antidepressants - s&d, CoD, evil bitches, cash cows and saviours of sanity

*raises hand* 300 milligrams a day. No noticable side effects.

I was on Effexor for a little while after a hospital stay two years ago. It worked incredibly well at pulling me from the deepest depths of depression. But I hated the "brain shivers" I got and became scared when I read that the dependency it could cause was dangerous for bipolars. Anyway I got off.

I wonder if the interweb has done me more damage in terms of "information" about my meds?

Great thread.

I am so surprised I didn't post on it eh.

Maybe Dom's revive should warn me off this thread, but hey.

It's been suggested that I go back on these. I'm a little reluctant, for various reasons, but I don't want to dismiss it outright if it's the best way forward. So I thought I'd bump this and see if anyone else had anything to say.

(more detail about the reasons may be forthcoming later, but I've typed out my epic rants and, well, tl;dr.)

i heard that the part of yr brain that makes serotonin atrophies because it's not being used anymore, if yr on antidepressants too long. so you come off them perma-depressed.

my cat has just been prescribed Elavil. How can I use this to my recreational advantage? Is it worth popping one? He seems quite content at the moment.
-- kyle (akmonday), Tuesday, May 4, 2004 3:33 AM (4 years ago) Bookmark Link

haa wtf?

I think the best idea is to listen to your doctor and not to people on the internet. I understand that if you live somewhere where your doc might make money from your meds you might feel apprehensive, but they're still muvh more informed than us/you/i.

HA, a true ilx question.

xp

i heard that the part of yr brain that makes serotonin atrophies because it's not being used anymore, if yr on antidepressants too long. so you come off them perma-depressed.

-- jeremy waters, Monday, July 28, 2008 8:31 PM (7 minutes ago) Bookmark Link

where did you hear this, it sounds like a bunch of bullshit.

dowd OTM

Plus there are tons of internet wackies who will tell you that if you are even thinking of talking about SSRIs, you're a brainwashed bitch who needs more yoga and chakra realignment. Those people always get me mad butthurt.

Listen to your doctor and those that know you well & care about you IRL.

Also there is nothing wrong with being on any medication and don't let anyone else tell you otherwise. Not that I's saying you should; once again, talk with a good doctor about this.

i think the real questions we need to be asking ourselves is how we can get our pets to score more drugs for us

where did you hear this, it sounds like a bunch of bullshit.

-- bell_labs, Monday, July 28, 2008 9:40 PM

i can't remember. it's one theory as to why people have such a hard time coming off SSRI's.

My mom-in-law's dog was prescribed klonopin. Six ml a day! It kind of lead to her getting addicted to klonopin (sorry dog, no pills for you).

Normal human dose is one-two ml a day.

x-post
well afaik there are very few studies about long-term antidepressant use and the research is far from being able to tell us anything like that.

i'd be really curious about seeing the results of actual studies , and it worries me that there aren't more. but when people say stuff like that i assume they got their information from a scientologist or something.

maybe it is bullshit, i dunno. have to have a bit of a google.

what's the generally accepted view of why some people have such a hard time withdrawing, especially long-term users?

I wouldn't be totally shocked if having serotonin provided via meds led to natural production being slowed/replaced/etc by the brain, just from the standpoint that the body usually gets rid of draws on its resources that become unnecessary. However if you were underproducing IN THE FIRST FREAKIN PLACE, that doesn't really change anything, does it.

i think that it's thought that there is a temporary reduction in SSRI production but i've never seen any claims that it causes permanent brain damage. i know that some people bounce back. and the people that generally respond to SSRIs are people with a genuine deficiency to begin with, not people with situational depression, so it makes sense they would be depressed when they go off them.

can i just say (as a long-term user ... 10 years?) that i missed my lexapro for three days last week, and by the third day i was considering throwing myself under a bus. i mean, not really, but that's how it felt.

i'm not saying one way or another about brain damage but just reiterating that if you're going to take these things be careful not to miss doses or just go off whenever you feel like it.

yeah, i know that feeling and it sucks :( there is no way i'd last 3 days even.

listen to your doctor, yes, they know a lot. but they aren't God, and they're often lazy (or, overworked, if you'd like) mofos who always take the option that's easiest for them. really easy to throw pills at a patient (pills recommended by that nice pharmaceutical rep lady who routinesly comes by and buys lunch for the whole office) and be off to the next one than try to suss out and deal with a patient's individual-specific problems and the causes of thos problems.

that's a therapist's job, not a doctor's

I wouldn't be totally shocked if having serotonin provided via meds led to natural production being slowed/replaced/etc by the brain, just from the standpoint that the body usually gets rid of draws on its resources that become unnecessary. However if you were underproducing IN THE FIRST FREAKIN PLACE, that doesn't really change anything, does it.

