At least, not most of the time.
Reuptake inhibitors represent a $20+ billion dollar industry. The first reuptake inhibitors were known as ‘nonspecific reuptake inhibitors’ or ‘tricyclic antidepressants’ and were introduced in 1958. The first selective serotonin reuptake inhibitor (SSRI) was introduced in the US in 1989. In order to receive approval, a drug must demonstrate that it is safe and effective. One would assume that this means the drug demonstrates significantly better results than the placebo. However, the data for reuptake inhibitors in the treatment of depression shows a completely different story.
There is a great summary of 20 double blind, placebo controlled studies on www.neuroassist.com. In summary, these studies indicate that only 7% of people showed relief of symptoms greater than placebo (sugar pills); the placebo effect in these studies alone is 30-40%. The moral of the story is that less than 1 in 10 people are helped by reuptake inhibitors – a staggering fact in light of how often they are prescribed.
However, the problems don’t stop there. Reuptake inhibitors actually make neurotransmitter imbalance worse in everyone that takes them. That is the reason why some people have immediate significant side effects, while others develop side effects over time. It is also why often the drugs seem to quit working over time (prompting a stronger prescription or other drug recommendations) and why almost everyone that tries to come off these drugs after a period of time feels worse than they did before going on them.
The National Institute of Drug Abuse web site contains a discussion on how reuptake inhibitors deplete neurotransmitters. In essence, what happens is that by blocking the reuptake of neurotransmitters (i.e., serotonin, dopamine or norepinephrine), these drugs cause more neurotransmitters to be exposed to conditions that increase their metabolism and destruction. The long-term effect is neurotransmitter depletion. This means that these drugs are actually making the cause of the problem worse.
However, when people that have been taking these drugs try to stop, the full effects of depleted neurotransmitters are observed (which have been made significantly worse by the drug), and the person feels worse. The drug has effectively created a condition where people do not want to stop the drug because of the way they feel due to neurotransmitter depletion caused by the drugs.
Neurotransmitters do not cross the blood brain barrier. The only way to increase neurotransmitter levels in the brain is by administering the nutrients the brain needs in the right proportions to allow the brain to make the necessary neurotransmitters. The amino acid nutrients needed for synthesis of serotonin and the catecholamines (dopamine, norepinephrine and epinephrine) need to be provided in proper balance to be effective. In some people, this means laboratory testing may be needed to determine the correct balance. This is true whether a person wishes to remain on reuptake inhibitors or not (if someone chooses to remain on reuptake inhibitors long term, a foundation of the appropriate amino acids and cofactors can be taken to stop further neurotransmitter depletion due to the medications).
At this point, a larger question often comes to mind – something along the lines of ‘how can a drug that only works 7% of the time be prescribed so often?’ I believe the answer is that people demand it – they know they don’t like how they feel and they want to feel better. The medical doctors they go to see have few tools in this regard that provide lasting relief, but they do have tools. So they use the tools they have at hand (reuptake inhibitors and other drugs).
However, there is a better, more effective, and safer long term solution. Amino acid therapy can help rebalance the underlying imbalances responsible for these conditions in most cases, without the side effects and long term depletion of reuptake inhibitors.
