paxilkilledme: Flying in circles? - Newbie seeks truth!

[paxilkilledme]

I started taking maprotiline (Ludiomil), a tetracyclic antidepressant 22 years ago and at the time thought it was a miracle of miracles.  I went to the hospital because I couldn't eat and was worried and depressed.  They referred me to an addictionologist who prescribed the drug and said I had an eating disorder and was an alcoholic and drug addict.  I suppose he didn't give me Prozac because he was afraid it would cause further weight loss.  I have never felt comfortable around people and to this day have no friends.  Isolation has been the norm for me for 47 years.  Ludiomil seemed to work wonders and gave me a good appetite, allowed me to sleep soundly, and a sense of well being along with a major case of sexual dysfunction.  That always concerned me because I wanted to meet that special girl and together we could navigate life together.  As time passed, I managed with the help of the drug.  I guess you could say that the drug made me feel like it was okay that I couldn't have a relationship so I settled for less.  I have had extensive talk therapy and it was always the goal to move forward and strive for personal growth.  As I write this and look back, for whatever reason, I feel as if I have not made any progress at all.  I woke up today at around 5:00pm and whenever I have the chance I sleep as much as I can which I have been doing for years now.  I am completely amotivated and have little desire to do anything whatsoever.  Basically, I feel like I am just hanging out waiting to die.

 

Years ago, when I went to the hospital seeking help it was because I wanted to change and despite the paragraph above, I believe that I still want things to change.  I feel worse now than ever before insofar as the melanchollia and lack of drive and I attribute these things to serious brain changes due to all of the psychotropic drugs that have been prescribed to me by doctors.  Since Ludiomil, I have taken just about every SSRI known as well as the atypical antipsychotic Seroquel.  I believe I can safely say that after 22 years of taking these drugs that they simply don't work after my brain had gotten used to them.  In fact, I believe that whatever brain changes have occurred have been for the worst. To be sure I don't think my life's situations could get any worse as I merely exist and not live, I am reactive and am not proactive and so I am not afraid of what might happen if I stop taking the medications.  That's not to say I have a plan to off myself if quitting the medications doesn't work but as I have paid good money to be advised by my shrinks, "if I always do what I've always done, I'll always get what I've always gotten".

 

I have quit the medications once before but it was only for a short time, 6 months to 1 year.  As soon as the pressures of life came upon me I remembered the happy pills and went right back to them.  Paxil has been the most effective by far of all the psychotropics for me and I actually liked the molecule because half of it resembles MDMA or ecstasy.  I'm certain that's where Galaxo Smith Klein got the idea for paroxitene since it is well known that MDMA floods the brain with serotonin.  In any case I know all about the withdrawal syndrome as I experienced / discovered it with no knowledge of it's existence.  As any user of these drugs knows, all you have to do is nothing but faithfully take your daily dose and over time, the brain zaps begin as the drug poops out.  That was fixed when the good doctor just gave me more.

 

So that brings me to the title of this post, "FLYING IN CIRCLES? - Newbie seeks truth!"  I understand that I am probably going to suffer withdrawal symptoms when undergoing the slow taper.  I have a milligram balance, a mortar and pestle, and a graduated cylinder and I am going to grind my tablet into powder and reduce the mass by 10% per month.  When I get to the really small doses I will dissolve the powder and dose it volumetrically.  So here is my grave concern.  I expect withdrawal symptoms but I also know that I may be so blessed as to have none at all.  If not, will I be able to differentiate between symptoms of the withdrawal syndrome and true anxiety and depression?  If I am able to get passed the withdrawal symptoms, how many of you relapse into your original disease state?  I am very interested to hear your experiences!

 

-paxilkilledme

 

[clearday]

You will be feeling SSRI withdrawal to varying degrees both during and after taper.

 

There's no way to tell during this process if any feelings of anxiousness or depression are due to withdrawal or just your old problems coming back.

 

IMO it is best to attribute any anxiousness and depression to withdrawal during this long process. I certainly was hit with depression during Prozac WD and it was due solely to WD, I never had depression before that. I was put on Prozac for mild anxiety, not for depression. 

 

Everyone's experience is unique, but common patterns emerge enough so that we can clearly recognize withdrawal when we see it.

 

Most SSRI withdrawal is accompanied by nasty, long lasting physical symptoms which can contribute to feelings of anxiety and depression. So if you have these feelings of physical withdrawal, and also anxiety and depression along with the physical symptoms, then I would attribute that anxiety and depression to the withdrawal package of symptoms at that time. Anxiety and depression can also be in and of themselves symptoms of withdrawal, and often are.

