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A new resource: ‘Understanding Antidepressants’


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Did you see that yesterday the electronic version of the New York Times had a front page article on the difficulties of antidepressants withdrawal?  I thought it might mention a new resource, my book ‘Understanding Antidepressants’.  I’ve presented the science behind how antidepressants work, their possible benefits, drawbacks (notably withdrawal), and alternatives.  It’s available on Amazon.  My hope is that is will be a good source of information.  Would appreciate your feedback and suggestions for future editions.  Link is: https://www.amazon.com/Understanding-Antidepressants-Wallace-B-Mendelson-ebook/dp/B07B4GWKSN/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1520279221&sr=1-1&keywords=Understanding+antidepressants&dpID=51CRhuvoM8L&preST=_SY445_QL70_&dpSrc=srchl      I’d also like to learn from you, am looking forward to reading about your experiences.

Psychiatrist. I am no longer active in this group.

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Welcome, Wallace.

 

Thank you for your interest in patient experiences with going off antidepressants and other psychiatric drugs. You might read a few of the topics in our Introductions forum, they are patient-reported case histories.

 

Can you please explain more about how your book covers the risk of withdrawal symptoms and how to go off to avoid them? (It might be helpful to make that chapter of the book available to members of this forum.)

 

For your information, here are the rationale and tapering methods we recommend. 

 

Members, please be polite and considerate in your responses to this topic. Wallace is a psychiatrist who wants to learn from patients. While you might be frustrated with psychiatry, please be kind to Wallace. Any doctor who would take the time to register, post, and read here is one of the good ones.

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

All postings © copyrighted.

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Dear Wallace, Thank you for your efforts.  Yours, Rosetta

https://www.survivingantidepressants.org/topic/16629-rosetta-ct-may-2011-too-fast-taper-feb-2017/?page=25

2001-2011 Celexa 10 mg raised to 40 mg then 60 mg over this time period

May 2011 OB Doctor's Cold switch Celexa 60 mg to 10 mg Zoloft sertraline (baby born)

2012-2016 - Doctors raised dose of Zoloft up to 150 mg

2016 - Xanax prescribed - as needed - 0.5 mg about every 3 days (bad reaction)

2016 - Stopped Xanax

Late 2016- Began (too fast) taper of Zoloft

Early 2017 - Trazodone prescribed for bedtime (doseage unknown)

Feb 2017 - Completed taper/stopped Trazodone

Drug free since Feb 2017

2017 - Unisom otc very rarely for sleep

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@Wallace

Nice to see that s1 in that world acknowledging withdrawal.

 

Since you are a doctor and know the effects and possibly treatments for bad one.. can you go through my thread .. i am off 2+ years and still suffering the effects that were not prior to medications.

 

I was polydrugged here in India in a span of 2.5 yrs... . also taken into trust that all the side effects are temporary and for a short while and a trade off that is worth considerable... 

 

I had to leave a starting good job of a software engineer .. lost coginitive abilities.. no memory or recall of past behaviors.. pssd. I am 28 now.

 

Pls look into my thread.. 

 

survivingantidepressants.org/topic/13850-bhasski-damaged-all-over-physically-mentally-and-spiritually/

 

08/13 - 01/14
Olanzapine, petril MD (Clonazepam ), Dicorate ER (divalproex). Soza 10 (Zolpidem)

02/14 - 05/14
Flunil ​20mg , Divaa OD 250 mg(divalproex), Amisulpride 50mg (1-0-2), zolfresh 5 mg , Quetiapine
05/14 - 08/14 Venlafaxine 75 xr ( 1-0-1), zapiz 0.25
10/14 Zaptra 12.5mg , Oxetol xr 150mg (0-0-1)
11/14 - 08/15
Paris CR 25 (paroxetine) , Oxetol xr 600 mg (0-0-1), nitrest 5mg , Quetiapine for a month.
09/15-11 Venlafaxine XR 75 ( 1-0-1), Mirtazipine 15, Respiredal 0.5, Lamitor 25, zillion 10.
12/15-02/16 Off Meds (C.T)

03/16-Mid April Sertraline, Aripropazole, Quetiapine, Etizolam.

After that : CT and on OTC supplements (Roadback), now on Ayurveda
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One more thing .. 

 

I wrote nice as a start... these are the words that I know..

While I rarely feel nice... Just to let you know how pathetic I am. 

