Many People Taking Antidepressants Discover They Cannot Quit • Hacker News Board

Re: Many People Taking Antidepressants Discover They Cannot Quit

#61

Post by jdietrich » Sat, Apr 07, 2018, 9:23 PM UTC

themgt wrote: post #27

vanderZwan wrote: post #9

Earlier quoted context omitted.

> Modern medicine is not in the business of curing diseases. I know enough people in the field of modern medicine to know that that is hyperbole. At least in the European countries that I have lived in. EDIT: I am sorry to hear from the responses to this that this may not be quite so hyperbolic in the US. I hope that trend will be reversed somehow.

Before you downvote op for an admittedly over-broad opinion you truly need to experience the USA model of overprescription, drug ads on billboards and all over TV shows targeted by demographic, all sorts of IP shenanigans to extend IP/re-patent/pointlessly reformulate/roadblock generics/cherry-pick studies for new drugs that have no real benefit but a higher price. European medicine is indeed worlds different, and th…

The US isn't synonymous with "modern medicine". It's a weird outlier in just about every respect. Vast amounts of clinical research and practice is happening outside of that bubble.

While it's true that the US has a serious problem with overprescribing, it's also true that many other countries are seriously underprescribing psychiatric medication, due to a combination of cost and stigma. Mental illness represents an immense global disease burden, with depression being the single greatest problem. The disease burden of depression is higher in many lower- and middle-income countries than in the US, mainly due to a lack of treatment.

Although there has been a great deal of controversy over antidepressant drugs, we are now highly confident that they are significantly more effective than placebo. Generic antidepressants are dirt cheap, with most costing less than $2 per month at international wholesale prices. We shouldn't lose sight of these facts.

http://www.thelancet.com/journals/lancet/article/PIIS0140-67... http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

Re: Many People Taking Antidepressants Discover They Cannot Quit

#62

Post by jaggederest » Sat, Apr 07, 2018, 9:24 PM UTC

thearn4 wrote: post #19

dbt00 wrote: post #17

I was up to 10mg/daily of Lexapro for two years. When my doctor and I agreed it was time to stop taking it, his advice was to go down to 5mg for a week, then stop. When I tried stopping after the 5mg dose I had constant vertigo symptoms and incredible difficulty sleeping. What I ended up doing was cutting the pills in half for a few weeks, then quarters, then removing one day a week from the schedule until I was down…

I had the same issues coming off of Lexapro. Weird brain shocks. Bupropion (Wellbutrin) has been better for me all around, but I worry about what it will be like coming down off of it too. The good news is that I'm overall in a good place and feel like I probably don't need it anymore.

For what it's worth, from my anecdotal experience, Bupropion is much, much milder in terms of withdrawal, and the symptoms are more in the realm of energy than paresthesia - groggy and listless, but not vertiginous and electrified.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#63

Post by fogzen » Sat, Apr 07, 2018, 9:26 PM UTC

pcwalton wrote: post #29

benevol wrote: post #20

I hope that this doesn't come over as sarcastic, but the pharmaceutical industry is a business , and they will always operate like one: A business is about making the most money possible: Maximizing revenue is about minimizing the main costs which are generated by the activities of: (a) acquiring the customer (through: advertising and marketing) and, (b) retaining the customer (in this case: through dependency). Ther…

You are suggesting that depressed people may want to take LSD in lieu of SSRIs, which is horrendous advice that can, for example, trigger panic attacks in those with comorbid anxiety. Please don't.

What study shows LSD is more dangerous than SSRI’s? Antidepressants can also cause psychotic episodes, panic attacks, suicide, etc.

Both drugs have mechanisms of action that we don’t fully understand and both affect the brains homeostasis.

If it’s irresponsible to prescribe LSD for depression it’s irresponsible to prescribe SSRI’s as well

Re: Many People Taking Antidepressants Discover They Cannot Quit

#64

Post by wbkang » Sat, Apr 07, 2018, 9:26 PM UTC

Is there a reason why people are trying to stop taking it? If it helps your life, why not keep using it? For example, I have been taking antihistamine daily for the last 18 years for skin allergy. My QoL is significantly better with it, and unless there is some magical cure, I don't see why I should stop just because it's a "drug", "chemical" or "unnatural".

For example, from the article,

> "A year and a half after stopping, I’m still having problems. I’m not me right now; I don’t have the creativity, the energy. She — Robin — is gone"

If that's important to you, why not continue?

Re: Many People Taking Antidepressants Discover They Cannot Quit

#65

Post by Fnoord » Sat, Apr 07, 2018, 9:30 PM UTC

mirimir wrote: post #23

That brings back horrible memories. I took an SSRI for several years, initially prescribed by a GP. But the problem was that I wasn't "depressed". I am bipolar, and sometimes got stuck in down mode. The SSRI did make me more functional. But what it mostly did was make me affectless. That is, I could be sad or happy or angry or whatever, and I felt pretty much nothing. However, I still did whatever someone who was sad…

> Also, I lost interest in sex, and it took forever to reach orgasm.

