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Dr. David Healy on prolonged antidepressant withdrawal syndrome (2009)

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Dr. Healy has long warned of the dangers of antidepressants. This is from 08/20/09 correspondence with our member squirrel, reposted with her permission

 

Dr. David Healy on protracted antidepressant withdrawal syndrome

 

Dr. Healy is a professor in Psychological Medicine at Cardiff University School of Medicine, Wales, director of the North Wales School of Psychological Medicine, and former secretary of the British Association for Psychopharmacology. He is the author of The Antidepressant Era, The Psychopharmacologists, The Creation of Psychopharmacology, Mania: A Short History of Bipolar Disorder (Johns Hopkins Biographies of Disease), Psychiatric Drugs Explained, and Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression (Medicine, Culture, and History), as well as many scholarly articles published in medical research journals.

 

He has been invited by the MHRA to advise the UK health service on antidepressant withdrawal and antidepressant withdrawal syndrome. A formal recommendation with citations will be released shortly.

Background

It is now generally accepted that antidepressants can cause physical dependence and a withdrawal syndrome, so that stopping antidepressants can commonly lead to withdrawal problems, that these problems may be severe in some instances but are generally less severe, and that these problems may last for months but are more often over within weeks. This piece outlines what is known about states of persisting difficulty and what can be done to remedy them.

 

First, it has been known since the 1960s when dependence on and withdrawal from antipsychotics was first outlined that in addition to classic states such as tardive dyskinesia that might be revealed by withdrawal, a variety of stress syndromes and persisting affective disturbances that have been termed tardive dysthymia, tardive akathisia and other tardive syndromes might also emerge.

 

Second, by the time enduring problems emerge after antidepressant discontinuation, the character of the initial problem has commonly changed. The initial problems often centre on phenomena that have been termed electric zaps, and electric head, but later these recede into the background and are replaced by a restless or dysphoric state consistent with a tardive dysthymia or tardive akathisia.

 

It should be noted that in addition to the abnormalities of sensation common in the initial phases, many of those affected complain of anxiety and depressive symptoms also. It may not be clear to patients or their doctors that these later onset depressive states are new developments, as they may often appear continuous with early onset withdrawal states and may even harder to distinguish from an original depression than the initial withdrawal state was.

 

Enduring states of this type can follow discontinuation from almost all antidepressants active on the serotonin system. The problem has not been as apparent on other antidepressants but this may reflect frequency of usage of SSRIs rather than anything else.

 

The problems appear more common in women than in men but this again may reflect frequency of usage.

 

The characteristic symptoms include “depression”, depersonalisation, agitation/akathisia, a generally labile state and stress intolerance.

 

Enduring problems can follow either abrupt or tapered discontinuation of treatment. One difficulty lies in knowing how common such states are.

 

A great number of individuals presenting to their doctors with these disorders are in all likelihood being told they have a recurrent affective disorder and are probably commonly being put back on an antidepressant.

 

This will happen for three reasons. First the problems will often look “depressive”. Second, most physicians simply do not think that higher order neurological problems of this sort could persist this long. Third, the problems at this point may seem to physicians to be different to the original problems on withdrawal and those affected may be persuaded of this. This interpretation is made more likely by the fact that most people will have had slightly better periods before a bad period leads them to seek help. But even tardive dyskinesia goes through good and bad phases.

 

Finally, this scenario overlaps with problems that can appear after stopping benzodiazepines, where the acute phases of withdrawal, which overlap with acute SSRI withdrawal, differed in profile from more chronic syndromes. The profile of chronic post-benzodiazepine difficulties is similar to that of chronic post-SSRI problems, with the chronic syndromes being more apparent in women.

 

Treating Severe Discontinuation Difficulties

In terms of the initial treatment of severe discontinuation difficulties, there are serotonergic and non-serotonergic options.

 

The serotonergic options as outlined in a number of withdrawal protocols involve going on a serotonin reuptake inhibitor such as fluoxetine or imipramine, often in liquid form and tapering extremely gradually.

 

A second option involves moving to a tricyclic antidepressant or an antihistamine or St John’s Wort on the basis that these share antihistaminic and serotonin reuptake inhibiting properties in common but are less potent (“gentler”) than SSRIs.

 

A third option involves treating with agents acting on different systems. Apparent success has been reported with choline-esterase inhibitors or lamotrigine. These have appeared in some instances to ease withdrawal problems in individuals who have found it very difficult to get off treatment.