 

Some people emerge from withdrawal with their same old problems they had before going on SSRIs. Others emerge without those problems.

 

IMO it is best to soldier through taper and withdrawal, and wait until a year after the process is over, once the smoke clears, to see what your baseline anxiety and depression levels settle down to. And then find other ways to deal with that other than SSRIs, if SSRIs have caused you problems in the past.

[paxilkilledme]

Hi Clearday,

 

Thank you for your response.  I see that you are probably familiar with divorce since you inserted that quote in your signature.  I also see that you are still battling the effects of having taken Lexapro in the past.  Congratulations on your 14 months free of the SSRI's!!!

 

You mentioned that you began taking the SSRI's for mild anxiety.  It looks to me like you have had this anxiety for a long time, all the way back to 1996.  I believe my depression began with what I called worry but that is nothing more than anxiety at some level.  Having had anxiety form my life by effecting everything I say and do I believe that resulted in both anxiety and depression.  It was so debilitating that I, in complete desperation, took a drug that I was afraid of and didn't want to take and now, many years later, here I am.

 

Since your experience with the SSRI's has been so long, at what point did you decide that enough was enough?  Did your anxiety go away early and you have been battling WD since the mid 90's or have you been struggling with anxiety or WD or both or are you not able to tell?

 

By looking at the history in your signature, you often go cold turkey.  I very recently tried to do that from 30mg/day paxil over spring break and I became so sick and disoriented after 4 days that I immediately went back to 30mg ED.  The fog is just now starting to clear.  You have made it 14 months now and I am so excited for you.  I look forward to one day having a clear day.

 

Thank you for your reply.  It's nice to know that I am not alone.

[Altostrata]

Welcome, PKM.

 

It's quite common that antidepressants make people sluggish, apathetic, and unmotivated.

 

Since you have been on them so long, if I were you, I'd take special care to very gradually taper. See Why taper by 10% of my dosage?

 

Paxil comes in a liquid form for tapering, see Tips for tapering off Paxil (paroxetine)

[clearday]

Since your experience with the SSRI's has been so long, at what point did you decide that enough was enough?  Did your anxiety go away early and you have been battling WD since the mid 90's or have you been struggling with anxiety or WD or both or are you not able to tell?

 

 

I did have mild anxiety, it was a very stressful time of my life back then. The Prozac never really helped. I don't know why I stayed on it for six years. I figured it was helping, maybe a little, but by six years I didn't feel too good and I figured the drug just wasn't helping, so I got off it.

 

I was fine for 4 months, then got hit hard with withdrawal, severe for two months, then lifted to more tolerable level, symptoms lingered for 3 years. Had no idea that it was all caused by Prozac WD, thought it was a mystery illness or something. Then almost normal for a couple years.

 

Went on Lexapro 2009 for mild dysthymia, it did help lift that right away. So stayed on it. Decided to go off it since I felt normal for so long. Dysthymia has never come back since I stopped Lexapro. I have no depression or anxiety worth mentioning. I am largely my same old self. I avoid stress, exercise, eat right, and that helps a lot.

 

If I could do it all over, I never would have taken SSRIs. They're just too damaging, should only be taken by desperate cases. I was never informed that these drugs could be so harmful and difficult to come off of.  

 

And btw, I am lucky to not have gone through a divorce. But I've seen enough of them to know difficult they can be -

[paxilkilledme]

Thank you all for your kind words!  I don't think most people know about the brain changes that occur when one starts to take psychotropics.  We just trust that the doctors know what they are doing. In the early 90's when I started with tetracyclics the internet was nowhere near as what it is today and also because I didn't even own a computer, I was more or less in the dark.  The funny thing is that I did go to group therapy and there were many people there who had been on these drugs for far longer than me.  They were complaining about how they were on multiple drugs and had been in and out of the hospital and that they were still depressed.  Ashamedly, I dismissed them as winers who were psychologically weak.  Ironically, here I am in the same place as them minus the multiple hospitalizations.

 

Because of my experience with trying to quit or the drugs just pooping out leading to WD, I feel confident that I am going to have to use the slow taper, that's the plan anyway.  I have a strong chemistry background and am comfortable grinding the pills, accurately weighing, and making my own dosages.  I am willing to help anyone who may not be able to get their hands on the liquid medications.

 

 

I was fine for 4 months, then got hit hard with withdrawal, severe for two months, then lifted to more tolerable level, symptoms lingered for 3 years. Had no idea that it was all caused by Prozac WD, thought it was a mystery illness or something. Then almost normal for a couple years.

