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Communications with Dr. Stuart Shipko

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Barbarannamated

 

Another theory is that getting off throws the brain in a psychosis-like state which actually does the damage. I got psychotic after 4-5 months off.

 

Could someone please elaborate on this theory and provide resources such as links to substantiate it?

This may be the missing piece of the puzzle I've been looking for all this time.

 

I have a little trouble with "psychosis-like state". From what I understand, psychosis is a clear break with reality. That said, I have definitely felt like I was on a slippery slope throughout this - the perceptual distortions are very strong and cause an unrealness that is frightening. Judgment is tweaked. Perception of time is off - one day will go so s-l-o-w-l-y I feel I can hear every second tick by. Other days fly by, regardless of activity/busyness. I like the flybys.

 

I don't mean to minimize this, but caution the use of the term "psychosis". That could get a new diagnosis and new medication.

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Altostrata

I've never heard of this "psychosis-like state" theory. Perhaps Claudius can clarify.

 

I agree with Barb. As far as I know, it's not psychosis, it's autonomic nervous system dysfunction. It would be a very long hypothetical stretch to call it psychosis, or indeed any psychiatric disorder.

 

In fact, adverse effects are often misdiagnosed as bipolar disorder and medicated unmercifully with all kinds of drug cocktails, much to the detriment of the patient. In an alternative universe inhabited by some psychiatrists, psychosis lives next door to bipolar disorder. But adverse effects are none of the above.

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RebelMaven

I'm interested in this part:

 

Another theory is that getting off throws the brain in a psychosis-like state which actually does the damage.

I want to know if sudden withdrawal that lasted several months can lead to permanent damage.

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Altostrata

Nobody has been able to answer that.

 

We know for a fact that people do recover from prolonged withdrawal syndrome. It can take years, but they do recover.

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RebelMaven

Oh My God. This is NOT happening.

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jr1985

Does Dr Shipko try to taper someone off their current AD, using the 10% 3-6 weeks rule, and just stop if it gets bad? Or does he try the Prozac bridge, etc before giving up?

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Altostrata

All of the above. He's very skilled at tapering.

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Claudius

I see to my pleasure that dr. Shipko has joined the board. I send him a mail last year and his reaction was the one that my neurologist convinced that there was at least a probability of persistend withdrawal effects from Paxil. So I want to welcome him to the board and thank him for his help.

 

I hope more doctors will join and hope that something will change.

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Claudius

I've never heard of this "psychosis-like state" theory. Perhaps Claudius can clarify.

 

I agree with Barb. As far as I know, it's not psychosis, it's autonomic nervous system dysfunction. It would be a very long hypothetical stretch to call it psychosis, or indeed any psychiatric disorder.

 

In fact, adverse effects are often misdiagnosed as bipolar disorder and medicated unmercifully with all kinds of drug cocktails, much to the detriment of the patient. In an alternative universe inhabited by some psychiatrists, psychosis lives next door to bipolar disorder. But adverse effects are none of the above.

 

This "theory" was just a thought of mine. I got off about 5-6 times and got terribly sick but felt perfectly well again weeks after reinstating. In fact too well, because I was not triggered to do my investigation for which I paid a terrible price.

But my thought was that the damage is not done immediately because in that case, reinstating would not take the symptoms away. It took a few months after my final quit that I start to hallucinate, and my worst trauma from the past (about bullying) rose its ugly head and nearly drove me to murder. I think back of that period as a form of psychosis.

But is is a speculation, nothing more. I am now over 4.5 years post CT and still not recovered although there is still progression and I guess I will finally heal from it, at least physically/neurologically. If the damage to my career is repairable is still uncertain after being completely unable to work for years and still not able to embark in a fulltime job.

