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

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Shep
Posted (edited)

This month, Psychiatric Times ran an article about the online psychiatric drug withdrawal forums. Psychiatric Times is a peer-reviewed academic medical journal that is well-regarded among mainstream psychiatrists. Between this article and the recent New York Times article, word is definitely getting out. 

 

The full journal is linked below (scroll down to see where the article "Online Communities for Drug Withdrawal" starts):

 

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

 

Some key findings:

 

  • Benzo Buddies.org receives on average 250,000 hits a month and Surviving Antidepressants receives approximately 150,000 hits each month.
  • A generic search of YouTube for "antidepressant withdrawal" or "benzo withdrawal" will bring up 7,000 and 14,000 personal videos blogs, respectively.
  • The message is that physicians have been unprepared for these withdrawal disorders and are unable to treat or even guide patients through complicated withdrawal from these substances.
  • The onset of severe withdrawal symptoms sometimes does not respond to re-initiation of medication.
  • Persistent withdrawal reactions can last years.
  • Unavoidable severe withdrawal symptoms may occur despite slow withdrawal over several months or years.
Edited by Shep
fixed outdated link

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Altostrata

Thanks very much, Shep. This could be a watershed moment.

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DrugfreeProf

Amen. The word is getting out--finally--and I'll just bet that we'll soon see the esteemed "thought-leaders" of psychiatry scattering around trying to cover things up, like cockroaches do when you turn the lights on.

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bubbles

Thank you for posting that article. Very interesting.
Bubbles

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Grayskies

 

Optimistic article.

Although I consider it one of my ‘bibles’ for interpersonal changes, “the feeling good handbook” which is by David burns, MD (Cognitive behavioral therapy) in the section on antidepressants states that it would take a patient 2 weeks “and as much as 4 weeks”  to withdrawal from Effexor.. this author is best case scenario for a physician well educated on ADWD. It’s quite astonishing. I am currently trying to get off this drug, and I cannot imagine ever doing this in 4 weeks without having a total nervous breakdown! 

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Shep
1 hour ago, Grayskies said:

 

Optimistic article.

Although I consider it one of my ‘bibles’ for interpersonal changes, “the feeling good handbook” which is by David burns, MD (Cognitive behavioral therapy) in the section on antidepressants states that it would take a patient 2 weeks “and as much as 4 weeks”  to withdrawal from Effexor.. this author is best case scenario for a physician well educated on ADWD. It’s quite astonishing. I am currently trying to get off this drug, and I cannot imagine ever doing this in 4 weeks without having a total nervous breakdown! 

 

I read that book many years ago. I don't know which edition you have, but the original came out in the 1980s before much was written about AD withdrawal. Out of curiosity, I just googled "Dr. David Burns and antidepressant withdrawal" and landed on an interesting exchange on his website:

 

Problems with Antidepressant Withdrawal

 

Dr. Burns not only cites the research of Dr. Irving Kirsch and the placebo effect, he states, "I am not an expert in withdrawal from these drugs, but if I were in practice now I would rarely, if ever, use the so-called 'antidepressants,' for a myriad of reasons."

 

It looks like he is indeed one of the "good" doctors in the quest for mental wellness. I suspect there may be more of these kinds of good doctors out there who simply need the education and to become empowered to really help their patients off these dangerous neuro-toxins. 

 

The recent developments in the NYT and Psychiatric Times are moving in the right direction. 

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Grayskies
10 hours ago, Shep said:

 

I read that book many years ago. I don't know which edition you have, but the original came out in the 1980s before much was written about AD withdrawal. Out of curiosity, I just googled "Dr. David Burns and antidepressant withdrawal" and landed on an interesting exchange on his website:

 

Problems with Antidepressant Withdrawal

 

Dr. Burns not only cites the research of Dr. Irving Kirsch and the placebo effect, he states, "I am not an expert in withdrawal from these drugs, but if I were in practice now I would rarely, if ever, use the so-called 'antidepressants,' for a myriad of reasons."

