Is it bad to be on antidepressants for a long time? Understanding the risks and benefits

October 13, 2025 •

3 min read

According to the CDC, more than 60% of patients aged 12 and up taking antidepressants have been on them for two years or longer. This growing trend prompts the question, is it bad to be on antidepressants for a long time? The answer is complex, involving a careful balance of therapeutic benefits and potential long-term risks that should be navigated with a healthcare provider.

Quick Summary

Long-term antidepressant use involves balancing therapeutic benefits against potential side effects, which range from manageable issues like weight gain and sexual dysfunction to serious health risks like cardiac problems. Some users may also experience a loss of effectiveness over time or withdrawal symptoms when stopping, underscoring the need for careful medical supervision.

Key Points

Balancing Act: The decision to be on antidepressants long-term requires weighing the benefits of mood stabilization and relapse prevention against potential side effects and health risks.
Common Side Effects: Long-term use is associated with persistent side effects like sexual dysfunction, weight gain, and emotional blunting, which can impact quality of life.
Potential Systemic Risks: Newer research indicates a possible link between long-term antidepressant use and increased risk of heart disease and metabolic issues like diabetes, though confounding factors exist.
Risk of Tachyphylaxis: The body can build a tolerance to antidepressants over time, leading to a loss of effectiveness, sometimes referred to as 'antidepressant poop-out'.
Discontinuation Syndrome: Abruptly stopping medication can cause withdrawal-like symptoms, making a medically supervised, gradual taper necessary.
Holistic Approach: Medication is often most effective when combined with other therapies, such as counseling, and healthy lifestyle habits like exercise.
Personalized Care: There is no universal rule for how long someone should stay on antidepressants; the decision should be made collaboratively with a healthcare provider based on individual needs and health status.

The Balancing Act: Weighing the Long-Term Benefits and Risks

Antidepressants significantly improve life for many by regulating neurotransmitters and restoring emotional stability. Long-term use helps prevent relapse, manages chronic conditions, and enhances quality of life. However, the increasing number of long-term prescriptions necessitates examining potential adverse effects. Deciding on long-term use requires a personalized evaluation of benefits versus drawbacks with a healthcare provider.

Common and Chronic Side Effects

Some side effects can persist or worsen with long-term antidepressant use, impacting quality of life. These include:

Sexual Dysfunction: Very common, especially with SSRIs, affecting libido and ability to achieve orgasm. This can be long-lasting.
Weight Gain: Many gain weight over time, potentially leading to other health issues like diabetes. A 2015 study noted average annual weight gain exceeding 3% of body weight for those on antidepressants.
Emotional Numbing: Some report a feeling of reduced emotional intensity, affecting both positive and negative feelings.
Fatigue and Insomnia: Long-term use can disrupt sleep, causing either excessive sleepiness or difficulty sleeping.
Gastrointestinal Issues: Chronic nausea, constipation, or diarrhea can occur, varying by medication type.

Potential Long-Term Systemic Risks

Research suggests potential associations between long-term antidepressant use and more serious health risks. It's important to consider that underlying depression can also contribute to these health issues, making it difficult to isolate the medication's effects.

Cardiovascular Risks: A 2022 study linked long-term use (over 10 years) to an increased risk of heart disease and related mortality, particularly with non-SSRI antidepressants.
Metabolic Changes: Long-term use, especially of SSRIs and tricyclics, may increase the risk of type 2 diabetes.
Cognitive and Dementia Risks: Studies have yielded conflicting results regarding a link between long-term antidepressant use and dementia risk, particularly in older adults. Interpreting these findings is challenging due to the confounding effects of depression itself.

Antidepressant 'Poop-Out' and Tolerance

Some individuals may experience a decrease or loss of antidepressant effectiveness over time, known as tachyphylaxis or 'antidepressant poop-out'. Possible reasons include neuroadaptation or worsening of the underlying condition. Treatment adjustments, such as dosage changes, switching medications, or adding therapy, may be recommended.

