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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by Philip N. on September 27, 2006, at 19:21:38
In reply to Re: Long Term Antidepressant Withdrawal Success, posted by linkadge on September 27, 2006, at 19:02:22
Linkadge, how long did it take you to feel that you were beyond the meds? At least where you could move on?
Posted by Phillipa on September 27, 2006, at 22:33:24
In reply to Re: Long Term Antidepressant Withdrawal Success, posted by Philip N. on September 27, 2006, at 19:21:38
Link aren't you doing pretty good now? Love Phillipa
Posted by SLS on September 28, 2006, at 15:07:29
In reply to Long Term Antidepressant Withdrawal Success, posted by Philip N. on September 27, 2006, at 18:43:54
> This is my first time to post. I am wondering desperately if there are many success stories out there of people successfully coming off of antidepressants after several years (9).
Yes. However, some people have a more recurrent subtype of depressive disorder that requires them to remain on medication indefinitely.
> I have been trying for 9 months and am spiralling downhill.
> Now the answer is that it's been long enough and that any discontinuation syndrome would have been long gone.
Yes.
> My suspicians are otherwise.
I am curious to know what your rationale is.
> I want to participate in life again and I'm wondering at this point if I'm holding out with false pretenses.
I believe that you have been relapsing. It is the original depressive disorder that is re-emerging. It is not any type of residual withdrawal rebound depression. The depression that sometimes comes from the withdrawal from antidepressants occurs during the first weeks following discontinuation and disappear shortly afterwards.
For how many months did you feel absolutely well after you discontinued medication?
> I now have agorophobia and return of depression with escalating anxiety.
What do you mean by agoraphobia? Is this new? What do you experience? How about the anxiety? Is this new also?
How old are you? How old were you when you began to notice depressive symptoms or excessive anxiety?
You can go for second opinions to confirm that you have a recurrent major depressive disorder or decide to trust your doctor's judgment. Don't trust absolutely anyone's opinion here. Do some other research on the Internet. Use the word "recurrent" in your searches.
I know I would have wanted to come off of antidepressants if I were in your situation. Of course, I would have tapered the dosage gradually if my doctor were smart enough to tell me to. You were performing an experiment. Now you have the results. How will you interpret them? Can you accept your own logical conclusions? What course of action do these conclusions indicate? What, if anything, would prevent you from taking it?
Do the research in order to more confidently interpret the results of your experiment. My opinion is that you have a recurrent affective disorder that will need long-term treatment.
- Scott
Posted by Philip N. on September 28, 2006, at 19:16:59
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by SLS on September 28, 2006, at 15:07:29
Hi Scott. I am 49 years old. I began on AD's roughly 10 years back during an extremely stressfull job transfer where I had no input. I thought the medications would embolden me to carry through when I didn't think I could. 2 years later I stopped drinking alcohol and thought again that the ADs were able to assist me in that life changing event. I am still with the same psych I've had throughout although the time on the meds just seem to fly away. I figured back in December that it was time to move on from that long ago period and assumed I was strong enough now for the graduation from the ADs. I felt fairly OK through May to JUne when I started a slow withdrawal from my life as I was living. I was never agoraphobic before and the anxiety and depression set in with a vengeance by late July -early August. I have looked all over the web trying to understand my situation and most everything I see on the sites about SSRIs is negative concerning long term dependence and repeat depression. Some are saying that it could involve the rest of one's life. Many can't get past the initial discontinuation. My doc is pushing for me to return to medication and I'm getting to the point now where I don't think that I can maintain this road without them. In fact, my family has been really concerned for these past 2 months. I had to have a hernia operation 4 weeks ago and I really stressed over that also for the 2 months before the operation. But prior to that I was already developing some OCD behavior and feeling alot more emotional than when I was on the meds. ( I thought the feeling of emotions was a good thing) I never really looked into the literature on AD therapy before now and I'm shocked at what I deem is mostly negative regarding side effects, duration, switching, discontinuation, etc.. My fear now is that I'm in a double jeopardy. I know I can't fulfill my role as a father, husband and friend in my current shape and I feel my self dwindling like I've never felt before. Most on these sites seem to want off the meds. Maybe I've been reading too much of the negatives but I do have several friends that have been unsuccessful at staying off there medication when they have tried. The longest went for about 1 year. My concern is with my seeming inabilty to function the harder I try without them either. I feel that my doctor knows what she is doing but I was trying to believe in myself. I'm thinking now that I will have to start back and maybe try a slow taper if and when I inmprove enough but it seems that there are alot of people that don't succeed with that avenue either. I've run myself nuts looking at some of the alternatives such as the herbs and such but now it's become imperative that I do something other than what I've been doing. THANK YOU for your reply. Let me know!
