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The Challenge of Going Off Psychiatric Drugs

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Re: The Challenge of Going Off Psychiatric Drugs

#111

Post by jdietrich »

DanBC wrote: post #93
mmjaa wrote: post #16

Earlier quoted context omitted.

>I agree that it's under-discussed. I think the reason its under-discussed is that there is a collective group-think which functions as overwhelming (to the individual) reinforcement: "there is no other way available to solve this problem than the mass sale and consumption of pharmaceuticals". The moment someone proposes a non-pharmaceutical (read: profitable) solution to many of these ills, they are shut down by the…

> to a very Western You meant American, because in the UK the front-line treatment for depression or anxiety is a talking therapy, coupled with social prescribing (which to be fair has variable availability), and then medication if indicated. OP talks about a long term prescription for clonazepam, and current advice is that long term benzo use must be avoided.

>You meant American, because in the UK the front-line treatment for depression or anxiety is a talking therapy, coupled with social prescribing (which to be fair has variable availability), and then medication if indicated.

It's the front-line treatment for mild depression and mild-to-moderate anxiety, because of the poor evidence for the efficacy of antidepressant medicines for patients with less severe illness. SSRIs and talking therapies are recommended equally for moderate or severe depression and severe anxiety, because the evidence suggests that they are equally effective.

NICE guidance states that benzodiazepines should not be prescribed for more than two weeks, because of diminishing efficacy and the risk of dependence.

SSRIs are cheaper and more convenient than psychotherapy, which should not be underestimated. The NHS certainly can't afford to offer psychotherapy to everyone who could benefit and many Americans don't have adequate insurance coverage. Getting psychotherapy outside of office hours can often be a significant challenge, which is a total dealbreaker for many people. I would certainly like to see greater use of psychotherapy (particularly for people with chronic and/or severe disorders), but there's nothing innately wrong with the widespread use of a safe and effective class of drugs. There just isn't any evidence to suggest that SSRIs are inferior to psychotherapy, although it may be the case that some patients who do not benefit from SSRIs would benefit from psychotherapy (and vice-versa).

https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#ste...

https://www.nice.org.uk/guidance/cg113/chapter/1-Guidance#st...

Re: The Challenge of Going Off Psychiatric Drugs

#112

Post by GlenTheMachine »

travisjungroth wrote: post #77
GlenTheMachine wrote: post #47

Earlier quoted context omitted.

Not fully, but I strongly suspect it had a lot to do with the building I work in. My building has no windows. My lab simulates space, so it is a big room that is painted black. Daylight Savings had just stopped, so I was getting an hour of sunlight driving in to work, no sunlight during the day, and leaving after it got dark. I think my circadian rhythms were completed screwed up. Once you have insomnia for a few wee…

Holy crap you were living in constant darkness. Of course you had sleep issues. Did you ever try light exposure?

Yes, of course. I got a sunlight lamp and put it over my monitor. I actually went so far as sitting outside in the evening for an hour, every day. I also tried taking melatonin.

But the thing with insomnia is that it is self-reinforcing. You get conditioned to lying in bed awake, and that's what your brain then expects to do when you go to bed. And then you get anxious about it, which makes it worse. Once you have it, removing the original cause doesn't solve the problem.

In my defense, I worked under these conditions for five years before it became an issue.

Re: The Challenge of Going Off Psychiatric Drugs

#113

Post by GlenTheMachine »

DanBC wrote: post #91
dekhn wrote: post #86

Earlier quoted context omitted.

I had to explain tapering to my psychiatrist, who also was very skeptical of the "brain zaps" I reported feeling when I went off Paxil. I ended up moving my prescriptions to my GP and managing the tapers myself, because the doctors don't really know how to do it.

Brain zaps are unpleasant. They are nothing like the withdrawals from benzos, which can include seizures which can be life-threatening.

Yeah, I had brain zaps when I tried to go off Remeron. One thing at a time...

Re: The Challenge of Going Off Psychiatric Drugs

#114

Post by mastox »

thanatropism wrote: post #83
abstractbarista wrote: post #75

I found this to be a very intriguing read. Upon finishing it, I am terrified of these drugs, terrified of pharmaceutical companies, and terrified of the cognitive dissonance in the study of mental illness. I would try absolutely anything before these drugs. It's a freaking nightmare, thrust into reality.

That's a shame. Most of these pieces are hysteria. Journalists and lawyers never go after people who seem to be fine with medication. Here's hoping you don't have serious mental health problems in the future.

I think some would argue that you aren't fine if you are on these kind of medications, and "fine" might be an illusion to the patient and their peers.

Re: The Challenge of Going Off Psychiatric Drugs

#115

Post by flycaliguy »

mastox wrote: post #95
martinald wrote: post #79

Earlier quoted context omitted.

