Are there risks from staying on antidepressants for many years?

Studies have identified potential health problems from staying on antidepressants long-term, such as:

● Increased risk of developing osteoporosis⁴

● Increased risk of bleeding⁴

● Negative effects on the liver⁵

● Increased risk of cataracts⁵

● Increased risk of cardiovascular disease⁶

● Increased risk of an early death⁴

● Some antidepressants have been associated with an increased risk of dementia⁷

● The longer you use an antidepressant also increases the likelihood of withdrawal symptoms when the dose is reduced or stopped⁸

Tolerance or “poop-out” also may occur from long-term antidepressant use. This brings on a gradual need to increase the dose of their medication over time, with less and less effect.⁹

Some studies suggest long-term use of antidepressants can cause low mood, possibly due to extended drug effects on the brain.¹⁰

⁴ Coupland, Carol, Paula Dhiman, Richard Morriss, Antony Arthur, Garry Barton, and Julia Hippisley-Cox. 2011. “Antidepressant Use and Risk of Adverse Outcomes in Older People: Population Based Cohort Study.” BMJ 343 (aug02 1): d4551.https://www.bmj.com/content/343/bmj.d4551

⁵ Carvalho, André F., Manu S. Sharma, André R. Brunoni, Eduard Vieta, and Giovanni A. Fava. 2016. “The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature.” Psychotherapy and Psychosomatics 85 (5): 270–88. https://www.karger.com/Article/FullText/447034

⁶ Bansal, Narinder, Mohammed Hudda, Rupert A. Payne, Daniel J. Smith, David Kessler, and Nicola Wiles. 2022. “Antidepressant Use and Risk of Adverse Outcomes: Population-Based Cohort Study.” BJPsych Open 8 (5): e164. https://www.cambridge.org/core/journals/bjpsych-open/article/antidepressant-use-and-risk-of-adverse-outcomes-populationbased-cohort-study/6AAA6943E55F8B08DD9E25155E72931F

⁷ Richardson, Kathryn, Chris Fox, Ian Maidment, Nicholas Steel, Yoon K. Loke, Antony Arthur, Phyo K. Myint, et al. 2018. “Anticholinergic Drugs and Risk of Dementia: Case-Control Study.” BMJ 361 (April): k1315. https://www.bmj.com/content/361/bmj.k1315

⁸ Horowitz, M. A., Adele Framer, Michael P. Hengartner, Anders Sorensen, and David M. Taylor. 2022. “Estimating Risk of Withdrawal from a Review of Published Data (Accepted manuscript - CNS Drugs).”

⁹ Kinrys, Gustavo, Alexandra K. Gold, Vincent D. Pisano, Marlene P. Freeman, George I. Papakostas, David Mischoulon, Andrew A. Nierenberg, and Maurizio Fava. 2019. “Tachyphylaxis in Major Depressive Disorder: A Review of the Current State of Research.” Journal of Affective Disorders 245 (October 2018): 488–97. https://www.sciencedirect.com/science/article/abs/pii/S0165032718316859?via%3Dihub

¹⁰ El-Mallakh, Rif S., Yonglin Gao, Brian T. Briscoe, and R. Jeannie Roberts. 2011. “Antidepressant-Induced Tardive Dysphoria.” Psychotherapy and Psychosomatics 80 (1): 57–59. https://www.karger.com/Article/Abstract/316799