Posted by Phillipa on September 28, 2006, at 21:18:31
In reply to Re: Long Term Antidepressant Withdrawal Success, posted by Philip N. on September 28, 2006, at 19:16:59
I feel the same way. After I weaned successfully of l0mg of paxil 8years ago I'm stuck on ad's that don't work. I've been told theraphy and my own pace of doing things is better by my pdoc. Love Phillipa
Posted by Philip N. on September 28, 2006, at 21:56:52
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Phillipa on September 28, 2006, at 21:18:31
Hi Phillipa. When you say successfully weaned, how long were you off and how long had you been on them before that? Have you tried to wean again during these past 8? Do you think that this means that we in fact really need to be on them? I've read that generally the ADs are to treat for like 6 months to maybe 1 year and at remission to then be stopped.(tapered off) Are there people who can successfully come off and then go on as needed or is it always as hair raising? THANKS
Posted by Phillipa on September 28, 2006, at 22:10:33
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Phillipa on September 28, 2006, at 21:18:31
Oh I'm still on them. Since I went off the one that worked none have worked since. Love Phillipa
Posted by Jost on September 28, 2006, at 22:43:19
In reply to Re: Long Term Antidepressant Withdrawal Success, posted by Philip N. on September 28, 2006, at 19:16:59
Hi, Philip.
You seem to believe that the recurrence of depression is due to a delayed discontinuation reaction. Based on my withdrawal from high levels of an AD, which wasn't quite cold turkey but which was, in retrospect, too precipitous, and what I've read, I'd have to question that respectfully, and of course, with qualifications (that I don't know your history, and am not a pdoc, or anything of that sort).
After discontinuation there can be a period when the drug is still in one's system, possibly five or a few more days, but generally in the immediate aftermath of stopping the drug, one tends to experience whatever symptoms one will. This depends a lot on the gradualness of the taper, and one's own biology, etc.
Of course, others with different experiences and information may disagree with me. I'll be interested to hear if others find to the contrary on that.
But I'd be surprised if you had no discontinuation problems, and then at a time fairly remote from the last dose (eg months or years), had a withdrawal reaction. It's far more likely that your depression has returned. This often can happen.
One thing-- you talk as if not being able to function at a high level without ADs, is somehow a sign of weakness or being less than you should be. As if the goal is to get off them, and become normal or not dependent on them.
Getting off ADs isn't a the goal, again IMO. If you don't need them, great-- Medications of any kind, if not necessary, should not be taken, ADs being no exception. But there's nothing wrong with using ADs. What matters is having the best life you can. If ADs help you accomplish that-- then I say great--honest, that's terrific and you're lucky.
No need to " try" to get off-- or "try" to stay off, if it warrants it.
Nor are most people here trying to get off per se-- in my estimation-- but rather to manage their ADs, including side effects, optimal dose, etc--by becoming more educated, and more able to be effective advocates for themselves given that they can know their reactions and tolerances better than anyone else can.
There are some who want to get off because of SEs, or the possibility that some other med may help more. Many times, trials of ADs are unsuccessful-- and many other times, they help tremendously, or a good bit, or enough to justify the downside.
