America is currently in a Great Depression - and it's just as disastrous as the economic crash of 1929. The Great Depression of today is a country in which 18.4 million Americans have been diagnosed with clinical depression. To put this into perspective, it's more prevalent than cancer, AIDS, and diabetes all combined. Antidepressants may seem like the antidote of depression, but they're far from being a logical treatment option.
The most comprehensive research study of antidepressants to ever be conducted was recently published in The Lancet. It included 21 different types of antidepressants, 116477 participants, and 522 trials (double-blind, parallel, RCTs). The results concluded that the efficacy of antidepressants is "modest" at best. In fact, Fluoxetine (also known as Prozac) was found to be one of the least effective options, despite it being one of the most commonly prescribed treatments in America. The study also found that the antidepressants with slightly higher efficacy had the highest dropout rates due to severe side-effects. Long story short. Are antidepressants effective? Yes. Are they highly effective? No.
These results are alarming because there are multiple alternative treatment options that offer the same level of efficacy without side-effects such as weight gain, insomnia, constipation, and erectile dysfunction. One such treatment is exercise. Americans often seem to underestimate the power of the mind-body connection which may explain the country's over-dependence on pharmaceuticals. One study published in the Journal of Psychiatric Research found that exercise is an evidence-based, effective treatment for depression. In addition, it has virtually no side-effects and a myriad of benefits that go beyond mental health including improved cardiovascular condition, muscle strength, energy levels, stress management, and sleep quality.
The results of all these studies don't suggest that antidepressants are completely useless - in fact, research has consistently shown that they can decrease depressive symptoms for many individuals. The monumental problem here is that they're incredibly overprescribed, especially in America, for no logical reason. Antidepressants should be the last resort, not the first one. Physicians and society as a whole are all susceptible to publication bias - positive studies funded by billion-dollar pharmaceutical companies are much more likely to be featured in the media, while negative studies are often forgotten. This publication bias has led to the efficacy of antidepressants to be highly overstated. Physicians need to prescribe treatment plans that include exercise and lifestyle changes before they prescribe pharmaceutical treatments. This alone will greatly reduce the number of individuals on antidepressants.
There's a reason why America has a worldwide reputation for being fat and lazy. The fat part is obvious, but the lazy part goes far beyond the Netflix and junk-food loving culture. We're always looking for the quick-fix that requires the least amount of effort. Sure, taking an antidepressant every morning to increase dopamine levels may result in a better mood, but so does going on a walk around the block. The latter just requires some motivation and grit to get through it.