Although this will not come as news to anyone who’s been on any one of the most common psychiatric medications prescribed — such as Celexa, Lexapro, Cymbalta, Prozac, Xanax, Paxil, Effexor, etc. — getting off of a psychiatric medication can be hard. Really hard.
Much harder than most physicians and many psychiatrists are willing to admit.
That’s because most physicians — including psychiatrists — have not had first-hand experience in withdrawing from a psychiatric drug. All they know is what the research says, and what they hear from their other patients.
While the research literature is full of studies looking at the withdrawal effects of tobacco, caffeine, stimulants, and illicit drugs, there are comparatively fewer studies that examine the withdrawal effects of psychiatric drugs. Here’s what we know…
Benzodiazepine withdrawal has a bigger research base than most classes of medications — SSRI withdrawal has much less research. So what’s that research say? Some patients are going to have an extremely difficult and lengthy time trying to get off of the psychiatric drug prescribed to them. Which ones? We don’t know.
One study nicely summarizes the problem experienced in many such patients:
Various reports and controlled studies show that, in some patients interrupting treatment with selective serotonin reuptake inhibitors or serotonin and noradrenaline re-uptake inhibitors, symptoms develop which cannot be attributed to rebound of their underlying condition. These symptoms are variable and patient-specific, rather than drug specific, but occur more with some drugs than others. […]
There is no specific treatment other than reintroduction of the drug or substitution with a similar drug. The syndrome usually resolves in days or weeks, even if untreated. Current practice is to gradually withdraw drugs like paroxetine and venlafaxine, but even with extremely slow tapering, some patients will develop some symptoms or will be unable to completely discontinue the drug.
Psychiatrists and other mental health professionals have known ever since the introduction of Prozac that getting off of benzodiazepines or the “modern” antidepressants (and now add the atypical antipsychotics too) can be harder than getting symptom relief from them. Yet some psychiatrists — and many primary care physicians — appear to be in denial (or are simply ignorant) about this problem.
Back in 1997, a review of the literature on SSRIs (selective serotonin receptor inhibitors) outlined the problem (Therrien, & Markowitz, 1997):
Presents a review of 1985 — 96 literature on withdrawal symptoms emerging following the discontinuation of selective serotonin reuptake inhibitor (SSRIs) antidepressants. 46 case reports and 2 drug discontinuation studies were retrieved from a MEDLINE search.
All of the selective serotonin reuptake inhibitors were implicated in withdrawal reactions, with paroxetine most often cited in case reports. Withdrawal reactions were characterized most commonly by dizziness, fatigue/weakness, nausea, headache, myalgias and paresthesias.
The occurrence of withdrawal did not appear to be related to dose or treatment duration. Symptoms generally appeared 1 — 4 days after drug discontinuation, and persisted for up to 25 days. […]
It is concluded that all of the SSRIs can produce withdrawal symptoms and if discontinued, they should be tapered over 1 — 2 weeks to minimize this possibility.
Some patients may require a more extended tapering period. No specific treatment for severe withdrawal symptoms is recommended beyond reinstitution of the antidepressant with subsequent gradual tapering as tolerated.
The conclusion is quite clear — some patients are going to suffer from more severe withdrawal effects than others. And, just like psychiatry has no idea which drug is going to work with which patient and at what dose (unless there’s a prior medication history), psychiatry also can’t tell you a damned thing about whether a patient is going to have difficulty getting off of the drug when treatment is completed.
It’s simple trial and error — every patient that enters a psychiatrist’s office is their own personal guinea pig. That is to say, you are your own personal experiment in finding out what drug is going to work for you (assuming you’ve never been on a psychiatric drug in the past). Our scientific knowledge hasn’t yet advanced to be able to tell what drug is going to work best for you, with the least amount of side or withdrawal effects.
The U.S. Food and Drug Administration (FDA) doesn’t require pharmaceutical companies to conduct withdrawal studies in order to analyze a drug’s impact when it’s time to discontinue it. It only requires a broader safety evaluation, and a measure of the drug’s efficacy. The FDA is concerned about adverse events while a patient is taking the drug — not adverse events when the drug is removed. In recent years, some have been calling on the FDA to require pharmaceutical companies to conduct more analysis on a drug’s discontinuation profile, so that the public and researchers can get a clearer picture.