 

I can write .. but dont feel , so cant talk same face to face.

08/13 - 01/14
Olanzapine, petril MD (Clonazepam ), Dicorate ER (divalproex). Soza 10 (Zolpidem)

02/14 - 05/14
Flunil ​20mg , Divaa OD 250 mg(divalproex), Amisulpride 50mg (1-0-2), zolfresh 5 mg , Quetiapine
05/14 - 08/14 Venlafaxine 75 xr ( 1-0-1), zapiz 0.25
10/14 Zaptra 12.5mg , Oxetol xr 150mg (0-0-1)
11/14 - 08/15
Paris CR 25 (paroxetine) , Oxetol xr 600 mg (0-0-1), nitrest 5mg , Quetiapine for a month.
09/15-11 Venlafaxine XR 75 ( 1-0-1), Mirtazipine 15, Respiredal 0.5, Lamitor 25, zillion 10.
12/15-02/16 Off Meds (C.T)

03/16-Mid April Sertraline, Aripropazole, Quetiapine, Etizolam.

After that : CT and on OTC supplements (Roadback), now on Ayurveda
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Thank you for pointing me to the introductions forum and the rationale and tapering methods. My book was designed to give folks more information about antidepressants, both benefits and drawbacks, so that it’s possible to weigh them as completely as possible when making choices. It also talks about alternatives that are available.

      Mostly I’m here to learn. What kinds of schedules seemed to work best? Are some antidepressants harder to come off of than others?  Do people who later have withdrawal symptoms have anything in common, which can be predicted in advance? Why do some people get a particular withdrawal symptom, while other people develop another? These are the sorts of things that I would like to learn.

Psychiatrist. I am no longer active in this group.

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All good questions! Here are my observations after counseling thousands of people in tapering:

 

- We advocate 10% reduction per month. While this seems agonizingly slow (it is), the patient consensus is that 25% reductions result too often in severe withdrawal symptoms. The rationale and methodology is here Why taper by 10% of my dosage?

 

- In the literature on withdrawal syndrome, paroxetine and venlafaxine have been repeatedly mentioned as having the highest incidence of withdrawal symptoms. The research drops off in the mid-2000s. Anecdotally, we have also seen a lot of difficulty here with Cymbalta and Pristiq (neither of which are available in graduated dosages). However, we have reports of severe and prolonged withdrawal syndrome from all psychiatric drugs, including fluoxetine, bupropion, lamotrigine, trazodone, and even SAM-e.

 

Our most popular topic is Tips for Tapering Off Wellbutrin (bupropion), with nearly a half-million views, followed by Tips for Tapering off Lexapro (escilatopram), with more than 300,000 views, and Tips for Tapering Off Pristiq (desvenlafaxine), 264,000 views. This probably is related to the frequency of prescription of the drugs rather than severity of tapering difficulty. However, it does indicate that many people have probably tried to go off bupropion, etc., gotten withdrawal symptoms, and resorted to the Web to find an exit path.

 

As they say in the literature, there is a lot of individual variability.

 

- A history of going on and off psychiatric drugs, cold switches, cold turkeys, or prior adverse reactions or withdrawal syndrome seems to predispose people to withdrawal difficulties. (We're also seeing antibiotics precipitating or exacerbating withdrawal syndrome.) Since most people probably have gotten adverse reactions or tried to go off their drug or accidentally skipped a dose and gotten withdrawal symptoms, this aspect of risk is very, very common. The nervous system is not made of rubber.

 

(Wallace, one thing you can do for us is to tell your colleagues never, ever recommend skipping doses to taper. This brings on a humongous withdrawal syndrome. We all know these drugs need to be taken consistently. If you observe your patients getting withdrawal symptoms when they accidentally forget a pill, what would you expect to happen if they skip doses to taper?)

 

Physicians are very blase about switching people from psychiatric drug to psychiatric drug, and they should not be. Every drug switch has its cost.

 

People who have been taking a drug for years are definitely at risk for withdrawal syndrome, the dosage level doesn't seem to matter. (Doctors erroneously often tell patients they're taking a "low dosage" when they're taking the usual dosage. 20mg Prozac is not a low dosage.) However, we see people having difficulty coming off when they've taking the drug for only a few months. The literature says anyone who has taken the drug for more than a month is at risk for withdrawal syndrome; this probably was observed at clinical trials, which are usually less than 2 months.

