Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Prefect on January 2, 2013, at 22:13:58
So what is our final word on this issue?
I've dosed up my Luvox from 50 mg/d to 100 mg/d to tackle an agoraphobia/PD relapse, and I'm almost in a sick way a little disappointed that it seems to be helping me a little. I was going to use this relapse as an excuse to get off Luvox all together if it didn't help. The research I've been doing leads me to believe more and more that medication is counter productive in the treatment of my condition as it interferes with fear exctinction learning process of the hypocampus, so once I recover on the medical baseline I'm on now, if I discontinue medication relapse will be imminent. But oh well, I feel better now and I'm not inclined to mess with my gains as I have too much to lose.
This means now I've been on this SSRI for 16 years! I keep reading about theories about long term SSRI use leading to major depressive disorder and I'm not sure how proven this theory is now and how well researched a phenomenon it is.
But the idea scares me. I would like to hear views of the people on this board on this issue, and how much they buy into this theory, and what their own experiences have been.
Posted by Phillipa on January 2, 2013, at 22:35:20
In reply to Tardive Dysphoria - Does it scare you too?, posted by Prefect on January 2, 2013, at 22:13:58
I know so many people that are out in the world and don't think twice about taking an antidepressant. Don't look them up. Don't doubt a thing and they seem to be fine. Phillipa
Posted by Phillipa on January 2, 2013, at 22:40:30
In reply to Re: Tardive Dysphoria - Does it scare you too? » Prefect, posted by Phillipa on January 2, 2013, at 22:35:20
I also know people that take an ad for a while and stop it hence I don't raise my doses. My neighbor stopped lexapro after years of use and seems so much happier now. She does take xanax and gabapentin. But no more ad's. I've lived here and watched her change she's happier now. Phillipa
Posted by jono_in_adelaide on January 2, 2013, at 22:43:02
In reply to Re: Tardive Dysphoria - Does it scare you too?, posted by Phillipa on January 2, 2013, at 22:40:30
I'd say possible but rare - 10% of americans are now taking SSRI's - it would be unusual if a small number of them didnt go on to chronic, untreatable depression - we had chronic, untreatable depression long before Prozac and the other SSRI's
Posted by SLS on January 3, 2013, at 0:33:00
In reply to Tardive Dysphoria - Does it scare you too?, posted by Prefect on January 2, 2013, at 22:13:58
The existence of tardive dysphoria has not been proven, although it may occur. Here is the abstract of the G. Fava (as opposed to M. Fava) paper:
http://www.ncbi.nlm.nih.gov/pubmed/12633120
I haven't seen any retrospective investigations producing numbers to scrutinize. It would be difficult study prospectively - and perhaps unethical. Your case does not support Whitaker's argument. You didn't have major depressive disorder (MDD) 16 years ago when you first started antidepressant treatment, and you still don't have it. The "oppositional" explanation is nothing more than a theoretical model at this point. There are some observations that support its occurrence, though. Changes in receptor numbers (upregulation or downregulation) is a consistent observation with antidepressant drug exposure. There are probably other compensatory reactions as well. However, it might very well be that these compensatory "oppositional" phenomena are precisely what is needed for these drugs to work. The course of untreated depression is one of increasing severity. It would be difficult to prove that the worsening reported by Whitaker should be explained by tardive dysphoria rather than being the natural course of the illness.
What do I believe? While I do believe that tardive dysphoria is a possibility, I am not convinced that it occurs with great frequency. Robert Whitaker would have us believe that it is ubiquitous. This comes from a person who states that he doesn't even believe that antidepressants work in the first place. They appear to work for you and me. Whitaker writes books and articles as a reporter without having a Ph.D. or M.D. Or course, I also write stuff without academic credentials. However, I find Whitaker's arguments to be circumstantial rather than scientific. I don't think he has been able to prove cause and effect, either physiologically or epidemiologically.
It is only natural that you should be concerned after reading the article that you found. In your subject line, you asked "does it scare you?" The answer is "no", it does not scare me. I am keeping an open mind, though. Personally, I feel that the benefit to me is worth the theoretical risk.
- Scott
Posted by jono_in_adelaide on January 3, 2013, at 16:37:57
In reply to Re: Tardive Dysphoria - Does it scare you too? » Prefect, posted by SLS on January 3, 2013, at 0:33:00
My gut feel is that you'd be at far more risk having an untreated major depression that the risk of developing tardive dysphoria..... in the same way that while taking an antibiotic has certain risks, an untreated pneumonia is far more risky than a course of Levaquin
Posted by Prefect on January 3, 2013, at 20:24:49
In reply to Re: Tardive Dysphoria - Does it scare you too?, posted by jono_in_adelaide on January 3, 2013, at 16:37:57
I suppose. Mood disorders run in my family. Cousin with OCD, depression, GAD, mother with GAD and panic disorder (I remember her dropping valium drops in her tea in the 70s when I was a kid), brother with severe autism, myself with anxiety, somatization disorder, agoraphobia and panic disorder.
But I've never been depressed. It's not something I want to add to my portfolio that's for sure. But I'm a true believer in behavioral and lifestyle factors and have been willing to put up with an inhuman amount of anxiety to persevere in maintaining a high functioning life. I've enganged in no avoidance behavior whatsoever during this relapse(writing this post from a 10 hour drive away from home for holidays) and I think I'm already coming out of this 4 month relapse on top, on 100 mg/d Luvox and no benzos.
Safe to say if meds don't induce depression, my lifestyle and bahvior won't either. Fingers crossed. I love my life, I love my wife, and possess a stupid amount of selfworth. Don't know where it all comes from, but I don't want this medication to ever mess with that.
This is the end of the thread.
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