While all SSRIs have these problems, two drugs in particular appear to stand out in what little research is out there — Paxil (paroxetine) and Effexor (venlafaxine). The Internet is littered with horror stories of people trying to discontinue one of these two drugs.
And they’re not alone — benzodiazepines can also be extremely difficult to stop. “Withdrawal reactions to selective serotonin reâ€uptake inhibitors appear to be similar to those for benzodiazepines,” says researchers Nielsen et al. (2012). ((Thanks to Beyond Meds for the suggestion of this blog topic.))
What Do You Do About Withdrawal?
Most people are prescribed a psychiatric medication because it’s needed to help alleviate the symptoms of a mental illness. Not taking the medication is often simply not an option — at least until the symptoms are relieved (which often can take months, or even years). Psychotherapy, too, can often help not only with the primary symptoms of mental illness, but also as a coping mechanism during medication withdrawal. ((Tellingly, I could find no similar withdrawal syndrome associated with leaving psychotherapy, although certainly some people have difficulty with ending psychotherapy.))
The important thing is to go into the process with your eyes wide open, understanding the potential that discontinuing the medication may be difficult and painful. A very slow titration schedule — over a period of multiple months — can sometimes help, but may not always be enough. In some extreme cases, a specialist who focuses on helping people discontinue psychiatric drugs might prove helpful.
I wouldn’t let the problems with withdrawing from some of these medications prevent me from taking the drug in the first place.
But I would want to know about it beforehand. And I’d want to be working with a caring, thoughtful psychiatrist who not only acknowledged the potential problem, but was proactive in helping his or her patients deal with it. I would run — not walk — away from a psychiatrist or physician who claimed the problem didn’t exist, or that I shouldn’t worry about it.
This article was edited to clarify a few sentences on Feb. 14, 2013.
References
Kotzalidis, G.D. et al. (2007). The adult SSRI/SNRI withdrawal syndrome: A clinically heterogeneous entity. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 4, 61-75.
Nielsen, M., Hansen, E.H., & Gøtzsche, P.C. (2012). What is the difference between dependence and withdrawal reactions? A comparison of benzodiazepines and selective serotonin re-uptake inhibitors. Addiction, 107, 900-908.
Therrien, F. & Markowitz, J.S. (1997). Selective serotonin reuptake inhibitors and withdrawal symptoms: A review of the literature. Human Psychopharmacology: Clinical and Experimental, 12, 309-323.
41 comments
Oh, the rage against meds and psychiatrists… Let’s wipe cancer tratments also. You know, they have enormously bad adverse effects. Less animosity could have been nice.
@Shlomo:
Sounds like a good idea to me! After than let’s ban all public forums where people discus problems they’ve had with products and services merchants sell. Then we can all be silent, ignorant, powerless mice.
Psych meds are better than nothing for some people, but a lot of people were hurt by lack of info about them and yes, disgruntled consumers are often angry and often would like to save others from going through the pain they’ve been through. I don’t consider that to be “rage against meds†as you put it. No one is going to ban sedatives, etc., from the people who want them, so I don’t know why you’re upset unless you’re one of the merchants making or selling them and you’re worried about losing profits.
Even doctors who mean well (many doctors don’t care that much, they just wanted a high status, high paying job) are often given inaccurate information from the merchants who sell the drugs. Thankfully there are films like “Generation Rx†by Kevin Miller, and forums like this where people can exchange information.
Do you have a problem with knowledge and protecting people from harm?
@Shlomo
Considering the low effectiveness rates of antidepressants (e.g., the June 2016 study from Oxford saying they don’t work for kids, teens and young adults and can cause violence and suicide, and many other studies saying most of the benefit is from the placebo effect like recent research from Harvard Placebo Studies Program) it’s silly to compare them to cancer treatments.