 

We also see people who have immediate severe adverse reactions, but whose physicians persuade them to continue taking the drug, often with the addition of a benzo (which also incurs physiological dependency). These are people who should never take the drug in the first place. Even if exposure was only a few tablets, they often have symptoms that are identical to severe withdrawal symptoms for years, i.e. neurological dysregulation. Their recovery pattern is the same as that of severe withdrawal syndrome: Very gradual, slow, frustrating, with a lot of setbacks.

 

- Why do people develop particular withdrawal symptoms? First off, sleep disruption is so common as to be almost universal. These drugs affect the sleep cycle.

 

Otherwise, much of withdrawal syndrome is neurological dysregulation, which tends to attack whatever physiological stress point one might have. Generally, the nervous system becomes hypersensitive to all kinds of stimuli; it has this in common with fibromyalgia (a common misdiagnosis, also chronic fatigue syndrome). Hyper-reactivity may be expressed in brain zaps (see Lhermitte's sign) or other paresthesia, pain, or waves of unpleasant stimulation often described as "anxiety" or "panic."

 

It may also be felt as unprecedented dark thoughts, low mood, or horror. Downregulation has sidelined a regulating neurotransmitter from the neurological symphony and it's out of tune.

 

The hypersensitivity extends to all psychiatric drugs, drugs such as antibiotics, and sometimes even supplements and foods. The person may become extraordinarily light-sensitive, for example. For that, we recommend reducing light stimulation by darkening rooms and wearing dark glasses. This reduces the cycle of hyper-reactivity in the eyes and it eventually fades away.

 

To me, it's very important to see withdrawal syndrome as a global neurological dysregulation. That is why symptoms come and go and mutate, the nervous system is struggling to patch itself up, with varying success, despite the handicap of downregulation. Recovery is a slow, progressive, iterative process. As drug hypersensitivity is built in, attempting to repair this drug damage with other drugs often makes it worse. Fortunately, neuroplasticity is also built in, and if the nervous system can adapt to the drugs, it can adapt to their absence -- as long as we don't interfere with 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

All postings © copyrighted.

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38 minutes ago, Altostrata said:

The hypersensitivity extends to all psychiatric drugs, drugs such as antibiotics,

 

I just had a tooth extraction and implant on Friday and have been taking Amoxicillin, which is making me very nervous about side effects.  The surgeon recommended starting the antibiotic before the surgery, and I told him I would rather not because I am very sensitive to medications.  However, he said they were required after the implant because of the foreign body.  How long should I take them?  Can I cut the regimen short of what he prescribed without danger of infection?  I know you cannot give medical advice, but can you give me anecdotal ideas?  Thank you in advance.

RM

Alcohol periodic excessive 1963-1976, Valium sporadic 1964-1973,  Imipramine off & on 1982-1985, Fluoxetine 10mg-80 mg. Oct., 1995-Jan., 2014; Cymbalta, other ADs 1/2014-3/2014; Abilify 5 mg. 3/2014 - 8/8/17; Trintellix 20 mg. 3/2014 - 9/2017; Propranolol 60-80 mg. sporadically Sept-Oct, 2017; Seroquel few days Sept 2017 (c/t); Wellbutrin 150 mg. Sept, 2017 updosed to 300 mg. few days till c/t Oct 8, 2017, fish oil, vitD, vitE Oct 16, 2017-pres. Lipoflavonoid 4/2017-pres.  Fluoxetine 10 mg. Sept-Oct 8, 2017, 20 mg. 10/9- 10/15; 10 mg. 10/16 - 12/29;  9 mg. 12/30 - 2/9; 2 mL liquid (8.1mg) 2/10 - 3/7; 1.8 mL (7.29 mg) 3/8 -3/20; 1.6 mL (6.561mg) 3/20-4/2; 1.4 mL (5.9 mg) 4/3-4/14; 1mL (4 mg.) 4/15-4/22; .9mL (3.6mg) 4/23-5/1; .81mL (3.24 mg) 5/2-5/24; .73mL (2.916mg.) 5/25-6/8; .65mL 6/9-6/23; .6mL 6/24-7/17; .58mL 7/18-7/28; .525mL 7/29-8/13; .5 mL 8/14-21; .45mL 8/22-31; .4mL 9/2-21; .35mL 9/22-10/4; .3mL 10/5-28; .25mL 10/28-11/10; .2mL 11/11-11/24; .18mL 11/25-12/3; .1mL 12/4-12/18. Zero-12/19/18-present.

