immediate results

Third, antidepressants do not work immediately. In some cases, the first signs of improvement may be noticeable within a few days, but more commonly benefits evolve gradually over a few weeks. If one agent does not seem to work or causes side effects, it is not unusual for a doctor to try another. There is no way to know for certain which medication will work best for a given individual. As a result, some trial and error may be necessary.

Antidepressants are not like antibiotics 

Fourth, antidepressants are not like antibiotics that are taken for a few days and then stopped. If a medication appears to be working well, it is important to continue taking it for an extended period of time – typically, at least six to twelve months. If the medication is stopped too soon, symptoms are likely to return. For many individuals, mood disorders related to neurotransmitters are a chronic or recurring problem, and long-term use (sometimes years) may be necessary to maintain the beneficial effects.

To answer your question, then: while it’s impossible to say for sure without knowing a great deal more about your situation, we can safely assume that you probably won’t be taking antidepressants "for the rest of your life." Nevertheless, because of the possibility of incurring discontinuation syndrome or forfeiting the progress you’ve made thus far, we would warn you strongly against discontinuing this medication unless directed to do so by your physician. Always consult with your doctor before making decisions of this nature. And remember that, due to the non-addictive nature of prescription antidepressants, there is no serious risk associated with their ongoing use.