Dr. Shipko tells that he is not able to treat people who are already too long in WD, past the point of reinstatating and that means I still did the right thing by not reinstating when WD did not subside after months though I first promised myself to "give it one half year", and later "give it one year", but when I still felt miserable after a year I did not reinstate because, though still totally unaware of protracted WD, I realized that these was NOT my original condition and the had to be some connection with my Paxil use. Moreover, I know that if I would reinstate after one year suffering, that would be my final surrender to PAxil and in that case I would have preferred death.

 

Maybe I still saved my life by listening to that realization...

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RebelMaven

Dr. Shipko tells that he is not able to treat people who are already too long in WD, past the point of reinstatating....

 

....I know that if I would reinstate after one year suffering, that would be my final surrender to PAxil and in that case I would have preferred death.

So protracted withdrawal is why the drug no longer works to reinstate. How long of a protracted withdrawal would it take before the drug could not be reinstated?

 

I know that no matter what happens I know I will find peace in the end. Either I will die from a seizure while in withdrawal or I will go so psychotic that I don't know what I am doing and I'll kill myself.

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Altostrata

It's unclear what the window for reinstatement is. The sooner, the better. The longer, the more iffy.

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RebelMaven

It's unclear what the window for reinstatement is. The sooner, the better. The longer, the more iffy.

 

So after the SDS for two months they put me on the Prozac and tapered me back up. I did not respond to 20mg so they went to 40mg. I wonder if this will make SSRI withdrawal harder next time.

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Altostrata

Your complex history with being overmedicated and going on and off drugs has completely changed the landscape. There's no way to predict how it will go. Your system has probably been sensitized so you should plan to wean off Prozac very slowly.

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RebelMaven

Your complex history with being overmedicated and going on and off drugs has completely changed the landscape. There's no way to predict how it will go. Your system has probably been sensitized so you should plan to wean off Prozac very slowly.

 

Yes, you are quite correct.

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Barbarannamated

Dr. Shipko tells that he is not able to treat people who are already too long in WD, past the point of reinstatating....

 

 

I've left 2 email messages with Dr. S over the last month+ to try to get appointment and received no response. Several months ago he responded very quickly to a general message,. not request for appointment. I hope it's not because of being too far out/protracted.

 

I will call.

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jr1985

I really hope he's wrong when he says there are some people who can never come off their antidepressant. I also hope I'm not one of them.

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compsports

I really hope he's wrong when he says there are some people who can never come off their antidepressant. I also hope I'm not one of them.

 

If you need encouragement, I got off of 4 psych meds. I am not going to lie and say it was easy. Just take it very slowly.

 

Barb, keep us posted about Dr. Shipko. Many doctors seem to be bad about responding to email so hopefully, that is what you encountered.

 

CS

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Altostrata

Recently had a conversation with Dr. Stuart Shipko.

 

He believes recovery from psych drug-induced neurotoxicity can take up to 8 years.

 

About benzo withdrawal:

  • He challenges Ashton's received wisdom that a crossover to diazepam is standard procedure.
  • He said some people can't tolerate the crossover. He wrote the e-book to explain you can directly taper from an benzo without the transfer.
  • He contradicts Ashton's resistance to holding or updosing (this may be where the weird misinterpretation of "tolerance withdrawal" comes from. He said she inherited this position from heroin withdrawal procedures, in which you NEVER want to give the addict more of the drug.
  • He also opposes Ashton's recommendation of using an antidepressant to counter benzo withdrawal. He said all his anxiety patients got worse on antidepressants.

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Altostrata

Dr. Shipko has a series of 11 (undated) interviews on Power Surge, "A Warm and Caring Community for Women in Menopause"

 

Among other subjects, he discusses benzo and antidepressant side effects and withdrawal.

 

The most recent is here http://www.power-surge.com/transcripts/shipko11.htm , with links to the other transcripts at the bottom.

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woof

Does Dr. Shipko currently understand AD destabilization and the time limititations on reinstatement?

 

Does Dr. Shipko currently understand AD destabilization and the time limititations (if any) on updosing?

 

Is there a consensus on these two topics per others who are knowledgeable on these issues (eg Dr. Healy) or others who are knowledgeable ?