This is a common side effect of SSRIs. I have the same, but I very much enjoy that side effect. Saves time, and already got a child anyway. I still love pleasuring my significant other just as much as before, btw.

People who have bi-polar usually get mood stabilisers such as lithium prescribed. Perhaps anti-psychotics? SSRIs are known to be problematic for bi-polar personality disorder.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#66

Post by superkuh » Sat, Apr 07, 2018, 9:33 PM UTC

>Yet withdrawal has never been a focus of drug makers or government regulators, who felt antidepressants could not be addictive and did far more good than harm.

They're not addictive. They cause dependence. There is an important difference. Addictive things increase incentive salience of stimuli associated with the drug. They increase wanting. And that increased wanting leads to increased usage.

Dependence on a drug does not have this aspect. It just represents the bodies physiological adaptation to the new state.

Conflating the two is bad practice for an article ostensibly about medicine. And it leads people, and that set includes legislators, to think about using more government violence to enforce regulations of drugs which create dependence.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#67

Post by mirimir » Sat, Apr 07, 2018, 9:33 PM UTC

wbkang wrote: post #64

Is there a reason why people are trying to stop taking it? If it helps your life, why not keep using it? For example, I have been taking antihistamine daily for the last 18 years for skin allergy. My QoL is significantly better with it, and unless there is some magical cure, I don't see why I should stop just because it's a "drug", "chemical" or "unnatural". For example, from the article, > "A year and a half after s…

Taking an SSRI more or less made me sociopathic. Sociopathic with a grin, perhaps, but still dangerous to myself and others. On the other hand, I wasn't depressed, and could work effectively.

So basically, it was side effects. Friends worried about me.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#68

Post by jdietrich » Sat, Apr 07, 2018, 9:34 PM UTC

dfsegoat wrote: post #14

thatsamonad wrote: post #5

Earlier quoted context omitted.

I take Wellbutrin and Lamictal (a mood stabilizer) every single day for PTSD and I wouldn’t really be able to function without them. I really wouldn’t call myself or the psychiatrist who prescribed them irresponsible. I’d say it’s equally irresponsible to make a blanket statement about something that does actually help people in certain circumstances. That being said, there are a number of GPs out there who prescribe…

I could not agree with you more: Both my partner and I have been on SSRIs / SNRIs before for LIMITED DURATION (3-12 mo). We would not have a healthy, happy, functional family without these types of interventions available. I found (I suspect like you) that having an psychiatrist - an MD, who can provide both cognitive/behavioral and pharmacological interventions - is the key.

>I could not agree with you more: Both my partner and I have been on SSRIs / SNRIs before for LIMITED DURATION. Probably over 10 times between the two of us.

You might want to consider maintenance therapy. The actual evidence for severe discontinuation effects is quite limited, but we have fairly strong evidence that maintenance therapy significantly reduces the rate of relapse. It's natural to want to avoid taking drugs indefinitely, but it's often a better option than a long-term cycle of depression, treatment, discontinuation and relapse.

I suspect that a substantial proportion of people mistakenly believe that they're "addicted" to anti-depressants, when really they're just receiving an effective treatment for a chronic condition. They feel worse when they stop taking the pills, because the pills are doing what they're supposed to do.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#69

Post by fogzen » Sat, Apr 07, 2018, 9:34 PM UTC

Fnoord wrote: post #58

ada1981 wrote: post #51

Keep in mind that SSRIs appear to do little more than active placebo in the vast majority of cases with the downsides of withdrawals and all the other symptoms including deceased emotions in general. There are many alternatives that have been shown to be as or more effective. Writing and then reading 14 Gratitude Letters to people. Spending an afternoon a week outside. Practicing telling the 100% truth in your relati…

> Writing and then reading 14 Gratitude Letters to people. > Spending an afternoon a week outside. > Practicing telling the 100% truth in your relationships. > And of course, Psychedelics. Heh, a decent psychologist would suggest #3 during e.g. CBT sessions. Suggesting #4 is downright dangerous, you don't know who reads your post. Readers, please seek professional help -based on conventional science- instead. I tried…

How is suggesting psychedelics more dangerous than suggesting the use of antidepressants? Data shows both can cause panic attacks and psychotic episodes...

Both drugs have mechanisms of action we don’t fully yet understand, and both may cause serious side effects.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#70

Post by jack_h » Sat, Apr 07, 2018, 9:36 PM UTC

wbkang wrote: post #64

Is there a reason why people are trying to stop taking it? If it helps your life, why not keep using it? For example, I have been taking antihistamine daily for the last 18 years for skin allergy. My QoL is significantly better with it, and unless there is some magical cure, I don't see why I should stop just because it's a "drug", "chemical" or "unnatural". For example, from the article, > "A year and a half after s…

Anecdotally I quit because I had just entered a relationship and the anti-depressants affected my sex life in a pretty big way.