Well, it depends on if the baseline post-drugs is even lower. Obviously a major study is needed, if one isn't already underway. There are definitely many other chemicals that the body will stop producing if it's being supplemented from outside, but -- outside of steroid users' legendary shrivelings -- I don't know which ones bounce back and which ones don't.

I know it's helped quite a few people, but Effexor frightens me -- some patients apparently have to take it for life, as the (reportedly super-intense) withdrawal symptoms never stop.

exactly. LOTS of people bypass the therapist stage.
xpost

I have already asked parents and boyfriend, but nobody I know well enough offline to ask has been on them (yeah, I know! I don't know many people right now, it has to be said), hence digging up this thread. I'm aware that I've let myself get a bit jaded about them with not much to back it up, so I wanted to read some personal experience.

Already booked a doctor's appointment - he's a super-smart guy and he's usually a sympathetic listener, but in the past his advice has seemed more aimed at getting the newly-diagnosed depressive on some kind of standard plan. I wouldn't try to do anything without listening to him first, but if he says I should be on them I'd like to feel a bit more comfortable with the idea myself first.

re effexor: the last time i missed a dose for over 48 hours was when i was 17. it was also the first time. i'm not saying the withdrawal doesn't suck, it clearly does, and it is 100% of the reason i've never tried to discontinue effexor. i've heard of people having brain zaps for up to a year afterwards.

it sucks that the most frightening thing about pregnancy is that i would have to go through withdrawal, and if it was unplanned, i'd have to go through it while my body was going through all of these other changes...that is even scarier to me than actually giving birth.

but honestly? i don't know if i'd be anywhere without antidepressants. i might have eventually become this stable, but i really doubt i would have made it. i do think they helped me, but i definitely have really mixed feelings about it.

i used effexor for a couple of years and yes, the headaches that i got when i would miss doses were quite scary. like migraines but without the pain; you'd feel weird zaps and tingles, like your brain was spinning around in your skull. actually it was not unlike coming down off of hard drugs (the illegal kind).

and back to granny dainger:

at this point, every large healthcare organization, whether hospital or university system or HMO or PPO, has split off it's mental health care from it's general health care. because they're really different things. so complaining that your doctor gave you pills is a bit like complaining that you went to the doctor with a toothache and he gave you pain pills. if you wanted oral surgery, why didn't you just go to the dentist? i would be surprised if a GP gave you pills but no recommendation to a therapist.

actually if you're in an HMO you'd need to go to your doctor first ... but you'd just say, "i'm depressed and want to see a therapist", or "i'm hearing voices and want to see a psychiatrist". and that would be that.

i wouldn't be too wary of the fact that there's a "standard plan" for depression. i mean, that's what makes it a profession, in the sense that law or accountancy is a profession. there's a standard plan for everything, whether you have broken bones, or cancer, or pneumonia, or colitis or what. and the reason there's these standard plans is that they've been shown to work for the vast majority of people. (an interesting question is why people are worried about that: do they imagine medicine happens like it does on TV hospital shows, where every time someone goes into the doctor's office the doctor sits around with his buddies for an hour trying to figure out what's wrong with you and what can be done?)

so you should be *happy* that there's a standard plan: it means your condition is treatable, and has been successfully treated in thousands (millions?) of other people.

I don't know, Spacecadet, what are your reasons for your reluctive stance on your doctor's advice?

There's no 'failure' in going back to meds if needed. A feeling of failure can only make you feel more distressed about taking meds again, fighting the very thing that's probably the right thing to do right now. I assume you know this, having taken meds before.

I've been on meds for six, seven years now. There were times I felt strong, and decided to take smaller doses, but on occasion I've had to up it again. After all these ups and downs in dosage I'm at 75mg Efexor today, starting out at 150mg all these years ago. So that's... something, I guess.

I did learn there's no 'reward' in the simple idea of 'must-stay-free-of-meds'. It's an appealing thought, definitely, but you can come up to a point where it's just not realistic. So if your fear is: "I don't want to use meds anymore because they suck and I'll be stuck on them forever", that's very understandable, but it's also ultimately about the future. And you seem to be needing help right now. Ignore the long-term visions of dying a meds-taker in sixty years, and think about today, about right now. That's what counts most now.

xpost

it dosen't matter if it's a PCP or if it's a "therapist" met with you for a half hour and then threw pills at your problems. i'm using "doctor" in a broad sense to refer to whoever the med professional is that someone is trusting to help them with their mental state. The fucked up part is that, insuarance-wise, someone who goes to therapy for a year is looked on less favorably than someone who has no trad therapy but takes medication.

granny d, i mean a therapist with whom you meet regularly to talk over your problems, not a therapist who "met with you half an hour and then threw pills at your problems".

are you really hoping that the doctor is going to say that you're that one-in-a-million person with a thyroid problem who needs it zapped with radiation? or that you're an incurable depressive who needs a lobotomy? or that they'd like to put you on a special experimental treatment? you're depressed because you have a brain tumor? or that you were really adopted?

^^ i'm not trying to make of fun of you, these are things that i thought when i was disappointed with my "standard plan". i was like, "eat right, regular sleep, exercise, meds, see a therapist, keep a diary ... that can't be all?!? i have PROBLEMS!!!" ...

re effexor: the last time i missed a dose for over 48 hours was when i was 17. it was also the first time. i'm not saying the withdrawal doesn't suck, it clearly does, and it is 100% of the reason i've never tried to discontinue effexor. i've heard of people having brain zaps for up to a year afterwards.

it sucks that the most frightening thing about pregnancy is that i would have to go through withdrawal, and if it was unplanned, i'd have to go through it while my body was going through all of these other changes...that is even scarier to me than actually giving birth.

I have been on Effexor since 2001 except for two years between now and then. I had moved to England and couldn't find a Dr when I ran out and when through the withdrawals. All in all the "brain zaps" lasted for about a week and it was bearable - barely. I went on it again a couple years later when my anxiety got bad again. Despite all the withdrawal issues (this morning I was 7 hours late in taking it and already started feeling funny) I'm happy with it. It's worked wonders for me and I don't experience any other effects.

Prozac + therapy has worked great for me (fwiw my depression revolved mostly around self-image problems & social anxiety)

have yet to go off it though

ENBB otm, can't say anything else. There's always this chicken/egg question hovering somewhere in the back of my mind - is it the thing I needed for all those years (poor serotonine production?), or have I become addicted to Efexor and simply can't go without it anymore, which is why I feel bad without it?

But I really can't be bothered by that question anymore. Ofcourse, evolution and survival instinct is in all of us, which is why I can't accept the image of me using Efexor still after twenty years from now. But I have also experienced how it more or less keeps me on track nowadays. The trick is acknowledging that track is a different one from the track I was on ten years ago.

[also, but this is very off-topic: Efexor is a major hangover destroyer! The times I was accidentaly without it, alcohol made me sick all the time. But don't try this at home.]

Attempt to summarise long, dull reasons for being reluctant (sorry, they're still long and dull):
1. I don't feel depressed so much as frustrated at not escaping a mental rut. World of difference from when I was first put on SSRIs.
(Then again I'd convinced myself I wasn't ill then, and I haven't managed to turn my life around much since, with or without medication.)

2. I was on sertraline for two years and they did fuck all for me except a few mildly unpleasant side-effects (skittery heartbeat which kept me awake at night, constant headaches, unsettling dreams I couldn't wake up from, subsequent inability to tell when I was awake).
("fuck all" may be hindsight but my parents said the same thing unbidden, which I was not really expecting)

3. But I was lucky enough not to have any really horrible side-effects or withdrawal symptoms. Effexor at least made me ill quickly enough that I came off it after a week when I couldn't even swallow the tablets. Given all the horror stories, trying another brand seems like agreeing to another round of Russian roulette. Need to convince myself that the next attempt could go right as easily as wrong.

4. sorry Abbott: kneejerk doubt of current neurochemical understanding ("serotonin appears to be a good thing; we don't know why or what it's interacting with, but let's throw chemicals in until the level increases") and distrust of pharmaceutical corporate practice ("who gives a shit as long as we can hide any negative clinical trials and make a few billion before we have to pull it from sale")

...but yeah, I realise I know fuck all about that stuff and if the doctor prescribes me something for a physical ailment I don't refuse the prescription and shout about capitalism, so I guess I should cross 4 off. After all I do know there are people out there whose lives were improved by these things, and I know moonship's going to school me on this one...

what's the generally accepted view of why some people have such a hard time withdrawing, especially long-term users?

This is like asking a diabetic why they have such a hard time going off insulin.

I wrote:
1. I don't feel depressed so much as frustrated at not escaping a mental rut. World of difference from when I was first put on SSRIs.
(Then again I'd convinced myself I wasn't ill then, and I haven't managed to turn my life around much since, with or without medication.)