 

 

 

 

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India
On 12/11/2011 at 10:15 PM, annej said:

My Intro[url="http://survivingantidepressants.org/index.php?/topic/1542-annej-off-long-term-snris-since-july-2011/"]

 

My thoughts on Dr. Stuart Shipko after spending 1.5 hours in consultation with him this year. . .

 

My impression is that Dr. Shipko is highly frustrated by the numbers of people finding out that they experience great distress and discomfort in trying to get off of psychotropics. He was unable or unwilling to offer me any help in getting off of the 5 or 6 medications that I was on at the time I saw him.

 

I don't blame him for not wanting to take on this immense undertaking, but my family and I left his office feeling hopeless after my consultation. He said, and I quote:

 

"The SSRI (SNRI) and the benzo are the very least of your problems". I completely disagree with this statement although I respect his right to think this.

 

 

"You are screwed." Yes, he actually told this to me in front of my family. I sure felt screwed, especially after hearing this.

 

He then went on to say:

 

"I will not be responsible for getting you off medication because I never put you on them in the first place". I respect his personal decision not to get involved with trying to help people get off psychotropics because I am sure that it is very difficult to support someone through their agony, but don't physicians care for people when they are ill and need help?

 

I got the distinct impression that Dr. Shipko does not think it within the best interests of those who might struggle with withdrawal symptoms to take the risk of tapering off of these drugs. His essay which has been posted on this forum, but I will post it again is actually very good and I think it does offer a valid perspective. It is difficult getting off of these drugs and it can be dangerous, but I think he is to quote another poster,a "tad bit fatalistic". I think the scariest possibility that he raises is if the patient goes off medications, finds out that they cannot tolerate the withdrawal symptom, reinstates the drug only to find out that it does not work. I have not run across anyone in my travels that this has happened to, but I don't doubt that this situation exists in the rare minority of patients. [url="http://empathic.ning.com/forum/topics/some-thoughts-on-stopping?xg_source=activity"url]

 

These are just my personal interpretations of my consultation with Dr. Shipko. Other than that, my family and I are very pleased that I decided to get off meds and I hold a lot of hope for the future.

 

I will say one last thing and that is that the quality of my life, even though I am going through benzo withdrawal, is so much better off the multiple drugs than it ever was on them. I'll take my chances and learn how to live drug free.

 

:) Hugs, annej

Kelly Brogan M.D is more positive 

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Rhiannon

I would love to talk to Dr. Shipko sometime--it sounds like a lot of the things he has concluded are similar to things I've figured out myself.

 

One of those is the 3-6 month "relapse" window with AD withdrawal. I saw something written by him on another site (MIA I think) where he mentioned that window. I see it so commonly on here, I'd say in almost all the uncomplicated AD withdrawal cases we get here (that is, people who have primarily either too-fast-tapered or CT'd just one antidepressant, without a big complex multidrug history). I think it's a phenomenon that really needs to be researched, although I'm definitely not holding my breath that THAT will happen. Basically it seems like a lot of people get through acute WD okay and their symptoms settle down or they just don't have a lot of symptoms, and then somewhere around 3-6 months out they get hit with symptoms that are almost invariably diagnosed as "return of the original condition" and they end up back on ADs. 

 

It was a fist-pumping "yes!" moment for me when I saw Shipko commenting on the same thing. And it seems he also agrees with me about the "tolerance withdrawal" myth with benzo WD (that is, the one where people think they are having more symptoms because they aren't tapering fast enough so they are afraid to slow down or hold during a taper.)

 

Anyway--Dr. S if you're out there and you'd like to connect, drop me a line, or if anyone talks to him, let him know I'd like to correspond.