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6 hours ago, Wallace said:

Did you see that yesterday the electronic version of the New York Times had a front page article on the difficulties of antidepressants withdrawal?

Yes, I read it with great interest.  I was also interested in the overwhelming responses of people defending the continuation of SSRIs due to the "return of clinical effects of depression."  Some people abjectly refuse to acknowledge that withdrawal syndrome is not the same as the symptoms of depressing.  https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html?nl=top-stories&register=google

Alcohol periodic excessive 1963-1976, Valium sporadic 1964-1973,  Imipramine off & on 1982-1985, Fluoxetine 10mg-80 mg. Oct., 1995-Jan., 2014; Cymbalta, other ADs 1/2014-3/2014; Abilify 5 mg. 3/2014 - 8/8/17; Trintellix 20 mg. 3/2014 - 9/2017; Propranolol 60-80 mg. sporadically Sept-Oct, 2017; Seroquel few days Sept 2017 (c/t); Wellbutrin 150 mg. Sept, 2017 updosed to 300 mg. few days till c/t Oct 8, 2017, fish oil, vitD, vitE Oct 16, 2017-pres. Lipoflavonoid 4/2017-pres.  Fluoxetine 10 mg. Sept-Oct 8, 2017, 20 mg. 10/9- 10/15; 10 mg. 10/16 - 12/29;  9 mg. 12/30 - 2/9; 2 mL liquid (8.1mg) 2/10 - 3/7; 1.8 mL (7.29 mg) 3/8 -3/20; 1.6 mL (6.561mg) 3/20-4/2; 1.4 mL (5.9 mg) 4/3-4/14; 1mL (4 mg.) 4/15-4/22; .9mL (3.6mg) 4/23-5/1; .81mL (3.24 mg) 5/2-5/24; .73mL (2.916mg.) 5/25-6/8; .65mL 6/9-6/23; .6mL 6/24-7/17; .58mL 7/18-7/28; .525mL 7/29-8/13; .5 mL 8/14-21; .45mL 8/22-31; .4mL 9/2-21; .35mL 9/22-10/4; .3mL 10/5-28; .25mL 10/28-11/10; .2mL 11/11-11/24; .18mL 11/25-12/3; .1mL 12/4-12/18. Zero-12/19/18-present.

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I don't know, RealMe. You don't want to get an infection. You'll have to ask your doctor.

 

1 minute ago, RealMe said:

I was also interested in the overwhelming responses of people defending the continuation of SSRIs due to the "return of clinical effects of depression."

 

I agree, patients as well as doctors make this mistake.

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

All postings © copyrighted.

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  • Moderator Emeritus

Hi Wallace and welcome to SA,

 

There is currently a petition before the Scottish Parliament:  PE01651: Prescribed drug dependence and withdrawal

 

They are accepting submissions from anywhere in the world, not just Scotland or the UK.

 

The submissions are people's experiences in a nutshell, ie concise.  They are well worth reading if you wish to gain an insight into how psychiatric drugs (being on, trying to get off and bad reactions) have affected people's lives.  I have read about 1/3 of them.

 

This is the link to the submissions which are available to the public:  http://www.parliament.scot/GettingInvolved/Petitions/PE01651  

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

Plodding along inch by inch:  12" = 1',  3' =  36 " or 1 yard,  1760 yards  = 63,360" or 1 mile

Current from 6 Mar 2021:  Pristiq 0.328 mg

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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2 hours ago, Altostrata said:

All good questions! Here are my observations after counseling thousands of people in tapering:

 

- We advocate 10% reduction per month. While this seems agonizingly slow (it is), the patient consensus is that 25% reductions result too often in severe withdrawal symptoms. The rationale and methodology is here Why taper by 10% of my dosage?

 

- In the literature on withdrawal syndrome, paroxetine and venlafaxine have been repeatedly mentioned as having the highest incidence of withdrawal symptoms. The research drops off in the mid-2000s. Anecdotally, we have also seen a lot of difficulty here with Cymbalta and Pristiq (neither of which are available in graduated dosages). However, we have reports of severe and prolonged withdrawal syndrome from all psychiatric drugs, including fluoxetine, bupropion, lamotrigine, trazodone, and even SAM-e.

