Withdrawal from Antidepressants • Hacker News Board

Re: Withdrawal from Antidepressants

#71

Post by markroseman » Wed, Dec 21, 2016, 1:57 AM UTC

numinary1 wrote: post #65

It seems to me that many of the drugs in this category are effective sometimes for some people. People I have known who were suffering acutely often cycled through several drugs, sometimes in combination, dosages etc. It appears to me to be mostly trial and error. But for some people the results are miraculous. They solve real problems with few if any side effects. For others, they either don't work at all or have in…

While there is some work done on matching people up with specific drugs, this is still very much in the research phase.

Still, for many people, it's more trial and error than it needs to be. Many family doctors still don't match up symptoms with neurotransmitters, and then put people on the wrong class of drugs altogether (e.g. something like Wellbutrin which works on norepinephrine and dopamine instead of an SSRI for anxiety which is more associated with serotonin).

Part of the reason is that new drugs keep coming out so it's difficult to keep up, and eventually they all start to blur together.

The best practical predictor of success on a given medication today is if you have a close relative who's had success on that medication.

Re: Withdrawal from Antidepressants

#72

Post by markroseman » Wed, Dec 21, 2016, 2:01 AM UTC

dannylandau wrote: post #57

KermitCole wrote: post #47

As an editor on Mad in America, I appreciate the thoughtful and thorough discussion here. We would welcome any stories or analysis that the commenters here might venture to contribute to MIA. Thanks, Kermit Cole

Are there any comprehensive portals that provide information about the prevalence of each drug's side effect? The only one I know of is HealthBee? - https://healthbee.co/

I find drugs.com useful, which seems to be derived from product monographs. Knowing that "very common", "common", "uncommon", "rare" and "very rare" have specific meanings (e.g. common -> 1%-10%) helps.

Re: Withdrawal from Antidepressants

#73

Post by mrob » Wed, Dec 21, 2016, 2:02 AM UTC

drzaiusapelord wrote: post #17

aaron-lebo wrote: post #5

Not sure if this supports the article or is just a warning, but going off of anti-depressants can be fatal. If depression relapses anti-depressants that once worked can prove ineffective. (edit: wrongly said SSRIs and not anti-depressants) David Foster Wallace: Wallace died by suicide on September 12, 2008, at age 46. Wallace's father reported in an interview that his son had suffered from depression for more than 20…

Phenelzine is actually a MAOI, which is a different class of drug. My understanding is that Wallace had hard to treat depression and was on this more dangerous class of drug as SSRI's didn't work well on him. He also died with Clonazepam and Temazepam in his system. Wallace also received electric shock therapy, which suggests his depression was much more serious than most cases. I think his case is very much an edge…

What do you mean by "short lived"? Phenelzine is an irreversible MAOI, which means its effects persist even after it's cleared from the body. The only way to regain normal MAO function is to wait for the disabled enzymes to be replaced, which takes weeks.

Re: Withdrawal from Antidepressants

#74

Post by jat850 » Wed, Dec 21, 2016, 2:02 AM UTC

69mlgsniperdad wrote: post #21

I have been on paxil(paroxetine) three separate times. Each was between six months and one year in duration. The first time, I was on a 10mg daily dose. I had quite a few issues when starting the medication the first time; however after a few weeks, I felt great. When I initially discontinued, I had the worst side effects I have ever experienced. Electric shocks in my neck and back of head, depression, mood swings, a…

Your experience is remarkably similar to mine. They are more and more rare, but after nearly 6 years off the medication, I still experience the occasional brain shock. Compared to the early withdrawl period, it's more of an annoyance than anything - but when the shocks were coming constantly, it was an incredibly unsettling experience.

I hope you're well now.

Re: Withdrawal from Antidepressants

#75

Post by markroseman » Wed, Dec 21, 2016, 2:03 AM UTC

setq wrote: post #53

maxxxxx wrote: post #50

Earlier quoted context omitted.

My girlfriend has this with Zoloft. The doctors are telling her how to withdraw and if it doesn't work they just don't believe it. It seems they are trained to believe their textbooks to the point of ignoring things right in front of them.

I have some horror stories on this sort of drug and attitude which I don't wish to detail here with an identifiable account, but you are spot on. Many people have suffered in the hands of doctors with that attitude, some irreversibly harmed in the process. Arrogance, showboating, non-science and anti-pragmatism are the biggest killers.

Agreed. Doctors would never get away with the level of shoddy care or outright patient abuse they often do in any other field except psychiatry. There are some fantastic psychiatrists and GP's who do a fantastic job with psychiatry, but just as many if not more crappy ones. Very frustrating, and a disaster for patients.

Re: Withdrawal from Antidepressants

#76

Post by markroseman » Wed, Dec 21, 2016, 2:06 AM UTC

rudolf0 wrote: post #28

69mlgsniperdad wrote: post #21

I have been on paxil(paroxetine) three separate times. Each was between six months and one year in duration. The first time, I was on a 10mg daily dose. I had quite a few issues when starting the medication the first time; however after a few weeks, I felt great. When I initially discontinued, I had the worst side effects I have ever experienced. Electric shocks in my neck and back of head, depression, mood swings, a…

Doctors can be notoriously ignorant and contradictory when it comes to mental illness-treating drugs. There's a lot of literature out there and a lot of them don't keep up. I don't know why it is. Not that you shouldn't trust doctors, but I always do some Googling to get a second opinion about all psychoactive drugs I'm prescribed.

For GP's, it's because there's an increasing amount of information in every single field, so it stands to reason they'll be more on top of some than others. Where it gets bad is when they choose not to keep at least slightly up to date (well, literally UpToDate) on things like basic mental health that make up a huge portion of most GP practices.

Re: Withdrawal from Antidepressants

#77

Post by markroseman » Wed, Dec 21, 2016, 2:08 AM UTC

innocentoldguy wrote: post #40

69mlgsniperdad wrote: post #21

I have been on paxil(paroxetine) three separate times. Each was between six months and one year in duration. The first time, I was on a 10mg daily dose. I had quite a few issues when starting the medication the first time; however after a few weeks, I felt great. When I initially discontinued, I had the worst side effects I have ever experienced. Electric shocks in my neck and back of head, depression, mood swings, a…

I had a similar experience. I've only ever taken Paxil once, for maybe a month or so. Going into it, the only side-effect I experienced was an inability to climax during sex—-yeah, I know, too much information, but people need to know what they're getting into. When I stopped taking it, I experienced the same electric shock sensations you're talking about. My eyes twitched terribly, and I bounced back and forth betwe…

Improperly managing side effects (i.e. letting people know ahead of time about possibilities, using compensatory medications or switching altogether) is a big problem with many people who prescribe psychotropics. In competent hands, most people can generally find a medication or combination that works for them with tolerable side effects.

Re: Withdrawal from Antidepressants

#78

Post by throwaway713 » Wed, Dec 21, 2016, 2:09 AM UTC

I was on Nardil (phenelzine) for about 6 months. That's some weird stuff right there. I gained a whole bunch of weight, lost the ability to dream while sleeping, and couldn't eat any foods with tyramine in them (like Iberian ham or fava beans), but man, chocolate cake never tasted so heavenly as when on Nardil.

Prior to Nardil, I had been taking Prozac (fluoxetine) but a combination of sexual side effects, an impatient disposition, and scientific curiosity prompted me to ask my psychiatrist about Nardil. He said, "Why not?" This psychiatrist would prescribe just about anything (not that I see anything wrong with that) so over the course of grad school I tried Prozac, Nardil, Modafinil, and Adderall. Oddly enough, it turned out that an extremely low dosage of Adderall fixed most of my issues. My psychiatrist started with me 30 mg twice a day but I found that 10 mg worked better (less euphoria, more focus), so nowadays I only take 10 mg Adderall about twice a week and don't seem to have any depression or focus issues anymore.

Re: Withdrawal from Antidepressants

#79

Post by outworlder » Wed, Dec 21, 2016, 2:16 AM UTC

vomitcuddle wrote: post #12

As someone who had to abruptly come off venlafaxine due to side effects, I can tell you that it was complete hell. I experienced vomiting, the weirdest, most horrible nightmares every night, sleep paralysis with hallucinations and a recurring feeling of "electic shocks" inside my head. This lasted about a month. I think it borders on inhumane not to mention possible withdrawal symptoms before prescribing this awful "…

Oh well. Just today I was prescribed half my usual dosage of venlafaxine so that I can taper off and quit (will go back to a small dose of citalopram)

I'm not looking forward for the withdrawal symptoms – I know them too well. You will only forget to take it once.

Not looking forward to it.

Re: Withdrawal from Antidepressants

#80

Post by numinary1 » Wed, Dec 21, 2016, 2:23 AM UTC

markroseman wrote: post #71

numinary1 wrote: post #65

It seems to me that many of the drugs in this category are effective sometimes for some people. People I have known who were suffering acutely often cycled through several drugs, sometimes in combination, dosages etc. It appears to me to be mostly trial and error. But for some people the results are miraculous. They solve real problems with few if any side effects. For others, they either don't work at all or have in…

While there is some work done on matching people up with specific drugs, this is still very much in the research phase. Still, for many people, it's more trial and error than it needs to be. Many family doctors still don't match up symptoms with neurotransmitters, and then put people on the wrong class of drugs altogether (e.g. something like Wellbutrin which works on norepinephrine and dopamine instead of an SSRI fo…

That certainly makes sense since the problem has a higher likelihood of stemming from the same root cause, but also speaks to how little is known.

So include the social graphs of people who are on antidepressant discussion boards and pick up on friends, family, socioeconomic features ...

I so want to use ML tools on medical treatment data, but it's so hard to come by. Have toyed with a couple of startup ideas based on the tendency of people who share a condition to establish ties. Crohn's disease, cutaneous lymphoma. But the groups are too small. Mood disorders on the other hand...