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Why Antidepressants Don’t Work for Treating Depression

Why Antidepressants Don’t Work for Treating Depression

HERE’S SOME DEPRESSING RECENT medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

The study I’m talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit — but almost none of the studies that show these drugs are ineffective. (1)

That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.

The problem is even worse than it sounds, because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.

That leaves us with a big problem — millions of depressed people with no effective treatments being offered by most conventional practitioners. However, there are treatments available. Functional medicine provides a unique and effective way to treat depression and other psychological problems. Today I will review seven steps you can take to work through your depression without drugs. But before we get to that, let’s take a closer look at depression.

What’s in a Name?

“Depression” is simply a label we give to people who have a depressed mood most of the time, have lost interest or pleasure in most activities, are fatigued, can’t sleep, have no interest in sex, feel hopeless and helpless, can’t think clearly, or can’t make decisions.

But that label tells us NOTHING about the cause of those symptoms. In fact, there are dozens of causes of depression — each one needing a different approach to treatment. Depression is not one-size-fits-all, but it is very common.

Women have a 10 to 25 percent risk and men a five to 12 percent risk of developing severe major depression in their lifetime. (2) One in ten Americans takes an antidepressant. The use of these drugs has tripled in the last decade, according to a report by the federal government. In 2006, spending on antidepressants soared by 130 percent.

But just because antidepressants are popular doesn’t mean they’re helpful. Unfortunately, as we now see from this report in The New England Journal of Medicine, they don’t work and have significant side effects. Most patients taking antidepressants either don’t respond or have only partial response. In fact, success is considered just a 50 percent improvement in half of depressive symptoms. And this minimal result is achieved in less than half the patients taking antidepressants.

Food allergies cause inflammation, and studies now show inflammation in the brains of depressed people.

That’s a pretty dismal record. It’s only made worse by the fact that 86 percent of people taking antidepressants have one or more side effects, including sexual dysfunction, fatigue, insomnia, loss of mental abilities, nausea, and weight gain.

No wonder half the people who try antidepressants quit after four months.

Now I want to talk to you about the reasons why doctors and patients have been deceived by the “antidepressant hoax.” Despite what we have been brainwashed to believe, depression is not a Prozac deficiency!

How We have Been Deceived by the Antidepressant Hoax

Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The team of researchers that reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt …

The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers, and hunt down hidden data under the Freedom of Information Act. What they found was stunning.

After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”

That means the results were twisted to imply the drugs worked when they didn’t.

This isn’t just a problem with antidepressants. It’s a problem with scientific research. Some drug companies even pay or threaten scientists to not publish negative results on their drugs. So much for “evidence-based” medicine! I recently had dinner with a step-uncle who runs a company that designs research for drug companies. He designs the study, hires the researcher from an esteemed institution, directs the study, writes up the study and the scientist just signs his or her name after reviewing it.

Most of the time, we only have the evidence that the drug companies want us to have. Both doctors and patients are deceived into putting billions of dollars into drug companies’ pockets, while leaving millions with the same health problems but less money.

The scientific trust is broken. What can we do? Unfortunately, there is no easy answer. But I do think functional medicine, on which my approach of UltraWellness is based, provides a more intelligent way of understanding the research. Rather than using drugs to suppress symptoms, Functional Medicine helps us find the true causes of problems, including depression.

I see this in so many of the patients I have treated over the years. Just as the same things that make us sick also make us fat, the same things that make us sick also make us depressed. Fix the causes of sickness — and the depression takes care of itself.

Taking antidepressants is not the answer to our looming mental health epidemic. The real cure lies in rebalancing the underlying systems in your body, at the root of all healthy and illness.

Consider a few cases from my practice …

A 23-year-old had been anxious and depressed most of her life and spent her childhood and adolescence on various cocktails of antidepressants. Turns out, she suffered from food allergies that made her depressed.

Food allergies cause inflammation, and studies now show inflammation in the brains of depressed people. In fact, researchers are studying powerful anti-inflammatory drugs used in autoimmune disease such as Enbrel for the treatment of depression.

After she eliminated her IgG or delayed food allergies, her depression went away, she got off her medication — and she lost 30 pounds as a side effect!

Here’s another story … A 37-year-old executive woman struggled for more than a decade with treatment-resistant depression (meaning that drugs didn’t work), fatigue, and a 40-pound weight gain. We found she had very high levels of mercury. Getting the mercury out of her body left her happy, thin, and full of energy.

