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It deals with a small town psychiatrist who takes a whole town off of anti-depressants, and an ancient monster is summoned from the depths attracted by all the heightened emotions and terrorizes the town.
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.
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 drugs from the market.
Doctors that tells you how to reduce the SSRI/SNRI are following what's available on the market, and generally the gap between doses is always huge and gives a big gap and so bigger withdrawal. Once I asked to a pharmacist if he could make smaller doses and he answered me to be like a good junky and open the capsules and cut them myself. I was a bit shocked at the moment, but at least it costs me less that him having to do it a that helped me greatly to reduce a SNRI without feeling too much symptoms.
So a good advice, is look at the half-life of the drug you are taking, and be a good junky and split the capsules or have liquid form to reduce by small amount.
Half-Life of Specific SSRIs
- Fluoxetine (Prozac): 4 to 6 days, with its active metabolite norfluoxetine lasting 7 to 16 days.
- Sertraline (Zoloft): Roughly 22 to 36 hours.
- Citalopram (Celexa): About 36 hours.
- Escitalopram (Lexapro): About 27 to 32 hours.
- Fluvoxamine (Luvox): 17 to 22 hours.
- Paroxetine (Paxil): About 21 to 24 hours.
Half-Lives of Common SNRIs
- Venlafaxine (Effexor): About 5 hours for immediate-release (extended-release has an effective transit/clearance profile, though parent half-life remains short); its active metabolite (desvenlafaxine) has a half-life of about 11 hours.
- Desvenlafaxine (Pristiq): About 11 hours.
- Duloxetine (Cymbalta): About 12 hours (range of 8 to 17 hours).
- Levomilnacipran (Fetzima): About 12 hours.
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 also went cold turkey from escitalopram about a decade ago, and my experience was not as tame as yours; my ideation kicked into 6th gear, with paranoia, nausea, and insanely intense and vivid dreams every night. That was while on a 10mg dose. I have been on over-max-dose venlafaxine for nearly a year now. I think it has been an enormous improvement in my life on nearly every axis, but if I miss a dose by even a few…
Earlier quoted context omitted.
I also went cold turkey from escitalopram about a decade ago, and my experience was not as tame as yours; my ideation kicked into 6th gear, with paranoia, nausea, and insanely intense and vivid dreams every night. That was while on a 10mg dose. I have been on over-max-dose venlafaxine for nearly a year now. I think it has been an enormous improvement in my life on nearly every axis, but if I miss a dose by even a few…
Venlafaxine has a small half-life so that might be why if you miss a dose by a few hours you'd get withdrawal symptoms. Drugs is leaving fast you body and so concentration is quickly decreasing. Apparently there's a extended-release, don't know if it's already what you have but maybe you could ask to try another SNRIs that has a longer half-life.
Lookup "occupancy chart antidepressant", study the chart. There is an exponential drop-off at lower doses. Hence to taper off without feeling it, one needs to cut smaller and smaller doses, (or liquify) which may be impractical.
Interesting; I wasn't aware that 20mg was considered the minimum effective dose for fluoxetine. I tried tapering from 20mg to 15mg (alternating 10/20) after ~4 years and was absolutely fine; I then tried the next step down to 10mg and crashed hard . Probably going to stay on it for life now, which is fine; I never really experienced any negative side effects.
I forget exactly which antidepressant I was on, but when i finally stopped taking it, i was instructed to reduce dosage by half a pill every two weeks. Anecdotally, that was not anywhere close to slow enough. I had panic attacks almost every day while I was reducing the dosage. Those weeks were hell. I couldn’t think straight. I honestly don’t remember much of what occurred during that time, because the withdrawal to…
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…
Men’s inability to perform is causing a huge hit on their psyche. So in any case consider wisely, I heard many accounts of very disappointed men.
It may help women, but that’s a different thing.
For men - only in rare cases to be considered if ever.