 

It looks like he is indeed one of the "good" doctors in the quest for mental wellness. I suspect there may be more of these kinds of good doctors out there who simply need the education and to become empowered to really help their patients off these dangerous neuro-toxins. 

 

The recent developments in the NYT and Psychiatric Times are moving in the right direction. 

 

That’s very interesting. Thanks for sharing. I respect his stance on these matters so it is good to know he believes relief is possible drug-free.

Like everyone else on this forum, i didn’t have a warning that this drug would be so hard to go off once I was on it. 

In fact, I wonder if anyone who has prescribed me these has ever done it themselves? I find myself regretting going on it, but at the same time i know the place I was in back then needed stability and I am not sure therapy could have made it happen for me. I do regret not working harder to find a better therapist fit. I gave up on CBT back then because it wasn’t a good fit with my therapist, and of course it’s hard for them to help you when you’re so ashamed of your problems that you can’t quite tell anyone about them “I’m not sure what makes me anxious.” 

I saw a psychiatrist at that time that tried to diagnose me with bipolar disorder (and I know with absolute certainty I do not) so i threw in the towel and thought the mental health community had nothing to offer me and I was just to suffer forever. 

I had myself in a ball sobbing on a daily basis and could barely eat. When I was handed a prescription for Paxil and I found myself finally enjoying my life again it felt nothing short of miraculous at the time. I truly wonder how I could have recovered from this place without some medications at least in the beginning.. and yet.. here I am... It might not have changed my mind if the MD had said “I can give you this pill to make you feel better, but you won’t have a sex drive, your husband will be fed up with you for it, you won’t be able to cry, and you’ll gain 20 pounds, and go through hell if you ever try to quit.” Still it would be nice to have had the information. Good to see things are moving in the right direction. 

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Altostrata

I'm hoping doctors will soon get up to speed and this site will no longer be needed.

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Waiting12

Awesome!

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Dan998
9 hours ago, Altostrata said:

I'm hoping doctors will soon get up to speed and this site will no longer be needed.

 

You deserve a break, Alto. You've done an amazing job with this site.

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cinephile

This is so exciting.  As a long-time member of this forum (I remember Alto from Paxil Progress), I am just so proud of her being mentioned in this important article.  It may even be a landmark article.  The persistence and sheer willpower she has had to run this site is astonishing.  But ALL of us are astonishing.  We've had no choice but to be astonishing.  That's the good part of all this suffering. 

 

There's so much I could say about this article, but I came away feeling positive about it.  I think the generational change as older doctors retire could be very beneficial.  New psychiatrists will have come of age on SSRIs and will know of their side effects and if they haven't gone through withdrawal themselves, they are likely to know someone who has.  And they will be more open to new ideas and won't necessarily dismiss patient reports on forums such as these out of hand.  Awesome.  

 

As it happens, us over at the pssdforum (http://www.pssdforum.com/) are mobilizing after the publication of the New York Times's "withdrawal" article to get them to write a piece on PSSD (Post SSRI Sexual Dysfunction).  PSSD may be too "niche" for the public at this point, but there was a time when it was impossible to even consider studies being done on SSRI withdrawal, too.  I've also contacted a couple other people that may lead to a published piece of some kind.

 

I'd like to conclude this post by reminding us all that we're in this together.  And I don't necessarily mean people like us on the forums.  I mean the scientific/medical community AND patients.  If you read my old posts you'll read about someone different than who I am today.  I am no longer an anti "big pharma" guy, although I of course understand that they have a role to play in this mess too.  And I truly believe most psychiatrists truly want to help, but their training can be tragically limited.  And I also believe that many of these meds that have ruined our lives can save countless lives.  They can and do.  But that doesn't mean our voices don't matter -- they sure as hell do, and we have to keep our voices being heard as often as possible.

