A recent study published in Psychotherapy and Psychosomatics,has concluded that antidepressant use increases risk for all-cause mortality.1 It is generally known that most antidepressants work by affecting serotonin in the brain – inhibiting reabsorption by neurons so its activity lasts longer. However, the exact mechanisms of these drugs – serotonin reuptake inhibitors (SSRI), tricyclics (TCA) and other types – are not specifically known. The effects that these drugs have on serotonin in other organs systems is even less clear.
All Major Organ Systems Use Serotonin
All major organ systems, from the gastrointestinal tract, liver, kidneys and heart, all use serotonin from the blood stream. The action that antidepressants have on blocking serotonin absorption in these organs could be part of the underlying cause of multiple organ systems not functioning properly, and ultimately an increase in the premature death seen associated with antidepressant use in the study.
The study was a meta-analysis that looked at 17 different large studies; hundreds of thousands of people were included in the datasets. The findings showed that antidepressant users had a 33 percent higher chance of death than non-users, and a 14 percent increase risk of having a cardiovascular event. The data was insignificantly different between SSRIs and TCAs.
The conclusions by the researchers were that it may not be safe to be taking antidepressants while we still don’t fully understand how they are working in the body. Roughly 1 in 8 Americans are currently taking a prescription antidepressant medication. These medications are often being prescribed by family physicians without a formal diagnosis of depression, because they are thought to be safe. This research undermines these assumptions and asks physicians to reevaluate the absolute need for the prescriptions they are writing.
- Maslej MM, Bolker BM, Russell MJ, et al. The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. Psychother Psychosom. 2017;86(5):268-282.
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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.