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Nielsen, 2012 Selective serotonin reuptake inhibitors (SSRI) – sales, withdrawal reactions and how drug regulators reacted to this with benzodiazepines as comparator


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As a layman, I found this very interesting and supportive of the idea that regulators, doctors and pharmaceutical companies, to a higher or lesser degree and probably due to different motivations, are turning a blind eye to the very real problem of SSRI abstinence symptoms, that I could experience first hand.
My own doctor didn't believe that I was experiencing symptoms and attributed them to a nocebo effect, combined with psychological factors.
This must stop, I was very lucky to find this forum, otherwise I wouldn't have found the idea of having it prepared into smaller dosages in a compounded pharmacy. Otherwise, I think I would still be on it.

12. December 2012
The Nordic Cochrane Centre
Faculty of Health Sciences University of Copenhagen
Selective serotonin reuptake inhibitors (SSRI) – sales, withdrawal reactions and how drug regulators reacted to this with benzodiazepines as comparator.
 Margrethe Nielsen


Full text: www.cochrane.dk/research/theses/Nielsen%20PhD.pdf
Psychotropic drug use has increased in all European countries, also in Denmark, due to the introduction of the so-called selective serotonin reuptake inhibitors (SSRIs) in the late 1980s and changed prescription habits. Further, patients have raised the suspicion that the SSRIs could cause dependence. This suspicion has, however been rejected by marketing authorisation holders and by regulatory agencies, the latter being responsible for guarding public safety in relation to medicines.The overall aim of this PhD thesis was to explore the life-cycle of the SSRIs and compare it with benzodiazepines with respect to use and dependence. This was investigated in 3 studies. In the first study, we explored the possible causes for the sales of psychotropic medicines in Denmark. In the second study we explored the rationale for claiming that benzodiazepines cause dependence while selective serotonin reuptake inhibitors (SSRIs) do not. The third study was a documentary study describing actions and statements of the regulatory agencies in UK, USA, England and Denmark. We explored the communications from drug agencies to the public saying that benzodiazepines cause dependence whereas selective serotonin reuptake inhibitors (SSRIs) cause a withdrawal syndrome because the phraseology of the communications might explain why benzodiazepines are viewed as being addictive in contrast to SSRIs.


The first study showed that the sales of psychotropic drugs has fluctuated widely over a 37-year period. We believe that the decline in sales of benzodiazepines was primarily due to the recognition that they cause serious dependency and by initiatives at a national level to curb their use, and that the recent steep increase in sales of SSRIs is a direct consequence of marketing pressures, as the effect of the SSRIs is overestimated.

The second study showed the withdrawal reactions to SSRIs were very similar to those for benzodiazepines. It therefore makes no sense to describe only the latter as dependence symptoms. denied that the reactions indicated SSRI dependence. Drug regulators underestimated in both cases the frequency and severity of the symptoms. The third study showed that in the perspective of the precautionary principle it could be understood as if the drug agencies have refused to acknowledge that SSRIs can cause dependence, with reference to the diagnostic disease manuals ICD-10 and DSM-IV, and minimised the problem with regard to the severity and the number of people affected.


In this perspective changes in the communication from drug regulators to the public about adverse effects happened slowly.


In the perspective of the risk management principle it could be understood as if the drug agencies have reacted in concordance with the slow growing knowledge of adverse drug reactions and have sharpened the information to the public over time. However, relying on spontaneous reporting of adverse effects leads to underrecognition and delayed information about the problems.

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Thank you, yima, very interesting paper.

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

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thankyou,  now they are marketing SRNIs , always a new one, to replace old model, that dont work......


but new models are worse than old ones, just take years for the side effects and adverse publicity to show up, then it is a new drug, that is better than last drug.  


Weird, like poison is poison, the new poison, apparently, is never as bad as the last poison, so we are told to take the "new poison"... Great marketing techniques.  


Like saying lead isnt as bad as cyanide, so eat lead... love it!

1992 Dothiepin 375mg 8 weeks, exhaustion/depression.  Serotonin syndrome, oh yes!  seizures . Fell pregnant, 3rd baby, Nitrous Oxide, 3 weeks mental hospital pp psychosis. zoloft tegretol.

Feb 1996 ct tegretol, tapered Zoloft 8 weeks. as (unexpectedly)  pregnant. Steven died after 3 days.(Zolft HLHS baby).  98 had run in with Paxil, 2 tablets, 3 weeks taper, survived.
2005..menopause? exhausted again. Zyprexa, mad in three days, fallout....  Seroquel, Effexor, tegretol,   and 8 years of self destruction. Failed taper.
Damn 1/4 valium... nuts again! .fallout, zoloft 100mg  seroquol 400mg mirtazapine 45 mg  tegretol 400mg.  Mid 14 3 month taper. Nov 14 CRASH.
Mid 15 ....   75mg  seroquel,  3 x 1800mg SJW  2 week window end of December followed by 6 week wave
5/2 68mg seroquel, 2.5 x 1800mg SJW::::20/2 61mg seroquel, 2.5 x  SJW::: 26/2 54mg seroquel, 2 x SJW::::21/3 43mg seroquel, 1 x 2700SJW :::: 23/4 36mg seroquel 1 x 1800 SJW
15/5 33mg seroquel, 1 x SJW::::   28/5 30mg seroquel, 1 x SJW::::;  18/6 25mg seroquel 1/2 SJW::::, 11/7 21mg seroquel 1/2 SJW::, 26/7 18mg seroquel 1/2 SJW:::, 9/8 12mg seroquel :::, 16/8 6mg seroquel ;;;;, 12/9 0 jump.

23/9  3mg.....,  27/9 0mg.  Reinstated, 6mg, then 12mg.............  LIGHTBULB MOMENT,  I have  MTHFR 2x mutations.  CFS and issues with MOULD in my home. So I left home, and working 150km away during week, loving it.

Oh was hard, panic attacks first week, gone now, along with the mould issues.

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It's not just dependence or withdrawal. It's a kind of brain damage, in my opinion. Why can't they admit that when people turn into complete messes after they stop the drugs, it means their brains are changed for the worse, i.e., damaged. Of course we tend to get better over a period of months or years...but that means we have recovered from the damage, not that none occurred. And not everyone does get relief, from what I have read.

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:

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