Taken by 7 Million French People: This Medication May Increase Cognitive Decline After Age 65

A new scientific analysis published on June 6 has renewed debate over the long-term use of antidepressants, a treatment taken daily by millions of people in France, often for years. The study, conducted by Australian researchers and published in the Australian Journal of General Practice, questions whether the long-term effectiveness of these drugs has been overstated. The key issue, according to the authors, is that many “relapse prevention” trials may have confused true return of depression with withdrawal symptoms caused by stopping the medication too quickly.

In the studies reviewed, treatment was often stopped abruptly, on average within four days. Any immediate worsening of mood after discontinuation was then counted as a relapse. The researchers argue that this design does not clearly separate a recurrence of the illness from the effects of withdrawal. As a result, some of the apparent benefit seen over time may actually reflect the fact that continuing treatment prevents patients from experiencing withdrawal symptoms rather than preventing a genuine relapse of depression.

The analysis also highlights potential harms associated with longer-term use, especially beyond one year. Reported risks include cognitive problems that may affect memory, emotional blunting described as a narrowing of the emotional range, weight gain, insomnia, and sexual dysfunction. The authors say sexual side effects may affect 50% to 80% of users. For people over 65, they also note increased risks of stroke, falls, cataracts, and heart disease.

The article identifies antidepressants as the drug family under discussion. In France, nearly 7 million people use antidepressants each year, including widely known brands such as Prozac and Seroplex. These medications are commonly prescribed on the basis of the serotonin theory of depression, which suggests that boosting serotonin levels between neurons helps treat the disorder. However, the authors note that no biological mechanism of depression has been definitively established, and the idea of a simple “chemical imbalance” remains debated.

Because these medicines alter the nervous system over time, they can lead to physical dependence. If stopped too quickly, the brain may react with anxiety and other withdrawal symptoms. The difficulty, the authors say, is that these symptoms can resemble depression itself and may be mistaken for a relapse on standard depression rating scales. This can create the impression that the drug is still needed to prevent the illness from returning, when in fact it may be preventing withdrawal.

The researchers stress that antidepressants should never be stopped abruptly without medical supervision, as sudden discontinuation can be harmful. They recommend regular reassessment of treatment, generally every six months, and gradual dose reduction over several months when stopping is appropriate. For treatment-resistant depression, other options, including newer medications, may be considered. For mild to moderate depression, non-drug approaches such as psychotherapy and lifestyle changes may also be effective. The central message is that treatment decisions should always be made with a doctor, and patients should discuss any concerns before making changes to their medication.