And if it’s “animosity” you don’t want to see, don’t look at the egoic tantrums many service providers throw then someone dares to criticize their profession or judgement (like the angry comments by the psychiatrist “The Leprecaun†a few comments down).
As a possibly misdiagnosed bipolar patient who ended up on 6 drugs (but I certainly had depression at one time), I think the problem is horribly under-addressed, even in your article. How would someone find a specialist in withdrawing drugs? How can we find solutions apart from reinstating the drug(s)?
I was put on klonopin 22 years ago to treat RLS that interrupted sleep, but were not severe. In 2010 I decided it was time to go off.. the RLS had probably stopped. Well, they had, but getting off was not so easy. I had one of the better taper experiences and it’s taken me now 30 mos., with 2 to go. My story is not extreme, and had I any idea, I would not have started taking them.. Sinemet was a choice and I had not idea when the Doc asked my preference. I’ve been helping other people come off benzos and can assure you there are few doctors who understand how difficult tapering can be. Please read further. I am also a therapist and thinking of attending your June seminar in MA.
Thanks for such a pointed and incisive article. What was left unsaid, of course, is the obvious reverse conclusion that psychotropics can cause addiction and/or dependency.
If psychiatrists have known of this fact ever since the introduction of Prozac in 1987, why haven’t they told patients? Instead, all we have heard is their parroting of the pharma line that only benzos are difficult to withdraw from and even then it’s not so bad.
Yet another black eye for a profession that cannot even lay claim to good “management” of symptoms.
No, anti depressants are not addictive. I am a recovering addict/alcoholic. Addiction is when you constantly want to take the substance, you crave it. You take it to face anything difficult and you take way more than prescribed. Eventually you feel like a fish out of water every moment that you do not have it. I was addicted to barbiturates and that was my story. Anti-depressants give no high, they are like taking aspirin. Eventually after taking them a long time you start feeling human again, that’s all. I would take my bottle of 30 Valium in the first two days I had it, then I’d have to find another substance, when I was in my addiction. Anti-depressents are totally different, people hate having to take them. I hate taking them.
If “the syndrome usually resolves in days or weeks, even if untreated”, I’d probably just leave it untreated and let it go away. Only if it were interfering with someone’s life would I want to intervene.
My personal experience with SSRI-discontinuation syndrome was that it was at most, just annoying. It was nothing I wouldn’t have been able to live with. And then, it was gone.
one more day on those drugs and i would have been dead. but so glad to make money for those crooks.
thanks for the shortened life.
Dr. Grohol, thank you for bringing this to the attention of Psych Central readers.
In the recursive echo chamber that is psychiatric research, psychiatry has published many articles emphasizing that withdrawal symptoms are mild and last only a few weeks. This includes Kotzalidis, 2007 quoted above.
(These papers also obtusely imply that withdrawal symptom patterns are idiosyncratic, rather identifying them as autonomic destabilization.)
One of Kotzalidis, 2007’s central sources is researcher Peter Haddad, who is cited in almost all antidepressant withdrawal studies.
In a 2001 paper, Dr. Haddad wrote: “Most reactions are mild and short-lived and require no treatment other than patient reassurance. Severe cases can be treated symptomatically or the antidepressant can be reinstated before being gradually withdrawn. Reinstatement usually leads to symptom resolution within 24 hours. Some individuals require very conservative tapering schedules to prevent the re-emergence of symptoms.”
Author or co-author of many papers about antidepressant withdrawal, Dr. Haddad is always careful to say “usually” or “most” when it comes to sunny predictions about how long withdrawal syndrome takes to resolve, because he knows there are cases where it takes many months or even years to resolve.
Those reports of severe antidepressant withdrawal syndrome are unpublished and have been buried by the pharmaceutical companies, but researchers such as Haddad, Alan Schatzberg, and Richard Shelton are well aware of them.
Haddad goes on to say: “Discontinuation symptoms have received little systematic study with the result that most of the recommendations made here are based on anecdotal data or expert opinion. Research is needed to provide a firm evidence base for future recommendations.”
