Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

Post reply on HN
Print view View original

211–220 of 376 posts

Re: Doctors are finally learning to manage antidepressant withdrawal

#211

Post by move68k »

drayfield wrote: post #128

I've been on 40mg citalopram for about 20 years now. I've tried a few times to come off either tapering or cold turkey and in all cases it's been horrendous. My biggest worry is that I'll never be able to come off them as I'm on such a high dosage, even if it was tapered off over a very long period of time.

Hey, don't lose hope. I got prescribed and took 30 mg of Citalopram for about 10 years to treat general anxiety. At some point, I wanted to stop taking it because of the emotional numbness (and also because of a tendency toward mildly aggressive episodes).

I gradually reduced the dosage from 30 to 20 mg (over the time of 3 to 4 months), then down to 10 mg (for another 2–3 months), and then I finally reduced it to 5 mg (half a 10-mg tablet) over a period of 4–6 weeks. I told my doctor beforehand, they only told me that I should fade it out slowly. But please excuse me for not knowing the exact time frames of the tapering process any more. I took my time at the beginning of the tapering and moved more quickly toward the end.

During and afterwards I didn’t notice any severe side effects, aside from the fact that the recurring emotions really overwhelmed me at times. Not only that, but I would cry at the slightest hint of emotional and romantic scenes in movies and series, which lasted for about three months. Nowadays, I feel quite normal. I miss the slight comfort Citalopram gave me, but I have my feelings back, I feel more myself again. If a bit more anxiety is the price for that, then so be it.

Re: Doctors are finally learning to manage antidepressant withdrawal

#212

Post by mancerayder »

chewbacha wrote: post #153

I’ve been on a SSRI for 5 years and not once have I thought about getting off of it. It literally saved my life. 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 d…

An unfortunate aspect of modern discourse and thinking is how black and white discussions can feel. Several sides of the topic can co-exist together and all be true, so (well, in my experience and reading):

- Some people really benefit from and even need SSRIs or other psychoactive drugs to function well in society.

- Too many people are prescribed them such that there may be more harm than good. They may have side effects or were prescribed them to deal with a situational problem that could have been better managed with therapy.

- Whether justified or no, a prescription is given with no off ramp provided. It's almost as if you're defective and the drug is fixing you, and the solution are pharmaceuticals, which again may be true for some subset of those prescribed. People clearly are trying to taper and are suffering.

More controversially, psychiatry is something of an art (if you're generous) or a racket. Because there's no way the "chemical imbalance in the brain" theory can be validated empirically. In the US you meet with one for 15m, get prescribed a cocktail of drugs, a few months later you report if it worked, and if not they'll up the dose or play around with the cocktail. I don't know how we call that stuff science.

Re: Doctors are finally learning to manage antidepressant withdrawal

#213

Post by warmwaffles »

chewbacha wrote: post #153

I’ve been on a SSRI for 5 years and not once have I thought about getting off of it. It literally saved my life. 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 d…

> I’ve been on a SSRI for 5 years and not once have I thought about getting off of it.

I had this same outlook too. Was on one for about 6 years and then my first kid was born. I felt nothing emotionally when she came in to the world and I discussed this with my wife. Two years later, my second child was born and it was a radically different experience and I am glad I got off.

My GP warned me, "Don't cold turkey it, taper off, cut the dosage and ween off. Ask your wife to pay attention to your moods, if you go sour and can't recover, you may want to consider going back on."

Over those 6 years on it, I learned a lot about how to deal with the stress. I definitely think that's a missing key in the whole treatment process.

Re: Doctors are finally learning to manage antidepressant withdrawal

#214

Post by Scubabear68 »

jkxyz wrote: post #175

I went cold turkey off of citalopram when I was a teenager and it was a pretty unpleasant two weeks of heart palpitations, but the immediate benefit of no longer experiencing emotional blunting made me avoid taking any more antidepressants for 10 years. I was prescribed it by a GP and never given any real support in my mental health or in coming off of it. It was a real black pill for me on the UK's treatment of ment…

It can't be emphasized enough for me just how unpleasant side effects like heart palpitations, tachycardia and related conditions really are. For me at least, those kinds of conditions trigger something close to a panic attack which feels like a very deep seat primitive protective measure in our brains.

Laying in your bed trying to be restful and feeling your heart slamming away at 140 beats per minute with little you can do about it goes behind miserable into outright alarming, even if you are "used" to it.

Re: Doctors are finally learning to manage antidepressant withdrawal

#215

Post by ivansavz »

The relevant book is The Maudsley Deprescribing Guidelines Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs by Mark Horowitz and David Taylor (2024).

This book is for medical professionals, but if you find your doctor doesn't have the relevant training then worth to educate yourself. The TL;DR is that you need to go really slowly in the final steps.

Horowitz also has many talks and podcast appearances on youtube. Example old video https://www.youtube.com/watch?v=LRr09mvMEAU but he has many more recent ones.

I don't have any direct experience with this, but I've been watching my best friend struggle with widthdraw symtoms for many year, and I also know from doctor friends that they are not trained on de-prescribing protocols.

Re: Doctors are finally learning to manage antidepressant withdrawal

#216

Post by krupan »

bcjdjsndon wrote: post #161
chewbacha wrote: post #153

I’ve been on a SSRI for 5 years and not once have I thought about getting off of it. It literally saved my life. 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 d…

[flagged]

There's situational depression (my mom died, my girlfriend dumped me, etc.) and then there's depression. Winston Churchill called his The Black Dog. It is relentless and not related to any situation you are in. If you don't understand then be thankful.

The cause is not entirely clear. SSRIs do not help you "bury it." It's not an emotional problem or a lifestyle problem or anything like that. There's no "it" to bury. SSRIs seem to remove whatever cause is in your brain/nervous system. They literally are lifesaving drugs with almost no side effects for many people!

Re: Doctors are finally learning to manage antidepressant withdrawal

#217

Post by bcjdjsndon »

MSFT_Edging wrote: post #196
bcjdjsndon wrote: post #160

[flagged]

I think this is a very different problem. I'm prescribed those "happy pills" as you call them. I forget to take them regularly, in fact I think you may have just reminded me to take mine as long as I remember by the end of this comment. There isn't a high, in fact if I don't modulate how I eat and hydrate, I don't feel it. But if I get the timing just right, with the correct breakfast and everything, I can just barel…

[flagged]

Re: Doctors are finally learning to manage antidepressant withdrawal

#219

Post by _puk »

bsuvc wrote: post #16
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…

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.

These comments about brains zaps is the first time I've heard confirmation from what I've experienced.

I've had them every time I've started or stopped a *pine antidepressant.

Like, something rolls off the counter and my natural reaction would catch it.

Instead, my hand doesn't move, and a brain zap.

Physically painful.

Re: Doctors are finally learning to manage antidepressant withdrawal

#220

Post by bcjdjsndon »

krupan wrote: post #216
bcjdjsndon wrote: post #161

Earlier quoted context omitted.

[flagged]

There's situational depression (my mom died, my girlfriend dumped me, etc.) and then there's depression. Winston Churchill called his The Black Dog. It is relentless and not related to any situation you are in. If you don't understand then be thankful. The cause is not entirely clear. SSRIs do not help you "bury it." It's not an emotional problem or a lifestyle problem or anything like that. There's no "it" to bury.…

[flagged]
Post reply on HN