Experts are raising concerns that prolonged use of antidepressants, taken by millions of Americans, may be associated with significant health risks, including heart problems, weight gain, weakened bones, and even cognitive decline. While these medications are widely prescribed for depression, anxiety, and other conditions, research into their long-term effects remains limited, leading some specialists to question whether the benefits of extended use are being overstated.
More than 34 million American adults, approximately one in eight, use antidepressants, making them one of the most common drug classes prescribed in the United States. Although antidepressants can be life-changing for many, helping to manage symptoms by increasing serotonin levels, a growing body of evidence suggests potential adverse effects when taken for years. Studies indicate that roughly half of individuals on these medications have been taking them for over two years, with millions continuing treatment for five years or more.
Professor Joanna Moncrieff, a psychiatrist at University College London, participated in a review of research on long-term antidepressant use. The review, which focused on individuals taking antidepressants for over a year, found links to type 2 diabetes, weight gain, and an increased risk of falls and fractures in older adults. "We certainly can't say that long-term antidepressants are safe or harmless," Professor Moncrieff stated. "We have not done enough research to know that. The main finding of our review is that the evidence for the effects of long-term antidepressant treatment is very poor."
Other experts echo these concerns. Dr. Sameer Jauhar, a psychiatrist at Imperial College London, noted that different antidepressants have distinct long-term effects, particularly on the cardiovascular system, which should inform prescribing decisions.
Potential Cardiovascular Risks
One of the most concerning potential side effects is the impact on heart health. Certain antidepressants, particularly older types like serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants, can increase levels of norepinephrine, a hormone linked to increased heart rate, higher blood pressure, and narrowed blood vessels. Some antidepressants may also prolong the QT interval, a measurement on an electrocardiogram. A prolonged QT interval can increase the risk of dangerous heart rhythm disturbances, potentially leading to palpitations, dizziness, and in rare cases, sudden cardiac death.
A study presented at the European Society of Cardiology Congress in 2025 found that taking antidepressants for one to five years was associated with a 56 percent increased risk of sudden cardiac death, with the risk escalating with longer duration of use.
Other Emerging Concerns
Beyond cardiovascular effects, research suggests a higher risk of fractures, especially in adults over 50. Studies indicate that individuals taking SSRIs or tricyclic antidepressants may be up to twice as likely to suffer broken bones, with the risk increasing over time. The exact reasons are not fully understood but may be related to lifestyle factors associated with depression itself, such as smoking and reduced physical activity.
The link between antidepressants and type 2 diabetes is also being investigated. While weight gain associated with some antidepressants may play a role, researchers also suspect these drugs could interfere with the body's blood sugar regulation.
Evidence linking antidepressants to dementia is less certain, as depression is a significant risk factor for cognitive decline. However, some older antidepressants may affect memory, and one 2025 Swedish study suggested that individuals with existing dementia experienced more rapid decline when taking high doses of SSRIs.
The Challenge of Long-Term Treatment
Current clinical guidelines typically suggest patients consider discontinuing antidepressants after achieving significant improvement for at least six months. For recurrent depression, treatment may extend to two years or more. However, the complexity of separating drug side effects from the symptoms of depression itself makes definitive causal links difficult to establish. Depression itself is associated with an increased risk of heart disease, stroke, diabetes, and dementia due to factors like fatigue, lack of motivation, and potential inflammation.
Professor Glyn Lewis, Professor of Epidemiological Psychiatry at University College London, acknowledges that many studies are observational, identifying associations rather than proving causation. "It's clearly something we have to take seriously," he said.
Furthermore, long-term use can lead to more severe withdrawal symptoms, including "brain zaps," mood changes, and flu-like symptoms. Experts emphasize that patients should never stop taking antidepressants abruptly and should consult a healthcare professional for guidance on safely tapering off the medication.
While the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK states that each antidepressant has unique benefits and risks clearly outlined in prescribing information, Professor Moncrieff suggests that patients should actively question whether long-term antidepressant use remains the best course of action, especially if the drugs are not significantly more effective than placebo treatments.