Or consider the 49-year-old man with severe lifelong depression who had been on a cocktail of antidepressants and psychiatric medication for years but still lived under a dark cloud every day, without relief. We found he had severe deficiencies of vitamin B12, B6, and folate. After we gave him back those essential brain nutrients, he called me to thank me. Last year was the first year he could remember feeling happy and free of depression.

These are just a few of the dozens of things that can cause depression.

The roots of depression are found in the 7 keys to UltraWelless and the 7 fundamental underlying imbalances that trigger the body to malfunction. Taking antidepressants is not the answer to our looming mental health epidemic. The real cure lies in rebalancing the underlying systems in your body that are at the root of all healthy and illness.

Here are a few things you can do to start treating your depression today.

7 Steps to Treat Depression without Drugs

  1. Try an anti-inflammatory elimination diet that gets rid of common food allergens. As I mentioned above, food allergies and the resultant inflammation have been connected with depression and other mood disorders.
  2. Check for hypothyroidism. This unrecognized epidemic is a leading cause of depression. Make sure to have thorough thyroid exam if you are depressed.
  3. Take vitamin D. Deficiency in this essential vitamin can lead to depression. Supplement with at least 2,000 to 5,000 IU of vitamin D3 a day.
  4. Take omega-3 fats. Your brain is made of up this fat, and deficiency can lead to a host of problems. Supplement with 1,000 to 2,000 mg of purified fish oil a day.
  5. Take adequate B12 (1,000 micrograms, or mcg, a day), B6 (25 mg) and folic acid (800 mcg). These vitamins are critical for metabolizing homocysteine, which can play a factor in depression.
  6. Get checked for mercury. Heavy metal toxicity has been correlated with depression and other mood and neurological problems.
  7. Exercise vigorously five times a week for 30 minutes. This increases levels of BDNF, a natural antidepressant in your brain.

Overcoming depression is an important step toward lifelong vibrant health. These are just of few of the easiest and most effective things you can do to treat depression. But there are even more, which you can address by simply working through the 7 Keys to UltraWellness.

Now I’d like to hear from you…

Have you been diagnosed with depression?

How have antidepressants worked for you?

Do you plan to try any of the approaches mentioned here?

Please let me know your thoughts by leaving a comment below.


(1) Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260.

(2) Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y. 2007. Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981-2004. Acta Psychiatr Scand. 116(3):182-188.

Mark Hyman MD is the Medical Director at Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

Comments (10)

  • Hi Dr. Hyman,

    I was diagnosed with depression in 2009. I tried many different SSRI type antidepressants which did not relieve my depression. They made it worse. My depression consisted of loss of mental ability and motivation. When I took these antidepressants I felt terrible sadness. It was clear that these feelings came from the SSRI’s.

    I came upon your website approximately 7 months ago (October 2012) and immediately started taking all of the supplements you recommended and my depression is going away. I started noticing a difference withing a few weeks of taking the supplements.

    Because of depression my life suffered for nearly 4 years. I have a lot of work to do to get back to living a fulfilling life however if it weren’t for taking the supplements you recommended and reading your website I wouldn’t be able to.

    I also want to mention that I saw 6 physicians to try and help myself and not one of them ever recommended vitamin supplements. I can’t believe that my answer was as close as my local drugstore.

    Thanks Dr. Hyman.

  • I’ve been on antidepressants for years now and while they helped the initial problem if severe insomnia and multiple-daily panic attacks, they seem to have actually made my depression worse. What’s even more problematic is that withdrawal symptoms are horrendous for me. I’ve switched meds a few times over the years and every time the transition is extremely rough for me – flu-like symptoms, crazy mood swings, etc. I’m currently on a generic form of Effexor and if I miss a single dose I have terrible headaches all day and into the next.

    How does someone like me ween off of antidepressants altogether? The daily panic attacks were so horrible, I didn’t want to risk them returning, but I’m finally fed up with the roller coaster of antidepressant medications and I think they are preventing some of the supplements from working. I’ve been taking Vitamin D and Fish Oil for a couple of years now, and they seemed to have helped some, but I still have extreme fatigue, depressed mood, despair, suicidal thoughts etc.

    I’m currently on the lowest dose (I think) available of the time released effexor so I’m not sure how to wean off without heavy withdrawal symptoms.