 

Our most popular topic is Tips for Tapering Off Wellbutrin (bupropion), with nearly a half-million views, followed by Tips for Tapering off Lexapro (escilatopram), with more than 300,000 views, and Tips for Tapering Off Pristiq (desvenlafaxine), 264,000 views. This probably is related to the frequency of prescription of the drugs rather than severity of tapering difficulty. However, it does indicate that many people have probably tried to go off bupropion, etc., gotten withdrawal symptoms, and resorted to the Web to find an exit path.

 

As they say in the literature, there is a lot of individual variability.

 

- A history of going on and off psychiatric drugs, cold switches, cold turkeys, or prior adverse reactions or withdrawal syndrome seems to predispose people to withdrawal difficulties. (We're also seeing antibiotics precipitating or exacerbating withdrawal syndrome.) Since most people probably have gotten adverse reactions or tried to go off their drug or accidentally skipped a dose and gotten withdrawal symptoms, this aspect of risk is very, very common. The nervous system is not made of rubber.

 

(Wallace, one thing you can do for us is to tell your colleagues never, ever recommend skipping doses to taper. This brings on a humongous withdrawal syndrome. We all know these drugs need to be taken consistently. If you observe your patients getting withdrawal symptoms when they accidentally forget a pill, what would you expect to happen if they skip doses to taper?)

 

Physicians are very blase about switching people from psychiatric drug to psychiatric drug, and they should not be. Every drug switch has its cost.

 

People who have been taking a drug for years are definitely at risk for withdrawal syndrome, the dosage level doesn't seem to matter. (Doctors erroneously often tell patients they're taking a "low dosage" when they're taking the usual dosage. 20mg Prozac is not a low dosage.) However, we see people having difficulty coming off when they've taking the drug for only a few months. The literature says anyone who has taken the drug for more than a month is at risk for withdrawal syndrome; this probably was observed at clinical trials, which are usually less than 2 months.

 

We also see people who have immediate severe adverse reactions, but whose physicians persuade them to continue taking the drug, often with the addition of a benzo (which also incurs physiological dependency). These are people who should never take the drug in the first place. Even if exposure was only a few tablets, they often have symptoms that are identical to severe withdrawal symptoms for years, i.e. neurological dysregulation. Their recovery pattern is the same as that of severe withdrawal syndrome: Very gradual, slow, frustrating, with a lot of setbacks.

 

- Why do people develop particular withdrawal symptoms? First off, sleep disruption is so common as to be almost universal. These drugs affect the sleep cycle.

 

Otherwise, much of withdrawal syndrome is neurological dysregulation, which tends to attack whatever physiological stress point one might have. Generally, the nervous system becomes hypersensitive to all kinds of stimuli; it has this in common with fibromyalgia (a common misdiagnosis, also chronic fatigue syndrome). Hyper-reactivity may be expressed in brain zaps (see Lhermitte's sign) or other paresthesia, pain, or waves of unpleasant stimulation often described as "anxiety" or "panic."

 

It may also be felt as unprecedented dark thoughts, low mood, or horror. Downregulation has sidelined a regulating neurotransmitter from the neurological symphony and it's out of tune.

 

The hypersensitivity extends to all psychiatric drugs, drugs such as antibiotics, and sometimes even supplements and foods. The person may become extraordinarily light-sensitive, for example. For that, we recommend reducing light stimulation by darkening rooms and wearing dark glasses. This reduces the cycle of hyper-reactivity in the eyes and it eventually fades away.

 

To me, it's very important to see withdrawal syndrome as a global neurological dysregulation. That is why symptoms come and go and mutate, the nervous system is struggling to patch itself up, with varying success, despite the handicap of downregulation. Recovery is a slow, progressive, iterative process. As drug hypersensitivity is built in, attempting to repair this drug damage with other drugs often makes it worse. Fortunately, neuroplasticity is also built in, and if the nervous system can adapt to the drugs, it can adapt to their absence -- as long as we don't interfere with it.

Thanks so much for your thoughtful comments.  You’ve given me a lot to think about, and I appreciate it!

Psychiatrist. I am no longer active in this group.

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Thanks so much for your thoughtful comments, particularly about skipping doses.  You’ve give me a lot to think about, and I appreciate it.!

Psychiatrist. I am no longer active in this group.