 

Managing Tardive Dysthymia

The management of tardive dysthymia is a different problem to managing severe withdrawal. At present it is not clear what if anything might help the difficulties some people seem faced with 6 months or more into the discontinuation period.

 

Faced with ongoing problems, people commonly ask whether it might be worth going back on the original antidepressant and starting a new and even more gradual taper.

 

This seems problematic for two reasons. First going back on something that has caused such difficulties, perhaps through some vulnerability of the taker’s serotonergic or a related system, seems risky.

 

Second at least some of those who have gone back on treatment have needed to go back on a higher dose than previously in order to alleviate problems and in some instances a return to the original medication has not alleviated the problem.

 

Generally the longer the interval off the drug, the less likely it has been that reinstituting the treatment will lead to a resolution of the symptoms.

 

If an individual does return successfully to treatment, the question is what next.

 

Based on experience with the management of withdrawal from antipsychotics, one option might be to remain on treatment indefinitely. There are several drawbacks to this.

 

In the case of the antidepressants it is not at present known if ongoing treatment increases the risk of premature mortality or other disorder. The risks of fractures or haemorrhages seem slightly increased, and perhaps more substantially increased if combined with other treatments like aspirin.

 

If the taker has found the SSRI helpful but also emotionally blunting, this would be a significant impairment to quality of life to have to live with.

 

A second option is to turn to an antihistamine, such as chlorpheniramine, or to a tricyclic antidepressant, such as dosulepin or imipramine, or to St John’s Wort. The rationale here that a small amount of serotonin reuptake inhibition is all that is needed to produce a helpful anxiolytic effect in those suited to drugs of this type. SSRIs are in fact almost grotesquely overpowered for the purpose – using one is rather like having a sports car in a 30 mph zone.

 

Third turn to a completely different therapeutic principle. Among the options are drugs active on the cholinergic system, calcium channel blockers or dopamine agonists.

 

Choline-esterase inhibitors may help tardive dysthymic states, in that they have been reported to offer a benefit in tardive dyskinesia, and have been helpful in some cases of SSRI withdrawal.

 

Calcium channel blockers have been reported to benefit some individuals with enduring problems after antipsychotic withdrawal.

 

Dopamine agonists or stimulants are used in restless legs and related syndromes, and restlessness is often a component of the problems facing individuals after stopping antidepressants.

 

The final point concerns the likely duration of a tardive dysthymic episode. Based on the precedent of tardive dyskinesia, and of the difficulties some patients faced on discontinuation from benzodiazepines such states may last for 1-4 years. In older individuals there is a possibility they may last indefinitely. In younger individuals, they are more likely to clear up in a 12-36 month timeframe.

 

The resolution of difficulties may require something like a synthesis of new receptors to replace receptors that have been jettisoned in the face of physiological stressor of the SSRI. Whatever the mechanism recovery does happen but may take years and seems likely to be facilitated by activity of various sorts and most probably an avoidance of psychotropic medication – including antihistamines and other compounds.

 

Pregnancy – a Special Consideration

The issues above are particularly complex for women considering pregnancy, given evidence that serotonin reuptake inhibitors increase the risk of birth defects, spontaneous abortions, primary pulmonary hypertension and neonatal withdrawal syndromes.

 

Although more women on antidepressants have perfectly normal babies than have babies with one of the above problems, there is also the issue of the toll that 9 months of worrying might take on a mother and the effect of this on the relationship between mother and child.

 

Women contemplating pregnancy or suspecting or finding themselves pregnant and anxious to withdraw may have very real problems in the event of a significant withdrawal. A cross taper to fluoxetine liquid is problematic in that fluoxetine is also linked to an excess of birth defects and the other problems found with Seroxat.

 

 

MANAGEMENT STRATEGIES

 

Managing New Affective Episodes

Another issue that needs to be addressed is the emergence of what is in fact a new affective episode rather than a flare-up of tardive dysthymia.

 

In this case, it seems likely that if someone got well on a serotonergic agent in the first instance, they are more likely to show a better initial response to another such agent than they are to respond to an agent from a different class.

 

This raises the question of whether the short term benefit is worth taking given the likely longer term problems. To some extent this issue depends on what the alternatives are.

 

First if this is a depressive disorder that has responded to a serotonergic agent in the first instance, it is less likely to be severe and as such the risks of attempting to bring about a quick response with drugs – such as the risk of suicide – are not high.

 

It would seem best however to take a drug that has less potent serotonin reuptake inhibiting properties – such as imipramine.