 

So I've just become more nuanced in my thinking.  My psychiatrist has helped with that.  He totally believes in PSSD (he's read the literature) and admits that it's difficult -- if not impossible -- to know if it's withdrawal or just re-emergence of symptoms.  That happened to me last Thanksgiving when I finally, finally got off an SSRI after an 18 month taper and felt worse and worse and had to go back on it after 6 months being off.  And, truly, I don't know if it was withdrawal or not.  In fact, I'm inclined to believe it was depression because my life has been a chaotic, stressful mess in the last near decade. 

 

The kicker is that the SSRI may have "worked" in that it kept me from bottoming out, but it also flattens me terribly and it's so hard to do anything with next to no motivation (and pitiful sexual function!).  And my sexual function did not return even after being off the med for six months.  My psychiatrist admitted I'm the first patient he's seen where this has been the case.  We both agree the only explanation for such baffling, unique symptoms (genital anaesthesia, complete loss of morning erections) can only be due to the SSRI, even though I was off it for six months.  Now, I know six months is a drop in the bucket for symptoms to abate, but because I need to hold down a job I simply had no choice but to go back on the SSRI.  I'm currently tapering down again and hopefully will be able to come off -- someday.  I truly hope it doesn't come down to an agonizing choice of me being flattened/sexless or being debilitatingly depressed.

 

There are just so many things to consider about psych meds and society.  It's excruciatingly complex.  Endless, really.  One patient may lament ever going on the med if they knew how bad the side effects/withdrawal would be, but they can only say that in hindsight.  There's a good chance they were suffering terribly and were desperate for relief when they took the med and even if they knew all the withdrawal horrors we know about ahead of time may very well have taken the med anyway, especially if it saved their life.  We need to look at this from as many angles as possible, or the scientific community just won't take us seriously.

 

But then there is also the very real issue of over medication.  I truly don't believe that so many Americans need to be on psych meds, especially antidepressants.  At the very least, I think psychiatrists should be more vigilant than ever to give 6-12 month "status updates" to see if the patient still needs to be on meds (primary care docs are notorious for parking patients on psych meds).  As the NYT article states, so many patients are being parked on meds long-term, often needlessly.  That was certainly my story -- parked on SSRIs since 1998 for what was in hindsight just very slight depression, and stuck on them ever since.

 

Sorry for the long post, but this thread really galvanized me.

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peng

Fine, balanced post, cinephile.

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Dude

Thanks for the post, Shep. It's good to know that they're beginning to acknowledge the problem more and more within there own circles. Maybe it'll help change things.

 

That being said, there are a couple of things I found slightly annoying about the article. First of all, they've known for quite a long time. The evidence has been staring them in the face for years and they've simply chosen to ignore it until now because it was just too inconvenient for them. But now that things have become even more inconvenient for them as a result of ignoring it for so long, they finally seem prepared to acknowledge it. Don't get me wrong, I'm glad they're finally doing so. But for them to play innocent and simply claim that they didn't know is insulting to all of us.

 

Secondly, they wrote that "[clinicians] may misdiagnose these withdrawal syndromes as manifestations of the underlying original mental illness, a new physical condition, or perhaps an adverse effect of a different medication". And what bothers me most about that statement is the assumption that anyone who is ever given psychiatric drugs must have been mentally ill in the first place (basically by definition) and that any form of psychological suffering for which medication has been prescribed (which is what the statement also implies, in my opinion) is the manifestation of an actual, physical illness.

 

The fact that this part of the statement is followed by the words "a new physical condition" implies this too (if there's a new physical condition then there must have been an old physical condition too; and it's pretty obvious what this "old" or "original" physical condition is in their opinion). A lot of us have been prescribed these drugs because of symptoms that had either psychological or physical causes that had nothing to do whatsoever with "mental illness" in the form of our brains malfunctioning. Perhaps there are some people out there who's symptoms do indeed result from some an actual functional (i.e. neurological) problem within their brains. But they are in all probability a tiny minority. Most people who are put on this junk are suffering for other reasons (as most of the people on this site are well aware of).

 

So although what we're dealing with here is indeed the acknowledgement of the existence of withdrawal syndromes, it's being acknowledged within the context of the medical (i.e., psychiatric) model of psychological suffering. Okay, it's not surprising considering that the article appeared in the psychiatric times and was co-written by Edward Shorter (who's a defender of the medical model), but it should still be taken into account. Psychiatry's acknowledgement of withdrawal syndromes may very well be considered a step in the right direction, but we should remember that psychiatry created this problem in the first place and that psychiatry is ultimately the problem itself. And we can only hope that society will one day seriously question the legitimacy of the profession's existence.

 

And in this regard I have to say that despite also being quite familiar with the complexity of this subject, I do not agree with some of cinephiles statements (though I still respect his right to express his own opinion just like the rest of us, of course) . Psychiatry's legitimacy within society currently rests upon its being a scientifically based profession, after all. But the fact is that its not and that they have indeed cause more harm than good over the long run. And for the past thirty-five years they have not only displayed an incredible amount of ignorance but an equal amount of arrogance too (regardless of their alleged "intention to help" that cinephile referred to). So I for one am not inclined to take their side any time soon, despite having also attempted to see things from their perspective (which itself could very well be seen as a form of Stockholm syndrome, especially when it leads to sympathizing with them).

 

They also wrote in the article that "(...) mental health professionals need to familiarize themselves with and interface with these online communities". Well, they're welcome to familiarize themselves with this and any other site, of course. But who of you really want a bunch of psychiatrists creating their own profiles on this forum and "interfacing" with us? I sure as hell don't. To me that'd be crossing a line. This site was created for those of us who have been harmed by psychiatry in order for us to support each other. For those who caused the problem in the first place to start "interfacing" with us on this forum (i.e. our sanctuary, so to speak) defeats its purpose and might very well end in some kind of mass exodus.

 

Lastly, they also wrote that "[t]hese syndromes need further research, or more patients will continue to turn away from the medical establishment to look for support from other patients on the internet" (as if the latter were a bad thing). To me that sounds very much like a statement from someone who's worried about losing their territory (as opposed to someone who's main concern is to help those suffering) and is something that is quite reminiscent of psychiatry's legitimacy crisis from the sixties to the early eighties. Personally, I think it's about time they entered into another such crisis. Only this time I hope it has serious negative consequences for them.

 

So in conclusion, yep, it's great for them to be acknowledging the problem of withdrawal. But I wouldn't get too enthusiastic about the article and it's assumed implications.

 

Anyway, those were my two cents on this subject.

 

 

 

 

 

 

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snostorm

I came away feeling the same way.  They are still not there.  They seem to make excuses for these drugs streamlined approval without knowing their long term side effects, or the iatregenic effects they cause to millions.  Like its a quandary to do that because it will keep the drugs away from people that can benefit from them by doing due diligence.  This is a crime perpetuated in the name of psychiatry by big pharma and the FDA.  Its a major problem and it isn't going to go away.  Its impact is vast.  That it has taken this much time to even get this point of awareness is mind boggling.  They had a good racket...well it must be that you need to be on the drug because without it you are suffering.  They essentially made millions of drug addicts by peddling this poison for all sorts of ridiculous reasons from post pardem depression to fibromyalga. 

 

Its only starting.  This site and the multitudes of support groups can no longer be marginalized.  

 

 

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cinephile

I should also point out that the editor-in-chief emeritus for the Psychiatric Times is...Ronald Pies!  Yes, that Ronald Pies.  Again: all is not black and white, even for a polarizing figure like Ronald Pies. 

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Dude
23 hours ago, cinephile said:

I should also point out that the editor-in-chief emeritus for the Psychiatric Times is...Ronald Pies!  Yes, that Ronald Pies.  Again: all is not black and white, even for a polarizing figure like Ronald Pies. 

You mean the same Ronald Pies who in 2011 once said that “well-trained psychiatrist” had never claimed that all “mental disorders” were caused by a chemical imbalance and who then, after having been confronted with evidence to the contrary, refused to retract his previous statement and simply added that "psychiatrists who told their patients that they suffered from a chemical imbalance did so thinking it would be helpful to them"?