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1 hour ago, ChessieCat said:

Hi Wallace and welcome to SA,

 

There is currently a petition before the Scottish Parliament:  PE01651: Prescribed drug dependence and withdrawal

 

They are accepting submissions from anywhere in the world, not just Scotland or the UK.

 

The submissions are people's experiences in a nutshell, ie concise.  They are well worth reading if you wish to gain an insight into how psychiatric drugs (being on, trying to get off and bad reactions) have affected people's lives.  I have read about 1/3 of them.

 

This is the link to the submissions which are available to the public:  http://www.parliament.scot/GettingInvolved/Petitions/PE01651  

 

Psychiatrist. I am no longer active in this group.

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Thank you so much, I’m not familiar with this site, and will definitely check it out!

Psychiatrist. I am no longer active in this group.

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  • Moderator Emeritus

Thanks Wallace for taking the time to find out the truth about the harm that occurs when trying to withdraw from these horrible drugs. We many heartbreaking personal testimonies from thousands of members.

 

These drugs really do ruin lives. Everyone here would probably agree that the brutal withdrawal symptoms are many times worse than the original condition that caused them to go on the drugs in the first place.

 

If you head over to the success stories section you will find that it is possible to recover from withdrawal, but it can take many, many years of suffering before returning to an acceptable quality of life.

 

 

2001: 20mg paroxetine
2003-2014: Switched between 20mg citalopram and 10mg escitalopram with several failed CT's
2015: Jan/ Feb-very fast taper off citalopram; Mar/ Apr-crashed; 23 Apr-reinstated 5mg; 05 May-updosed to 10mg; 15 Jul-started taper; Aug-9.0mg; Sep-8.1mg; Oct-7.6mg; Nov-6.8mg; Dec-6.2mg
2016: Jan-5.7mg; Feb-5.2mg; Mar-5.0mg;  Apr-4.5mg; May-4.05mg; Jun-3.65mg; Jul-3.3mg; Aug-2.95mg; 04Sep-2.65mg; 25Sep-2.4mg; 23Oct-2.15mg; 13Nov-1.95mg; 04Dec-1.75mg; 25Dec-1.55mg.
2017: 08Jan-1.4mg; 22Jan-1.25mg; 12Feb-1.1mg; 26Feb-1.0mg; 05Mar-0.9mg; 15Mar-0.8mg; 22Mar-0.7mg; 02Apr-0.6; 09Apr-0.5mg; 16Apr-0.4mg; 23Apr-0.3; 03May-0.2mg; 10May-0.1mg

Finished taper 17 May 2017.

 

I am not a medical professional. The information I provide is not medical advice. If in doubt please consult with a qualified healthcare provider.

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And, may I add, the recovery pattern, which is fairly consistent from person to person (very slow, gradual, waves and windows, frustrating, can take years) demonstrates these people are not suffering from a "relapse" of any sort of psychiatric condition, unless you include iatrogenic neurological dysregulation among psychiatric conditions.

 

(NB: The DSM committee has repeatedly refused to include a diagnosis code for antidepressant withdrawal syndrome.)

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

All postings © copyrighted.

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  • Moderator Emeritus

We have many members here wondering about the knowledge, or rather lack of knowledge, that medical professionals have regarding psychiatric drug use and withdrawal.  The medical profession gets their information from the pharmaceutical companies.  Gwen Olsen was a pharmaceutical representative for 15 years:

 

We are trained to misinform (6 minutes)

 

Manipulating Doctors (10 minutes)

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

Plodding along inch by inch:  12" = 1',  3' =  36 " or 1 yard,  1760 yards  = 63,360" or 1 mile

Current from 6 Mar 2021:  Pristiq 0.328 mg

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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Many thanks, I will definitely take a look at it.

Psychiatrist. I am no longer active in this group.

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1 hour ago, Altostrata said:

And, may I add, the recovery pattern, which is fairly consistent from person to person (very slow, gradual, waves and windows, frustrating, can take years) demonstrates these people are not suffering from a "relapse" of any sort of psychiatric condition, unless you include iatrogenic neurological dysregulation among psychiatric conditions.

 

(NB: The DSM committee has repeatedly refused to include a diagnosis code for antidepressant withdrawal syndrome.)

 

Thanks for pointing this out, I appreciate it.

 

Edited by ChessieCat
added response from following post

Psychiatrist. I am no longer active in this group.