  • This is a long one: I started a search recently to find a way to taper off COMPLETELY Wellbutrin XL 300 mg a day. What has prompted me to do this is several reasons – My HMO used to have Wellbutrin on its formulary drug list, and then it was gone. I had to do battle with doctor and the HMO pharmacy to prove I couldn’t take the generic Bupropion. Eventually the HMO granted me a special authorization to take Wellbutrin which I must contact the HMO every year to re-authorize. Since it is a non-formulary, I pay a higher co-pay, so I then went through the Wellbutrin manufacturer’s patient assistance program for a “savings card” that dropped the co-pay down to only $4. The catch..the savings card is a one-time, 24 month refills of Wellbutrin and now I’m SOL and back to paying a high co-pay for a supposedly necessary medication for depression. I agree I have depression, but it seems to be manageable around this game of getting the wellbutrin at a reasonable co-pay.

    I then contacted my HMO about mental health services and made several calls to nearby psychiatrists in the area. NO ONE has called me back to make an appointment. I have read that many psychiatrists are ill-equipped to work with a patient to get OFF a medication, but they are quick with a pen to prescribe something IN ADDITION to the anti-depressant a patient is taking (been there, and done that until I threw up my hands, and kept quiet two years ago).

    I googled online for information about tapering off wellbutrin, and found a few fairly honest accounts of individuals who took it on themselves to taper off an antidepressant, not necessarily wellbutrin. and those few accounts were from individuals who had taken antidepressants for only 2 or 4 years…

    I’ve been on wellbutrin for 20 PLUS years!! Starting back in the early 1990s with regular wellbutrin and then switching over to the XL after it became available. I even tried the highest level of wellbutrin…450 mgs, and suffered headaches that felt like I was having a stroke and slacked back off to 300 mg.

    Now, I have been following you Dr. Hyman RE: diabesity for several years. I’ve looked for the foods in my diet that may have caused me some allergic reactions, not so much for the diabetes I’ve been diagnosed with since 2005 , but for the FMS and CFS/ME I was diagnosed with in 2002. I see an endocrinologist now every 3 months, mostly for a follow up and minor insulin adjustments.

    I’ve been taking Vitamin D and FINALLY have a normal Vitamin D level. I take omega-3 fats, vitamin B12, but canot tolerate B6 or folic acid.

    I WAS seeing a nutritionist for about 6 months and took a supplement called “MD”Mega Defense manufactured by Waiora. As it was explained to me, it would help detox my body of heavy metal toxicity as well as be a good natural antibiotic against the flu, and other viruses . I should also mention that I do not have any issues with mercury including a discussion with my dentist about fillings…and I do not have any mercury fillings.

    While seeing the nutritionist I was also referred to another nutritionist who recommended enzymes because it appeared my digestive tract was slow and possibly many of the supplements and vitamins and other nutrients from what I was eating was not breaking down quickly enough to have any benefit.

    All my doctors and nutritionists say I need more exercise. It’s my ONE basic speed bump in getting anywhere with my depression , obesity, diabetes, acid reflux, FMS, CFS or ME. Okay, so I tried taking a diabetes exercise class in my community. After having been very athletic up into my 30s , the class was so simple, but within two weeks of starting, I had to quit. I started experiencing extreme pain in my chest, and it was the atypical symptoms of acid reflux that I’ve been dealing with for about 15 years now. I think I pulled a muscle. The class was in MAY, and its August now and I’m still having pain in my chest.

    No, it isn’t a heart attack and it isn’t acid reflux…been to the ER several times in the last couple of years, and I go through the motions with xrays, blood tests, and given a GI cocktail and sent home.

    I watch Dr. Oz. I started taking DGL for my heartburn and acid reflux about 9 months ago, and I haven’t had to take any acid reflux meds since then…That leaves two prescriptions…insulin and wellbutrin.

    Prehaps you know of a doctor in my area that would be willing to work closely with me on tapering off wellbutrin? Could it be so simple as to quit taking something that I may not have needed for so many years?

    • Patti, perhaps you’ve already tapered off of Wellbutrin, but I wanted to respond anyway in the hopes of helping others.

      The testimonials you typically see online about the difficulties of quitting antidepressants almost always refer to patients on SSRIs, or Selective Serotonin Re-uptake Inhibitors. Serotonergic drugs have a distinct discontinuation syndrome, which some describe as ‘brain zaps’ and others describe as similar to withdrawal from opiates or other street drugs. Effexor, as discussed by Kate, below, is notorious for causing many problems upon discontinuation, and the patients who tend to succeed at getting off of it follow strict tapering programs, much like an opiate addict tapers from a gradually decreasing methadone dose.