Some are absolutely disillusioned with ADs, often understandably. Most of us have had a bad experience, because many of us don't respond adequately to available drugs-- So far, no medications that work for us have been devised. It's unfortunate, but not, IMO, a reason to turn against meds completely.
This site is great for information, anecdotal and general, and companionship and support in working through the complexities of the medical (and other) landscapes.
Maybe you don't need to resist ADs, in principal., but rather to learn to use them as best you can, in consultation with your Pdoc.
Jost
Posted by Phillipa on September 28, 2006, at 22:58:31
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Jost on September 28, 2006, at 22:43:19
Jost excellent post. Love Phillipa
Posted by SLS on September 28, 2006, at 23:33:33
In reply to Re: Long Term Antidepressant Withdrawal Success, posted by Philip N. on September 28, 2006, at 19:16:59
Depression sometimes gets worse over time, regardless of the type of drug intervention or whether there is any intervention at all. This is particularly true of cases that follow a recurrent course. Before the age of the SSRIs, these things were observed. Of course, you will never know the natural course your depression would have taken. But that is a silly thing to hold out for. Plenty of people who have not taken medication or have taken medication intermittently have been followed historically to know the variety of courses depressive illness can take - including rapid cyclicity.
> I have looked all over the web trying to understand my situation and most everything I see on the sites about SSRIs is negative concerning long term dependence and repeat depression.
Long term dependence = dysinformation
Long term remission = desired outcome
> Some are saying that it could involve the rest of one's life.
Of course. Currently, people with diabetes must take insulin for the rest of their lives. So what is the leap in logic to be made here?
> Many can't get past the initial discontinuation.
Let's not worry about others. I have no idea what the weaknesses are in others' taper strategies. We have a Withdrawal board for that. You open up capsules, bite off pieces of tablets, use flexible-dosing, take benadryl, cross-over to Prozac, etc. It is do-able.
> My doc is pushing for me to return to medication and I'm getting to the point now where I don't think that I can maintain this road without them.
What makes you feel that way? What are you experiencing?
> I never really looked into the literature on AD therapy before now and I'm shocked at what I deem is mostly negative regarding side effects, duration, switching, discontinuation, etc..
I am unclear as to what you mean by this. What do you find negative about these things? Even more important, what applies to you personally?
> My fear now is that I'm in a double jeopardy.
What do you mean here?
> I know I can't fulfill my role as a father, husband and friend in my current shape and I feel my self dwindling like I've never felt before. Most on these sites seem to want off the meds.
Ok. Maybe it is time for you to look for a variety of themes in websites to develop a more balanced understanding of the disease and its treatment rather than continuing to dwell on "these sites". If you can't find any, try Google:
http://www.google.com/search?hl=en&q=major+depressive+disorder
I haven't reviewed the results, so you can report back to us what you find.
I doubt you have agoraphobia. It is more likely that you are experiencing more generalized anxiety. For now, just assume that it is part of the Major Depressive Disorder that you are likely diagnosed with, and that it will disappear along with the depression. You don't have to have a separate anxiety disorder.
What family history is there of mental illness, if any?
- Scott
Posted by Philip N. on September 29, 2006, at 8:10:57
In reply to Re: Long Term Antidepressant Withdrawal Success » Phillipa, posted by Phillipa on September 28, 2006, at 22:10:33
Phillipa, if they are not working how are you able to stay on them? Or have you simply not been able to wean off?
Posted by Philip N. on September 29, 2006, at 8:40:06
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Jost on September 28, 2006, at 22:43:19
Hi Jost. In many ways I hear what you are saying. I've just gotten mired in the internet on this complicated subject which is truly serious stuff.
There is so much controversy about the effects of these meds and what they don't know long term as they are initially targeted for short term regimens. As in Phillipa's situation, what do you do when you still take them and they are not working? Do they stop working and yet prevent us from moving beyond them? Do they help by strengthining the brain or "rewiring". If they restructure the brain are we then dependent on the prescence of the chemical to keep it working symptom free?I'm wondering about the numbers of people out there who do not have trouble once they are through with therapy and have moved on. My doctor says that the majority of people who take these meds don't have long term problems and that you won't find them on these sites struggling per say. Does that put us in the category of "lifers"? I've read that 12 million women and 6 million men in the U.S. are on some kind of AD.
I look too much at the big picture sometimes but I wonder about the commonalities more than the differences. I realize that in the end I will have to decide on the quality of life in my current status and that will involve me and my doctor. I don't want to scared away from what I may really need so I am trying to learn more about the history of Depression Illness and what the accepted regimens have proven to be.
The worst culprits on the discontinuation that I'm seeing are the SSRIs and I've taken Prozac and Lexapro over these years . I'm wondering if I shouldn't look into some of the older meds as I may have to go back on them but I'm concerned about discontinuation downstream. Then I wonder if I need to stay more in the present as that is where I'm living and struggling. I hope this makes sense. Thanks....let me know.
Posted by Philip N. on September 29, 2006, at 9:14:54
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by SLS on September 28, 2006, at 23:33:33
Hi Scott.
One of my biggest difficulties in this knowing whether or not I have crossed a line so to speak with this illness where it will always be there. I've also tried to ask myself if that's been the case all along (since youth). What I mean by that is acceptance of who I am.
My family was not extended on either side so I don't know about histories outside of immediate but there was alot of alcohol in earlier years until 2 yeras after I started ADs in 1998. At that time I felt that kicking the booze aside was paramount to any satisying living. It may be the opposite with these medications but it runs opposite to my way of thinking.
As long as I felt that this was all helping me I never really had a concern. Sure there are the effects on emotions and what have you but it seemed to be moving forward in a positive direction. It's when I ran aground after stopping that I've been struggling with any bearing that years under their influence may have had.
I'm sure with the alcohol I was self medicating as the professionals call it. It is agreeable that I've struggled with Depression most of my life since my teen years. I thought most of that was due to an irresponsible lifestyle even though I was funtional at work and school and having a family.
I've thought of the meds as a crutch not unlike alcohol and believed that at this point in life my lessons would allow me to put them aside also.
In my current state I don't think that is the case. I thought this was something that I was controlling with voluntary assistance of medication but it may prove that the nature of the illness mandates assistance.My doctor says also that much of this is progressive as we age and that we can't bounce back as we did 20 or 30 years ago from adversities in life. I thought we become wiser as we age and maybe this experience is giving me more personal insight than I realize.
My fear of double jeopardy is that when I start back on meds I'm drawn further into that circle but at the same time from where I'm at I don't know if I have a choice. Some say be strong and move on but when we are on our backs and life is moving past us how long can we maintain that way of living? Currently I don't even want to leave the house (6 weeks now). I feel that I at least need to be strong enough for my wife and children to accept my situation and listen to the professionals. After all, none of us choose to suffer like this and I do know it is a true illness. When your head is all screwed up though it makes you question things maybe more than you would "normally". All I want now is to be present for my family and not so engrossed in my fears that they have to suffer uneccesarily due to my stubborness if you can call it that.
I will admit still that the controversy surrounding SSRIs has me in a personal quaqmire as they may be the best meds currently available. Again, if they are, what do we do if and when they stop working?
Thanks......let me know.
Posted by Phillipa on September 29, 2006, at 18:59:52
In reply to Re: Long Term Antidepressant Withdrawal Success » Phillipa, posted by Philip N. on September 29, 2006, at 8:10:57
Just keep putting one foot in front of the other. I use my benzos for sleep. And am not going to try going to the max on luvox 300mg. If not EMSAM still isn't off my list. Love Phillipa
Posted by Phillipa on September 29, 2006, at 19:02:44
In reply to Re: Long Term Antidepressant Withdrawal Success » Jost, posted by Philip N. on September 29, 2006, at 8:40:06
Stay in the present. You could get hit by a car tomorrow. Get my jist? Love Phillipa
Posted by Philip N. on September 29, 2006, at 21:39:18
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Phillipa on September 29, 2006, at 18:59:52
Hi Phillipa. How often do you use the benzos and how much?