This is too negative. I know I'm much better now. Back then I was in a bad way but I thought I was just being stupid and lazy and the doctor would laugh me out of the surgery. Now I can recognise how depressed I was then and I don't feel like that at all. I picked up some mental habits while depressed that I can't seem to shake, and now I'm not technically depressed I'm hoping I might finally get myself together to shift them, is how I currently look at it.

(I got re-referred to therapy on this basis, but general calmly thought-out frustration at self for still being completely incapable of day-to-day productivity gave medium-high scores on the Beck inventory despite complete difference in feeling, which combined with how difficult I still find it to talk about last time round = therapist goes, wait, why aren't you on meds? and sends me back to the GP)

Yeah, I've gone well into "things you shouldn't tell the internet" territory and scared everyone off. But I'm off to sleep on it for tonight. Thanks for replying and for not calling me an immature science-phobic jerk for #4 (yet). I am actually encouraged that the post-revive answers have been more positive about antidepressants than the previous ones; I know I sound pretty kneejerk anti-medication, but I did want some other opinions, otherwise I'd have told myself I was right without asking ILX.

not really, the range of withdrawal symptoms seems to be much wider than simply feeling depressed again.

xpost

I know moonship's going to school me on this one...

is it that obvious that i'm a teacher? ;_;

i would say it sounds like you've thought this out pretty well! besides, i'm not sure antidepressants have anything to do with my day-to-day productivity other than getting me out of bed & the house.

Passing spacecadet, don't worry about being tmi, we're all being a little tmi but I think its good to talk about this instead of blindly going into it just based on drs orders. The decision is absolutely yours and unless you are endangering yourself or others you don't have to do anything you don't feel confortable doing.

I really like that people are talking about their experiences here.its really interesting.

(fwiw my depression revolved mostly around self-image problems & social anxiety)

this was me circa 13-16 years old. i was on paxil for a short while then, less than half a year if i remember right, and they did a world of good to kind of rid me of the worst aspects of my social anxiety and depression. i have mixed if mostly positive feelings about it, in the sense that it was kind of the shove in the right direction so that i was able to work on a lot of other things about myself without meds. losing a lot of weight helped the self-image problem, and i dont know that i would have had the self-worth to do anything about it without the anti-deps. still super introverted (like if the myers-briggs tests matter for shit, i always get at least 90% introverted) and get the occasional social panic attack in situations with lots of (mostly strangers) people. but i sweat everyday shit a lot less than i did 5 years ago.

i mean a sorta macho part of me wishes i was able to just deal with it cognitively on "my own" (was seeing a therapist for a couple of years, so rly on my own=sans meds) but i guess i was fortunate (or mild enough a case of depression) to not merit needing to be on it too long.

Hey spacecadet, I know you ain't being all anti-science! What I meant by my rather blunt and over-broad comment ("there is nothing wrong with being on any medication and don't let anyone else tell you otherwise") is that sometimes people need certain medications, and there's no shame in that.

ie It's okay to be on klonopin if you've got crushing anxiety, or digitalis if you have certain heart problems. Someone might be fine with just therapy (or something else) for anxiety, another person might have the sort of heart problem that just requires aspirin. Klonopin (benzodiazapene) and digitalis (fucking toxic foxgloves!) are potent chemicals, and potent medicines, that help certain people to enormous extents with their mental or physical problems. (Don't accidentally take digitalis...when I did, I saw green halos and vomited all day.)

I totes understand ambivalence (or worse) toward the wide, weird world of psychopharmeceuticals. Neuroscience is a wicked young field but so much of psychiatry acts like it is the One Ring to Solve it All. Like you said, there's a lot of uncertainty on all's part & sometimes it does feel like darts in the dark. Plus, without insurance or patience assistance, SSRIs are fucking 'spensive!!! (I hope you have one or both available.)

That said, basically two things have kept me from going over the edge. One is trying to stay chill & not take on unduly stressful situations, when avoidable. The other is taking medication! (Surprisingly, I have had a harder time finding a good therapist than I have a good psychiatrist or nurse practitioner.) I've been on Lexapro for two years (maybe a little longer?) and it works great. I still have emotions but it defs keeps me from crying and wishing I was not alive all day & all night, every day & night. It keeps me from not going to class or work because I'm too scared or too apathetic. And not all have that bad of side effects if you need to taper down & quit taking them (Paxil & Effexor are pretty notorious for being the worst).

OTOH you seem a wise & introspective person, and I'm sure you'll figure out what's best for you. I'm defs not trying to push you either way. Science has proven the best treatment plan for a mental illness (or such) is the one you research and choose for yourself. What I am reiterating, longwinded, is that it's okay to take SSRIs if they help you.