      Buproprion/Wellbutrin (sometimes prescribed as Zyban for those looking to quit smoking) is different. It is a weak norepinephrine and dopamine re-uptake inhibitor, with a much milder and lesser side effect profile than SSRIs like Effexor. In most cases, patients can skip a dose or three, or even a full week, without much effect and with few to no discontinuation side effects. I observed this myself, having been on the drug for two years, and my psychiatrist says this is the case as well. He primarily treats addicts (including nicotine addicts, for whom this drug, in its Zyban incarnation, was tailor-made) and people with PTSD. He prefers prescribing Wellbutrin to these patients because it is both non-addictive and effective at re-setting the damaged “reward circuit” in their brains. The patients he sees would not tolerate an antidepressant with a discontinuation syndrome, as they are already deathly afraid of withdrawal in any form. In this patient population, Wellbutrin (or Zyban, or generic Buproprion, depending on one’s healthcare plan — they are identical) is a great choice.

      It does not matter how long you have been on the Wellbutrin — your tolerance will not skyrocket over time. Wellbutrin is not Effexor, nor is it methadone or Suboxone. The amount you need in Year 1 of treatment is usually the amount you’ll be taking 5 years in. And you can skip doses or quit at any time, with few to no side effects, other than perhaps the risk of your depression returning.

      As always, I recommend that people looking to discontinue Buproprion/Wellbutrin/Zyban (again, they’re the same drug) do so with the guidance of a psychiatrist or GP specializing in treating depression. But if this is not possible, discontinuing Wellbutrin can generally be done safely at home, with minimal or no disruption to one’s health or daily routine. Of course, I would be remiss if I didn’t urge you to research the side effects of quitting this medication, while checking to ensure you do not have another health issue that would be worsened by an abrupt (or gradual) cessation of this medication.

      Best of luck to anyone quitting Wellbutrin in all of its forms, and best of health and peace of mind to you all!

  • Dr. Hyman……October 16, 2014

    I have been on anti-depressants for many years. 300mg of Venlafaxine daily is the one today.
    I am 72 yrs old and have recently been diagnosed with Celiac disease and I am going into surgery
    Oct. 20 for an Endoscopy and colonoscopy. I have tried many times to not take the Effexor, however,
    the brain zaps, and rediculously high blood pressure, and anxiety drive me to resume again.
    I have a new young (male) Dr. and I would like to ask to be hospitalized to withdraw from this
    pharmaceutical. I have had a wt. problem, my sugars are 6.0 in the morning, which I try to control with
    diet. Do you think asking to be hospitalized to deal with this problem is unreasonable.
    To do this on my own is a living nightmare, causing heart problems as well. I often wonder what these
    drugs do to my liver. Thank you for listening.

    • Hello Kate,
      We encourage you to work with your doctor to ask for what you need to support your health.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Hi Dr Hyman,

    After having our third child I was prescribed antidepressants for anxiety. I tried for a year and a half to treat myself “naturally” before finally using the prescription and mentally I have been much better.

    So now I am on day 4 of the 10 day detox. I
    I am starting to feel better and coming out of the brain fog, however I have not lost any weight (I am following plan to a t) (my husband has lost 14 pounds! ).

    My question is this: do you know how being on antidepressants may affect your results? Shouldn’t I, in theory, still be able to lose weight even if I’m taking an antidepressant? Do you have any research/information in this regard?


    • Hello Angela,
      Congratulations for reaching Day 4 of the 10-Day Detox Diet program! Sometimes it takes more than the 10 days to transform your health and see the results on the scale. Be sure to also measure your waist, hips, and thighs to see changes in measurements in addition to your weight. Being consistent with the program is what gets results, and everyone responds at their own pace.

      Did you know you can work with Dr. Hyman’s nutritionists virtually? For personalized nutrition coaching where you can receive 1:1 support with Registered Dietitians, please see:
      Wishing you the best of health,
      Dr. Hyman Staff

  • I’ve been on these medications (SSRI) and SSNI’s for 3 years. Despite my doctor swapping different brands in some sort of vague hope that they will miraculously ‘work’.

    They do NOT work and I seem to be getting more side effects (constipation, copius mucus from mouth and anus) with each change of brand. They’ve also affected my libido.

    I’ve decided that I will taper the latest drug off when it finishes and will come what may.

    To put it simply, they do not work and are making me worse.