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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by linkadge on August 19, 2007, at 20:34:20
This post is in no way an attempt to bash SSRI's, I just have a genuine question that I was wondering if anyone can relate to.
I know I have asked the question before, but does anyone feel like they have developed a drug problem after taking SSRIs?
I was exposed to SSRI's for a fairly long period of time growing up, (7-8 years). I was taken off them at 22-23, but feel like things have never been the same.
I never had a drug problem, infact I had never used a single illegal substance, but since being taken off them I continually feel there is something missing, that I try to fill with other drugs.
I know this may be a contoversial idea, but does anyone else feel like they have been turned on to other drugs, by using SSRI's?
BTW, I don't think it is a manic reaction, as I used SSRI's in the prescribed way for years without any problems, with no other agents.
I feel the problem has happened after coming off the SSRI's.Thoughts, anyone?
Linkadge
Posted by twinch42085 on August 19, 2007, at 20:45:03
In reply to SSRI's gateway drugs?, posted by linkadge on August 19, 2007, at 20:34:20
i can't relate because I have never taken SSRIs but I have taking 4 mg of risperdal for 6 months. Tried tapering off and became manic. I resorted to drugs to sooth my manic temptations. Do you have bipolar if you don't mind me asking?
Posted by linkadge on August 19, 2007, at 21:37:45
In reply to Re: SSRI's gateway drugs?, posted by twinch42085 on August 19, 2007, at 20:45:03
I personally don't believe so. I had some horrable mood swings after discontinuing SSRI's but they calmed down.
I don't have highs.
Linkadge
Posted by Jamal Spelling on August 20, 2007, at 5:25:35
In reply to Re: SSRI's gateway drugs?, posted by linkadge on August 19, 2007, at 21:37:45
I think SSRIs can certainly be gateway drugs insofar as they raise awareness of the possibility of modifying behaviour and mood using chemicals. The same could be said of all psychotropic substances, but for many people, SSRIs are their first interaction with psychopharmacology, and open up a world of other psychotropics too.
Before I began using SSRIs, I never thought of the possibility of changing my behaviour chemically, while after I began using SSRIs, I suddenly found myself wanting to medicate every little behavioural deficiency that I had.Jamal
Posted by linkadge on August 20, 2007, at 10:28:53
In reply to Re: SSRI's gateway drugs?, posted by Jamal Spelling on August 20, 2007, at 5:25:35
>Before I began using SSRIs, I never thought of >the possibility of changing my behaviour >chemically, while after I began using SSRIs, I >suddenly found myself wanting to medicate every >little behavioural deficiency that I had.
This is true for me. Before SSRI's I was quite ridgedly against the use of meds to alter mood.
Now I'm liberal about it. Some say thats a good thing, but I think its a bad thing.Linkadge
Posted by SometimesBlue on August 20, 2007, at 11:34:22
In reply to Re: SSRI's gateway drugs?, posted by Jamal Spelling on August 20, 2007, at 5:25:35
It's kind of like which came first, the chicken or the egg.
For me, I used other drugs prior to using SSRI's. But I think that I was self-medicating (trial and error) to try to find what I ws missing in my head, chemical wise that is. For example, when I used extasy, initially is was too strong for me so I would smoke a little weed and it leveled out perfectly. I felt great, outgoing, energetic, very social.
Then the first time I was on Lexapro, I felt the exact same great feeling (confident, outgoing, positive and happy)...maybe not so strong, but it was definately working for me. But I have a strong tolerance for any drug and so I when I went off lexapro and then back on, it was never the same. Sadly. And now I find myself self-medicating again to try to find that same great feeling that I miss oh-so-much :(
-SB
Posted by sam123 on August 20, 2007, at 23:19:25
In reply to Maybe..., posted by SometimesBlue on August 20, 2007, at 11:34:22
Other way around for me. Self medicating with drugs served as a gateway to psycomeds, which treated the reason I was doing drugs.
Posted by SometimesBlue on August 21, 2007, at 9:45:20
In reply to not, posted by sam123 on August 20, 2007, at 23:19:25
i know self-medicating is never a safe bet, and always looked down upon...but it is a sign that something is missing...whatever that may be.
Posted by mike lynch on August 24, 2007, at 0:03:30
In reply to SSRI's gateway drugs?, posted by linkadge on August 19, 2007, at 20:34:20
I definitely compensate with drugs because of passed ssri use.. I just feel like doing nothing anymore, I don't get it and I hate it. I really have a hard time connecting to society it seems and how could these insecurities *not* lead to drug abuse?. Ever since I took ssri's my life has become seriously meaningless.