The “expert opinion” comes from U.S. committees underwritten in 1997 by Lilly (manufacturer of Prozac) and 2006 by Wyeth (manufacturer of Effexor). (Schatzberg and Haddad served on both committees.)
“Expert opinion” about withdrawal syndrome, then, is molded, if not dictated, by commercial interests.
In short, whatever medicine knows about antidepressant withdrawal syndrome is based on anecdotes collected by a few researchers, recycled throughout the entire body of literature on the subject. This reflects the doctors’ opinions (possibly influenced by pharma consulting contracts), not the experience of patients.
If you want to see patient experiences, hundreds of thousands of posts all over the Web report withdrawal syndrome lasting many months or years.
I’m still recovering from my own withdrawal from Paxil in October 2004.
On my peer support web site for tapering and withdrawal syndrome, SurvivingAntidepressants.org, there are many reports of prolonged withdrawal syndrome, as well as many more about difficulty in tapering. (Case histories may be read here http://tinyurl.com/3o4k3j5 )
What’s emerged is that, at the risk of destabilizing their nervous systems, some people need very gradual tapering taking months or years to go off psychiatric medications.
If only people could find “a specialist who focuses on helping people discontinue psychiatric drugs”! I know of only a few such knowledgeable practitioners in the entire world. (I’m always looking for doctors who understand tapering to refer people to, if you know of such, please contact me through SurvivingAntidepressants.org.)
Every doctor who prescribes psychiatric medication should be well-versed in tapering techniques. Few know anything. (Do NOT skip doses to taper!!!!) This is a disgrace to all of medicine.
You have to wonder why physicians forget the basic mantra that is the basis of medicine: to go from least to most invasive.
Why psychiatrists allowed managed care to eviscerate us in denying our rights to be therapists is Chamberlain-esque as an analogy. To embrace the failed premise of biochemical imbalance is the slow death of ingesting trace amounts of arsenic every few days these past 2 decades.
But, the lie has been perverted so the public knows nothing else but pills give skills. And we are a culture of dependency, it is just so pervasive, people can’t differentiate what is appropriate versus disruptive. Hence the leadership we have in the political groups across this country!
Sounds like another psychologist who hasn’t had the medical training nor experience to “know” what we psychiatrists know. I hope the writer of this article isn’t generalizing when he assumes that patients’ are the “guinea pigs” of psychiatrists. This is a notion that invokes anger in me as a psychiatrist. When a primary care physician changes to a different antihypertensive or diabetic medication, is it assumed that the patient is a guinea pig in this instance? I doubt it! This type of physician is assumed to simply be doing what’s best for the patient. Personally, I try to “know” my patient beyond simply picking a psychotropic drug out of the proverbial hat. I’ve actually seen over years of training how difficult the withdraw symptoms can be and for the writer of the article to assume that we base our knowledge only on research is just that…an ASSUMPTION! The balance of research, training, education, and EXPERIENCE all culminate into choosing the best options for our patients. I really do wish psychologists and the like would make better attempts and not overgeneralizing!!!
Sounds like another psychiatrist or doctor who hasn’t had the personal experience of actually ever having to have gone to one of his profession and be given an antidepressant medication with no mention of withdrawal symptoms made. And another psychiatrist or doctor who dismisses legitimate concerns over how psychiatric meds are commonly prescribed today.
As the psychiatrist knows, I’m sure, most antidepressants are prescribed by general practitioners — not psychiatrists. Do you think they go into a detailed explanation of withdrawal effects of these drugs every time they write a prescription?
And while I think it’s great you take time to get to “know” your patients before prescribing a medication to them, the fact (and science) remains that there is no data supporting your choosing Med A over Med B — unless they have a pre-existing or other medical condition. There’s no laboratory or other test you can look at that tells you Med A is going to work better than Med B in Random Patient M. Zero.
I’m glad there are good psychiatrists like you out there, but for most people, it’s pot luck to be able to find someone like you.
