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Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

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Re: Doctors are finally learning to manage antidepressant withdrawal

#121

Post by burnt-resistor »

litigator wrote: post #45
laughing_man wrote: post #37

SSRIs and SNRIs just didn't work very well for me. If they had an positive effect at all, it wasn't enough to rise above the proverbial noise. Coming off of them wasn't too bad though. I got the brain zaps, but those were easy to cope with. More than anything the whole experience was a waste of money, and what finally fixed my problems was retirement and a greater attention to my health.

Have you looked into mirtazapine (tetra cyclic), vortioxetine (serotonin modulator) or atomoxetine (SNDRI). Atomoxetine has been a god send for me.

I've tried 20-some-odd antidepressants titrating off and on and usually back off again.

Mirtazapene (ATeCA) is the only one that could manage my depression. Unfortunately, it leads to severe weight gain that my health plan's formulary refuses to cover GLP-1 for because obesity is considered "a choice". It's the only one where the depression mostly goes away and the side-effects aren't life-threatening/-debilitating for me. If I forget a single dose at night or anytime I go to sleep without taking it first, I end up with almost exactly the feeling of an alcohol hangover. It's also a pretty powerful antihistamine. I also usually can't get to sleep if I don't take it. :/

Vortioxetine gave me horrific myoclonus and vestibular symptoms.

Atomoxetine is mostly for ADHD and gave me tachycardia, profuse sweating, uncomfortable nervousness, and anxiety. It didn't do shit for my ADHD or depression.

YMMV.

Re: Doctors are finally learning to manage antidepressant withdrawal

#122

Post by seri4l »

bsuvc wrote: post #16
sandcat_ wrote: post #7

To provide one additional anecdote: I came off escitalopram with no taper after taking it for about five years (10mg). I got brain zaps for a while, got very irritated at times, but largely was fine after a few weeks. Not downplaying the withdrawal effects for some people, but they’re not as catastrophic as this article suggests for many (perhaps most). And overall I’m very glad I took it! It got me through a rough p…

It's been years since, but I too had brain zaps coming off of it. It took a few months for those to go away. I tried to describe it to my doctor and he seemed like he never heard of it before and sort of look at me like I was crazy, or at least that is what I sensed. But I ended up researching online and found it was a thing that happens.

Your psychiatrist looked at you like you were crazy?

Re: Doctors are finally learning to manage antidepressant withdrawal

#123

Post by Schlagbohrer »

esperent wrote: post #106
herbst wrote: post #104

Earlier quoted context omitted.

It has a long and scary list of side effects, good if it works for you

They all do and my reading has always been that bupronion has less scary side effects than e.g. escalitopram.

There's a medicine named escalate-o-pram?

Re: Doctors are finally learning to manage antidepressant withdrawal

#124

Post by Schlagbohrer »

cameronh90 wrote: post #47
SV_BubbleTime wrote: post #23

[flagged]

What if the drugs just make us... better? As in happier, less stressed, and more suited to what modern life requires from us. Happiness isn't necessary to pass on your genes. Most animals, especially prey animals, spend much of their lives scared, because death is inevitable otherwise. We've now created a safe and pleasant environment our ancestors could only dream of, yet many of us are still unhappy. There's no rea…

"more suited to what modern life requires from us." This part scares me because I would prefer that we rearrange our economic and social world so that people can have more free time, more vacation, more relaxation, and way more social time too.

I have known many people in my personal life in the united states who have an extremely stressful and depressing life due to external stressors (job, debt) and in response are on powerful psichiatric meds with the sometimes-severe withdrawal problems mentioned in this thread.

Re: Doctors are finally learning to manage antidepressant withdrawal

#125

Post by abbadadda »

lloydatkinson wrote: post #96

Well this would be an improvement over my former NHS GP practice deciding the best way for me to come off antidepressants was immediately stopping them without renewing the prescription or even discussing it with me! I think they just forgot to renew the prescription.

Oof, this tracks with my experience on the NHS… it seems like extreme busyness comes off as a lack of due care.

One time I met a psychiatrist after moving to a new area. In our very first meeting he takes me off a medicine I’ve been on for nearly 7 years, cold turkey. Then? _Zero_ follow-up, no check-ins, and I can’t get an appointment on my own for months. The decision may have been wise, leaving out specifics here, but the lack of follow-up really was negligent.

Re: Doctors are finally learning to manage antidepressant withdrawal

#126

Post by bb123 »

There is a real lack of transparency in communicating some of the long term impacts of SSRIs to new patients. When I was prescribed sertraline not one doctor mentioned the massive (and sometimes permanent!!) sexual side effects, the likelihood of weight gain or how brutal it would be to taper off.

Also, I ended up ignoring my doctor's (way too aggressive) tapering schedule and managing my own down-dosing with a pill crusher and a milligram scale. I went about 5x slower than the standard advice and avoided all of the worst side effects.

I don't think it would have changed my decision to start taking it but I would rather have known about all this up front so I could make a more informed choice.

Re: Doctors are finally learning to manage antidepressant withdrawal

#127

Post by pcblues »

Zoloft for me (Sertraline) years ago. Was on for a few years and came off cold-turkey when it didn't seem to help any more.

My life outside my head was crazy enough. My mind then matched it. I don't regret taking it, but it is a real trap of taking sanity from your own future and paying it back later. Advice I received was if my body could handle it, I should stay on it forever. I didn't like that idea, though. Among the negative side effects, the chemical sexual drive suppression caused its own problems. YMMV of course.

Re: Doctors are finally learning to manage antidepressant withdrawal

#128

Post by drayfield »

I've been on 40mg citalopram for about 20 years now. I've tried a few times to come off either tapering or cold turkey and in all cases it's been horrendous. My biggest worry is that I'll never be able to come off them as I'm on such a high dosage, even if it was tapered off over a very long period of time.

Re: Doctors are finally learning to manage antidepressant withdrawal

#129

Post by pcblues »

delichon wrote: post #13
sandcat_ wrote: post #7

To provide one additional anecdote: I came off escitalopram with no taper after taking it for about five years (10mg). I got brain zaps for a while, got very irritated at times, but largely was fine after a few weeks. Not downplaying the withdrawal effects for some people, but they’re not as catastrophic as this article suggests for many (perhaps most). And overall I’m very glad I took it! It got me through a rough p…

Good news, exposure therapy is quite effective for arachnophobia and is the first-line treatment. SSRIs do not have the same level of supporting evidence, and the effects are not as durable.

Exposure therapy does not work for everyone in all areas. Sometimes not at all.

Also, see the debate around discussing traumatic events in therapy immediately versus waiting a year.

Throwing people in the deep end doesn't always result in a swimmer :)

YMMV of course.

Re: Doctors are finally learning to manage antidepressant withdrawal

#130

Post by asa123 »

bb123 wrote: post #126

There is a real lack of transparency in communicating some of the long term impacts of SSRIs to new patients. When I was prescribed sertraline not one doctor mentioned the massive (and sometimes permanent!!) sexual side effects, the likelihood of weight gain or how brutal it would be to taper off. Also, I ended up ignoring my doctor's (way too aggressive) tapering schedule and managing my own down-dosing with a pill…

somewhat off topic but i’ve thought about tapering like this, but i’ve got wondered where can one get a calibrated milligram scale? or perhaps it doesn’t matter too much.
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