Why Antidepressants Don’t Work for Treating Depression

By Mark Hyman, MD on 05/13/2010

Here’s some depressing recent medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

The study I’m talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit -- but almost none of the studies that show these drugs are ineffective. (1)

That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.

The problem is even worse than it sounds, because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.

That leaves us with a big problem -- millions of depressed people with no effective treatments being offered by most conventional practitioners. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. Today I will review 7 steps you can take to work through your depression without drugs. But before we get to that, let’s take a closer look at depression.

What’s in a Name?

“Depression” is simply a label we give to people who have a depressed mood most of the time, have lost interest or pleasure in most activities, are fatigued, can’t sleep, have no interest in sex, feel hopeless and helpless, can’t think clearly, or can’t make decisions.

But that label tells us NOTHING about the cause of those symptoms. In fact, there are dozens of causes of depression -- each one needing a different approach to treatment. Depression is not one-size-fits-all, but it is very common.

Women have a 10 to 25 percent risk and men a 5 to 12 percent risk of developing severe major depression in their lifetime. (2) One in ten Americans takes an antidepressant. The use of these drugs has tripled in the last decade, according to a report by the federal government. In 2006, spending on antidepressants soared by 130 percent.

But just because antidepressants are popular doesn’t mean they’re helpful. Unfortunately, as we now see from this report in The New England Journal of Medicine, they don’t work and have significant side effects. Most patients taking antidepressants either don’t respond or have only partial response. In fact, success is considered just a 50 percent improvement in half of depressive symptoms. And this minimal result is achieved in less than half the patients taking antidepressants.

That’s a pretty dismal record. It’s only made worse by the fact that 86 percent of people taking antidepressants have one or more side effects, including sexual dysfunction, fatigue, insomnia, loss of mental abilities, nausea, and weight gain.

No wonder half the people who try antidepressants quit after 4 months.

Now I want to talk to you about the reasons why doctors and patients have been deceived by the “antidepressant hoax.” Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!

How We have Been Deceived by the Antidepressant Hoax

Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The team of researchers that reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt …

The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers, and hunt down hidden data under the Freedom of Information Act. What they found was stunning.

After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”

That means the results were twisted to imply the drugs worked when they didn’t.

This isn’t just a problem with antidepressants. It’s a problem with scientific research. Some drug companies even pay or threaten scientists to not publish negative results on their drugs. So much for “evidence-based” medicine! I recently had dinner with a step-uncle who runs a company that designs research for drug companies. He designs the study, hires the researcher from an esteemed institution, directs the study, writes up the study and the scientist just signs his or her name after reviewing it.

Most of the time, we only have the evidence that the drug companies want us to have. Both doctors and patients are deceived into putting billions of dollars into drug companies’ pockets, while leaving millions with the same health problems but less money.

The scientific trust is broken. What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, Functional Medicine helps us find the true causes of problems, including depression.

I see this in so many of the patients I have treated over the years. Just as the same things that make us sick also make us fat, the same things that make us sick also make us depressed. Fix the causes of sickness -- and the depression takes care of itself.

Consider a few cases from my practice …

A 23-year-old had been anxious and depressed most of her life and spent her childhood and adolescence on various cocktails of antidepressants. Turns out, she suffered from food allergies that made her depressed.

Food allergies cause inflammation, and studies now show inflammation in the brains of depressed people. In fact, researchers are studying powerful anti-inflammatory drugs used in autoimmune disease such as Enbrel for the treatment of depression.

After she eliminated her IgG or delayed food allergies, her depression went away, she got off her medication -- and she lost 30 pounds as a side effect!

Here’s another story … A 37-year-old executive woman struggled for more than a decade with treatment-resistant depression (meaning that drugs didn’t work), fatigue, and a 40-pound weight gain. We found she had very high levels of mercury. Getting the mercury out of her body left her happy, thin, and full of energy.

Or consider the 49-year-old man with severe lifelong depression who had been on a cocktail of antidepressants and psychiatric medication for years but still lived under a dark cloud every day, without relief. We found he had severe deficiencies of vitamin B12, B6, and folate. After we gave him back those essential brain nutrients, he called me to thank me. Last year was the first year he could remember feeling happy and free of depression.

These are just a few of the dozens of things that can cause depression.

The roots of depression are found in the 7 keys to UltraWelless and the 7 fundamental underlying imbalances that trigger the body to malfunction. Taking antidepressants is not the answer to our looming mental health epidemic. The real cure lies in rebalancing the underlying systems in your body that are at the root of all healthy and illness.

Here are a few things you can do to start treating your depression today:

7 Steps to Treat Depression without Drugs

1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. As I mentioned above, food allergies and the resultant inflammation have been connected with depression and other mood disorders.

2. Check for hypothyroidism. This unrecognized epidemic is a leading cause of depression. Make sure to have thorough thyroid exam if you are depressed.