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Thanks for reading, Wallace. From your responses, I don't quite feel we have a dialog going.

 

Could you expand on your understanding of withdrawal syndrome and how our comments might have changed it?

 

(Members and mods, please refrain from any comments that might imply these medical errors are deliberate by the doctors or that, individually, they have anything but good intentions.)

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

All postings © copyrighted.

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Dear Altostrata, I just wanted to say that I appreciate all that you’ve shared with me. I realize I’ve only written brief answers, and apologize that they are not more elaborate.  The reason is that I’m really here to learn,, and I do that mostly by listening.  I’ve had the sense that although I’ve been aware of withdrawal issues, and indeed written about them, but have been wondering if I really appreciated their magnitude.  I was finding things to read about it and came across your website.  There’s a famous medical saying: ‘When you’re not sure, try listening to the patient.’, and I’m a great believer in it.  So I joined your group, with interest to hear people’s experiences, and am coming to realize that there’s a large body of people who have had a very difficult time with withdrawal, more than I had realized. That’s the main thing, in response to your question, that your comments may have changed in my understanding. So I’m afraid that I don’t have much to contribute, but am learning a lot and have appreciated your sharing with me.  I hope I’m not being disappointing in not having more of a dialog, but I’m a firm believer that the best way to learn is to listen. 

Psychiatrist. I am no longer active in this group.

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1 hour ago, Altostrata said:

Thanks for reading, Wallace. From your responses, I don't quite feel we have a dialog going.

 

Could you expand on your understanding of withdrawal syndrome and how our comments might have changed it?

 

(Members and mods, please refrain from any comments that might imply these medical errors are deliberate by the doctors or that, individually, they have anything but good intentions.)

 

Psychiatrist. I am no longer active in this group.

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PS: You might wish to note the public posting I made yesterday on Facebook about The NY Times article, and suggested that there be more attention paid to to, and research in, antidepressant withdrawal.

Psychiatrist. I am no longer active in this group.

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Thank you Wallace -- you're doing important work. 

Aug-Dec 2015 Prozac 20mg / Dec 2015-Feb 2016 Prozac 15mg / Feb 2016-May2016 Prozac 20mg

May 2016-June 2016 15mg

June 2016-August 2016 10mg

October 2016-January 2017 15mg, alternating agitation/akathisia sets in --> cold turkey

January 2017 Clonazepam .5mg 

February 2017 Clonazepam 1mg (for a week) then .5mg morning and .25mg evening for about a month. Came down to .25mg morning and evening. 

May 1, 2017 Clonazepam .25mg morning and .125mg evening. // May 20, 2017 Clonazepam .25mg morning and .0625 evening (.3125 total).

early June .28125 // early mid june .25mg // mid june .21875 // late june .1875 // early july .15625 // early mid july .125 

mid july .09375mg // late july .0625 //early August 2017 down to .03125mg once a day, hopped off in mid August

reinstated at .0625mg late August // Oct 16 - updose to .07mg and switch to oral Rosemont solution

Nov 17 2017 reinstate Prozac .5mg // Nov 21 2017 prozac 1.6mg // Dec 18 2017  3mg prozac / fast taper off the reinstatement -- probably completely off early Oct 2018

June 2019 begin tapering off .07mg Clonazepam, Finish taper December 2019

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Thank you from me as well.  I really appreciate your coming here to learn more about our struggles with psychiatric medications.  Hopefully you've had a chance to read through some of the posts on the Introductions page to get a sense of how much pain many of us are in and how withdrawal for some of us has impacted almost all aspects of our lives.

-1/06 - 3/07 Cymbalta. Fast taper; withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin
-Tried several times to slowly taper Zoloft by 10%, then 5% every 4-6 weeks; could never get below approx. 40 mg - spring 2012 experienced major WD symptoms due to stress; tried to updose but no relief, back on Klonopin 1 mg.
-Switched over 5-6 mos from Zoloft to Citalopram. Finished Zoloft 1/13; Citalopram 35 mg and 1 mg Klonopin.
-8/13: 27 mg Citalopram; 1 mg Klonopin

-11/14: 12.6 Citalopram - began to have bad withdrawal symptoms; out of desperation increased to 1.25 mg Klonopin at the beginning of December.  12/13/14 16 mg Citalopram - going to stay here to try to stabilize; stabilized on 16 mg Citalopram after 4-5 months

