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Ben Carey's Second Article "Antidepressants and Withdrawal: Readers Tell Their Stories"


GentleSteps
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Published in today's NY Times: 

 

https://www.nytimes.com/2018/04/17/health/antidepressants-withdrawal-readers.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=2&pgtype=sectionfront

 

Highlights from this extremely important piece:

 

In a widely read article on antidepressant withdrawal published on April 8, The New York Times invited readers to describe their experiences coming off the drugs. More than 8,800 people responded — teenagers, college students, new mothers, empty-nesters retirees.

 

Dozens did write in to say the drugs had been lifesaving, literally so. “You fail to acknowledge that mood disorders can be lifelong, debilitating diseases requiring lifelong medical treatment,” wrote Rachel S., of New York.

A different kind of reader query would likely have attracted thousands of responses of gratitude for drugs that offered relief to tens of millions of people with chronic mood problems. Some doctors chimed in, too, more than one calling our focus on withdrawal irresponsible and unduly alarming to those who might benefit from antidepressants.

 

The volume and diversity of the other responses painted a different picture, showing how modern antidepressants, beginning with Prozac in 1987, have percolated through our culture and have shaped public understanding of mental health. These stories traced sharp demographic fault lines: Readers of different generations came to antidepressants, and tried to quit them, for different reasons.

 

(...)

 

Their reasons for wanting to stop taking them were rooted in part in the understanding that antidepressants were supposed to be a short-term solution, a bridge over troubled waters. But by the mid-1990s, drug makers had convinced government regulators that when taken long-term, the medications sharply reduced the risk of relapse in people with chronic, recurrent depression.

Thus began the era of indefinite or open-ended prescribing, and not just for the most severe cases of depression. The change in practice roughly coincided with the promotion of the “chemical imbalance” theory of depression: Marketers and some researchers implied that antidepressants corrected deficits in brain levels of serotonin, a neurotransmitter.

In truth, the theory has scant basis. No one knows the underlying biology of depression or any mood disorder. But that shift — along with a change in federal regulations, in 1997, allowing drug makers to advertise directly to consumers — helped undermine the stigma associated with depression and mood disorders generally.

 

(...)

 

The condition had some biological basis, it was felt, and antidepressants became a vastly popular option. Everyone knew someone taking them. Long-term prescription rates surged.

 

(...)

 

Nearly 1,000 young people in their 20s or younger responded the The Times’s invitation. They did not come of age during the rise of long-term use — their parents did, and often it was their parents who decided the medications could help them.

Many told us they were too young to know what the drugs were at the time, and didn’t learn until much later. As they enter high school and college, their understanding of the prescription culture is far different from that of generations before.

For one thing, many of their friends have been on antidepressants or other psychiatric medications for long periods. “I live in a college house of six girls, two of whom are on antidepressants,” wrote Julian O., 21, of Seattle.

“When brought up in conversation, the medications are discussed with vanity, as if they are veterans trying out the newest medication prescribed to them.”

Emma Dreyfus, 28, of Boston, said the “one mistake her parents had made” was putting her on Paxil at age 10 to treat anxiety. She weaned herself off slowly at age 23.  “I don’t blame them, but I wish we’d all understood the long-term effects.” She said she is starting graduate work in the fall, in social work, to help others facing similar challenges.

 

[Emma Dreyfus (and hopefully many like her) are set to have a powerful beneficial  impact on how states of emotional distress are regarded and healed. I found her commitment to be a source of great hope.]

 

(...)

 

[Carey closes with a memorable statement:]

 

Whatever their ages, all of us are part of Generation Rx — a huge, uncontrolled experiment with little precedent and few guideposts.

 

(confidential)

History 1996-2016.  1996-1997 Prozac 10mg.  1997-2007 Paxil 20mg  (CT - severe WD for @ 6 months w/o knowing what it was).  Early 2008. Paxil 60mg. 2013. Ativan 0.5. 2014- Ativan 1.02015 - Ativan 1.5  (0.5  am + pm + night).  2016: Paxil 60mg.  Ativan 1.5mg.