3. Take vitamin D. Deficiency in this essential vitamin can lead to depression. Supplement with at least 2,000 to 5,000 IU of vitamin D3 a day.

4. Take omega-3 fats. Your brain is made of up this fat, and deficiency can lead to a host of problems. Supplement with 1,000 to 2,000 mg of purified fish oil a day.

5. Take adequate B12 (1,000 micrograms, or mcg, a day), B6 (25 mg) and folic acid (800 mcg). These vitamins are critical for metabolizing homocysteine, which can play a factor in depression.

6. Get checked for mercury. Heavy metal toxicity has been correlated with depression and other mood and neurological problems.

7. Exercise vigorously five times a week for 30 minutes. This increases levels of BDNF, a natural antidepressant in your brain.

Overcoming depression is an important step toward lifelong vibrant health. These are just of few of the easiest and most effective things you can do to treat depression. But there are even more, which you can address by simply working through the 7 Keys to UltraWellness.

Now I’d like to hear from you…

Have you been diagnosed with depression?
How have antidepressants worked for you?
Do you plan to try any of the approaches mentioned here?

Please let me know your thoughts by leaving a comment below.

References

(1) Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260.

(2) Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y. 2007. Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981-2004. Acta Psychiatr Scand. 116(3):182-188.

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About the author

Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is the author of The UltraMind Solution. Dr. Hyman is now sharing the 7 ways to tap into your body’s natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.

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Comments

Thank you for writing this. I couldn't agree more. I was on meds for depression for years and now I am not on anything. I am better now than I was on meds. When I started working for the drug rehab that I work for I stopped taking them and started taking vitamins instead. Its amazing how vitamins can really help with depression.

Interesting article and I certainly agree with the one above about the vitamins. I always tell people that the best nerve pill and antidepressant pill I know of it to get a good Stess Tablet and take 1 tablet 4 times a day (at mealtime and bedtime). Magnesium Oxide 500 mgm. morning and evening is also recommended to speed your recovery to feeling normal. Stress depeletes the body of B vitamins and a deficiency of B vitamins causes a sluggish thyroid gland, so pep it up by giving your body what it needs to operate efficiently before having any of those expensive tests run.
It should go without saying that a good multivitamin/mineral
tablet at least once a day helps.

I could write a book! I'm 63yrs old and have been on antidepressants since I was 16. I had X4 admissions to mental institutions. In the end I had to retire early. I am a type 2 diabetic and save money buy scrimping on food and heat. I am very tired and can't seem to get motivated to do anything but keep the house tidy. I takeZopiclone7mg at bedtime. Amitriptyline50 mg for diabetic neuropthy, and Novo Citalopram 60 mg per day. I don't feel really depressed, but life has lost it's "glow" due to poor motivation...some days I can't find the energy to get dressed!
Could the meds have this effect on me?

I have been dealing with depression off an on for years. Meds never helped lexipro sent me to the hospital with a panic attack, after that I was afraid to take anything else. I take a super multi with lots of b vitamins ( way more than the rda) devised by Dr. Murphree for people with chronic fatigue and fibromyalgia. I am much better, eventhough I still struggle from time to time when stressful things beyond my control happen. I also have a wonderful counselor who helps me from time to time. I know what I have to do to feel better but it is hard to keep it up. Sometimes I get to feeling good and let things slip. Here are the things that help me:
1. Take a good multi-vitamin every day. Some of us for whatever reason need more than the RDA. I take 2000 mg of fish oil per day. I get my D level checked regularly and have to take some to get it up at times.
2. Get a good nights sleep. I know it is not good to take sleep meds but if you have to to get a good nights sleep, do it. It is better than not sleeping. My D.O. has me taking 200 mg of 5htp and I take 75 to 150 mg of lunesta with 400 mg of magnesium to help me sleep well. Sometimes for a few weeks I can come off the lunesta and maybe use some valerian, but that usually does not last long. When I don't sleep I go into a major depressed state. So, I do what it takes to sleep.
3. Eat healthy. I can't afford organic but I do my best to eat lots of fresh veggies and fruits and lean meat. I try not to eat very many sweets. I drink water that has been filtered with a Pur filter.
4. Exercise. I always feel better when I walk for 30 min a day.
This is the hardest thing for me to do regularly, but I always feel much better when I do.
5. I Pray. It always helps to put my worries in the hands of a God who can take care of them.
6. When one of those stresses that I have no control over happens, I get out paper and ink. I write whatever I am thinking. It may sound stupid but when I write it seems to get the worry out of me and on the paper. If it's back the next day I just write again. It really helps.
7. Find a good counselor who you feel you can trust. Then do what they tell you to do. That's where I learned writing helped me. She also helped me to see things in a different perspective.
8. Find a hobby that you love. I was looking for a way to get more exercise and found I love to dance. I am having so much fun and I look forward to it each week. I also sing and play the piano.
Don't ever give up. Keep doing the things you know help. Stick with it. Some day the headlines are going to say,"Cure for Depression Found", and it will be true. It's probably something really simple. We just have to hang in there.