Posted by Phillipa on September 29, 2006, at 21:48:54
In reply to Re: Long Term Antidepressant Withdrawal Success » Phillipa, posted by Philip N. on September 29, 2006, at 21:39:18
Daily for over 30 years. no abuse issue. Love Phillipa
Posted by Philip N. on September 29, 2006, at 22:12:28
In reply to Re: Long Term Antidepressant Withdrawal Success » Philip N., posted by Phillipa on September 29, 2006, at 21:48:54
My doctor would use them to srart me back on the ADs. The info that I've read on benzos is that daily use after as short as 2-4 weeks can addict some people or the anxiety from them sets in. My concern with that is since I have Anxiety Disorder, that would be a hell of a note for me even though I think it's commonly used to treat anxiety and to start people onto ADs the first 2 weeks or so. My doctor said some of her patients have been on them for years and can't come off. But it's what works for them and they do OK. I think I definitely would have to have them to get past the initial anxieties associated with starting back on ADs after my time off of them.She said that most people after acclimating on the ADs can then taper off of the benzos due to the decrease in anxiety. I used them some back 6 weeks ago before a hernia operation and I was wondering then if some of my increased anxiety may have been coming from needing to take anotner as I spaced them out. They sure helped to calm me down and I can see easily how I could get comfortable with them. Have you ever been on the benzo.org.uk site? This was all news to me!!
Posted by Phillipa on September 29, 2006, at 22:23:37
In reply to Re: Long Term Antidepressant Withdrawal Success » Phillipa, posted by Philip N. on September 29, 2006, at 22:12:28
Ashton? She just doesn't believe in them. Yes I will be on them for life. But what's the differance of a benzo or ad for life? Love Phillipa
Posted by Jost on September 29, 2006, at 22:59:30
In reply to Re: Long Term Antidepressant Withdrawal Success » Phillipa, posted by Philip N. on September 29, 2006, at 22:12:28
Hi again , Philip N.
My experience has taught me a few things-- one being that the rhetoric of "strength" has no place in discussion of depression and the use of ADs.
Maybe when you were younger, you associated ADs and alcohol, and also had an idealistic (and also maybe illusory) idea about not needing to be dependent, overcoming the bad feelings by force of will, in order to feel that you hadn't been dragged down, or weren't self-indulgent and, as you said, relying on a "crutch."
I totally understand that-- I had a long phase of that myself, coming from a home where ADs were considered really bad.
But an AD won't take who you are away, if it's any good for you-- if it does that, it's not working, and the issue is what alternatives there are.
It's not the rosiest picture-- but life is short-- unfortunately-- and we only have limited time to take the opportunity to live it. If there were better ADs, it would be great. But there are mostly ones that can work well, in many instances, but can, for some people, have frustrating, annoying, or even just confusing elements.
Still, I say if an AD (or even combination of ADs, as you see on this board) can give you a fuller life, now-- help you to be more emotionally present for your family, to begin to go back into the larger social world, maybe to find a job, or other meaningful contribution-- it's well worth some of the undoubtedly difficult struggles, existential questions, and practical questions, that may--or may not-- arise.
I respect your asking these questions and becoming satisfied in your own mind about the rightness of trying medication again. It could be difficult for a while, and you might (again, you might not) need the commitment to stay with it, which will only come if you do reach that inner decision. So, by all means, continue to question.
I hope you'll find your answer, and that it will move you toward the things you want.
Jost
Posted by Greenhornet on October 6, 2006, at 11:08:04
In reply to Re: Long Term Antidepressant Use » Philip N., posted by Jost on September 29, 2006, at 22:59:30
Philip.
My heart goes out to you. I have been away from this board for sometime, but would like to share my own experience with you in the hope that it can help. It might be best if you know a bit about me. I a retired Nurse, Clinical Specialist/Nurse Practitioner in Adult mental health. I am in my mid sixties, have raised a large family and am married to a retired physician.