Early Feb. 2017 - Paxil 80 - Ativan 3mg 
April 2017.   Paxil 70. Ativan 2.5 (1mg am, 0.5 noon, 1mg eve).
May 2017: Paxil 60; Ativan 2.0 (0.5 am, 0.5 pm, 1.0 eve)
June 2017: Paxil 50.  Ativan 2.0 (0.5 am, 0.5 pm, 1.0 eve)
July 2017: Paxil 45. Ativan 1.5 ( 0.5 am, 0.5, pm, 0.5 eve)
August 2017:  Paxil 42.5. Ativan 1.25 (0.5/0.25/0.5 (2 weeks), then 1.0 (0.25/0.25/0.5) (holding through September)
Start  September 2017: Paxil 40.0 Ativan 1.0
Dec. 2017: Paxil 40.  Ativan 0.75 (eve dose tapered to  0.25 over 4 weeks 3 cuts & 10 day holds).
Jan.13 2018:  Paxil  37. Ativan 0.75
Jan. 30 2018:  Paxil  34. Ativan 0.75 
Feb. 13 2018: Paxil 31. Ativan 0.75
March 1, 2018 - Paxil 37.  Ativan 0.75
 
Supplements: Vit C, MultiVitamin, Iron tablet. 3/18/18 - Omega-3 Fish Oil Capsules (2 x day).  
 
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Thank you for posting this, GS. 

-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 I 2021: 7.8 mg - 5.26 mg

2022: 1/5/22: 5.2 mg (1.25%); 1/12/22: 5.1 mg (1.25%); 1/19/22: 5.07 mg (1.25%); 1/26/22: 5.0 mg (1.25%); 5/1/22: 4.9 mg (1.25%); 5/8/22: 4.88 mg; 5/15/22: 4.8 mg  (1.25%); 5/22/22: 4.76 mg (1.25%); 6/5/22: 4.7 mg (1.25%); 6/12/22: 4.6 mg (1.25%); 6/19/22: 4.58 mg (1.25%); 6/26/22: 4.5 mg; 7/10/22: 4.47 mg (1.25%); 7/17/22: 4.4 mg (1.25%); 7/24/22: 4.36 mg (1.25%); 7/31/22: 4.3 mg (1.25%)

 

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  • 2 weeks later...

Thanks for bringing our attention to this further article on the subject, GS. There's just one issue I'd like to comment on which has also been commented on by another member of this forum with regard to the previous article. And that issue is what's contained in the following excerpt:

 

 

On 4/18/2018 at 5:00 AM, GentleSteps said:

Dozens did write in to say the drugs had been lifesaving, literally so. “You fail to acknowledge that mood disorders can be lifelong, debilitating diseases requiring lifelong medical treatment,” wrote Rachel S., of New York.

A different kind of reader query would likely have attracted thousands of responses of gratitude for drugs that offered relief to tens of millions of people with chronic mood problems. Some doctors chimed in, too, more than one calling our focus on withdrawal irresponsible and unduly alarming to those who might benefit from antidepressants.

 

As mentioned, other members of this forum seem to share similar views on this matter. I for one disagree to a certain extent.

 

I acknowledge the fact that there do seem to be those who claim that the drugs have helped them and that without them they may have taken their own lives. Now that may very well be the case (for example with regard to so-called antidepressants). And anyone who is suffering to such an extent and who believes that taking antidepressants (or any other psych drugs) may help them is certainly welcome to do so. It's a free world after all (at least in certain respects) and everyone should be entitled to do whatever they want as long as they don't harm anyone else in the process. And that includes taking psychiatric drugs.