Dr. Grohol,
Not yet another assumption! Why would you assume that I’ve never had the experience of going to a doctor/psychiatrist who didn’t take the time to explain potential side effects?! Wow!!! Doctors are people too as you know and we unfortunately sometimes encounter the types of physicians you describe in your article. And you are also very wrong in assuming that I’m yet another physician who “dismisses” how psychotropic meds are commonly prescribed today. I must tell you that it frustrates me to the core when I ask a new patient if their last physician covered certain side effects (especially potentially life threatening ones) and they tell me no. One woman was prescribed Valproic Acid and she was of childbearing age and I could tell by the look of surprise on her face that no one had covered the potential risks of anticonvulsants on a developing fetus! So I’m with you on this! And primary care physicians simply don’t have the time in a typical day to cover all this. Oh, and by the way, psychiatrists ARE doctors (we certainly went to medical school and have the loans, 36-hour calls to prove it). Not sure why there is still confusion about this. But I digress…I am in total agreement with you that it is “pot luck” for most people to find a psychiatrist such as myself. I wish everyone could find someone with the careful oversight/conscientiousness that I try to put forth on a daily basis. I hope that after our friendly correspondence that you at least no longer include myself in the general population of psychiatrists whom you’ve formed preconceived notions about….until later!
My apologies for the generalizations; you’re apparently one of the good ones. I suspect if most psychiatrists followed your footsteps (and that of other great psychiatrists I know and value), psychiatry as a profession would be more respected.
Just like finding a good therapist or a good psychologist, finding a good psychiatrist can often be a frustrating exercise. I wish there was a better way.
If you know how to taper people off psychiatric drugs so as to minimize withdrawal symptoms, please contact me at SurvivingAntidepressants.org
Case histories here http://tinyurl.com/3o4k3j5
About withdrawal syndrome here http://survivingantidepressants.org/index.php?/forum/16-from-journals-and-scientific-sources/
About tapering techniques here http://survivingantidepressants.org/index.php?/forum/14-tapering/
From my personal experience, and that of these people at http://bit.ly/jAjLKr , finding a good psychiatrist is very difficult — maybe 1 in 50.
Even among psychiatrists, gross overmedication is common.
Finding a psychiatrist or any prescriber who knows how to taper people off psychiatric medications to minimize withdrawal symptoms is even harder.
If you are a prescriber who is conversant with tapering methods, please contact me at SurvivingAntidepressants.org for local referrals and save lives.
Lep, how well do you “know” our patients? How long are your appointments and med checks? How often do you see them?
What advice do you give folks for tapering? (For example, by what percentage of dose should they taper? How long between drops?) How do you handle folks who experience poopout? DO you prescribe a slow taper for them or do you do quick switches from one antidepressant to another? Do you prescribe anti-psychotics to people on anti-depressants to help boost the effects of the ADS?
How many of your patients, whom you know well, are on multiple psych meds? How many of them are are more psych drugs now than they were five years ago?
Until you mention concrete examples of how you treat the people who are taking the drugs (aside from mentioning side effects), you don’t sound so different from the psychiatrist who mistook Paxil poopout for breakthrough symptoms of anxiety, then prescribed antipsychotics to combat the uncontrollable crying jags and irritability. Fast forward five years after quick switch to celexa, repeat, rinse…
You need to describe what you do for folks on the drugs for a while, before putting yourself up for canonization for mentioning side effects.
I’ve just started tapering from SSRI after 10 years. Yes, my doctor said take a pill every other day. He also said benzodiazepines would not be difficult to stop (wrong), so I knew to look for second and third opinions and personal experience wherever I can find it.
Thanks the sensible discussion about this. Looking forward to more.
Thanks for the post and ongoing discussion. My comment is quite simple. I was recently advised by my psychiatrist to quit taking my Effexor XR (37.5mg) cold turkey since the side effects of withdrawal wouldn’t be worse than the side effects it was causing me while taking it. The withdrawal was a living HELL!!! I have not started on a new anti-d yet. I have been on more than fifteen different medications and combos of medications that have not worked. At this point, I am not sure which scares me more – the depression or the thought of trying one more medication!! Just to reassure everyone, yes I am seeing my therapist. I can’t get in to see my psychiatrist for another 6 weeks due to her schedule. I am thinking about a change in doctors, not because I don’t think mine is trying her hardest to help, but I need someone who is more available during times like this.
