Australians’ dependence on antidepressants is soaring, rendering the country’s reputation as a home for the laid-back ‘no worries’ attitude a lie.
A study from the University of New South Wales found that more than three million (or 1 in 7) Australians use antidepressants every day, with more than 32 million prescriptions for the drugs now being issued each year.
On a per-capita basis, this usage puts Australia behind only Iceland – where seasonal affective disorder is common due to 19-hour winter nights – and the US ahead of dependency on the drugs, the ABC reported.
The study found that prescriptions have doubled over the past 10 years, while the onset of the Covid lockdowns caused an additional 15 percent increase in prescriptions.
Australians are world leaders when it comes to taking antidepressants and this is rising especially rapidly among young women (stock image)
The study found that Covid led to an increase in antidepressant use that was “greater among women than men, and greater among young women than other age groups.”
This suggested “an increased mental health burden in populations that were on a trajectory of increasing antidepressant use even before the pandemic.”
A major reason for the increased use of antidepressants is not only that more people use them, but that people become dependent on them for much longer than recommended.
Guidelines typically recommend taking antidepressants for up to 6-12 months after improvement, but this can take up to two years for people at risk of relapse.
The average length of time Australians have been on antidepressants has lengthened and now averages four years.
Australian clinical psychiatrist Dr Mark Horowitz has experienced firsthand the difficulty of coming off antidepressants
Long-term use of antidepressants can lead to weight gain, disrupted sleep, emotional sedation, constipation or diarrhea, sexual dysfunction, and low blood sodium.
There may also be a debilitating sense of dependence and addiction that undermines alternative ways of coping.
However, stopping antidepressants can be very challenging both physically and emotionally.
In 2021, a major study by the medical research organization Cochrane Australia looked at methods of stopping antidepressants.
London-based Australian clinical psychiatrist Dr. Mark Horowitz, one of the study’s authors, can attest personally to the difficulty of coming off antidepressants.
“I am one of hundreds of thousands of people who have gone through long, difficult, and harrowing battles after long-term antidepressants because of the severity of the withdrawal symptoms,” he said.
More than two million antidepressants are prescribed each year in Australia (stock image)
What makes stopping antidepressants particularly tricky is that common symptoms such as insomnia, depression, anxiety, and changes in appetite can be considered a relapse into the condition that prompted the original prescription.
“The difficulty in distinguishing between withdrawal symptoms and relapse presents a real challenge for patients, clinicians and researchers alike,” said Dr. Horowitz.
He said it can often lead to inappropriate continuation of antidepressants, which are usually prescribed by GPs in Australia.
Worryingly, a survey of antidepressant users found that between a third and half of them had no clear clinical judgment about why they were taking antidepressants or had a plan to stop taking them.
Emeritus professor of family medicine at the University of Queensland, Mieke van Driel, said there is a lack of proper research on the best ways to wean off antidepressants
Cochrane lead author Emeritus Professor of Family Medicine at the University of Queensland, Mieke van Driel, said in her GP practice that she had seen ‘firsthand how many patients struggle with coming off antidepressants’.
“While much is known about the increasing global acceptance of antidepressants, there is little high-quality evidence about safe and effective approaches to stopping treatment.”
Other common withdrawal symptoms include flu-like symptoms such as headache, chills, dizziness, body aches, nausea or sweating, gastrointestinal problems, and electric shock-like sensations or a rushing sound in the head.
Dr. Horowitz told the ABC he had been on antidepressants for 18 years after first taking them in his twenties, and found the experience of coming off them “terrifying and bewildering.”
“I was having panic attacks, I couldn’t sleep… symptoms I never experienced before I stopped taking these drugs,” he said.
Dr. Horowitz said there was such a lack of solid research and expertise on the subject that he was forced to turn to unofficial sources online.
“Instead, I found that the most useful information was found on peer support sites, where people who had withdrawn from antidepressants were forced to try and become lay experts themselves,” he said.
Going cold turkey from antidepressants is not recommended.
The guidelines from the Royal Australian and New Zealand College of Psychiatrists (RANZCP) recommend that antidepressants should be tapered off slowly, but admit that there is ‘insufficient evidence to recommend the best regimen for this’.
Dr. Horowitz said that because antidepressants have such a powerful effect on the brain, they have to be tapered off very gradually, over weeks or even years.
“We know that the slower you come off an antidepressant, the less excruciating the experience will be,” he says.
Dr. Horowitz says his personal struggle to get off the drugs was worth it.
“For me, while a difficult process, coming off antidepressants has been transformative — it has improved the fatigue, memory problems, and concentration problems that I long thought were due to other conditions,” he said.