 

But what these people should be aware of is that psychiatric drugs do not fix any brain abnormality that allegedly underlies their condition. Most of us on this site know this but the general public does not. Psychiatry has gone to great lengths to convince the general public that they know what causes the conditions such people suffer from and that they have a medical solution to offer that is based on scientific discoveries. And that is simply not the case. The same people would, for example, most likely "benefit" just as much from taking low doses of cocaine over an extended period of time (not that I would recommend it to anyone, of course, I'm just trying to make a point).

 

As a matter of fact, cocaine was used therapeutically about a hundred years ago, most notably by Sigmund Freud. But society soon came to realize that cocaine was addictive and led to all sorts of problems (including aggressive behavior) which is why it eventually became illegal and classified as a controlled substance. And what should also be noted are the similarities between modern day psychiatric drugs and illegal drugs with regard to their mechanism of action. Cocaine, for example, raises the levels of serotonin, noradrenaline and dopamine just like certain psychiatric drugs (such as SSRIs and SNRIs). And it does so in a very similar fashion too, namely by re-uptake inhibition of those particular neurotransmitters but, in addition, also by causing the release of more of them in presynaptic neurons (if I remember correctly). Yet if anyone suffering from depression were offered cocaine by their doctor today to "treat" their condition, I'm pretty sure they'd think he was insane and would leave his office immediately, never to return again (and would perhaps even call the police). Because after all, those suffering in such a manner go to doctors for help because they're looking for both a medical explanation of their problems and a medical solution, not just some superficial "solution" that temporarily might make it easier to live with the problems their facing. But that's exactly what psychiatry offers them, despite pretending to offer medical interventions.

 

So, the question is not whether those suffering deserve to be helped or not (which they of course do) but whether the "solution" to their problem offered by psychiatry is indeed what they were looking for, namely a medical one (the question of whether or not their original condition is indeed a medical problem is of course another issue). And I think this issue is something that is often overlooked in this whole discussion. And the reason I think it is never touched upon by psychiatrists themselves is because it undermines the legitimacy of their jurisdictional claim (namely their claim of professional jurisdiction over the area of "mental" suffering, which itself is based upon such suffering allegedly being a medical problem, their alleged understanding of the underlying causes and their allegedly being able to offer a medical solution for these problems).

 

There are further issues too, of course, such as these substances causing harm in the long run (and in some cases even after only brief exposure to them), the question of whether any relief is truly due to the drugs themselves or perhaps due to a placebo effect (which is something Irving Kirsch has been looking into for quite a while), the issue of withdrawal syndromes (of course) and, last but not least, what alternatives there are. I don't want to go into any further detail here since these issues have been and continue to be discussed elsewhere on this site (not to mention the fact that there's tons of literature on these subjects for which a thread can also be found on this forum).

 

However, the bottom line, in my opinion, is this:  if you want to take psychiatric drugs, then take them. But don't be fooled into believing they're actual medications. Their drugs in the same way that cocaine, heroin and amphetamines are drugs (to mention just a few). Maybe they will provide some people with some form of relief. But they do so at a price. And if you're really looking for a proper solution to your problems (and to truly understand them to begin with), you might want to look elsewhere. Especially in the long run.

 

 

 

 

 

 

 

 

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My gripe with anti depressants is that the patient isn't warned of the potential side effects on discontinuation & just how bad it can be. Additionally doctors dont taper patients and just take them off in a week or two causing absolute misery for the patient. I agree that these antidepressants are pretty much the same as illicit drugs if not worse im some cases. Chronic use is going to cause issues in the long run.

 

Paroxatine - 2004-2006

Effexor XR 75mg 2006 - 2016 (Discontinued Feb 2016) - Withdrawal for 6 months.

Effexor XR 75mg Re-instated June 2017 (Discontinued Dec 2017)

Effexor XR 2-3 mg Re-instated March 10 2018 - 1 day (Didn't work)

Effexor XR 2mg Reinstated (Again) May 11 2018. 6 Beads

July 2018 - 0.0mg of Effexor. Zilch

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Well said. I've yet to master the art of keeping it simple... Think I could learn a thing or two from members like you ;)

 

 

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