Do Antidepressanf and Antianxiety Drugs Increase Chronicity in Affective Disorders?

Prevention of Recurrent Depression With Cognitive Behavioral Therapy

“…9 Results of the latter study, 9 which had less stringent criteria for recurrent major depression, suggest the possibility that both short-term and maintenance treatment with cognitive therapy may yield better results than pharmacotherapy followed by psychotherapy. This possibility, which is intriguing also in light of sensitization hypotheses related to antidepressant use, [40][41][42] should be explored with future investigations. Cognitivebehavioraltreatmentwaseffectiveindecreasing residual symptoms of depression, replicating previous results.…”

The Road to Recovery from Depression – Don’t Drive Today with Yesterday’s Map

“…In the mid-90s, this journal opened a debate on the likelihood that antidepressant drugs might unfavorably affect the outcome of depression [22, 23]. A specific hypothesis was formulated, that long-term use of antidepressant drugs may increase, in some cases, biochemical vulnerability to depression and worsen the long-term outcome and symptomatic expression of illness, decreasing both the likelihood of subsequent response to pharmacological treatment and duration of symptom-free periods [22].…”

“…A specific hypothesis was formulated, that long-term use of antidepressant drugs may increase, in some cases, biochemical vulnerability to depression and worsen the long-term outcome and symptomatic expression of illness, decreasing both the likelihood of subsequent response to pharmacological treatment and duration of symptom-free periods [22]. In a subsequent formulation [24], a number of clinical findings (tolerance to the effects of antidepressants during long-term treatment, onset of resistance upon rechallenge with the same antidepressant drug, withdrawal syndromes, paradoxical effects of antidepressants in some patients, switching and cycle acceleration in bipolar disorder, very unfavorable long-term outcome of major depression treated by pharmacological means) were explained on the basis of the oppositional model of tolerance.…”

“…When this hypothesis was introduced in 1994 [22], a commentary appeared in Psychiatric News [25]. Donald Klein strongly disagreed on the interpretation of data that was offered, but agreed on the need to study the issue further.…”

Raising Questions about Antidepressants

“…The permanence of these changes and the potential long-term consequences are not clear. Fava [106, 107]and Baldessarini [108]have speculated that the receptor changes, similar to those found in tardive dyskinesia, may in some cases be irreversible, and may increase the biological vulnerability to depression in some patients following drug withdrawal, especially after long-term use. Baldessarini [108]has suggested that since some studies show a shorter time to relapse after drug discontinuation than would be expected from pretreatment history and the rate of drug removal predicts the time to the first recurrent episode, the combination of long-term drug treatment followed by withdrawal may be a causal factor in depression recurrence.…”