I was treated with traditional "psych" meds for more than 20 years for bipolar depression. Nothing worked, I suffered debilitating side effects until my body finnally had had enough an I broke out in hives. Forced to try something else, it was discovered that I was folate-deficient. I have been on an absorbable form of folic acid for a year and a half and have had no more bipolar symptoms.

From my personal experience, I have found out that "Silver Amalgam Dental Fillings" can cause Depression. The fillings are 50% Mercury. I had 14 of those fillings in my mouth. I had suffered with bouts of Depression since they were placed in my mouth when I was a youngster. Some more symptoms of Mercury Poisoning are Fatigue, Tiredness. Depression. Suicidal thoughts, Constipation. Cold hands and feet, frequent metallic taste in your mouth, unexplained chest pains, digestive problems, ulcers. I had ulcers when I had my Silver Amalgam Dental Fillings Removed and replaced. 2 weeks later, an upper GI test showed that the ulcers were gone. I believe getting those Mercury fillings out of my mouthhelped my stomach heal itself of those ulcers.

my dad has never been the same since trying an anti dep in 5/2008. they cocktailed him, ect and now on a benzo. he is currently weaning from the benzo and is in severe w/drawals. he cannot function. foggy, confused, can barely walk a block. he does have hypoglocemia and should have nver been put on a drug. he was always a "vitamin" person..possibly too much. any help or advice helpful. he is 67 years old, but seems like 90. this is so sad, like he is slowly dying.

Dr. Hyman,
I am a 52 year old male with a St. Jude's aortic valve. I also suffer from optical migraines. 5 different antidepressants tried over the years have all caused prefrontal lobe headaches. I am trying your 7 steps to treat depression without drugs. Do you have any other advice? THANK YOU VERY MUCH!

the Dr. gave me Cymbalta as i was very depressed after my husband died. its been 2 years and i dont feel i need it anymore. I also have osteoporosis and fibromyalgia.. twice I have tryed to wein off of it but I got so week I couldn;t function. How can I stop it without this happening. My Dr. says I get week because I;m depressed but from the information I;ve read, weekness is a side effect from stopping it. please help.

How is one supposed to be able to get the motivation to excercise when you can't stand living?

My friend is 82, she's lost her husband and dog recently, She's not depressed ... she's sad,,, she stays active, really active. Her Dr. has prescribed her citalapram, she says it makes her woozey, and she's had a fall. Because the Dr. has prescribed it for her she believes she should take the meditcation and follow Dr.s orders.... She's unaware that 'if' the anti-depressants work it will take 4-6 weeks to take effect, and the side effects can be suicide if stopped. I'm getting her literature on the subject, but hope that the Dr.s will research the subject. In Canada we get Dr.s giving out free samples from the drug companies to promote their products, and everyone likes free. This is my story, it's sad not depressing. thanks for listening. L

Thank you for your insightful article. I have been diagnosed with BP for approximately 10 years and I have been treated with a host of different medications that ultimately required a change due too severe side effects.

To be honest I'm not sure if I should be happy or extremely disappointed. For at least half of this time I had neurocognitive issues and until my most recent psychiatrist, all the other physicians claimed there was no correlation. Now after reading this a long with Dr. Kirsch's findings I am inclined to stop the three medications that I am currently on. Obviously in a reasonable way.

I have worked in the Medical Device Industry for over 20 years and this type of unprofessional and unethical manipulation has never been considered.(at least with the companies that I have been exposed to) I'm not sure what the outcome will be with regard to the Pharma Industry, but in my opinion this is just as reprehensible as burying Medical Device Reports (MDR's).

Long story short. I agree with most of what you wrote. Personally I used to lay in bed tossing and turning ruminating about all of the bad things that were going to happen. I couldn't shut my brain off, especially negative thoughts. Finally my cardiologist recommended a shrink who prescribed Celexa for me. Well the proof is in the pudding. Within a month my ruminating stopped and I was far less anxious and things that shouldn't have bothered me but DID stopped bothering me. I do want to get off it, now that I've modified my diet and lifestyle significantly but I thank God for the stuff...literally.
Mike. Male. 52.

Thanks a lot for this informative article... my wife ( 45y ) has been suffering from depression for the last 16 years, during the first years it was light,,, but since 2007 it has become very severe, spasms used to come and go in long intervals.She has taken various types of antidepressants, but all in vain, and her conditions is getting worse every passing day, she speaks about suicide... doctors say her depression is medicine - resisting,,, her current spasm started in last July,2011 and continued till now, she is really in very bad condition,,, will try your advice.
Appreciate it very much, to provide me with something that can alleviate her depression in the shortest possible time,,,

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