I dont mean to be alarmist but taking benzodiazepines for an extended time (anything more than 2 weeks is probably a bad idea, especially with strong ones such as clonazepam), is definitely not a great idea. There is a very prolonged withdrawal syndrome, with many not reporting feeling completely better after many years in cases of high dose long term usage. You may take the view that you can always take them, but ci…

I had no idea the impact of benzo's but my first thought after reading the OP and experiencing Cognitive Behavioral Therapy (CBT) myself, "Isn't that just a band-aid, not really treating the 'wound'". I guess I'm just agreeing with you from a philosophical point of view. For what's its worth for anyone (including OP) reading this, I found success in studying philosophy as a poor man's CBT especially Existentialism. I…

Stoic philosophy has a lot of overlap with CBT. It basically re-opened those cbt books for me and kept me at it.

Re: The Challenge of Going Off Psychiatric Drugs

#117

Post by mastox »

colesdefectum wrote: post #43

I rarely comment on anything but this hits rather close to home. After a rather severe bout of depression my doctor started feeding me drugs. SSRIs, NDRIs, benzos, and a handful of misc other prescriptions that were the flavor of the week. I felt like every visit was a game of 'lets try this new drug!' which would lead to negative side effects more often than not. Fast forward a couple years and I'm realizing that me…

> They were sure to tell me that if I stopped treatment I wouldn't be given any more refills and one doctor condemned me for even showing up to my appointment with the intention of discontinuing medications. He said I was wasting everyones time.

Wow. Just wow. That's very unfortunate that you had to go through that. That seems beyond malpractice and if its not, it should be. I don't want to dox anyone but those doctors should be avoided...probably by everyone...

Re: The Challenge of Going Off Psychiatric Drugs

#118

Post by rincebrain »

dekhn wrote: post #86
QualityReboot wrote: post #19

Earlier quoted context omitted.

Just so you know, because it sound like nobody told you... you really need to taper those drugs or the chance of seizure goes way up. It's not like other addictions, you can't just cold turkey benzos or alcohol if you've been using them daily for a long time. It can literally kill you, and you won't see it coming. There's various schedules on how to do it, here's a good starting point: https://www.aafp.org/afp/2017/1…

I had to explain tapering to my psychiatrist, who also was very skeptical of the "brain zaps" I reported feeling when I went off Paxil. I ended up moving my prescriptions to my GP and managing the tapers myself, because the doctors don't really know how to do it.

I'm continually impressed with the lowering of the bar for such professions every time I encounter another basic thing that some doctors are completely unaware of, and I'm sorry to hear you had to deal with that.

I've had a lot of complaints about various psychiatrists, but one constant even among the worst has been that they were always very, very cautious about the need to taper and the possible risks involved.

Re: The Challenge of Going Off Psychiatric Drugs

#119

Post by fwip »

dekhn wrote: post #86
QualityReboot wrote: post #19

Earlier quoted context omitted.

Just so you know, because it sound like nobody told you... you really need to taper those drugs or the chance of seizure goes way up. It's not like other addictions, you can't just cold turkey benzos or alcohol if you've been using them daily for a long time. It can literally kill you, and you won't see it coming. There's various schedules on how to do it, here's a good starting point: https://www.aafp.org/afp/2017/1…

I had to explain tapering to my psychiatrist, who also was very skeptical of the "brain zaps" I reported feeling when I went off Paxil. I ended up moving my prescriptions to my GP and managing the tapers myself, because the doctors don't really know how to do it.

It's shocking when psychiatrists don't know the side effects of the drugs they're prescribing.

My partner started taking sertraline (Zoloft) for depression, and started grinding their teeth at night. Their dentist asked if they'd started taking any new medicine lately, and was like "oh yeah that'll do that."

My partner's psychiatrist literally did not believe that the medication could cause this - despite it being right there on WebMD, not exactly secret knowledge.

Currently looking for a new psychiatrist.

Re: The Challenge of Going Off Psychiatric Drugs

#120

Post by GlenTheMachine »

iooi wrote: post #106
GlenTheMachine wrote: post #68

Earlier quoted context omitted.

Indeed, nobody told me. I experienced the immediate effects of withdrawal when my stomach started tensing up for no good reason, and I started sweating. That was enough to convince me to stop with the cold withdrawal and start tapering. I did not know this could have been life threatening. That's... comforting...

Be very careful tapering off benzos, the withdrawals are more dangerous than that of heroin [1]. You should definitely get your doctor involved in this process. You might also want to read through this [2]. 8 months might not be enough time to taper off depending on the time and dosage you've been on. [1] https://qz.com/677980/opioids-arent-the-most-dangerous-drug-... [2] https://en.wikipedia.org/wiki/Benzodiazepine_…

I've been on Klonopin for seven years. But I started out on the very lowest clinical dose, and for two months I tapered to 75% and for the last month I've been on 50%. In another month I hope to drop to 25%. So it will be at least six months, and as I said I started at a low dose. I feel great so far.
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