 

I can see how you thought you had a mystery illness especially if you just had cold and flulike symptoms.  My symptomology was different.  I had brain zaps along with all the other stuff and for the longest time now when I am laying or sitting still, one of my arms or legs will just jump for no reason even when I am taking the medication.  After researching, I found that psychotropic drugs can cause Tardive dyskinesia (TD), especially the antipsychotics.  I was given seroquel at low dosage to treat insomnia when the doctor refused to give me any more Luvox or benzodiazipenes.  I can't remember now but I believe the involuntarily jerking movements began before I started the seroquel.  I'm disheartened in that TD could be a permanent condition and I am so scared that I could have permanent neurological damage.  I truly believe that most doctors think they are doing the best thing for the patients by giving us these drugs, perhaps thinking the benefits outweigh the damage.  To their discredit, most physicians refuse to listen to people like us when we tell them the truth.  I will not be surprised that if, in the future, history records the psychotropic drug era and it's put on par with a lobotomy or bloodletting.

 

Knowing what I know now about this topic, I think I would have been forced to undergo the drug therapy because I was so sick and so broken to the point that I wasn't eating.  If I were to have chosen not to take the drugs, I would have had to quit my job and had somewhere to retreat that was supportive and stress free for an unknown period of time.  There is no such place like that for me.  Funny thing, when I think about Canada, I think about seclusion and nature.  Snow laden paths leading to beautiful scenery where everyone is your friend.  I live in the mid Atlantic region of the United States in a military town where nearly everyone is from somewhere else and you don't even really know your next door neighbor.

 

I'm happy to hear that you have not gone through a divorce.  Splitting up just multiplies anxiety and depression but then again so can a relationship.  Speaking about relationships, I am a teacher now and this substitute that I know is interested in me.  All I can think about is how could I date this person without them finding about how I really am.  Addicted to prescription drugs with no guarantee that I will be normal if I manage to quit.  Sexually inadequate and perhaps not able to be there emotionally for them.  To be honest, I am so emotionally blunted and numb that even though mentally I want to go for it, I'm inclined to say no just because of the risk involved.  There's always later!  Spoken by a hardcore SSRI user.

 

I hope you have a happy day Clearday!

[Songbird]

I have a milligram balance, a mortar and pestle, and a graduated cylinder and I am going to grind my tablet into powder and reduce the mass by 10% per month.  When I get to the really small doses I will dissolve the powder and dose it volumetrically. 

We recommend reducing by 10% of each dose, not just 10% of the starting dose, so the dose reduction gets smaller each time.  The 10% is a general guideline and kind of recommended maximum, many people do drops of less than 10%.  In general, the slower the taper, the milder the withdrawal symptoms are.  Your best bet is to listen to your body and adjust your taper accordingly.  There is a spreadsheet here that you may find helpful, although it sounds like you are already pretty clued up about making up your doses.

 

http://survivingantidepressants.org/index.php?/topic/7601-excel-spreadsheet-to-calculate-dose-weights-using-a-scale/

[clearday]

 I truly believe that most doctors think they are doing the best thing for the patients by giving us these drugs, perhaps thinking the benefits outweigh the damage.  To their discredit, most physicians refuse to listen to people like us when we tell them the truth.  I will not be surprised that if, in the future, history records the psychotropic drug era and it's put on par with a lobotomy or bloodletting.

 

Well put. They are certainly guilty of negligence and failing to keep current with all the evidence that clearly shows SSRIs cause long term nerve damage, extreme suffering, confusion and distress for thousands of their patients.

 

Astonishingly, the average psychiatrist tells their patients that SSRI WD can last no more than two months. We all know that the real withdrawal has tardive onset and often hits later than 3 months after discontinuance. and lasts for months and years. 

 

Their creed is "first, do no harm" when treating an illness; here, sadly, they are following "first, do more harm". Much to their discredit.

[paxilkilledme]

occupancy.tiff

 

I'm not sure if this chart is visible to you all but if not I have attached it to the post.  It is something that I found here on this very helpful website and I find it fascinating.

 

It shows the occupancy of serotonin transport (reuptake) receptors at varying dosages and plasma (blood) concentrations.  In a nutshell, to treat depression effectively, the therapeutic dose for paxil for the patients in this study was 20 mg/day.  This dosage resulted in an 80% blockade of serotonin reuptake.  In order to increase the blockage of serotonin reuptake receptors above 80% required huge increases in the daily dosage of paxil.  Below the 20 mg/day dosage, very small changes in daily dosing resulted in extremely large decreases in serotonin transporter occupancy.