Norelle, if I were you, after all that trial and error I might conclude that perhaps psychiatric medications are not for me.
After you’ve experienced a severe withdrawal reaction or other adverse reaction, often they work differently, too. They are powerful drugs and your nervous system can become sensitized to them.
It can take a long time for your nervous system to settle down from an adverse reaction like severe withdrawal or history of adverse reactions. What you’re experiencing now might be iatrogenic — drug-caused — rather than a psychiatric disorder.
In the course of my work with those coming off psych meds I’ve learned that there are few people, even among critics of psychiatry that have a clue at the potential severity of psychiatric drug withdrawal syndromes. That also means there are virtually no professionals that can offer meaningful support when people encounter serious issues. We remain dependent on each other.
Other than those who’ve directly experienced protracted withdrawal or those who have lived with those who have experienced it, it simply remains under appreciated and therefore under treated and under recognized even, as I said, among critics of psychiatry. It’s rather horrifying for those of us who find ourselves struck by such illness. While perhaps a minority, we are not an insignificant minority. I alone have had contact with 1000s of us.
The other thing to consider is that we are perhaps not even a minority because the fact is so many issues with withdrawal are not recognized at all and are instead considered and then treated as the “underlying illness,†many folks simply get sicker and sicker on meds and never even know why they’re ill. Those people never come to understand that all the multiple trials of drugs and the numerous times of coming off and on them has actually been the cause of their illness.
Generally, prolonged withdrawal syndrome is not recognized by medicine. You will find very few doctors to diagnose it and still fewer to treat it. I found that being well-educated and finding doctors who respected how much effort I put into educating myself helped me. It must be said, though, that it is also a curse because for every doctor who appreciates a knowledgable patient there are likely 15 or 20 or maybe even more who feel threatened by that same patient. Still, it is a plus to know what we are doing.
I hope this perilous situation changes as people learn from one another. For now far too many people are not in a position to get appropriate care or know how to properly educate themselves.
I’m 1001, I experienced a harrowing withdrawal from Pristiq. I have fat stranding on my pancreas, and the fever aphasia and brain zaps for 3 months were horrible. I couldn’t stop crying, and if I were to be examined by a psychiatrist in this time, it would have looked like a emergence of any number of mental illnesses.
I am also a trauma survivor. I was sexually – physically, mentally abused my whole lfe. I have been on one pill or another for 32 years, and I’m just exhausted. The sad part, is I just wanted to stay compliant.
Without proper insurance, the risk to cure is way too high. I also have a hard time trusting psychiatrists after being medicated, abandoned and forced into withdrawal multiple times.
I also have 15 different diagnosis’s, including a global learning disability (psychiatrists seem to ignore this diagnosis), and I have no idea what the diagnosis’ mean, or why they’re being applied.
Therapy is so often denied to me because of insurance issues. The repeal of the ACA will compound my barriers to seek treatment. I’m just living in the now. I know If I don’t I will fall into painful panic attacks over having to go back on the pills again.
Psychiatrists get to make their six figure salaries, and I get to remain unemployed, sick and aimless. It’s very sad, and I don’t feel like I have a voice. Right now I’m just hoping for the best.
Dr. Grohol, I too thank you for writing a blog entry on psych med withdrawal as in my opinion, it is a vastly ignored issue.
As an FYI, I took nearly 4 years to taper off of 4 psych meds which was done with the help of the slow tapering advice from internet withdrawal boards. In my opinion, if I had depended on the advice of my psychiatrist, it would have been done way too quickly and there is no doubt in my mind I would have failed. I would have ended up having to go back on the drugs to cover withdrawal issues that I am sure would have been falsely blamed as a relapse.
You go on to say, “In some extreme cases, a specialist who focuses on helping people discontinue psychiatric drugs might prove helpful.” Dr. Grohol, I know you mean well with this advice but the chances of that happening are as great a the NRA and Mark Kelley/Gabrielle Giffords agreeing on gun control issues.