Posted by rskontos on August 25, 2007, at 16:12:40
In reply to Re: SSRI's gateway drugs?, posted by mike lynch on August 24, 2007, at 0:03:30
You know I had not thought of it that way but you might have a definitely point. I went off my SSRI and feel blah most of the time. I refuse to take anything else but it is taking forever to get this drug out of my system. I have been so tempted to go back on something else. I had to up my topamax due to seizures that the cymbalta caused (it is the number one causer of seizures in peopel) anyway, I feel drawn to take something else. I have recently lower the topamax on my own which the neurologist said I could if it didn't help which it did but the memory lost thing was getting too bad I decide a few absence siezures were better than forgetting everything I knew from the name of the remote control to my address, and I feel better now and my memory is coming back but I still feel blah. I can't connect either. I thought it was my depression was back. Maybe it is the effects of the SSRI. I try to find meaning and starting working on a project I am excited about only today wham I am depressed again. This ssri gateway is interesting. Rk
Posted by sam123 on August 25, 2007, at 18:17:12
In reply to Re: SSRI's gateway drugs?, posted by rskontos on August 25, 2007, at 16:12:40
(it is the number one causer of seizures in peopel)
Nope. Epilepsy and seizure disorders are the number one reason of seizures, which has nothing to do with cymbalta. Genetics and brain injury are the top causes of seizures; drug induced seizures are far less common. The causes of seizures in adults are often idiopathic. Sounds like you already had seizures which puts you at greater risk. The chance of a seizure caused by antidepressants is quite low but they are all known triggers. The list of drugs that can trigger a seizure is quite extensive yet they are far from the common causes.
Posted by rskontos on August 25, 2007, at 20:06:58
In reply to Re: SSRI's gateway drugs?, posted by sam123 on August 25, 2007, at 18:17:12
No the neuro said when people are put on cymbalta they can easily have a seizure. I have not had any seizures since I was a teenager, mine were partial and the use of cymbalta jump started them. I got this from a neurologist who says she has a large number of new patients due to AD use and cymbalta being the worse of the AD.
Posted by rskontos on August 25, 2007, at 20:25:33
In reply to Re: SSRI's gateway drugs?, posted by rskontos on August 25, 2007, at 20:06:58
I had partial seizures due to a head concussion as a 10 year old. The doctors said I would eventually outgrown them I did. When I was tapering off cymbalta it started them back up. But when I went to the neuro she has in her opinion a high number of patients due to first time seizure activity with AD without any history. She was so familiar with AD's I was shocked. She did say that lexapro was the best one for me to try as it had the lowest likehood but that they still all had the risk. What is troubling to me was my doctor that prescribed to me didn't think or understand that cymbalta was the not the besrt one and that lexapro was the one she should have used for me. Now I have another issue to deal with if that isn't enough already going on with panic attacks and depression but now I will wake up feeling weird because I checked out for 2-3 minutes. Which was a partial seizure or absence seizure is. No one is aware of what is happening but me. I go to the doctor for help and wind up with another problem that had been dormant. All because someone didn't do their homework before prescribing a Class IV drug.
Posted by Larry Hoover on August 25, 2007, at 21:07:28
In reply to Re: SSRI's gateway drugs?, posted by rskontos on August 25, 2007, at 20:25:33
> I had partial seizures due to a head concussion as a 10 year old. The doctors said I would eventually outgrown them I did. When I was tapering off cymbalta it started them back up. But when I went to the neuro she has in her opinion a high number of patients due to first time seizure activity with AD without any history. She was so familiar with AD's I was shocked. She did say that lexapro was the best one for me to try as it had the lowest likehood but that they still all had the risk. What is troubling to me was my doctor that prescribed to me didn't think or understand that cymbalta was the not the besrt one and that lexapro was the one she should have used for me. Now I have another issue to deal with if that isn't enough already going on with panic attacks and depression but now I will wake up feeling weird because I checked out for 2-3 minutes. Which was a partial seizure or absence seizure is. No one is aware of what is happening but me. I go to the doctor for help and wind up with another problem that had been dormant. All because someone didn't do their homework before prescribing a Class IV drug.
I've been following your posts re: Cymbalta (duloxetine), and I've been biting my tongue. You are generally correct in what you say, but there are embedded comments which do not accord with the references I have, or sometimes basic physiology. For example, there is no accumulation of duloxetine in tissues. It follows first order kinetics, and is eliminated within days of discontinuation. Effects may linger, but that is the nature of pharmacology; the drug itself must disperse before its effects can do so.
