Jump to content
Altostrata

Shelton, 2006 The nature of the discontinuation syndrome associated with antidepressant drugs

Recommended Posts

Altostrata

At the same time this paper was published, Dr. Shelton sent me personal correspondence admitting that "I actually think the discontinuation syndrome is pretty bad in some situations and truly horrible in others....First, let's acknowledge one thing: there is a great deal of variability in response, with a lot of people experiencing bad symptoms and others little at all, but almost all resolve; that is, except for a very small group, where the symptoms become persistent...."

 

However, in this paper Dr. Shelton asserts withdrawal symptoms are mild and last only a couple of weeks -- anything after that is due to "something else."

 

This paper and the supplement to the Journal of Clinical Psychiatry in which it appeared was sponsored by Wyeth, manufacturer of Effexor.

 

J Clin Psychiatry. 2006;67 Suppl 4:3-7.

The nature of the discontinuation syndrome associated with antidepressant drugs.

Shelton RC.

 

Source

 

Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tenn. 37212, USA. Richard.Shelton at vanderbilt.edu

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/16683856 Full text here.

 

A common phenomenon accompanying treatment with nearly every major class of antidepressant is the emergence of the discontinuation syndrome in some patients. It is seen most frequently after the abrupt cessation of agents with shorter half-lives. The term withdrawal has been used in the past; however, the distinctions between discontinuation symptoms and drug withdrawal are clear. Thus, the use of proper terminology when discussing this phenomenon with patients will help to alleviate concerns and stop the spread of common misperceptions. In addition, awareness of the unique nature of discontinuation effects and a grasp of the typical time frame of their emergence can assist in distinguishing between discontinuation syndrome and relapse. As a result, it is vital that both patients and their relatives, especially caregivers, be provided with adequate education and a realistic and objective appraisal of expected outcomes upon initiation of antidepressant treatment.


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.

Share this post


Link to post
Share on other sites
Altostrata

Note: This paper was one in a supplement attached to the Journal of Clinical Psychiatry:

 

On his blog, Dr. David Allen says of journal supplements:

 

Journal Supplements are mini-journals mailed along with more legitimate, peer-reviewed journals (and usually having the same cover design) that consist of multiple articles which claim to review a particular topic in the field. Most doctors are unaware that the articles in a journal supplement are not peer reviewed like the articles in their accompanying primary journal, and that the supplements are usually sponsored by one pharmaceutical company.

The supplement was sponsored by Wyeth, manufacturer of Effexor, one of the worst antidepressants for withdrawal, and did its best to whitewash the problem of withdrawal syndrome. Alan Schatzberg was one of Richard Shelton's co-authors.

 

In the article posted above, Shelton describes categorically withdrawal symptoms as lasting only a couple of weeks, and if they persist after that time, directs the clinician to ascribe them to "something else."


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.

Share this post


Link to post
Share on other sites
alexjuice

Very nice... this racket is pretty distasteful even by racket standards.

 

By the way, I know a psychiatric doc named Shelton... no relation.


"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

Share this post


Link to post
Share on other sites
compsports

I saw your post on the 1Boring Old Man blog about this.

 

Good work. Dr. Shelton's hypocrisy needs to be exposed big time.

 

CS


Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

Share this post


Link to post
Share on other sites
Barbarannamated

I feel so delicate at this point. I'm afraid to go to any docs who will either dismiss, misdiagnose, or, as I get from my MD husband, mock me.


Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Share this post


Link to post
Share on other sites
Altostrata

Bar, do pop in and see Richard Shelton at Vanderbilt, just to say hello. He's known about prolonged withdrawal syndrome for years and years, but has declined to publish about it. He gets a lot of income from pharma.

 

I believe he's a devout Christian and will no doubt put on a good show of concern. He might pat your hand and give you a cup of tea.

 

You might tell him thousands of people are posting on the Web suffering from protracted withdrawal and they're not getting any respect or help anywhere because journal articles say it lasts only a couple of weeks.


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.

Share this post


Link to post
Share on other sites
Barbarannamated

I'm in CA right now, but will stop in to see Dr. Shelton when I'm back in Nashville. I'm planning to go to the ISEPP Conference in LA this weekend, so hopefully will have a better grasp of the info and players.

Do you know of anyone else attending the conference?


Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Share this post


Link to post
Share on other sites
Altostrata

Mark Foster is going to be there. How about starting a topic in Taking action about the conference?


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.

Share this post


Link to post
Share on other sites
alexjuice

He's known about prolonged withdrawal syndrome for years and years, but has declined to publish about it. He gets a lot of income from pharma.

 

Alto, I read your 06 exchange. Have you had occasion to talk to Dr. Shelton recently? Perhaps he is no longer as enthusiastic about the evidence in support of prolonged w/d? At least publicly, say?

 

Alex


"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

Share this post


Link to post
Share on other sites
Altostrata

Check out his recent publications http://www.ncbi.nlm.nih.gov/pubmed?term=%22Shelton%20RC%22%5BAuthor%5D Note his co-authors.


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.

Share this post


Link to post
Share on other sites
Barbarannamated

Interesting themes in his research.... socioeconomic status and depression, adiposity as a causal factor of depression, and I think I saw something about religion, too. Can't wait to meet this guy. I'm anti-religion, married to an MD, have bag lady syndrome-- and skinny! Think I'll confuse him?! Fun fun fun!


Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Share this post


Link to post
Share on other sites
Altostrata

He seems like a pharma shill to me. Loves hangin' with the jerks from Harvard. But who knows, maybe he was the one arguing for psychotherapy.

 

http://www.ncbi.nlm.nih.gov/pubmed/21450147

 

J Clin Psychiatry. 2011 Mar;72(3):e11.

Crisis of confidence: antidepressant risk versus benefit.

Nierenberg AA, Leon AC, Price LH, Shelton RC, Trivedi MH.

 

Source

 

Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, USA.

 

Abstract

 

Andrew A. Nierenberg, MD, assembled a group of experts to discuss recent research and lay media reports about the safety and efficacy of antidepressants for treating mild-to-moderate depression, including recent controversy surrounding antidepressant-related suicidality. The panel agreed that the data regarding the efficacy of antidepressants are complex, making it easy to misinterpret meta-analysis results. Additionally, the issue of suicidality is quite complicated, but the risk is not great enough to abandon the use of antidepressants, although patients should be monitored carefully. The panel discussed that patients who have mild or moderate depression may benefit from receiving evidence-based psychotherapy first, instead of antidepressants. The panel stressed that additional research and novel treatments are needed to improve outcomes for patients with depression. However, measurement-based pharmacotherapy is an effective tool for helping many patients with depression achieve remission and recovery. Clear communication with the public, the media, and nonpsychiatric clinicians about the safety and efficacy of antidepressants will encourage those who need treatment to seek it.


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.

Share this post


Link to post
Share on other sites
btdt

I guess Dr Shelton is a bust as far as help goes unless he has in some other place defined and offered understanding of and treatment for this drug induced  "something else."  very disappointing :(


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 :)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...

Important Information

Terms of Use Privacy Policy