Jump to content

Harvey, 2003 Neurobiology of antidepressant withdrawal


Recommended Posts

these journal articles both show that AD withdrawal partially caused by overexpression of NMDA receptors. Sure, it is light, and animal models, but would certainly explain if some people are getting help from NMDA antagonists like ketamine infusion, which I've been considering despite the expense.

 

 

https://www.ncbi.nlm.nih.gov/m/pubmed/12020747/?i=2&from=/14625154/related

 

https://www.ncbi.nlm.nih.gov/m/pubmed/14625154/

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

10) March 2020 - done with Paxil, 2.5mg Prozac

11) April 2021 - 0.03mg Prozac

Link to post
Share on other sites
  • 6 months later...
On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:

 

 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.

Hey alto,

I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.

I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?

Thank you in advance for your help

Edited by scallywag
remove graphic description of PSSD symptom

2004-2007 paxil

2015- zoloft 3 months zyprexa 3 months lexapro 3 months xanax

Med free since Feb 28th 2017

Mostly experiencing PSSD

Link to post
Share on other sites
  • 2 weeks later...
Jennifer78

This paper describes the neurological activity that leads to withdrawal syndrome. The authors conclude:

 

 

The distress that potentially accompanies antidepressant withdrawal has not always been sufficiently appreciated. As alluded to earlier, missed doses, abrupt dose reduction, or abrupt discontinuation of some antidepressants may be associated with an antidepressant discontinuation syndrome. Although the severity of withdrawal symptoms may vary with the type of antidepressant and between patients, all too often not enough emphasis is placed on the possible neurobiological effects and possible longer-term risks associated with inappropriate withdrawal or discontinuation.

 

As emphasized here, antidepressant discontinuation may involve a stress response accompanied by a set of specific biochemical responses that cause further neuronal dysfunction and that may compromise long-term outcome. This is not to say that clinicians should continue antidepressants indefinitely; it is, however, to emphasize that the decision to discontinue antidepressants should be made judiciously and on an individualized basis.

Biol Psychiatry. 2003 Nov 15;54(10):1105-17.

Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression.

Harvey BH, McEwen BS, Stein DJ.

 

Source

 

Division of Pharmacology, School of Pharmacy, Potchefstroom University for Christian Higher Education, Potchefstroom, South Africa.

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed?term=neurobiology%20withdrawal%20harvey Full text here.

 

Inappropriate discontinuation of drug treatment and noncompliance are a leading cause of long-term morbidity during treatment of depression. Increasing evidence supports an association between depressive illness and disturbances in brain glutamate activity, nitric oxide synthesis, and gamma-amino butyric acid. Animal models also confirm that suppression of glutamate N-methyl-D-aspartate receptor activity or inhibition of the nitric oxide-cyclic guanosine monophosphate pathway, as well as increasing brain levels of gamma-amino butyric acid, may be key elements in antidepressant action. Imaging studies demonstrate, for the most part, decreased hippocampal volume in patients with depression, which may worsen with recurrent depressive episodes. Preclinical models link this potentially neurodegenerative pathology to continued stress-evoked synaptic remodeling, driven primarily by the release of glucocorticoids, glutamate, and nitric oxide. These stress-induced structural changes can be reversed by antidepressant treatment. In patients with depression, antidepressant withdrawal after chronic administration is associated with a stress response as well as functional and neurochemical changes. Preclinical data also show that antidepressant withdrawal evokes a behavioral stress response that is associated with increased hippocampal N-methyl-D-aspartate receptor density, with both responses dependent on N-methyl-D-aspartate receptor activation. Drawing from both clinical and preclinical studies, this article proposes a preliminary molecular perspective and hypothesis on the neuronal implications of adherence to and discontinuation of antidepressant medication.

 

I'm confused about this article. So do we heal from cold turkey or not? What's the point in going off meds if it's only going to make us worse in the long run?

Trazodone 100mg stopped November 2016

Lamictal 200mg stopped November 2016

Celexa 40mg stopped 12-01-16

Abilify 10mg stopped 12-01-16

Wellbutrin XL stopped 6-14-18

I have been on some type of meds for @ least 15 years.

GOD BLESS! 🙏

Link to post
Share on other sites
  • Administrator
Altostrata
On 2017-05-05 at 6:29 AM, Bobo32 said:

 

On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:

 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.

Hey alto,

I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.

I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?

Thank you in advance for your help

 

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation

 

We know it's not good for your nervous system to go off psychiatric drugs suddenly. This paper describes why the potential neurological results might be. The research did not investigate the process of healing from this.

Edited by scallywag
remove graphic description of PSSD symptom in quoted post

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.

Link to post
Share on other sites

alto still having the 

On 2017-05-25 at 2:16 AM, Altostrata said:

 

On 2017-05-05 at 6:29 AM, Bobo32 said:

 

On 2011-12-22 at 8:19 PM, Altostrata said:

Dr. Harvey sent me this in correspondence:
 

Quote

I am very glad to see you are recovering from your own nasty experience. I find it especially interesting that you are showing this recovery using lamotrigine, which is a very effective inhibitor of glutamate release. Our studies have strongly implicated altered glutamatergic activity following antidepressant discontinuation/withdrawal, with especially overt activity at NMDA receptors acting to perpetuate the illness via a kindling-like action. One could even consider this to be a useful case report in support of the argument.


Hey alto,
I read what Dr. harvey said about glutamate dysregulation and how it could be the factor in withdrawal syndrome.
I am now 3 months into withdrawal and I improved in many ways except for tinnitus and pssd. What do you think I should do? Is iamotrigine the answer ?
Thank you in advance for your help

 

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

Alto, is it possible that neuronal damage due to SSRIs is the reason for PSSD? I dont know what to do for this symptom. Should I reinitiate and withdraw differently? I cut the lexapro pill in bits when I quit. Is it the reason I have this? 

 

Edited by scallywag
remove graphic description of PSSD symptom

2004-2007 paxil

2015- zoloft 3 months zyprexa 3 months lexapro 3 months xanax

Med free since Feb 28th 2017

Mostly experiencing PSSD

Link to post
Share on other sites
Jennifer78

 

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation[/color

 

I did a cold turkey. So am I not going to recover mentally?

Trazodone 100mg stopped November 2016

Lamictal 200mg stopped November 2016

Celexa 40mg stopped 12-01-16

Abilify 10mg stopped 12-01-16

Wellbutrin XL stopped 6-14-18

I have been on some type of meds for @ least 15 years.

GOD BLESS! 🙏

Link to post
Share on other sites
  • 3 weeks later...
On 2017-5-25 at 2:16 AM, Altostrata said:

 

Bobo, you've improved after 3 months, that's a very promising rate of healing. It may take somewhat longer for all the symptoms to go away. We don't know of any definite way to cure those symptoms. Please let us know how you're doing in your Intro topic.

 

Jennifer -- This paper describes what might happen after inappropriate discontinuation

 

We know it's not good for your nervous system to go off psychiatric drugs suddenly. This paper describes why the potential neurological results might be. The research did not investigate the process of healing from this.

when I took amoxacillin recently my movement disorder stopped completely... I found a source that said that ab lowers glutamate and also another source that said high glutamate causes huntingtons which is what my doc thought I had when it first started by the neurologoist she sent me to just said movement disorder...

 

if it was lowering glutamate that stopped it ... what are other potential treatments?  

i am looking for ideas

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

Link to post
Share on other sites
  • 1 month later...
  • Administrator

Please stay on topic in the Journals forum.

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.

Link to post
Share on other sites
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy