The question of whether or not you should start taking antidepressants is complex and difficult to answer. But even fuzzier is the question of when or if you should stop. Last May, NPR ran a piece called Coming Off Antidepressants Can Be Tricky Business.
Joanne Silberner writes:
Several top psychiatrists say there’s just not enough data to say for sure when to try coming off an antidepressant. Drug companies generally test their new products for a few months or up to a year. They don’t spend much time looking into how to taper off their products. The dense informational inserts that come with prescription drugs have a lot of information on how to take the product, but no information on how to stop.
Before posting, please read our blog moderation guidelines. The comments below begin with the oldest comments first. Click on the last comments page to jump to the most recent comments.
Before posting, please read our blog moderation guidelines.
Post a Comment:
Copyright © 1995-2013 Psych Central. All rights reserved.
Site last updated: 19 Jun 2013
|
Therese,
As one who successfully tapered off of a 4 med cocktail almost over 4 years by going very slowly (10% of current dose every 4 to 6 weeks,), I wanted to respond your blog entry.
Regarding point number 1, I vehemently disagree that only folks who are mildly ill will have the best chance of success. Many folks who were given dire predictions and told they were seriously ill and thus needed meds for life, are doing great off of meds.
Unfortunately, the mental health profession refuses to believe this can happen and discounts these stories.
Regarding point number 2, if I had consulted with my doctor, who advocated a way too fast tapering schedule, there is no doubt in my mind, that I wouldn’t have had the success I did in getting off of my psych med cocktail.. Many people have found that to be dangerous to their health.
While mine fortunately didn’t advocate this, many psychiatrists will tell someone to take a med every other day. That is the worst thing you can do as you put your body in withdrawal by that type of schedule.
Regarding point number 3, actually, if you have been on a med for several years, you might want to take longer than 2 months. I learned the 10% method from Paxil Progress which is independently operated and does not allow commerical links.
Regarding point number 5, there is never going to be a perfect time to start tapering. Even if you start when your life is stress free, you never know when you will be slammed out of the blue with something.
When I started tapering my meds, a year later, a close relative became seriously ill and eventually died. I also dealt with many other serious issues.
But I never considered pausing or stopping my taper because I saw these crisis’ as opportunities to practice the coping skills I had learned.
Regarding point number 6, this is a red hot button issue for me. In my opinion, most psychiatrists are falsely attributing a relapse to what is usually a way too fast tapering schedule as I mentioned concerning point 2. This really needs to stop and frankly, I find it disgraceful that this myth continues to be perpetuated.
Anyway, thank you for addressing antidepressant withdrawal as I think this is a very important issue. If someone wants support in getting off of antidepressants, I would strongly urge them to visit the Paxil Progress site. Again, it is independently operated and does not allow commercial links. There is no charge.
I have been on 20mg of Prozac many years and now have been on 20 mg of Simvastatin for several years. A long time ago, my psychiatrist suggested a taper to 3X a week for one month, 2x a week for a month, and 1X a week for a month. I am on the second week of 2X a week and seem a little more impatient but am feeling no increased depression. I went through a lot of talk therapy and think I now have a pretty good handle on dealing with stressful situations in my life. I was hesitant to start the taper before now because I read somewhere that it can be difficult to get back on anti-depressants you were on previously, if needed, because they may not work the second time around. Can anyone who has recently tapered similar to my situation comment? I’d really appreciate it.
Just a comment on point 6, for people contemplating going off their anti-depressant.
You can reduce the likelihood of relapse by being or having been in talk therapy designed to change behaviors and beliefs that contribute to depression. A program of aerobic exercise is also good relapse prevention. Time spent in nature has been shown to lighten mood – even 20 minutes just sitting under a tree.
Most common reasons people start using antidepressants are Depression and General Anxiety Disorder. Both are equally dangerous, but sometimes it can be even more dangerous to hide the problem behind the medication.
Very good points mentioned in this article on how to stop using antidepressants, in my opinion. There are reasons why people should or shouldn’t go for it. And of course, for some it will be easier than for others.
Overall, I think that anyone who will quit Antidepressants should understand that the problem will have to be dealt with in some other way afterwards.
I had to abruptly come off my antidepressant (Zoloft) that I had been on for 7 years because of an unexpected pregnancy. The withdrawal was TERRIBLE!! The psychiatrist was NO help in advice for withdrawal but instead seemed determined on frightening me about birth defects since I was unaware I was pregnant until I was at 5 weeks, therefore I was still taking my medication. I felt nervous ALL the time when trying to come off!
Don’t be surprised if you’re one of those people who feel no different following SSRI termination. Some of the latest research indicates that for all but severe depression, the SSRI drugs are no more efficacious than a sugar pill.
On another front, I’ve heard people who stop their SSRIs abruptly talk about having this thing called “brain zaps,” where they feel like there’s a jolt of electricity through their head/body.
Agree with AA. I was another one of those who was given a grim prognosis – multiple psych hospitalizations, seriously mentally ill, therefore meds for life. I have been off all psych meds (4-5 med cocktail)against medical advice since 2002 with nary a hospitalization and working full time. My meds were my problem.
I was told nothing about withdrawal (or discontinuation syndrome as MHP prefer to call it) and stopped the meds cold turkey, which was very dangerous. I landed in the ER begging for Effexor because I was so miserable (projectile vomiting, diarrhea, fever from dehydration, brain zaps, and generally freaking out) – they restarted Effexor and I decreased a little more slowly, although not slowly enough. It was hell.
It took a good year before my brain chemistry felt almost back to the way I was before I started the years of psych meds. Most likely during that year of recovery, MHP would have assumed I was relapsing as I struggled to get through the withdrawal process. This would have been an incorrect assumption.
MHP need to stop with the doom and gloom predictions. They can’t predict the need for “meds for life” and in my opinion all that does in many cases is help create a self fulfilling prophecy that people cannot heal.
This article offers very realistic points to consider when coming off an antidepressant. Having bipolar that is not an option for me, but do wish others well with this endeavor.
As a side note, Serzone was taken off the market in the U.S. in 2003 due to it causing liver damage with the possibility of it leading to death. I was on it 5 years before it was discontinued. Luckily, my liver suffered no I’ll effects.
If you’re trying to get off your meds or even just considering it, check out the website for a group called point of return. You don’t have to be on drugs that mess with your life! and this group has a really amazing support system of people that understand and listen unlike those freaking money sucking psychiatrists who refuse to budge from their preconceived ideas that you have a chemical imbalance and just can’t possibly do anything about it, but, oh well.
I came off my venlafaxine 6 months ago and in the last two months i have had a major major relapse. Its a disaster on a big proportion. I recommend that before you come off any medications no matter how good you feel make sure you have resolved the problems that made you take them in the first place. I made the mistake of thinking i felt great and coming off them. Little did i know that the next batch of stress that came along would hit me really hard, now my life is in tatters. If you do decide to come off make sure you have strong relaxation techniques in place like meditation and yoga, as well as talking therapys or CBT. take note of how your mood is and if you feel a drop in happiness go see your doctor or work out your problems before its too late.
Hi. I have been taking antidepressants for 4 years after my diagnosis of multiple sclerosis. After 4 years off changing to diffrent ones as none seemed to work as still felt depessed and suffered with anxiety, in all i felt like i was getting worse no better, which i can’t understand. Then i had my meds venlafaxine doubled then had a allergic reaction( not very nice) Fed up with all the meds… so for the past 2 weeks i have gone cold turkey… yes i have been down crying often feeling down not much diffrent while being on them tho! just fed up if masking my emotions as i have always been emotional. Is there any serious side effects from what im doing tho??
i wish that i would never have started taking anti depressants. i feel like i’m addicted to them. even worse, every few years it seems like i become immune to them so i have to switch to a different drug. it’s true, while on antidepressants i don’t feel sad, but i also just don’t feel much of any kind of emotion. i believe my apathy was caused by antideprssants. i’m not as imagninative, explorative, and artistic as i used to be. everyone is different. depression can not be measured by blood tests, etc. like most other diseases. it’s simply a guessing game. trial and error.
I have been on ALL antidepressants over the past 20 years. I’m still depressed. After 2 divorces, 2 children, a career with a unexpected layoff, I am ready to give up. I simply have no will to go on at this point. I am 46 and feel like calling it quits if it wasn’t for my 8 year old son who is my only reason to continue. Most of the time I feel he would be better off with someone that was normal….young, energetic and happy. My 20 year old daughter shows signs of a similuar depression. I would sleep all the time if I could. I only get up for my son. Since the layoff, I have no reason to get up. I’ve lost my competitive nature, drive, will, sexual drive, and reason for living. I’m starting to search myself for a cure. I’ve been thru all the antidepressants. I normally become amune to the drug after 3-4 years and have to change. I had a bad experience with paxil. I now also take xanex for panic attacks. I don’t know whether to go to the doctor or Im psyco. I just want to die!
start practising vipassanna meditation enroll for a ten day course for beginners you will find a center teaching vipassanna meditation close to where you stay via google search take it on practice and you will see for yourself the positive difference
I was on Effexsor for about 7 years, and have now been completely off it for 1 month. I still feel absolutely awful. I can”t concentrate on anything, like reading a book, or even adding a column of numbers. I am so cranky, and not just with others, with myself too! I tapered off this drug gradually and had all the symptoms … brain zaps, sleeplessness, extreme high body temperature, and more. How much longer is this going to go on? Today, I almost called my doctor to request going back on them but I really want to be free of this stuff. I definitely would not not go back on Effexsor again, it’s way to nasty. I don’t know waht to do. I cry at commercials. I don’t know how much longer I can stand it,