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Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

131–140 of 376 posts

Re: Doctors are finally learning to manage antidepressant withdrawal

#131

Though this article concentrates on the SSRIs, other meds like the SNRIs can have a similar or even worse withdrawal effect. We didn't call it "Side Effexor" for nothing. People legitimately need these drugs, including in the short term. The problem for acute stressors once they resolve is how to get them back off.

"People legitimately need these drugs"

First. Do no harm.

Re: Doctors are finally learning to manage antidepressant withdrawal

#132
post #130
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.

Relative precision is enough if you just want to get rid of pills

Re: Doctors are finally learning to manage antidepressant withdrawal

#133
post #130
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.

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

Re: Doctors are finally learning to manage antidepressant withdrawal

#134

Earlier quoted context omitted.

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.

> SSRIs do not have the same level of supporting evidence, and the effects are not as durable. To the extent that we can measure depression, SSRIs have been widely proven in gold standard phase III clinical trials to help with the treatment of major depression. What exactly is supposed to be lacking in the supported evidence?

GP is talking about using SSRIs for treating arachnophobia, not depression.

Re: Doctors are finally learning to manage antidepressant withdrawal

#136

Earlier quoted context omitted.

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?

Probably a misspelling of escitalopram, aka Lexapro.

Re: Doctors are finally learning to manage antidepressant withdrawal

#138
This is an absolute failure on the part of medical science. SSRIs went mainstream in 1988.

By 1992! We knew about withdrawal issues: https://www.wikidoc.org/index.php/SSRI_discontinuation_syndr...

Let's be generous and give it until the 2000s for the knowledge to spread and science to validate; and we're still left with 26 years of blundering around without IMO sufficient warning to patients about withdrawal risks.

I would wager some of the doctors who prescribe today were well past a glint in their father's eye when we started to know about this.

Re: Doctors are finally learning to manage antidepressant withdrawal

#139
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

Like buying a five gallon boiling flask, one assumes this will get one put on a list in the US.

Re: Doctors are finally learning to manage antidepressant withdrawal

#140

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.

> After a few weeks I was tapered off them. > I felt no different before, during or after them. SSRI onset is slow, which is one of the common problems with treatment. In studies where they survey both the patient and their family members, the family members actually start noticing improvements before the patient. Onset is slow and it takes a long time for patients to realize the positive effects. Ideally they’re pre…

> It’s not surprising you didn’t feel anything noticeable after a few weeks. It’s also unfortunate, but not too surprising, that your doctor wasn’t informed enough to communicate these things.

He probably did inform me, I was probably not paying attention at that time. Family does not know the details either, I'm dealing with this myself.

Anyway: depression is the least of my issues now, the clock is ticking.

Right now I'm sorting out my affairs without letting the kids know.

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