How long can you stay on antidepressants?

Clinical guidelines are vague, so we asked psychiatrists what to consider when deciding whether to continue taking these medications

- Christina Caron

When Marjorie Isaacson first started taking medication for depression in her late 20s, she considered it lifesaving.

At the time, she had been dealing with a rocky marriage and struggling to eat. The drug, she found, helped her gain equilibrium. "I was really grateful just to be able to function," she said.

But recently, Isaacson, 69, has been considering whether she wants to stay on antidepressants for the rest of her life.

Specifically, Isaacson wonders about the long-term effects of her medication, a serotonin-norepinephrine reuptake inhibitor that is known to raise blood pressure. And she feels unsettled by the emerging backlash against psychiatric drugs that has condemned their side effects and difficult withdrawal symptoms.

"As the years have passed, things have changed from 'Take it and see how it goes, no need now to be concerned' to 'Well, it's turning out things might be kinda complicated,'" she said. "That is worrisome."

Antidepressants are among the most prescribed and easily accessible drugs in the United States, and many people take them for years.

But even though modern-day antidepressants have been around for decades — the Food and Drug Administration approved Prozac for depression treatment in 1987 — there is very little information about long-term use. The FDA approved the drugs based on trials that lasted, at most, a few months, and randomized controlled trials of antidepressants have typically spanned only two years or less. Current clinical guidelines do not specify the optimal amount of time they should be taken for.