-7/15 - 3/16: reduced to 15 mg; ~ 2 months later w/d hit hard (probably r/t stress); 6/16 updosed to 20 mg Citalopram and trying to stabilize. Updosed to 1.5 Klonopin as well. Stabilized on 20 mg Citalopram after 4-5 months

8/17-9/17: feeling withdrawal symptoms at 20 mg Citalopram (due to stress) - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg

2021: 1/3/21: 7.8 mg (1.27% drop); 1/24/21: 7.7 mg (1.29%); 1/31/21: 7.6 mg (1.17%); 2/7/21: 7.5 mg (1.19%); 2/14/21: 7.4 mg (1.34%); 2/28/21: 7.3 mg (1.25%)

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6 hours ago, Wallace said:

PS: You might wish to note the public posting I made yesterday on Facebook about The NY Times article, and suggested that there be more attention paid to to, and research in, antidepressant withdrawal.

 

Hi, Wallace.

 

Thank you for coming to SA with an open mind and an interest in hearing from patients. 

 

Do you have a link to your Facebook post? 

 

You may be interested in a course that's being offered on the Mad in America Continuing Education site on psychiatric drug withdrawal from the vantage point of psychiatrists: 

 

Psychiatric Drug Withdrawal II - The Psychiatrist’s Perspective on Challenges, Opportunities, and Shared Decision Making

 

As you can see, you are not alone as a psychiatrist in your quest to learn more about how to help those of us experiencing difficulties coming off these drugs. These webinars have a chat room so you can ask questions and make contacts with the presenters. It might be worth exploring. 

 

The Mad in America website is a goldmine of information from both experts in psychiatry, as well as those with lived experiences, and I would highly recommend that site as another source of valuable information:

 

Mad in America

 

Again, thank you for listening to us and learning from our experiences. 

Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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Hi Shep, thanks for writing.  My posting about the New York Times article on antidepressant withdrawal can be found by going to Facebook and doing a search on ‘Understanding Antidepressants’.  

 

Thanks for the link to Psychiatric Drug Withdrawal II; I’ve really appreciated you and other members pointing me to resources such as this!

Psychiatrist. I am no longer active in this group.

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16 hours ago, Wallace said:

Dear Altostrata, I just wanted to say that I appreciate all that you’ve shared with me. I realize I’ve only written brief answers, and apologize that they are not more elaborate.  The reason is that I’m really here to learn,, and I do that mostly by listening.  I’ve had the sense that although I’ve been aware of withdrawal issues, and indeed written about them, but have been wondering if I really appreciated their magnitude.  I was finding things to read about it and came across your website.  There’s a famous medical saying: ‘When you’re not sure, try listening to the patient.’, and I’m a great believer in it.  So I joined your group, with interest to hear people’s experiences, and am coming to realize that there’s a large body of people who have had a very difficult time with withdrawal, more than I had realized. That’s the main thing, in response to your question, that your comments may have changed in my understanding. So I’m afraid that I don’t have much to contribute, but am learning a lot and have appreciated your sharing with me.  I hope I’m not being disappointing in not having more of a dialog, but I’m a firm believer that the best way to learn is to listen. 

 

Thanks, Wallace. You are certainly welcome to learn here! That is one of the reasons I started this Web site -- to inform the medical profession. I would happily close up tomorrow if patients could get tapering guidance and proper treatment for withdrawal symptoms from their physicians.

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

All postings © copyrighted.

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We seem to have a surge of new members, probably related to the NY Times article, which was syndicated in newspapers all over the world.

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

All postings © copyrighted.

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Yes, it seems to have had a big impact, I’ve heard a lot of people talking about it.

Psychiatrist. I am no longer active in this group.

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What are your psychiatrist colleagues saying, Wallace?

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

All postings © copyrighted.

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Haven’t heard anything.  There are a series of letters to the editor in The NY Times that are worth looking at.

Psychiatrist. I am no longer active in this group.

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On 4/11/2018 at 11:23 AM, Wallace said:

Haven’t heard anything.  There are a series of letters to the editor in The NY Times that are worth looking at.

 

You may be hearing more from your colleagues soon - Psychiatric Times just ran an article on the withdrawal forums that is really good. Scroll down a bit on the first page to view the article. 

 

Psychiatric Times - Online Communities for Drug Withdrawal: What Can We Learn?

 

Edited by Shep

Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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