 

Second, not intervening pharmacologically is a reasonable option for two reasons. One is that the natural history of such disorders is that they will resolve on average within 12-16 weeks. Another is that there is considerable evidence to suggest that those who respond without pharmacological or other interventions are less likely to relapse in future.

 

Third, related to not-intervening there are a number of things affected individuals can do for themselves. Exercising, particularly in a routine, is likely to be helpful, as is physical work generally. Diet, especially avoiding alcohol, is likely to be of some importance.

 

There are other more esoteric steps a person can take. One is sleep deprivation, which is undertaken regularly as an antidepressant treatment in many European countries.

 

Finally, CBT or other psychotherapeutic procedures may be of benefit, where they would seem to be less likely to be helpful in tardive dysthymic states.

 

Managing Withdrawal

 

A large number of doctors still halt antidepressants abruptly, possibly for 2 reasons. One, they are not aware they should taper the treatment. Second, it is not possible to taper the treatment as only a few drugs come in liquid form – fluoxetine, paroxetine and imipramine. Given that a transfer to fluoxetine liquid can cause its own problems, making liquid forms of all SSRIs available or disseminating information on how such formulations may be prepared is important.

 

Patients undergoing a marked withdrawal from antidepressants need an account of what is known about what is happening to them. Something on these lines:

Your brain has adjusted to the presence of an antidepressant and the removal of this stimulus now requires the brain to readjust. In some cases, some people readjust in the way a spring does when a weight is removed – it springs back into shape. For others the spring will get back to normal provided the weight is removed gradually. For some others, the spring will not readjust.

 

Some antidepressants appear to cause more problems than others but we do not know why this is. Fluoxetine may be helpful for some people as it makes the readjustment process more gradual but it is not helpful for all and comes with its own problems.

 

There are a number other possibilities, one of which is that problems are more likely with potent serotonin reuptake inhibitors such as paroxetine and venlafaxine, in which case the best strategy is to move to low potency serotonin reuptake inhibitor.

 

Managing Tardive Dysthymia

 

It is particularly important for patients suffering from this condition to have a name for the state and an explanation for what is happening.

 

For this reason it is proposed to name the enduring condition that can happen after discontinuation of an antidepressant tardive dysthymia. It is not clear how great the overlap might be between the tardive dysthymia linked to antidepressant, antipsychotic or benzodiazepine withdrawals.

 

That a number of people exposed to antipsychotics, benzodiazepines or antidepressants may have an enduring problem has been recognized for some decades. The risks of having an enduring problem appear slightly greater for women, and may increase with age.

 

There is no clear understanding of what happens in the brain to trigger such problems but it may be that with extended exposure to an antidepressant, some sensitive individuals lose receptors from the ends of their nerve terminals as part of an adaptive mechanism and when the drug is removed these receptors do not simply return to normal.

 

If the explanation offered above is even partly correct, it implies that with time the condition should resolve but this resolution may take months or years. It would seem intuitively sensible to suggest that activity, which helps to refashion nerve endings, would help and those affected should therefore be encouraged to be physically active and in general to live life as fully as possible and avoid shutting down or withdrawing from activities.

Activities such as walking or swimming may be helpful especially if undertaken in a graded programme that ensures there is daily activity and over time builds the activity levels up.

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Barbarannamated

Has he published these reccomendations?

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lionboy

hi Alto

when he says "may last indefinately in older individuals" what do you think he terms "older individuals".

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Barbarannamated

Good question!

BTW, I never found this information published anywhere.

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Altostrata

I don't know what he means by "older individuals."

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Barbarannamated

Older than my current age at whatever time I read this. ;)

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Altostrata

Ha! Older than me -- I'm going to be 62 in July.

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Nikki

The serotonergic options as outlined in a number of withdrawal protocols involve going on a serotonin reuptake inhibitor such as fluoxetine or imipramine, often in liquid form and tapering extremely gradually.

 

I did the Imipramine. It was helpful. I have heard some horror stories about Prozac.

 

Thanks for posting this Alto.

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btdt

I don't know what he means by "older individuals."

I don't see your history Alto .. how long drugged which drugs ect...so I can't figure how old you were starting Ads or how old you were when you quit. 

I have read reports of women having early menopause supposedly from taking effexor.... and wonder if part of the reason.  According to this article women have more issues with psych drugs than men.  Age and hormones ssri snri coming together to create the perfect storm.

Back to the chicken or the egg problem.

