[starkd]

There's no doubt there's a short term efficacy. The real issue is the waning efficacy over long term with risk of dependence.

[tartoran]

Short term to get you out of the dark hole or unstuck the rut, antidepressants are no panacea but are helpful especially combined with some other form of psychotherapy to figure out the underlying problem.

[starkd]

Right. Just don't stay on them for too long and make a plan to discontinue before becoming dependent. They are hard to get off of.

[tinyhouse]

Again, just anecdotal evidence, but I know people who have been taking it for more than 10 years with good results. One had to increase the dose over time but that's it. We don't know the long term impact of Lexapro and similar drugs to know how big issues the risk of dependence is. It's a tradeoff like everything in life. I agree it's better to find "safer" long term solutions if possible and stopping the meds gradually, but for many people it's not an option, so in the end it's their quality of life vs the long term risk of taking meds.

I feel many people who comment on meds like SSRI never really needed them so much so for them the long term safety is a big issue, but when these pills have a huge positive impact on your life then you are more willing to accept it.

[kingkawn]

As far as I know they were not developed or tested for anything beyond acute <6 month use

[tinyhouse]

Like most meds. The incentive of drug companies is to do enough testing to get an FDA approval (or equivalent in other places).

[runarberg]

Don’t discount the successes of a short term efficacy. Depression is a deadly disease. Sometimes a short term efficacy can be the different between life and death.

Usually depression is treated with a mix of drugs—such as SSRIs—and psychotherapy. I think health officials are completely aware of the long term effects, and that is why the treatment is most often multi-faceted.

[starkd]

No doubt they can be useful. Unfortunately, I don't have as much confidence as you in our health officials. It seems to resort to the lowest common denominator in recommending treatments. Psychotherapy is complex and it's hard to find a "good" counselor without multiple appointments to find one. It is highly personal treatment that is under the control of a highly unpersonal bureaucracy.

[zionic]

I worry about long-term users skipping a day and going deep down a blackhole. Some correlate mass shootings and heavy antidepressant use (then rapid cessation).

[ttpphd]

That is a moral panic whipped up by pro-gun crusaders who want to blame everything but the easy availability of guns for America's domestic terrorist problem

[bigbillheck]

> Some correlate mass shootings and heavy antidepressant use (then rapid cessation).

Seems like an attempt to deflect from much more likely issues.

[pjerem]

French people are notoriously heavily using antidepressants and still we have no mass shootings of any kind.

[nibbleshifter]

Legal access to firearms is pretty heavily limited in France compared to the US.

[starkd]

That's a very real risk. Do not suddenly stop these meds.