John Ruhland, a resident of Winnipeg, started taking antidepressants in 2000 due to severe stress at work and in his personal life that led him to the hospital. The medication helped him cope with the situation, and he was able to stop taking it for a year until his symptoms returned. After about 15 years, when his condition improved again, he went off the medication with his doctor’s supervision. Unfortunately, his symptoms resurfaced, prompting him to seek treatment once more.
In 2023, approximately 6.6 million Canadians received antidepressant prescriptions, an increase from 5.8 million in 2019, according to IQVIA health research data. These medications, such as selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI), are commonly used to treat depression.
The Centre for Addiction and Mental Health (CAMH) advises consulting a physician if feelings of sadness, despair, or excessive worry persist for more than two weeks. However, the duration of antidepressant treatment and the role of therapy in discontinuation can be unclear.
For patients experiencing their first depressive episode, CAMH suggests monitoring the medication’s effectiveness within two to four weeks, with full remission typically seen in six to twelve weeks. If symptoms do not improve, physicians may recommend alternative medications or a combination of medication and therapy.
Medical supervision is crucial when tapering off antidepressants, especially for those responding well to treatment. Some guidelines propose tapering off medication after six to nine months of symptom improvement, ensuring depression does not return.
While antidepressants may have side effects like sexual dysfunction, weight gain, and emotional blunting, these effects are usually mild and temporary as patients adjust to the medication. If a patient struggles with side effects, a doctor may suggest changing or discontinuing the medication under supervision.
A meta-analysis published in The Lancet Psychiatry supports slowly tapering off antidepressants combined with psychological support, showing effectiveness comparable to continuous medication. Although antidepressants are not typically addictive, patients may experience withdrawal symptoms known as antidepressant discontinuation syndrome (ADS) when discontinuing the medication.
For individuals like John Ruhland, depression can be a lifelong condition requiring long-term treatment. As a mental health advocate, he emphasizes the importance of seeking help and not suffering alone, whether it’s the first episode of depression or a recurring struggle.