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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

#351

Post by sandcat_ »

dllrr wrote: post #170
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…

I think you are the flip side of what you mentioned about the article. I don't see the article as saying withdrawal is catastrophic, in fact I see it being well balanced when stating numbers. But you just said many or most people don't experience that. If I were to take your approach, and make generalized statements based on my own experiences, I would say many if not most actually do experience significant withdrawa…

For sure. That’s all I wanted to provide: an alternative anecdote from the article which led with an anecdote of perhaps the worst case for withdrawals. If I’d read an article like this five years ago, I might not have gotten the help I needed.

Re: Doctors are finally learning to manage antidepressant withdrawal

#352

Post by movespebp »

15feetOfclay wrote: post #243

This comment section is absolutely full of people ready and willing to insist that people with depression simply need to cheer up and get over it. And all I can say is: I hope someone shows them a similar level of compassion when they are at their lowest.

It's an awful thing to suffer and full sympathy to anyone who does. What unfortunately has happened as well is that the drug companies have successfully convinced the public, providers and sections of the media that any criticism of their products is criticism of people who suffer.

There are very serious concerns about the safety and effectiveness of these drugs, but the companies consistently attempt to misdirect that, seeking to portray the criticisms as "stigmatizing" sufferers or "fear mongering", neither of which is true.

Re: Doctors are finally learning to manage antidepressant withdrawal

#353

Post by kbelder »

googaar wrote: post #20
D-Machine wrote: post #3

Best way to manage the withdrawal would be to dramatically reduce them being prescribed in the first place. The linked article says they have "small to moderate effectiveness", but this is being far too generous. The correct way to measure drug effectiveness is if the treatment meets the standard of a minimal important difference. I.e. you measure depression on various rating scales, like the 17-point HAM-D, and rese…

I can’t believe we’ve normalized anti depressants as a society. I’m about to get downvoted into oblivion for this take though. I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Also think that some people are dealt a tougher hand than most, and that for a small subset of humans, anti depressants are the most fitting cure.

I tend to feel the same way. The medication is obviously useful in some cases and for some conditions, but there's also a pushback against the notion that it isn't the best solution for other cases and conditions. There are cases where other solutions might be healthier, especially in the long term, but the availability of a potential pharmaceutical fix interferes.

And look at the new batch of weight-loss drugs. It's a similar circumstance. It's a wonder drug in many ways, helps so many people that wouldn't have been helped otherwise. Yet, also being used in some cases as a shortcut to avoid a behavioral change that would be advantageous for a person to do.

It is important to remember that there are people for whom these drugs are literal lifesavers. And at the same time, there are those for whom the drugs enable avoidance of fixing a root cause.

Re: Doctors are finally learning to manage antidepressant withdrawal

#355

Post by FatherOfCurses »

movespebp wrote: post #352
15feetOfclay wrote: post #243

This comment section is absolutely full of people ready and willing to insist that people with depression simply need to cheer up and get over it. And all I can say is: I hope someone shows them a similar level of compassion when they are at their lowest.

It's an awful thing to suffer and full sympathy to anyone who does. What unfortunately has happened as well is that the drug companies have successfully convinced the public, providers and sections of the media that any criticism of their products is criticism of people who suffer. There are very serious concerns about the safety and effectiveness of these drugs, but the companies consistently attempt to misdirect th…

I am as critical of Big Pharma as anyone else, but you can't seriously imply that our society places a certain amount of social stigma on people who take medication for mental illness. Some US insurance companies make it more difficult to get medication for mental illness because they often argue against the need for the medication.

Re: Doctors are finally learning to manage antidepressant withdrawal

#356

Post by FatherOfCurses »

googaar wrote: post #20
D-Machine wrote: post #3

Best way to manage the withdrawal would be to dramatically reduce them being prescribed in the first place. The linked article says they have "small to moderate effectiveness", but this is being far too generous. The correct way to measure drug effectiveness is if the treatment meets the standard of a minimal important difference. I.e. you measure depression on various rating scales, like the 17-point HAM-D, and rese…

I can’t believe we’ve normalized anti depressants as a society. I’m about to get downvoted into oblivion for this take though. I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Also think that some people are dealt a tougher hand than most, and that for a small subset of humans, anti depressants are the most fitting cure.

I can't believe we've normalized taking insulin as a society. There are better ways than drugs to fix your Type 2 diabetes.

Re: Doctors are finally learning to manage antidepressant withdrawal

#357

Post by swat535 »

mrguyorama wrote: post #332
pas wrote: post #165

Earlier quoted context omitted.

for anyone who's curious about the sexual side-effects, this subreddit has stories from the unlucky few https://reddit.com/r/PSSD/top/

The only medication for Premature Ejaculation that exists currently is a megadose of a special SSRI which has a short half life. If you are a man, SSRIs are very likely to make you last longer in bed, and that is often a very bad thing. If you are a woman, whatever the SSRI is treating may leave you better off than before, if you found the depression or anxiety to be an obstacle to your satisfaction. Many people howe…

Are you referring to dapoxetine ? It's not approved in US and it's not really a "megadose” of a regular SSRI since it's a different molecule.

Also, this is not only medication for PE.. there are many other options like fluoxetine, citalopram, PDE5s, etc .

Re: Doctors are finally learning to manage antidepressant withdrawal

#358

Post by musictubes »

gwbas1c wrote: post #230
asa123 wrote: 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.

Amazon: https://www.amazon.com/s?k=calibrated+milligram+scale --- They're common, cheap, and plenty of (recreational) drug dealers use them.

They are also great for photo chemicals mixed from scratch.

Re: Doctors are finally learning to manage antidepressant withdrawal

#359

Post by pessimizer »

orangedog wrote: post #296
WhitneyLand wrote: post #295

Earlier quoted context omitted.

So, this is not supported by the data when people are asked. Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain. I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.

> The most common side effects reported by patients in the study by Hu et al1 of 401 outpatients taking SSRIs were drowsiness (38%), dry mouth (34%), and sexual dysfunction (34%) > which was conducted in 1999-2000, questioned patients about side effects via phone interviews within 75 to 105 days of starting antidepressant therapy. The side effects deemed most bothersome were sexual dysfunction (17%) It's no where nea…

Do you think the one 25 year old short-term study that you found by yourself is the only study that has been done, and that anything that deviates from it is a distortion?

Re: Doctors are finally learning to manage antidepressant withdrawal

#360

Post by burnte »

D-Machine wrote: post #17
burnte wrote: post #11

Earlier quoted context omitted.

> Best way to manage the withdrawal would be to dramatically reduce them being prescribed in the first place. No, that will just hurt more people up front for longer. The truth is antidepressants have a larger effect on mental health than actually gets reported because of how improvements are measured. If you look at a patient who doesn't get out of bed, is in trouble at work/school for performance, doesn't spend soc…

> The truth is antidepressants have a larger effect on mental health than actually gets reported because of how improvements are measured. The truth is actually exactly the opposite, and I provided very high-quality evidence demonstrating this to be the case. You have nothing but bald assertions.

No, I have proof, I work in mental health, I'm part of our research committee's board, I see the actual data from our patients, other studies, the discussions about the data, etc. You simply completely ignored my core statement. I spelled out why different studies report different outcomes, and they're genuinely big problems.

You don't have to like it or agree with it but don't try to dismiss me, you linked 4 studies you don't even understand because you misrepresented the data they report. One of them actually PROVES my point. Another is a metastudy which is only useful for indicating future research avenues, not drawing clinical decisions. And lastly one proves my point about multi-drug failures requiring a change in treatment.

Antidepressants save lives and I will fight tooth and nail to preserve their access by patients.

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