Some women in their 30s have reported menopause induced by Effexor - something I have read a lot about and posted on in the old topix forum - also found in the now gone effexoractivist forum... there is the seemingly contradicted use of Effexor to treat menopause ...both natural and chemically induced.

There are missing links here and missing clues.  Information is stepped on deleted by some entity for a reason.

I for one had sex hormone tests when I was in tolerance and cold turkey from Effexor and all had extreme results. I suspect gender specific alterations hold a key at least in part to understanding and perhaps treating tardive dysthymia.

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angieb

I am trying to wean off venlor, I was on 150mg then did 75mg for two weeks and then 37.5 for two weeks, and now am taking half a capsule, mmmm head is flapping nausea and vertigo, not as bad as when I used to forget my 150mg pill in a day............but still unpleasant, how can I completely wean off this venlor with minimal side effects, some people say I should go on Prozac and use the two for a week then drop the venlor and do Prozac for a week and stop all together ????????? what would you suggest

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btdt

"The characteristic symptoms include “depression”, depersonalisation, agitation/akathisia, a generally labile state and stress intolerance.

Enduring problems can follow either abrupt or tapered discontinuation of treatment. One difficulty lies in knowing how common such states are. 

A great number of individuals presenting to their doctors with these disorders are in all likelihood being told they have a recurrent affective disorder and are probably commonly being put back on an antidepressant. 

This will happen for three reasons. First the problems will often look “depressive”. Second, most physicians simply do not think that higher order neurological problems of this sort could persist this long. Third, the problems at this point may seem to physicians to be different to the original problems on withdrawal and those affected may be persuaded of this. This interpretation is made more likely by the fact that most people will have had slightly better periods before a bad period leads them to seek help. But even tardive dyskinesia goes through good and bad phases. "

 

As I read this above I can't help but think of all the times I was put back on a drug desperate to keep my job and my home life in tack all the struggle so many times ... all while trying to over come wd from a drug I was given off label to treat pain... it seems like the dark ages of torture but it was not that long ago. 

 

But even tardive dyskinesia goes through good and bad phases. "

I feel I have spent a good part of my life in tardive dyskinesea I should learn how to say it properly in case some time a person is interested in hearing it.... I would often go long stretches of time without medication white knuckling it all the while trying not to lose my job.. or my mind may kids suffered because of this and that is not forgivable. 
 
As I read the list of things to do to treat it.. I see that over the years I have tried most of it.. going back on meds trying benzos trying AP... I guess all that is left to me is the less often tried. 
 
"In the case of the antidepressants it is not at present known if ongoing treatment increases the risk of premature mortality or other disorder. The risks of fractures or haemorrhages seem slightly increased, and perhaps more substantially increased if combined with other treatments like aspirin." 
 
I have already had issues with both bleeding a fractures so if I was not already convinced that would clinch it... I was already convinced.  I am not convinced Ad use will not impact the length of my life even tho I am not taking them now and never will again.  I feel they have left a legacy on my body after 18 years use.  No I can't prove it I am not trying to prove anything just stating my opinion. 
 
"Third turn to a completely different therapeutic principle. Among the options are drugs active on the cholinergic system, calcium channel blockers or dopamine agonists. 

Choline-esterase inhibitors may help tardive dysthymic states, in that they have been reported to offer a benefit in tardive dyskinesia, and have been helpful in some cases of SSRI withdrawal.

Calcium channel blockers have been reported to benefit some individuals with enduring problems after antipsychotic withdrawal.

Dopamine agonists or stimulants are used in restless legs and related syndromes, and restlessness is often a component of the problems facing individuals after stopping antidepressants. "

 
I am thinking I have tried at least one of all of these.. all took time all upset my apple cart once again.  The only one I think I have not tried would be the choline esterase inhibitors... quick search bring me to this
Cholinesterase inhibitors: drugs looking for a disease? - See more at: http://www.cwhn.ca/en/node/27630#sthash.NIqw5qEb.dpuf
not comforting in any respect. 
not convinced but I never heard of them either... 
 
As for timeline maybe I will be a lifer but I know Alto was done or close at 7 years so was Charles from antidepressantfacts so the timeline needs work... I want to be hopeful. 

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btdt

The final point concerns the likely duration of a tardive dysthymic episode. Based on the precedent of tardive dyskinesia, and of the difficulties some patients faced on discontinuation from benzodiazepines such states may last for 1-4 years. In older individuals there is a possibility they may last indefinitely. In younger individuals, they are more likely to clear up in a 12-36 month timeframe.

