In terms of “safety”, there’s the 1) safety reported in the clinical data vs 2) the safety of NOT taking the medicine.
Clinical reality – In terms of “hard data”, medications (including anti-depressives) are tested at various stages in the FDA drug approval process and after in various research settings along with testing by doctors of their own patients as therapy continues (liver, kidney, emotional state, etc)
You can find “official” data on anti-depressants, including their efficacy and adverse event/side effect profile. You’ll see a group of patients on the drug at a certain dose for a specified period of time (usually short). You’ll see what the official data says about what percentage of the test subjects the medication helped, to what degree (much better, a little better, etc), and how many instances were reported of “bad things” happening. Looking at anti-depressives, “bad things” can range from dry mouth and constipation to stroke and death.
Unofficial/anecdotal data may reinforce the conclusions of the official data. However, it is common to see contradictions.
The “value” of the medication to the patient is subjective. (There are official instruments (tests) that attempt to standardize the measurement of internal experiences.) However, only the patient, and those closest to them, know if she feels better or enjoys improved function.
What does the “value” of the medication have to do with safety? The costs of depression, whether referring to finances, work functionality, or emotional suffering and instability, are high across every dimension.
Therefore, our definition of “safety” must include not only health but the safety of all areas of our lives. In other words: is it safe to NOT take the medication?
Of course, when a medication is required to save a life, it is safer than the alternative.
1) will the med help me? + 2) will it hurt me? = Prescription choice
So, you have all of the above to research if you’re interested.
Three things to watch out for:
- Keep in mind that sometimes negative studies (studies where the drug fails the trial) are hidden by companies willing to suppress findings even if it literally costs lives. (ex. Vioxx)
- You will rarely find a doctor well-acquainted with a drug’s safety details. Most of the information they receive about the drug comes from those selling it. Naturally, the pros vs cons of the drug are often skipped over. Some companies routinely put sales above safety.
- The “unofficial data” comes from patients in online forums, alternative health research sites, and other anecdotal sources. Often, pharmaceutical companies will downplay and deny these reports.
For instance, it took years to acknowledge, define, and proactively treat the akathisia side effect sometimes caused by anti-depressive use. This is a terrible side effect, capable of driving suicide and perhaps even violent behavior directed at others.
It also took many years for any official acknowledgment of the severe and widespread nature of drug withdrawal aka “Discontinuation Syndrome”.
In other words, figuring out how “safe” a drug is not straightforward. Patterns may take years to appear and be widely disseminated.
- The safety of anti-depressives is mostly tested through short-term trials that are susceptible to manipulation and, by design, cannot reveal long-term safety reports.
- For this reason, I try to avoid using new drugs when I can. Too many unknowns.
- I take anecdotal evidence into consideration because patients rarely have an incentive to misreport their experiences with a drug.
- Strictly speaking, if safe means causing zero harm, no, anti-depressives are not safe. They are a foreign substance introduced into your body with widespread effects that aren’t fully understood. Further, your body must metabolize and clear these foreign molecules it finds toxic.
Innovative treatment options like IV Ketamine Infusions Therapy are already in use. Learn more about how and why Ketamine is often successful in treating Depression.