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Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

141–150 of 376 posts

Re: Doctors are finally learning to manage antidepressant withdrawal

#141
post #139

Earlier quoted context omitted.

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.

[deleted]

Re: Doctors are finally learning to manage antidepressant withdrawal

#142
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.

You can also taper off by reducing dosage one day of the week at a time. Thats how I tapered off a 10mg Escitalopram prescription: every 4 weeks, I added another day of the week where I reduced my dosage by 5mg. Took about a year to fully taper off and had to pause for a month here and there to stabilize, but it was worth it.

However, it was equally important that I had a support structure & tools to replace what the SSRI was doing. For me that was mindfulness and therapy.

Re: Doctors are finally learning to manage antidepressant withdrawal

#143
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.

Maybe another option is to dilute it with water so that you can use regular kitchen scales.

Re: Doctors are finally learning to manage antidepressant withdrawal

#144
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.

if the substance has good water solubility, you can do this by dilution, measuring volume, without a scale.

sertraline for instance: https://pubchem.ncbi.nlm.nih.gov/compound/68617#section=Solu...

don't do this with medications with special coatings or other methods for controlling release (SR/XR/etc).

Re: Doctors are finally learning to manage antidepressant withdrawal

#145
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.

You can also do a volumetric taper if you don’t have an accurate milligram scale (and none of the ones on Amazon are accurate). Dissolve a larger, known amount of medicine in a known amount of water or propylene glycol, depending upon solubility of the medicine. Then dose the liquid by volume. For example, 1 gram of medicine in 1 liter of water = 1 mg per ml. You can easily dose even microgram amounts this way.

Re: Doctors are finally learning to manage antidepressant withdrawal

#146
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.

you get a pill cutter. I was recommended to get one to ease in

Re: Doctors are finally learning to manage antidepressant withdrawal

#147

SSRIs and SNRIs just didn't work very well for me. If they had an positive effect at all, it wasn't enough to rise above the proverbial noise. Coming off of them wasn't too bad though. I got the brain zaps, but those were easy to cope with. More than anything the whole experience was a waste of money, and what finally fixed my problems was retirement and a greater attention to my health.

Have you looked into mirtazapine (tetra cyclic), vortioxetine (serotonin modulator) or atomoxetine (SNDRI). Atomoxetine has been a god send for me.

Atomoxetine can cause some wild mood-related side effects, just as an FYI for anyone considering it. For me, it made me perpetually pissed off, and made me feel like I had a cold. I’m jealous of people it works well for though - seems like a great drug when it works!

Re: Doctors are finally learning to manage antidepressant withdrawal

#148
post #65
post #16

Earlier quoted context omitted.

It's been years since, but I too had brain zaps coming off of it. It took a few months for those to go away. I tried to describe it to my doctor and he seemed like he never heard of it before and sort of look at me like I was crazy, or at least that is what I sensed. But I ended up researching online and found it was a thing that happens.

Interesting is your doctor a general practitioner or a psychiatrist? A psychiatrist definitely knows about this stuff. GPs in my experience know almost nothing about anything beyond what seems like a script they operate from.

Honestly, this is where chatbots and AI come into play and make an astonishing difference. I’m an AI realist/pessimist but its usefulness in general medicine is going to save millions of lives due to doctor ineptitude. They are after all just well read mechanics

Re: Doctors are finally learning to manage antidepressant withdrawal

#149
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.

Yeah, this is exactly why I couldn’t stay on it. I already deal with GAD and OCD, and whatever benefits it had for the depression were directly counteracted by the return of acute anxiety.

It was truly hellish. Feeling like I had this energy that I needed to use, while also feeling so anxious that I didn’t want to leave the apartment.

I know it works really well for some people but I was definitely not one of them.

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