You're right. It's not all black and white. It's brown.

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Dude
Posted (edited)

For easier reading, here's the same post again:

 

On 4/24/2018 at 11:47 AM, cinephile said:

I should also point out that the editor-in-chief emeritus for the Psychiatric Times is...Ronald Pies!  Yes, that Ronald Pies.  Again: all is not black and white, even for a polarizing figure like Ronald Pies. 

 

You mean the same Ronald Pies who in 2011 once said that "well-trained psychiatrist had never claimed that all "mental disorders" were caused by a chemical imbalance and who then, after having been confronted with evidence to the contrary, refused to retract his previous statement and simply added that "psychiatrists who told their patientes that they suffered from a chemical imbalance did so thinking it would be helpful to them"?

 

P.S.: There is a lot more I could write in response to your claims. But to be honest with you, I currently can't really be bothered to write a detailed response to what you've written. Besides, I think I've made my point.

Edited by Altostrata
removed strikethrough

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Dude

Okay, for some reason this bloody site has crossed through what I've written. As if it were that controversial. Anyway, screw it. I think you got the message.

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Altostrata

Dude, you accidentally set the text style to strikethrough. You can edit the post (for one hour) and correct this.

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Dude

Hi Alto

 

Thanks for your message. I gave it a go before the hour was up, but for some reason it didn't work. I also made sure that strikethrough was off when I posted my reply again (and was pretty sure I didn't have strikethrough turned on to begin with). Didn't make much difference though... Might have something to do with my laptop which has been acting up lately.

 

If you want, you could delete these last few posts and I'd give it another go (not because I have anything against cinephile as an individual, but simply because I think what I wrote was a valid counterargument, in my opinion, as short as it was). If not, then no worries, since it's the message that counts after all.

 

Either way, thanks for your advice.

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Dude

Well... maybe not a truly valid counterargument, but at least somewhat amusing and to the point... ;)

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Altostrata

I removed the strikethrough.

 

Ronald Pies most likely has had nothing to do with Psychiatric Times for several years, he retired. Yes, he was a stuffed turkey.

 

Another article just published in Psychiatric Times mentions SurvivingAntidepressants.org. Perhaps more psychiatrists will take a look.

 

 

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India
On 4/13/2018 at 3:33 AM, DrugfreeProf said:

Amen. The word is getting out--finally--and I'll just bet that we'll soon see the esteemed "thought-leaders" of psychiatry scattering around trying to cover things up, like cockroaches do when you turn the lights on.

It's very Orwellian. Like any cognitive dissonance, when you present with what is subjected, you become the scape goat. It happens in such subtle ways . However, it can be hugely traumatic to experience such invalidation. There is a great book that covers succinctly the history of madness

https://www.amazon.co.uk/Madness-Very-Short-Introduction-Introductions/dp/0199608032

It becomes clear that not much progress has been made only drugs have become the new straightjackets. The total denial of their side effects and wd . The powers psychiatrists hold are frightening. Their power over the vulnerable, their power to forcibly medicate and detain.  This is simplistic but it's horrifying. I like cinephiles perspective on this training and hope for a younger generation of psychiatrists. 

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India
On 4/21/2018 at 11:09 PM, Dude said:

And in this regard I have to say that despite also being quite familiar with the complexity of this subject, I do not agree with some of cinephiles statements (though I still respect his right to express his own opinion just like the rest of us, of course) . Psychiatry's legitimacy within society currently rests upon its being a scientifically based profession, after all. But the fact is that its not and that they have indeed cause more harm than good over the long run. And for the past thirty-five years they have not only displayed an incredible amount of ignorance but an equal amount of arrogance too (regardless of their alleged "intention to help" that cinephile referred to). So I for one am not inclined to take their side any time soon, despite having also attempted to see things from their perspective (which itself could very well be seen as a form of Stockholm syndrome, especially when it leads to sympathizing with them).

I am persuaded by this argument though as it tallies with my own experiences.

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