Navigating Discontinuation Syndrome

Stopping antidepressants abruptly can cause discontinuation syndrome, a withdrawal-like reaction resulting from the brain adjusting to the medication's absence. Symptoms can include dizziness, flu-like symptoms, anxiety, and mood swings. To minimize these effects, healthcare providers advise a gradual tapering process over weeks or months. Switching to a longer-acting antidepressant may help ease discontinuation for those on short-half-life medications.

Antidepressant Classes: A Comparison of Long-Term Side Effects


Feature	SSRIs (e.g., Citalopram, Sertraline)	SNRIs (e.g., Venlafaxine, Duloxetine)	TCAs (e.g., Amitriptyline, Nortriptyline)
Mechanism	Primarily increase serotonin levels	Increase serotonin and norepinephrine	Affect multiple neurotransmitters
Sexual Dysfunction	Common; reduced libido and delayed orgasm	Common; reduced libido and delayed orgasm	Frequent; erectile and ejaculatory problems
Weight Gain	Common risk	Possible risk	Significant risk
Cardiovascular Risk	Some increased risk for coronary heart disease	Higher increased risk compared to SSRIs	Greater risk of arrhythmias and hypotension
Dry Mouth	Less common	Possible	Very common and persistent
Tachyphylaxis	More commonly reported	Possible	Less commonly reported
Discontinuation	Symptoms are common, especially with shorter half-life drugs	Symptoms are common and can be severe	Symptoms can include anxiety and flu-like effects

Strategies for Managing Long-Term Antidepressant Therapy

Effective long-term antidepressant management involves collaboration with your healthcare team. Key strategies include:

Ongoing Monitoring: Regular appointments with your doctor are vital to track side effects, assess effectiveness, and address new health concerns. This includes monitoring metabolic and cardiovascular health.
Lifestyle Adjustments: Incorporating exercise and other healthy habits can complement medication and may help if drug effectiveness decreases.
Psychotherapy: Combining medication with therapy like CBT often provides the most effective and lasting results, offering coping strategies and addressing underlying issues.
Shared Decision-Making: Openly discuss the benefits and risks of continued medication with your doctor to make an informed decision tailored to your situation.
Safe Discontinuation: If discontinuing medication, do so under medical guidance using a gradual taper to minimize discontinuation syndrome. Guidance is available from sources like Harvard Health Publishing: Going Off Antidepressants.

Conclusion: An Informed Decision

Is it bad to be on antidepressants for a long time? The answer is nuanced. For individuals with chronic or recurrent depression, the benefits of long-term use, such as stable mood and relapse prevention, may outweigh potential risks. However, recent research on metabolic and cardiovascular effects emphasizes the need for careful long-term management. The best approach involves consistent communication with your doctor, a comprehensive treatment plan including therapy and lifestyle changes, and a personalized decision focused on overall well-being.

Frequently Asked Questions

Yes, in some cases, a person with chronic or severe depression may need to take antidepressants indefinitely. This is often done to manage symptoms and prevent relapse, especially for those with a history of recurrent episodes.

Long-term use can lead to side effects such as weight gain, sexual dysfunction, fatigue, dry mouth, and an increased risk of heart problems and diabetes, though the severity varies depending on the individual and the specific medication.

Yes, for some individuals, antidepressants can become less effective over time due to a phenomenon called tachyphylaxis, or 'antidepressant poop-out.' This may necessitate a dose adjustment or a change in medication.

Antidepressant discontinuation syndrome is a collection of withdrawal-like symptoms that can occur when someone stops taking their medication too quickly. Symptoms can include dizziness, flu-like symptoms, and mood disturbances.

It is crucial to work with a doctor to create a gradual tapering schedule. Slowly reducing the dosage over several weeks or months minimizes the risk and severity of withdrawal symptoms.

While therapy can be highly effective, many studies suggest that a combination of medication and psychotherapy provides the most effective and durable results, especially for severe depression. The best approach is often a holistic one tailored to the individual.

Research on the link between long-term antidepressant use and cognitive function or dementia is mixed and inconclusive, with some studies suggesting a possible link while others find none. It is challenging to separate the medication's effect from that of depression itself.