I find no reference to seizure induction from duloxetine in the medical literature, other than one mention of a syndrome called SIAHS, which has been observed with many different antidepressants, and drugs of other classes. The duloxetine monograph includes this small and hardly notable mention: " In placebo-controlled clinical trials, seizures/convulsions occurred in 0.04% (3/8504) of patients treated with duloxetine and 0.02% (1/6123) of patients treated with placebo." The difference was not significant, and the incidence was too small to raise any flags, in any case. If you want to find an antidepressant that is known to lower the seizure threshold, take a look at Wellbutrin (bupropion).
I don't know why you're slagging your doctor for not doing homework when there was no homework to do. And, I don't know which definition of "Class IV drug" you're referring to, but duloxetine is not a drug of abuse. Otherwise, I have no idea what you meant.
I'm sorry you've been through this ordeal, but your experience does not seem to be commonplace, notwithstanding your neurologist's comments.
Lar
Posted by rskontos on August 27, 2007, at 19:35:50
In reply to Re: SSRI's gateway drugs? » rskontos, posted by Larry Hoover on August 25, 2007, at 21:07:28
Lar, do you believe everything the drug manufacturer's literature say when they only do trials for 12 weeks presently. My neurologist is the one that says the drug can live in the tissues with in the the body. You are referring to shelf live. Yes cymbalta has a short shelf life which is why you need to taper off of it when coming off. But during my taper which was hell, I had brain zaps, and more things going on which wound me up in the hospital. Also, my neurologist has several patients all that had seizures due to AD's. Cymbalta being the worst. You might know your stuff but not all of it. Pardon me but I have been on three different boards and this isn't the first time I have heard what I have been talking about. But I will leave you guys to your stuff. I thought I would find support here but instead I have found people that believe everything Lilly spits out as truth. Beware of the drug companies it is money to them. Look at their protocol for getting off the drug. It doesn't work. There are several boards out there for withdrawal from AD's and it is de-toxong. Don't bit your tongue on my account. Wellbrutrin is not helpful for panic attacks. The homework the doctor didn't do is prescribing cymbalta for panic attacks versus lexapro and with seizure history that would have been the appropriate protocol.
Sorry you think I don't know what I am talking about but I do.
But I will shut up for now. Good luck to everyone on this board, I will find another.
Posted by Larry Hoover on August 27, 2007, at 20:28:39
In reply to Re: SSRI's gateway drugs?, posted by rskontos on August 27, 2007, at 19:35:50
> Lar, do you believe everything the drug manufacturer's literature say when they only do trials for 12 weeks presently.
Of course not. I'm a chemist, specializing in environmental toxicology. I interpret the chemistry of a substance in terms of their effects on organisms. The octanol/water partition coefficient for duloxetine, and the rate of enzymatic degradation, clearly show that this substance cannot accumulate in tissues.
> My neurologist is the one that says the drug can live in the tissues with in the the body.
No, it can't. Water solubility and osmosis are not going to let that happen.
> You are referring to shelf live. Yes cymbalta has a short shelf life which is why you need to taper off of it when coming off.
Half life. t½.
The published half-life is 8-17 hours, mean 12. Even at 17 hours, after five half lives (just over 3 1/2 days), there is 1/32 (i.e. 1/ 2^5) of the original blood concentration remaining.
> But during my taper which was hell, I had brain zaps, and more things going on which wound me up in the hospital.
Yes, there is a substantial withdrawal syndrome associated with duloxetine.
> Also, my neurologist has several patients all that had seizures due to AD's. Cymbalta being the worst. You might know your stuff but not all of it.
I didn't say it doesn't happen. I said it was uncommon. I would suspect that a neurologist such as yours is perhaps the most likely to "catch" such cases, on referral from other doctors.
> Pardon me but I have been on three different boards and this isn't the first time I have heard what I have been talking about. But I will leave you guys to your stuff. I thought I would find support here but instead I have found people that believe everything Lilly spits out as truth.
I don't mind your holding different opinions than mine. Debate shouldn't be seen as being unsupportive. I would hope you'd keep an open mind.
> Beware of the drug companies it is money to them. Look at their protocol for getting off the drug. It doesn't work.
What protocol is that?
> There are several boards out there for withdrawal from AD's and it is de-toxong. Don't bit your tongue on my account.
Okay.
> Wellbrutrin is not helpful for panic attacks.
Wellbutrin holds the dubious honour of being the psych drug most likely to induce seizure. They had to revise downwards the maximum dose to get the expected seizure rate down below 2%. Duloxetine is less than 0.1%, in comparison.
> The homework the doctor didn't do is prescribing cymbalta for panic attacks versus lexapro and with seizure history that would have been the appropriate protocol.
Okay.
> Sorry you think I don't know what I am talking about but I do.
I suggested there were minor problems within a body of truth.
> But I will shut up for now. Good luck to everyone on this board, I will find another.
Please don't leave on my account.
Lar
This is the end of the thread.
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