These people simply do not generally exist with the exception of the folks who appear on the Surviving Antidepressants board tapering list. And if you think you have found someone, they will seem like they know what they are doing until suggesting that you take another horrific med to cover the withdrawal effects of the first one, thus perpetuating the viscous cycle of being in what I call psych med “h-ll”,
You then say, “I wouldn’t let the problems with withdrawing from some of these medications prevent me from taking the drug in the first place.”
Personally, as one who did not have an easy time with withdrawal, even with a slow tapering schedule, in my opinion, that is the first thing you should think about and I wish to god I had. Knowing how ineffective antidepressants are long term and realizing I had plenty of non drug options would have made me realize the risks outweighed the benefits. In my opinion, unless a med will provide super benefits regarding your quality of life and in my opinion, most psych meds fail that criteria big time, I would ran as fast as I could from a doctor who wanted to prescribe them.
The days of treating mental health problems with just meds without offering other options and yes that includes issues like schizophrenia need to end. Peoples lives depend on it.
I couldn’t agree more with these particular comments, and a special kudo to DocJohn for writing this article. It’s a very important issue for so many, myself included. However, it’s clearly complicated. Have had great treatments, docs, therapists, meds over the years, and some, not so much at all. This comes from sixty years of life struggling with many mental health issues, seeing family, friends, struggle, and others in some previous teaching jobs I’ve had, working with special needs folks. We must keep trying to improve!
Hello,
Thank you for taking the time to write this article.
Yet, I would like to state that the heart of this social problem is not a lack of research about withdrawal, rather it stems from a dominant narrative about what should be done to treat those in psychic pain.
Psychiatric drugs are the first line of treatment in many cases and are administered to people suffering by diagnosing them with a simplistic tool known as the DSM.
I feel this needs to change. Not just in psychiatry, in the larger medical community and beyond.
“Fixing” underlying symptoms with drugs appears to work at first, of course! Many of us suffer from a lack of sleep, racing thoughts, anxiety, and the medication (over a few days) brings these emotions down to a tolerable level.
However, at this time, when the complex human experience has been tamed, perhaps it is time to administer care, empathy, sympathy, love.
Perhaps this sounds silly? But I think not. Grief and trauma can be healed through thinking differently, talking, hugs, love, trust, unconditional positive regard..in my experience.
Long term use of psychiatric medication hurts those suffering from trauma on more than one level. It hurts their bodies, and it hurts their self esteem because they are stigmatized and are in a dependent situation with their doctors and may feel that hope has been lost.
Maybe I’m a radical, but I think it’s time for a new story. A story that tells those suffering that they can and they will get better. And that medication is helpful for symptoms, yet wellness is in the hands of the patient. Offer options, offer help, offer love.
We are dealing with trauma and we need empowerment.
Thanks!
Take Care.
I certainly am one of those you speak of who suffered a severe withdrawal syndrome. And, nearly three years after stopping prozac, have still to regain ANY emotion, still have memory and concentration problems, taste, smell and hearing problems. Thankfully my severe physical and psychological symptoms have abated but those first few years were all about survival and I would never wish the experience on anyone. There should be warnings about the possibilities of withdrawal when you are introduced to these medications. I was not prepared for what would happen after discontinuing this drug. The experience is in a realm of its own.
I wont bore you all with my story, suffice it to say I no longer take any antidepressants, benzos or z dtugs.
I now firmly believe in what Dr Hirsch (Harvard) said on 60 Minutes – that Ads are only a fraction better at relieving depression than a placebo.I will never put myself in harms way agin, nor will I ever trust another psychitrist. My former doctor had me on all the above meds for over 12 years, then closed his practice and left me hanging. That was monthes ago, and I have never felt more ill. This doctor knew what happened, yet never even bothered to call me. Im done.
I’m collecting cases of withdrawal syndrome at SurvivingAntidepressants.org Register and start a topic to tell your story in the Introductions forum.
