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So the psychiatric establishment is finally, finally beginning to admit that PERHAPS they need to rethink the promiscious prescribing of antidepressants!


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Sounds like weasly-words to me, but at least it's a start. . .




The Risks Associated With Stopping an Antidepressant

Charles Raison, MD

Psych Congress cochair Charles Raison, MD, admits there are no easy answers to the questions clinicians face when prescribing antidepressants. But he hopes his talk at the upcoming 32nd annual Psych Congress will give attendees information they need to make informed decisions with their patients

Here, in part 4 of a 4-part series on DepressionCare360Dr. Raison discusses the risks that patients face when stopping an antidepressant and possible problems with restarting it.

Dr. Raison is the Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families; Professor, Human Development and Family Studies, School of Human Ecology; and Professor, Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin- Madison. He is also Director of Clinical and Translational Research for the Usona Institute, which conducts research on the therapeutic effects of psilocybin.

Dr. Raison's session, “Faded Love: A Critical Look at the Strengths and Weaknesses of Antidepressants for the Treatment of Major Depression,” will be held from 4:15 p.m. to 5:30 p.m. on Saturday, Oct. 5. 

Q: What risks are associated with stopping an antidepressant and with restarting it?



A: In psychiatry, the scientific literature is never 100% consistent, so there's always studies that support your position. But, I think the bulk of the studies suggest that in people who have had a response to an antidepressant, stopping the antidepressant increases the risk for relapse.

There's a large study showing that you're much more likely to get depressed again if you just stop an antidepressant quickly than if you remove it slowly. That's very consistent. That's one of the strongest pieces of evidence for this idea that the brain fights back against the antidepressant by themselves. The brain and antidepressants are pushing on each other, you take away the antidepressant and the push of the brain just pushes over the depression. So if you go slowly, it allows the brain to adjust to the absence of the antidepressant. That's the risk in stopping an antidepressant: your risks of being depressed again go up.




Go to Part 1: The Role of Antidepressants in the Treatment of Depression




Also, with some antidepressants more than others, there is a fairly regular occurrence of withdrawal syndrome. As a field, we were in denial about this for years. Patients came to us complaining about it and we didn't have the paradigm for it because these are not “addictive” drugs. I mean, nobody parties with their antidepressant, right? Many, many, people have pretty nasty withdrawal symptoms. Sometimes I think it can be confused with relapse into depression. People feel sick and dizzy. It's rough, and there are people who experience this withdrawal for weeks and weeks and weeks. There are case reports of people who have sort of experienced it forever. So that's another risk of going off the antidepressant.




Go to Part 2: The Risks of Long-Term Antidepressant Treatment







In general, there are studies showing that if you go off whatever psychotropic agent you're on, you're less likely to respond to it if you go back on it and you'll also have to be put back on at a higher dose to get the effect.



This is why one of the things about this talk is it provides information, but it doesn't provide easy answers. I just finished saying we might not want to think about keeping people on antidepressants forever, but I'm also now saying that taking people off their antidepressants comes at a risk too. But that's one of the reasons we should be thinking more upfront about can we help the person not get into a situation where they can't make it without their antidepressant.



—Terri Airov

Go to Part 3: Deciding When to Stop an Antidepressant

Drugfree Prof

Psychologist and Psychotherapist

Prozac 20 mg for approx 3 months during 2000, withdrew, no w/d sx

Prozac 10 - 30 mg Jan. 2008 - Dec. 2014

Ritalin 30-40 mg Jan. 2008 - Mar. 2015

W/d sx from Prozac started around 3 months after cessation--crying spells, depressed mood, lethargy; resolved in 8 - 12 mos. post cessation

Used and continue to use a TON of alternative methods--meditation, mindfulness, nutrition. supplements, exercise, etc.

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On 10/2/2019 at 2:15 AM, DrugfreeProf said:

Sounds like weasly-words to me, but at least it's a start. .

Yes, it’s progress. Where one goes the masses may  follow. It may at least have no impact on psychiatrists who say withdrawal does not exist at all ( as one nhs consultant psychiatrist vehemently stated to me  and  then who flip flopped between talk of  half life  and a few weeks- talk about a confused state of affairs )

1999:  Paroxetine (20mg). Age 16. 2007-2008: Fluoxetine (Prozac) for 1.5 years (age 25) Citalopram 20mg 2002-2005, 2009: Escitalopram (20mg), 2 weeks, (age 26) (adverse  reaction)/*Valium 5mg/Temazepam 10mg 2010: Mirtazipine (Remeron)( do not remember dosage) 2010, 5 months.                     2010-2017: Citalopram (20mg) (age 27 to 34) 2016: i.1st Sept- 31st Oct Citalopram 10mg , ii.1st November 2017-30th November 2017, Citalopram 5mg iii.1st December 2017- 4th February 2018, Citalopram 0mg, iv.5th February 2018- March 2018 Citalopram 5mg (10mg every other day) 28th February- tried titration of 5mg ( some adverse effects)

2018: 1st March 2018- 1st June Citalopram 10 mg (tablet form) /started titration 8mg , then 7 mg.2018: June 15th- 10th July Citalopram 10 mg pill every other day 2018: 10th July - 13th Sept Citalopram- 0mg  (CBD oil first month of 0mg, passiflora on and off) 2018 13th Sept Citalopram  2mg ,  approx 16th Sept 4mg , approx 25th Sept 6mg held.  2019: 11 Feb 19: 7mg (instant bad rxn) 12 Feb 19 6mg held 1 May 19 5.4mg held 5 Oct 19 5.36mg 22 Oct 19 5.29mg 30 Oct 19 5.23mg 4/NOV/19 5.18mg 12 Nov 19 5.08mg 20 Nov 19 4.77mg 7 May 22 2.31mg 17/09/2023 0.8mg

(Herbal/Supplements since 1st September: Omega Fish Oil 1200mg, 663mg of EPA- 2 tablets a day, magnesium and magnesium bath salts)

I did not die, and yet I lost life’s breath
- Dante
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Very fanciful description of how antidepressants work. I don't think this guy gets it.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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