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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

#191

Post by probably_wrong »

bcjdjsndon wrote: post #163
KurSix wrote: post #91

Earlier quoted context omitted.

For something prescribed to get someone through a temporary crisis, "how and when do we get you back off this safely?" should probably be discussed at the beginning, not years later when the patient decides to stop.

[flagged]

If a fireman is trying to stop a house fire and suddenly they catch fire themselves, no one would argue that they need to focus on the house fire first.

Antidepressants are the same: they won't stop the bigger fire by themselves, but by preventing you from catching fire right now they give you the tools to deal with the larger problem more effectively that if you tried to do it while flailing around and screaming.

Re: Doctors are finally learning to manage antidepressant withdrawal

#192

Post by clsec »

throwaway250501 wrote: post #56

When I was diagnosed with depression - amongst other things - my doctor prescribed SSRIs with a caveat that they might or might not work. After a few weeks I was tapered off them. I felt no different before, during or after them. What helped was 3 daily walks around the park, around 9km per day after each meal. Anecdotal but it is what it is. Right now I have bigger problems than just depression.

>>Right now I have bigger problems than just depression.

Just depression?! You might want to grab a little empathy before writing off something that has been a major problem in a large chunk of the populations lives. In fact, "just depression" has caused me to try to take my life multiple times. I can hardly see a "bigger problem" out there..

Re: Doctors are finally learning to manage antidepressant withdrawal

#193

Post by fny »

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…

The problem is that psychiatry is an absolute zoo. Ive heard that if you go to 10 doctors you'll get 10 different opinions based on the docs personal experience.

Even if there are trials for these medications, the field is not quantitative in practice. "Standard of care" is a myth.

Re: Doctors are finally learning to manage antidepressant withdrawal

#195

Post by movespebp »

tsoukase wrote: post #177

All cases are possible with S{S|N}RIs (I am a doctor but I know a little regexp). Patients that took them for two months and never needed again and others that cannot stop them after 20y. The start, the stop and every restart of the drug needs an indication so it should be approached with the same care as any medical decision. It's not right to call it withdrawal. These drugs are not addictive like benzos or alcohol…

The sexual side effects can be much much worse, and far more permanent than delayed orgasm or low libido - https://www.pssdnetwork.org

It's also not difficult to spot - the complete removal of libido, sometimes permanently for life, with these drugs has been seen in animal models, and also is not present in other classes of ADs. A lifetime of chemical castration effectively.

Clinicians really have been misinformed about these drugs, the awareness campaigns of the 90s still cast a long shadow, with many not really truly understanding the actual potentially permanent and serious effects of these drugs, or assuming that they're rarer than they are (they aren't rare) - because that's what the pharmaceutical company campaigns have told them.

Re: Doctors are finally learning to manage antidepressant withdrawal

#196

Post by MSFT_Edging »

bcjdjsndon wrote: post #160

[flagged]

I think this is a very different problem. I'm prescribed those "happy pills" as you call them. I forget to take them regularly, in fact I think you may have just reminded me to take mine as long as I remember by the end of this comment.

There isn't a high, in fact if I don't modulate how I eat and hydrate, I don't feel it. But if I get the timing just right, with the correct breakfast and everything, I can just barely manage to do the boring tasks that normally my brain will do nearly anything to distract me from.

Eventually tolerance does build, I manage that by taking weekends off and every 6 months or so, I'll take 1-2 weeks off cold turkey.

I need this shit to remotely participate in the bullshit gauntlet we call an economy. Without it, I'm essentially disenfranchised. I can get a job by channeling some hyper-focus long enough to show I'm not incompetent, but once the daily grind sets in, the rent payments don't stop.

These medicines are a by-product of the society we produced. We refuse to refine the society so we medicate the incompatibility.

Re: Doctors are finally learning to manage antidepressant withdrawal

#197

Post by trentnix »

fny wrote: post #193
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…

The problem is that psychiatry is an absolute zoo. Ive heard that if you go to 10 doctors you'll get 10 different opinions based on the docs personal experience. Even if there are trials for these medications, the field is not quantitative in practice. "Standard of care" is a myth.

The one thing they will all agree on is that you need pills of one sort or another.

Re: Doctors are finally learning to manage antidepressant withdrawal

#198

Post by richardlblair »

pas wrote: post #169
bcjdjsndon wrote: post #160

[flagged]

people whose life is amazing don't go through the process of getting stimulants (or even SSRIs) prescribed to them. psychiatrists know about this. the plan is usually to cycle the meds. is this great and works every time? no. is this better than the alternative? yes. ADHD is not great. and in many cases it's so bad people die from "not paying attention", and Ritalin (methylphenidate) is visibly helping people avoid t…

One should not question the seriousness of ADHD or the benefits of an appropriate treatment plan.

One should question the rate of which it is diagnosed, and who is getting diagnosed.

Re: Doctors are finally learning to manage antidepressant withdrawal

#199

Post by gilrain »

pyth0 wrote: post #180
gilrain wrote: post #178

Earlier quoted context omitted.

> Chronic depression doesn't usually have a "cause" Is that true or your guess?

I have first hand experience. Also "depression" is different from "chronic depression". You can experience the former as the direct result of some cause.

> I have first hand experience.

You can't have first-hand experience of "usually" where that applies to multiple people.

Re: Doctors are finally learning to manage antidepressant withdrawal

#200

Post by john_strinlai »

bcjdjsndon wrote: post #163
KurSix wrote: post #91

Earlier quoted context omitted.

For something prescribed to get someone through a temporary crisis, "how and when do we get you back off this safely?" should probably be discussed at the beginning, not years later when the patient decides to stop.

[flagged]

man, you're all over this submission shitting on antidepressants and questioning people's experiences. it's irresponsible and really not cool.
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