 

I have just two things I would like to say about this briefly.  Thank you Songbird for pointing out that I need to reduce my dosage by 10% of the previous dose each time and not by the total amount.  I was unclear when mentioned this in my earlier post.  I just wanted to add that the reason the incrementally smaller reduction in dosage is probably so effective at lowering WD symptoms is because of the dose / occupancy curve.

 

The second thing I would like to say is along the lines of a major complaint against the pharmaceutical companies and the health care system in light of the paper that I retrieved that chart from.  We have all been told the theory about how we suffer from a chemical imbalance in the brain and yet, effective treatment of depression requires an 80% reduction in serotonin reuptake!  An 80% reduction of a brain function is closer to completely shutting down serotonin reuptake than merely correcting an imbalance.  It just doesn't make sense that depressed people, around 1 in 10 people (USA), have serotonin levels that require modulation of a brain system by 80% for the treatment to be effective.  Clearly, something is gravely wrong.  It sounds like big pharma has missed something and they are treating depression and other disorders with a sledge hammer.  

[Songbird]

The second thing I would like to say is along the lines of a major complaint against the pharmaceutical companies and the health care system in light of the paper that I retrieved that chart from. We have all been told the theory about how we suffer from a chemical imbalance in the brain and yet, effective treatment of depression requires an 80% reduction in serotonin reuptake! An 80% reduction of a brain function is closer to completely shutting down serotonin reuptake than merely correcting an imbalance. It just doesn't make sense that depressed people, around 1 in 10 people (USA), have serotonin levels that require modulation of a brain system by 80% for the treatment to be effective. Clearly, something is gravely wrong. It sounds like big pharma has missed something and they are treating depression and other disorders with a sledge hammer.

Good point!  I've never thought of it that way before.  My take on this was that if we are really are just serotonin deficient, wouldn't the treatment be tryptophan or 5HTP so we can make more serotonin?  Is our so-called chemical imbalance low serotonin, or is it too high serotonin reuptake?  If we are reuptaking too much serotonin, why?  IMO it's a lot of complete BS made up to sell the pills.

[direstraits]

I read somewhere that serotonin has little to do with depression;there are people with low levels of serotonin who are not depressed and vice versa-so it's just a ploy by big pharma to sell drugs

[paxilkilledme]

 

My take on this was that if we are really are just serotonin deficient, wouldn't the treatment be tryptophan or 5HTP so we can make more serotonin? 

 

Taking substances such as tryptophan, 5HTP, DHEA, SAMe, and others are known to elevate people's mood by raising serotonin levels.  These substances are contraindicated with antidepressants because it can actually cause serotonin syndrome which can be fatal.  I'm just not sure if the boost in serotonin from taking tryptophan or 5HTP could come anywhere close to an 80% reduction in serotonin reuptake.  It probably would for some.  

 

I read somewhere that serotonin has little to do with depression;there are people with low levels of serotonin who are not depressed and vice versa-so it's just a ploy by big pharma to sell drugs

 

I think there is a lot of similar information out there about cholesterol.  There are people out there that live healthy lives with levels over 300.  The interesting thing is that the data about people dying from high cholesterol comes from people that have been hospitalized because of circulatory related problems.  They have a stroke or heart attack, end up dead or in the hospital, and they find the person had high cholesterol.  Okay, so high cholesterol kills some fraction of the populous but what is the number?  Healthy people with high cholesterol never get counted.  Now that everybody is being screened every time they go to the doctor and being put on the statins we will never know.

 

What is needed is an extremely thorough study of high numbers of people from a complete cross section of humanity to know what is normal and abnormal when it comes to serotonin.  Most importantly, the very first antidepressant imiprimine was first tested as an antipsychotic that failed miserably.  It was then retested as an antidepressant in a mental hospital and by chance, it supposedly worked for a population of people sick enough to be taken out of society.  The antidepressant ere was born without one ounce of energy being used to devise such a medication.  No studies!  Just the trial of a drug that was already on the shelf of a pharmaceutical company sitting there since the late 1800's.

 

If anyone is interested, there is a Youtube video called, "The Antidepressant Era" about what I just discussed above.  

[Altostrata]

We have an extensive discussion of the SERT occupancy curve at Why taper? Paper demonstrates importance of gradual change in plasma concentration

 

People cannot "correct" a serotonin "imbalance" by taking anything.

 

- First of all, the "chemical imbalance" theory is a myth. Again, chemical imbalance is a myth. Stop the lies, please.

 

- Second, the body has highly redundant mechanisms to regulate serotonin levels, including in the brain. The gut contains a huge amount of serotonin.

 

- Last, supplements, like antidepressants, can be stimulating. Sometimes this effect is interpreted as antidepressive. Plus -- the placebo effect is a wonderful thing.