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

Re: Many People Taking Antidepressants Discover They Cannot Quit

#211

Post by indecisive_user » Sun, Apr 08, 2018, 2:56 AM UTC

phkahler wrote: post #138

Karrot_Kream wrote: post #31

To offer the converse, I had a very traumatic event in my life and was put on an SSRI, which helped me function. After almost 2 years of taking it, I didn't think I needed it anymore and I tapered myself off very slowly but regularly, keeping logs and setting alarms. While in the beginning I felt some vertigo and other symptoms, I tapered very gradually, and was completely free at the end of my taper. My symptoms nev…

>> I'm eternally glad for my SSRI use and a medical system that knows when to prescribe it... Your story of recovery is a good one (and not the only good one). The problem is that a number of people in that same system don't see any need to get people off these medications. IMHO they are best used short term (whatever that means) while you work through your issues - like you did. For those reading, there is no "corre…

>The problem is that a number of people in that same system don't see any need to get people off these medications

Why is this a problem? If long term studies prove detrimental effects then sure, it's a problem.

But taking a pill every day isn't inherently bad for you. If you live in a northern climate you would probably benefit from taking Vitamin D every day your entire life, so what's the fundamental difference of an SSRI?

Re: Many People Taking Antidepressants Discover They Cannot Quit

#212

Post by icantdrive55 » Sun, Apr 08, 2018, 3:06 AM UTC

onetwotree wrote: post #200

superkuh wrote: post #66

>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…

Having been addicted to prescription pills, and currently being prescribed (and presumably dependent on) antidepressants, I think there are a few points that make the distinction abundantly clear: 1. When I consider stopping antidepressants, I'm not filled with anything like the dread I was when I thought about giving up the addictive pills. 2. I forget to take my antidepressants sometimes. I forget to refill the pre…

4. It's almost like they don't do anything?

(I've taken so many pricey antidepressants, and feel duped. I sometimes think drug companies pulled the ultimate scam. Produce a happy pill that barely gets by the FDA? A pill that really doesn't do anything besides side effects of course?)

Re: Many People Taking Antidepressants Discover They Cannot Quit

#213

Post by AnIdiotOnTheNet » Sun, Apr 08, 2018, 3:21 AM 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…

I was a very different person on an SSRI. Considering the state I was in when I started taking it, that wasn't really a problem. I was generally content with everything on an emotional level, but at the same time if I sat down and payed attention to how I felt I found I was still depressed, I just wasn't experiencing most of the emotional effects of it. Worse, when I took a look at how my personality had changed, I didn't like it.

After I changed jobs, and therefore healthcare providers because yay America, I didn't bother getting a new prescription. It was a rough ride coming off the stuff. I remember distinctly crying, like really intense honest crying with sobbing and tears and everything, over some plot point in a stupid TV show I was watching and, honestly, it was delicious. I was so grateful to be able to experience again, instead of just passively existing.

After several more years, none of them involving doctors, I finally found my way to more-or-less normality. For me, and I suspect many depressed people, it was philosophical. I had this idea of how the world should work, how I felt it should work, and I knew the world didn't work that way, and the dissonance of that manifested as depression. I think this is probably the normal reaction of the mind to this state, and under normal circumstances it is supposed to serve to motivate us to reconcile our model of reality with our observations of it, but for various reasons I once elaborated on in a different post, I think our current cultural mind-set is not only ill-suited to helping us with this, but actively making it worse.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#214

Post by raisedbyninjas » Sun, Apr 08, 2018, 3:27 AM UTC

Friedduck wrote: post #191

I know someone who took Effexor, who went through one of the most harrowing experiences of her life trying to quit. Her doctor seemed vested in keeping her taking the drug (I personally suspect some kind of incentive to sell the drug but don’t have evidence to back that up.) I can’t emphasize enough how serious these drugs are, and what a prison they can become.

You can see what pharma companies pay to your Dr. at https://openpaymentsdata.cms.gov/

Re: Many People Taking Antidepressants Discover They Cannot Quit

#215

Post by darkerside » Sun, Apr 08, 2018, 4:05 AM UTC

jdietrich wrote: post #87

ada1981 wrote: post #59

Earlier quoted context omitted.

Hmm... I question a meta study that says it has finally solved the issue and put it to rest, when there are plenty of other studies saying the exact opposite. Here's one: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12... "SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantl…

All the major meta-analyses come to roughly the same conclusion, which is that anti-depressants have modest positive effects. The paper you linked to finds exactly this, but argues that the effect size they found is insignificant because of the high risk of bias. Other studies have gone to extraordinary lengths to control for potential biases and come up with a very similar effect size. Reasoning about the data is qu…

As a layman, I find it surprising that SSRIs were clinically approved for treatment based on a 1 in 7 chance of demonstrating positive effects. Are other medications anywhere near as ineffective? Whether antibiotics, Tylenol, or Viagra, I can't imagine any of those being effective in less than, say, 5 out of 7 cases.

