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Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

201–210 of 377 posts

Re: Doctors are finally learning to manage antidepressant withdrawal

#201
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…

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Re: Doctors are finally learning to manage antidepressant withdrawal

#202

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 ab…

Right! No thread on antidepressants is complete without a downplaying of PSSD

Re: Doctors are finally learning to manage antidepressant withdrawal

#203
post #95

Only slightly related, but can anyone ELI5 why Bupropion XL is not the universal first line treatment for depression and is hardly used at all in Europe? It has fewer side effects vs. SSRIs, can be safely used as a long term medication (which many people do with SSRIs even though it can have negative effects), and doesn't have the same horrible withdrawal symptoms (although you still need to taper).

Anxiety is a common comorbidity in depression patients and buprioprion can dramatically raise anxiety levels It is a second-line treatment for a reason. Great when it works. Harmful when it does not.

Thank you, that answer makes a lot of sense.

Re: Doctors are finally learning to manage antidepressant withdrawal

#204

I’ve been on a SSRI for 5 years and not once have I thought about getting off of it. It literally saved my life. I remember a while life of depression and constant churn of recursive emotions destroying me. I’m worried that too many people are downplaying the benefits that this drug for those of us that it has helped immensely. And it’s extra risky to be downplaying it while RFK jr is actively working to remove the d…

I think the issue is informed consent. If people find benefit in them by all means they should be able to take them. But currently these drugs are being given out for the most mundane issues, many of them temporary, after a 2 minute visit with a Primary Provider/GP, with little to no discussion on potentially permanent and serious effects, whether that be long term withdrawal or the equally life ruining PSSD. Neither of which seem to be particularly rare given the number of prescriptions.

Re: Doctors are finally learning to manage antidepressant withdrawal

#205
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…

Could you share the specific mg/week taper you did for Sertraline?

I did 10% relative reduction in my dose per 2 weeks, until I got down to ~2-3mg and then went cold turkey from there. Very very conservative. The 10% relative part is important - if you dropped by a constant, say 5mg, proportionally you'd be doing bigger drops each time which is where people get into trouble, especially at low doses.

Re: Doctors are finally learning to manage antidepressant withdrawal

#206
post #130

Earlier quoted context omitted.

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.

AWS Gemini-20 below $100 Or a precision one for $$$ All the other sub-$100 ones are mostly junk, with a few decent ones. But just get the Gemini-20

Mine was a $30 gold scale from Amazon. Probably not accurate but provably consistent which is what I needed. I'd compare each dose and used a calibration weight to verify.

Re: Doctors are finally learning to manage antidepressant withdrawal

#207
Myself I tapered Paroxetine without any pill cutters or special techniques and had no physical problems... But I did have something like a manic episode that lasted for about six months, had a psychogenic fever, lost more than 30 pounds in a few months (I was working out like a "maniac" and eating a mostly liquid diet at times to take stress off my TMJ) and was very high functioning in most respects despite being under the influence of a system of delusions.

Re: Doctors are finally learning to manage antidepressant withdrawal

#208
post #192

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..

reading some of the parents other comments, i dont think they were trying to downplay depression in general, and i dont think they meant any offense.

they were, perhaps, slightly careless in their choice of words. that's all.

Re: Doctors are finally learning to manage antidepressant withdrawal

#210

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…

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