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Hisame
29 minutes ago, Rhiannon said:

One of those is the 3-6 month "relapse" window with AD withdrawal. I saw something written by him on another site (MIA I think) where he mentioned that window. I see it so commonly on here, I'd say in almost all the uncomplicated AD withdrawal cases we get here (that is, people who have primarily either too-fast-tapered or CT'd just one antidepressant, without a big complex multidrug history). I think it's a phenomenon that really needs to be researched, although I'm definitely not holding my breath that THAT will happen. Basically it seems like a lot of people get through acute WD okay and their symptoms settle down or they just don't have a lot of symptoms, and then somewhere around 3-6 months out they get hit with symptoms that are almost invariably diagnosed as "return of the original condition" and they end up back on ADs.

Hi Rhiannon,

It happened to me, not during withdrawal, but when I definitely got rid of paxil. The first three months I had a relapse windows (except for my tinnitus), and then real troubles began.

 

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Rhiannon
22 hours ago, Hisame said:

Hi Rhiannon,

It happened to me, not during withdrawal, but when I definitely got rid of paxil. The first three months I had a relapse windows (except for my tinnitus), and then real troubles began.

 

 Thanks Hisame. This seems to be a really typical pattern. I'm certain there is a neuro-physiological reason for it.

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bubbles

 

On 9/10/2019 at 2:56 AM, Rhiannon said:

One of those is the 3-6 month "relapse" window with AD withdrawal. I saw something written by him on another site (MIA I think) where he mentioned that window. I see it so commonly on here, I'd say in almost all the uncomplicated AD withdrawal cases we get here (that is, people who have primarily either too-fast-tapered or CT'd just one antidepressant, without a big complex multidrug history). I think it's a phenomenon that really needs to be researched, although I'm definitely not holding my breath that THAT will happen. Basically it seems like a lot of people get through acute WD okay and their symptoms settle down or they just don't have a lot of symptoms, and then somewhere around 3-6 months out they get hit with symptoms that are almost invariably diagnosed as "return of the original condition" and they end up back on ADs.

 

Where people feel fine for a few months and then crash? Yes, I've noticed this mentioned quite a lot, and experienced it. Not sure I ever felt brilliant, but def crashed at some months out. When I tried to raise it as WD, it was dismissed. I'd love to see some research on it. Interesting that Dr Shipko has noticed it also.

 

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ChessieCat

My drug history is very simple.

 

I was taking citalopram for many years and I think it reached tolerance (from current knowledge).  For some reason I decided to cold turkey it.  I felt great for at least 2 months.  Better than I had felt in a very long time.  Then I became bedridden for 2.5 weeks with "flu"
but no temperature.  I lost 8kgs because I didn't feel like eating.  Didn't understand that it was delayed withdrawal (again hindsight).  I must have improved a bit from the flu but wasn't feeling good because the psychologist then told me that I needed an AD like a diabetic needs insulin and I was advised to start Pristiq.  Thankfully it did cover the withdrawal symptoms, or most of them (I ended up starting 50mg and then ended up on 100mg - and ended up with mild serotonin toxicity).

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bubbles
3 hours ago, ChessieCat said:

I was taking citalopram for many years and I think it reached tolerance (from current knowledge).  For some reason I decided to cold turkey it.  I felt great for at least 2 months.  Better than I had felt in a very long time.  Then I became bedridden for 2.5 weeks with "flu"
but no temperature.  I lost 8kgs because I didn't feel like eating.  Didn't understand that it was delayed withdrawal (again hindsight).  I must have improved a bit from the flu but wasn't feeling good because the psychologist then told me that I needed an AD like a diabetic needs insulin and I was advised to start Pristiq.  Thankfully it did cover the withdrawal symptoms, or most of them (I ended up starting 50mg and then ended up on 100mg - and ended up with mild serotonin toxicity).

 

The sertraline mostly covered the symptoms, though my symptoms were all anxiety and depression. My symptoms were also complicated by having been off my thyroid meds for a few weeks. It wasn't clever, being off my thyroid meds, and it taught me that thyroid isn't an issue to be taken so cavalierly, regardless of how much I enjoyed not taking any pills for a bit. I still think it was WD, exacerbated by the thyroid issue, but it's actually impossible to know.

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