Re: Many People Taking Antidepressants Discover They Cannot Quit

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Post by verylittlemeat » Sun, Apr 08, 2018, 4:11 AM 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…

Personally I went off SSRIs because from the start I chose to look at them as a tool. I had no symptoms of depression until my mid 20s so I didn't buy the metaphor that SSRIs were filling some inborn defect in my brain. I got stuck in a rut of bad thinking patterns which I re-framed through therapy and SSRIs.

I don't think going off them had to do with worries over "unnatural" , rather it was just human curiosity to understand my own brain. I've tried other illegal drugs for similar cognitive insights. It just so happens that SSRIs are legal and have some degree of clinical efficacy.

As a side note I think therapy did more for me than SSRIs and I'm still in therapy but ymmv. Finding a good therapist is way harder than finding an anti-depressant prescription.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#217

Post by verylittlemeat » Sun, Apr 08, 2018, 4:19 AM UTC

pasabagi wrote: post #115

dimal wrote: post #109

Earlier quoted context omitted.

And of course, all patients read the long pamphlets extensively /s. We depend on our doctors to explain risks like this. And at the time I was discontinuing (not abruptly) the concept of “brain zaps” was met with great skepticism. I am fairly certain that some of the side effects you list (electric shock sensations) were added more recently. It took years of patients being ignored for the idea to be taken seriously.

I've also rarely received accurate advice regarding the likely effects and side-effects of anti-depressants - but I think calling brain zaps a 'risk' is a bit much. Maybe my zaps were nicer than yours, but I don't remember them being particularly painful - except one time I fell in the shower. Anti-depressants, especially something like venlafaxine, are strong meds for a strong condition. It would be surprising if th…

I had brain zaps and they were very distracting.

I took 2 SSRIs for about 3 years and went off them close to cold turkey. When I would move my eyes it felt like there was a delay between moving and seeing. This lasted for about a month. In general everything felt very disconnected/fuzzy/unreal. Sometimes it was close to what I imagine people describe as an out of body experience.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#218

Post by verylittlemeat » Sun, Apr 08, 2018, 4:39 AM UTC

Fnoord wrote: post #75

fogzen wrote: post #63

Earlier quoted context omitted.

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

> What study shows LSD is more dangerous than SSRI’s? Except that's not how it works. How it works is that SSRIs have been tested in trials, and are approved. LSD isn't. When someone says "try LSD" (or psilocybin which seems the newest rage these days) it means they'd illegally acquire the drug (who know for sure what drug they bought? [EDIT: and who knows the dosage/strength of active substance(s)?]), and administer…

I agree with everything in your comment but take issue with your dismissive attitude toward psilocybin as "the newest rage these days."

Western medicine is famously puritanical toward hallucinogenic drugs. Human social history is long and hallucinogenics being illegal is comparatively recent. It's an insult to the study of science that such an interesting and powerful drug is taboo to even study. Thankfully this seems to be reversing in my lifetime.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#219

Post by azernik » Sun, Apr 08, 2018, 5:00 AM UTC

Hydraulix989 wrote: post #195

azernik wrote: post #154

Earlier quoted context omitted.

Psychiatric meds in general, and SSRIs in particular, are super idiosyncratic.

Successfully treating someone's depression isn't the idiosyncrasy; the side effects are.

Efficacy (of any specific drug) also varies from person to person.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#220

Post by meowface » Sun, Apr 08, 2018, 5:39 AM UTC

indecisive_user wrote: post #211

phkahler wrote: post #138

Earlier quoted context omitted.

>> I'm eternally glad for my SSRI use and a medical system that knows when to prescribe it... Your story of recovery is a good one (and not the only good one). The problem is that a number of people in that same system don't see any need to get people off these medications. IMHO they are best used short term (whatever that means) while you work through your issues - like you did. For those reading, there is no "corre…

>The problem is that a number of people in that same system don't see any need to get people off these medications Why is this a problem? If long term studies prove detrimental effects then sure, it's a problem. But taking a pill every day isn't inherently bad for you. If you live in a northern climate you would probably benefit from taking Vitamin D every day your entire life, so what's the fundamental difference of…

The issue isn't taking medication daily; it's taking psychotropic, brain- and personality-altering medication for years, especially when it comes with potential for bad side effects which may last after cessation (such as with SSRIs). I take vitamin D daily and I really don't think you can equate it to SSRIs whatsoever.

Clearly SSRIs help many people in a significant way, but their mechanism of action is still poorly understood and their effects are powerful enough that they should be prescribed and taken long-term only with careful advising and caution. For some people, maybe taking them until the day they die is the best option, but it probably is also harmful for some people to take them for several years.