The resolution of difficulties may require something like a synthesis of new receptors to replace receptors that have been jettisoned in the face of physiological stressor of the SSRI. Whatever the mechanism recovery does happen but may take years and seems likely to be facilitated by activity of various sorts and most probably an avoidance of psychotropic medication – including antihistamines and other compounds.

 

I think he has a point here as when I was well enough to be out and about I felt a lot better I must take into account the car accident and surgery... right at 4 years off... add to the drugs to treat this and that... bp headaches pain...infections I am srue are all part of my delay in recovering.... bummer but maybe that is reason to be more hopeful. 

 

There are other more esoteric steps a person can take. One is sleep deprivation, which is undertaken regularly as an antidepressant treatment in many European countries. 

Interesting.. wonder if I do this without think of it.

 

That a number of people exposed to antipsychotics, benzodiazepines or antidepressants may have an enduring problem has been recognized for some decades. The risks of having an enduring problem appear slightly greater for women, and may increase with age.

There is no clear understanding of what happens in the brain to trigger such problems but it may be that with extended exposure to an antidepressant, some sensitive individuals lose receptors from the ends of their nerve terminals as part of an adaptive mechanism and when the drug is removed these receptors do not simply return to normal.

 

A tipping point where there is no coming back.. maybe I hope I am not one of them even if I am I am not going to give up trying to improve and learn... like I said before I will let you know as the Fat Lady did not sing yet. 

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WiggleIt

Eff this. Tricyclics did this to me, so I don't see why they are considered a potential management tool. Really bummed about the tipping point info and about the fact that women may have less chance of recovery.

 

I am a woman who was started on meds at age 32. Stopped at age 35 and have been off for 3.5 months. Was SUPER healthy prior to meds, plus athletic. Not one muscle left on me anymore, plus am now dumb.

 

Really would like to know if recovery is going to happen for me.

 

Not to be nosey about your age, Alto, but it'd be really helpful to know at what age you started withdrawal. Please tell me it was older than 35...

 

If I'm starting withdrawal at an age after the tipping point, I'll... I don't know.

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WiggleIt

Also, the stuff about tardive dyskinesia having good and bad spells sucked to read, because I thought I was going to have a chance to recover from that.

 

This also hints that akathisia could manifest itself later. I'm having brain zaps now, so according to Healy, things could still get worse? Christ, I already have everything else, including myoclonic jerks and scrunchy face. Can't I please be spared from the rest of hell?

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WiggleIt

I know all these resources are here to help us, but sometimes the information makes me want to give up and pray for death to come to me quickly and peacefully.

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Altostrata

I was 54 when I went off Paxil.

 

We have a lot of people here who had a spell of akathisia and were never bothered by it again.

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WiggleIt

I was 54 when I went off Paxil.

 

We have a lot of people here who had a spell of akathisia and were never bothered by it again.

 

Thank you, Alto.  Your response really is appreciated.  Thanks for not minding me "prying" about your age.

 

I can't remember… did you slow taper, or rapid, or ct?  If I remember correctly, you went slowly and used lamotrigine, right?

 

Although Healy and Shipko are perhaps most credible on these withdrawal syndromes, is it okay for me to hate them a little when they write stuff that discourages me?  I just fear that they are the most knowledgeable, and their knowledge does not always just with the best case scenario that I hope i become.  In fact, everything they write seems to give me reason to lose hope.

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Arcticjessy

Hi

So St. John's wort may be worth a try ? I was told to avoid this one

 

Thanks

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chicken

Something he said really stands out to me

 

"Activities such as walking or swimming may be helpful especially if undertaken in a graded programme that ensures there is daily activity and over time builds the activity levels up."

 

When I was in school and in the military and engaged in lots of physical exercise I had no anxiety episodes. It appears that he is correct with exercise, and that nerve endings refashion themselves with physical activity. We are a society of couch potatoes. We don't do a lot of physical activity. This may account for some of our so called mental problems.

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westcoast

Does anyone exercise, and has it helped your recovery?

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WiggleIt

Exercise currently sets off my symptoms too much.  But I used to loooove it.  Plus, I can't exercise now because of the muscle dysfunction the meds caused in my body.  Light stretching and walk up and down the hall a few times a day. 

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Iamfine

Does anyone exercise, and has it helped your recovery?

Yes and yes.

 

I noticed in the article that he often says "may" and "possibly" and "we don't know why". Reminds me of how they tell us how antidepressants work. The truth is nobody knows much, it's all a guess and we are all doomed to some form of misery because of these drugs.

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nz11

Great article and yes i thought it had come from the guidelines guide.

I just asked this question in my intro so thought i would post it here. 

 

Question: In this article is Healy describing/calling akathisia as 'Tardive Dysthymia' . It seems to me he is.

Are these two words interchangeable, one and the same? Maybe it is just a word for 'protracted ssri wdl' .

 

First, it has been known since the 1960s when dependence on and withdrawal from antipsychotics was first outlined that in addition to classic states such as tardive dyskinesia that might be revealed by withdrawal, a variety of stress syndromes and persisting affective disturbances that have been termed tardive dysthymia, tardive akathisia and other tardive syndromes might also emerge.

 

oh it appears he is.

Note to myself: Always reread article.

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Mort81

Exercise isn't on my radar yet.I get a negative reaction from even the lightest of activities.

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Christian

This article freightens me as I'm sure it does others. I don't understand how David Healy and maybe a couple of others are the only ones that say these negative things. It sounds hopeless. There appears to be a difference in WD symptoms that bring us here. Though all serious in their own way but if you have tarditive dysthymia (which appears that I now have) you are screwed. The other aches and pains might go away over time but the dysthymia is the one you don't want, most dehabilitating and more than likely is permanent. Of the success stories on here, I would be interested to know if anyone came out of this state.

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Altostrata

I do not think you can say which wins the Worst Symptom sweepstakes.

 

People do recover from tardive dysthymia. Like the other post-acute withdrawal symptoms, it takes time and can be very gradual.

 

Setting your mind to healthy habits, such as getting gentle exercise each day, is essential to support healing.

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Christian

Ok. I didn't mean to say the other symptoms weren't serious at all. All of our symptoms are very serious.

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Trichotomous

People do recover from tardive dysthymia. Like the other post-acute withdrawal symptoms, it takes time and can be very gradual.

 

Setting your mind to healthy habits, such as getting gentle exercise each day, is essential to support healing.

 

God, I hope so. Otherwise....

 

I must emphatically agree with the notion that antidepressants are often far too powerful to successfully manage symptoms in some cases. The sports car analogy makes perfect sense to those having lived through all this. I feel that I traded one set of problems for another almost as bad. And now I have something altogether hellish.

 

I would gladly trade zaps for what I'm feeling now.

 

Question:

 

"Apparent success has been reported with choline-esterase inhibitors or lamotrigine." (Above.)

 

and....

 

"Researchers have discovered a significant link between high use of anticholinergic drugs - including popular non-prescription sleep aids and the antihistamine Benadryl (diphenhydramine) - and increased risk of developing dementia and Alzheimer's disease in older people."

 

Are choline-esterase inhibitors and anticholinergic drugs related?

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downtongirl

In reading Dr. Healy's above information I noticed he said a back up plan might be celexa or imipramine....to taper off of an especially difficult antidepressant like paxil or effexor....has anyone switched from paxil or effexor to celexa or imipramine if so what was your experience?

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Christian

Downtown Girl,

 

I'm not suggesting as I'm nowhere near qualified but after I heard about FunkyBaboon's passing I read his thread. It looks like a few years back he fell into some bad Celexa WD. He tried several meds but ended up on a tricycleric (Nortriptline). I guess he stabilized.

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anonymous4317

Something he said really stands out to me

 

"Activities such as walking or swimming may be helpful especially if undertaken in a graded programme that ensures there is daily activity and over time builds the activity levels up."

 

 

Same here. Both have been helpful for me ever since WD. 

 

Places that are as natural and open as possible (parks/ponds for walking, swimming pools with lots of sunlight flowing in, etc.) seem to make me feel better. 

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Junglechicken

Downtown Girl,

I'm not suggesting as I'm nowhere near qualified but after I heard about FunkyBaboon's passing I read his thread. It looks like a few years back he fell into some bad Celexa WD. He tried several meds but ended up on a tricycleric (Nortriptline). I guess he stabilized.

Christian,

 

Funky's passing wasn't caused by AD WD, but a freak accident.

 

JC

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nz11

I was also told by dr Healy that once ssri withdrawal set in there was nothing anyone could do and no relatable treatment and it was unlikely to go away.

 

 

It was a email he sent saying that once ssri withdrawal became entrenched there was no treatment and was unlikely to go away by itself.

 

Was wondering if Prof Healy may have changed his view on ssri recovery.

This member may have misread the email though.

 

 

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