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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

#271

Post by exogenousdata »

almost_usual wrote: post #46

SSRIs not Benzodiazepines. Withdrawals from the later can be life-threatening if you abruptly stop after prolonged use.

While you are entirely correct that immediate withdrawal of benzos is life-threatening, the same is true for short-acting SSRIs/SNRIs.

For eg, when admitted to a psych ward, there are a handful of things that the hospital will continue giving to a patient and gradually taper. Benzos, SSRIs/SNRIs, anti-psychotics, anti-convulsants & alcohol.

I mention this just to urge folks not to go cold-turkey on SSRIs/SNRIs as it can be life-threatening.

Re: Doctors are finally learning to manage antidepressant withdrawal

#272

Post by hirvi74 »

krupan wrote: post #225
fny wrote: post #193

Earlier quoted context omitted.

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.

Definitely prefer psychologists and therapists over psychiatrists, but don't discount how much something like an SSRI can help

But how does one know? According to some studies, spontaneous remission happens in about half the cases of depression in a given year.

It's happened to me plenty of times. That's why I refuse to medications. All I have to do is just wait it out.

I am not claiming no one gets any benefits, rather how can one be certain the benefits are actually not from something else? If the goal is to improve, then I suppose it does not truly matter. But I just like to understand things when I can.

Re: Doctors are finally learning to manage antidepressant withdrawal

#273

Post by micromacrofoot »

krupan wrote: post #229
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…

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

This is the same myth that women get told about hormonal birth control, it's not an "if" with side-effects of SSRIs, it's a "how much" and "when"

Re: Doctors are finally learning to manage antidepressant withdrawal

#274

Post by deinonychus »

krupan wrote: post #229
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…

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

I experienced a lot of stuff I didn't really notice how bad they were until I was off of them. Anhedonia, apathy, lack of volition, and sexual side effects. I also have trouble remembering parts of my life when I was on SSRIs.

I don't regret trying or even taking them for extended periods. They make the bad thoughts go away and raised the floor for my mood. But they also put a pretty low ceiling on it, too. I was probably on them for too long but clearly medicine doesn't have a perfect framework for handling every corner of this space, so I don't really blame anyone. There's a goldilocks zone for drug, dosage, and treatment length and I don't think I was always in it.

I've talked to many people who have bad things to say about SSRIs. On the other hand, my girlfriend is on one right now and seems very satisfied.

Re: Doctors are finally learning to manage antidepressant withdrawal

#275

Post by chakintosh »

None of my doctors spoke of the withdrawal side effects. But they'd happily prescribe stuff.

I was on SSRI (Sertraline) for around a year, and it absolutely demolished my libido, to a point where I became repulsed by it and actively avoided anything sexual with my wife. Luckily, I didn't gain any weight but the sexual side effects were brutal. I eventually visited a couple other doctors, same story, keep sertraline, increase the dose and here are some multivitamins, good luck bro.

Eventually had enough of the bull** and stopped it all cold turkey, both Sertraline and Lamotrigine, no tapering off or anything. The headaches that followed were brutal but for me it was way better than the risk of ruining my marriage.

A year later, I went back for another try, got prescribed Bupropion and Lamotrigine (again) but neither made any difference, they basically had the same effect as the water I drank with them. So again, stopped them cold turkey and vowed to never get any drugs for my depression and anxiety, and came out with the conclusion that therapy is broken. They'd happily prescribe meds than actually get to the bottom of the issue, it's a symptomatic treatment.

Re: Doctors are finally learning to manage antidepressant withdrawal

#276

Post by RankingMember »

krupan wrote: post #229
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…

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

> Despite considerable improvements in side-effect profiles, antidepressants continue to be associated with a significant burden of side effects that affect, treatment adherence and quality of life. Hu et al1 studied 401 patients with depression who had recently been prescribed an SSRI, and found that, after 75 to 105 days of treatment, 86% of patients reported at least, one side effect, and 55% experienced one or more bothersome side effects.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/

Re: Doctors are finally learning to manage antidepressant withdrawal

#277

Post by orangedog »

hirako2000 wrote: post #266
orangedog wrote: post #254

Earlier quoted context omitted.

What's wild about that? What does the science say? I've tried a variety and I can't say whether I've experienced side effects. That's just an anecdote but that's the thing with this discussion, that's all you will get. If people don't suffer side effects, they're not likley to get on HN and post about them, etc. The bigger issue is the person dealing with these issues is taking them because they are not well-off. If…

They don't post on HN but a cousin post references an entire subreddit dedicated to it. They are also anecdotal, hundreds, thousands of people suffering side effects. Given dozen of millions people in the U.S alone are prescribed those things daily, that a drop in the ocean. But not everyone post on Reddit either

Yes but again this is the exact example of anecdotes. Those not suffering aren't going to seek out subreddits to post about their non-problems. You can find a subreddit about everything, whether that's representative of anything or not.

Re: Doctors are finally learning to manage antidepressant withdrawal

#279

Post by hirvi74 »

cynicalkane wrote: post #269
bcjdjsndon wrote: post #160

[flagged]

One characteristic of ADHD is that many people don't build up tolerance, or only minor tolerance, to therapeutic doses of some stimulants including amphetamines. It's really not the same as what's being discussed here.

That is not a characteristic of ADHD. Th most damaging thing to ADHD is the myth that the medications affect people with ADHD differently. It is the most pseudoscientific piece of information that is commonly repeated.

As for tolerance, it absolutely happens. Most people do not stay on the medications for a long enough time to really feel the tolerance to begin with. Sure, in a clinical trial of four to six weeks, it might not be noticed. I've been on them for well over a decade, and it's a night and day difference.

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