Adult Mental Health/psychiatry became my field after my own struggles with depression began approximatly thirty years ago. I was basically on one antidepressant or another for most of that time. Today the only medication I take is for my arthritis. I struggled and watched others struggle with discontinuation syndrom frequently.
Of course I understand the individuality of each person and their biochemical makeup, so I try and keep that in mind as I share my experience.
It took me nearly four years to become medication free without withdrawal or discontinuation problems. Absolutly the only way that "worked" was - of course one med at at time with sometimes as much as three to six months before beginning to stop the next one. The ONLY thing that worked, and it truly did when getting down to less that one pill/tablet/capsule, was liquid form and a very finely incremented syringe. At the end I was taking as little a one or two milligrams of the liquid daily..
There are also "Compounding Pharmacies" that you can deal with especially if the medication does not come in a liquid form. You might want to check out this link.http://www.rxlist.com/rxboard/effexor.pl?noframes;read=5863
Do not look at every symptom as a relapse of your depression!! Find a psychiatrist or other physician who does not put such emphasis on "pharmacological psychiatry"
I have been forced to rethink my entire mindset concerning mental health due to this experience. If I knew what I know now when all of this began those many years ago I would NEVER touch another pschoactive drug! I know that these are harsh words and that there are many who feel that they have benefited greatly from antidepressants. One must do ones own research and decide, but there are too many questions and unknowns with these drugs.
I wish you success and I will pray for you.
Posted by Philip N. on October 6, 2006, at 19:22:13
In reply to Re: Long Term Antidepressant Use, posted by Greenhornet on October 6, 2006, at 11:08:04
Thank you for sharing.
Might I ask, have you taken any of the SSRIs and how long have you been off of the antidepressants?
Did you have to take more than one at a time? I've been off for 9 months but I stopprd cold turkey after about 9 years as I didn't know any better. The last 3 months I've retreated so far that I'm going to have to start back so I can still be here for my family. I never knew about all the discontinuation concerns and such. I also have been worse off than any time before these medicines. Thank you for some encouragement..Philip
Posted by Philip N. on October 6, 2006, at 19:36:58
In reply to Re: Long Term Antidepressant Use, posted by Greenhornet on October 6, 2006, at 11:08:04
I've got so many questions! I forgot to ask how long would you stay at the next lower dose and did you ever have to go back to a higher dose for awhile before resuming? Was there any antidepressant that proved harder than the others or did you find them all similar when tapering?
Thanks again.....Philip
Posted by greenhornet on October 10, 2006, at 15:06:26
In reply to Re: Long Term Antidepressant Use » Greenhornet, posted by Philip N. on October 6, 2006, at 19:36:58
> I've got so many questions! I forgot to ask how long would you stay at the next lower dose and did you ever have to go back to a higher dose for awhile before resuming? Was there any antidepressant that proved harder than the others or did you find them all similar when tapering?
>
> Thanks again.....PhilipPhilip,
I USUALLY stayed at the lowered dose five days. I never had to go back up that I can remember.
I have taken Prozac, Effexor and Lexepro (and Celexa pior to the Lexepro).
I am glad to answer whatever questions I can. GH
Posted by Philip N. on October 10, 2006, at 18:14:56
In reply to Re: Long Term Antidepressant Use, posted by greenhornet on October 10, 2006, at 15:06:26
Thank You for answering!
How long have (had) you taken ADs altogether?
I am fearful now of the medicine but I know more than I did also. I'm thinking that I have to get back on the Lexapro and hope I can turn thus around and then later on start a very slow taper over months and see how it goes.
You read so many things. I have read that quitting cold turkey the way I did can certainly lead to problems months afterward. I didn't give myself any time to acclimate to living without the med. I'm hoping I can back up and start over if and when but I can't not deal with it.
Also from what I've read I should try the Lexapro first as that was what was working before I switch to anything else.
Does this sound like a plan to you?..Thanks again
This is the end of the thread.
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