These case histories are to document the problem, educate physicians, and track progress as people recover — which most do, eventually, though it can take years.
Doctor many of the anti-medication posters here are zealots involved in what has been called a cult that attacks medical science. This group believe in conspiracy theories involving Big Pharma and psychiatry (like Scientology).
Word to the wise.
Doctors dunno anything abt getting through withdraw, i be try ed detox and everything there is to find to get through this stuff …. but its all about if do wanna stop… i m in my day 6 and felling horrible ,, i hate Denmark and the treatments here
Weeks and months? Are they kidding? Im suffering for almost 3 years now from protracted withdrawal symptoms. IT IS HELL. There is just no other way to heal the mind… you must do it naturally…be with nutrition and peers/family help. My withdrawal was horrendous…from having out of this world thoughts that are penetrating your head up to having an ulcer for 1 whole year! And having muscle contractions inside your body where you dont know where its coming from…. Geeze… if I only knew I could heal my mental illness by eating a lot of greens with food (cabbage, brocillis and lettuce) and doing excercise, sunlight walks and revisiting my Catholic faith… I would not have taken those dangerous and uneccessary drugs.
You and me both.
12-step programs.
I have PTSD, which I got after a shooting I witnessed in June 1994 at Fairchild Air Force Base in Spokane, WA. I was later misdiagnosed with multiple different psychiatric conditions, none of which proved to be the case-and some very malignant assumptions, to say the very least, about me that some providers made, came as quite a shock.
I also found that after I developed diabetes when given Zyprexa to medicate for sleep (for me, it wasn’t sleep, it was a coma), and for some effects on mood. Multiple other medications were given.
It left me intoxicated. To this day, I did things I am neither proud of, nor are they things I can explain. I attribute that to what I felt was intoxication from being prescribed too much medication.
One by one, I tapered of most everything. And slowly. The effect, I am shocked by-it took months if not close to a year to be myself again. And that’s the withdrawal.
I lived in a legal state at the time, and had very close supervision-and offset many of those withdrawal symptoms by using medically prescribed marijuana (I am not advising this, I had worked closely with a team of providers, who knew and were supportive of the discontinuation of this). And the other reason medical marijuana was an option for me, was that right before then, I developed the effects of Reflex Sympathetic Dystrophy/Complex Regional pain Syndrome. And gastroparesis.
This is what probably makes me a bit of an exception, so I won’t advocate buying some street weed, and chucking your medications-and I’m not qualified to make a call like that for anyone.
The other thing-is that it also made the PTSD worse. So when I was coming off all that stuff, 20 years that my mind had stored some very intense memories, sights, smells, sounds, etc-came rushing back. What I had done was delay the inevitable. And it was the year or so from hell.
Added to that the medications prescribed to slow some of the pain of the RSD/CRPS rotted my teeth to the gumline, and I was like that for a year-while my family had to raise the money for my oral surgery (I was turned away by dentists because of the RSD, they stated they weren’t qualified). Because I had to be intubated for the procedure.
Coming out of that-took months to have the ability to think straight.
I do still treat some of the anxiety, but for me, I think keeping it simple is what works best. And finding spiritual comforts.
I believe the risk benefit needs to be more carefully weighed, and that other classes of medicines besides benzos needs to be studied-atypicals and other mood medications on withdrawal issues.
What is a crying shame is the number of diagnoses that I wound up with from the effects of medications. And from providers who should be able to admit that sometimes medicines cause the symptoms they are intended to relieve-instead, I was taken apart as a human being.
But I know the truth, God knows, and so do my current providers. And fortunately in my case (and no, I no longer use weed-I don’t need it), with anxiety treated, I feel much better than I have before.
What is medicine for some people, it is not medicine for everyone.
I went through what you did. Though, not as severe. Thanks for your input. I went through an extremely abusive childhood, and I had been on psych meds since the age of 12 years old. I am also learning disabled, and I’m on disibility. My insurance was cut off and I spiraled into withdrawal syndrome from pristiq. Free from the side effects, I’ve taken up running, I’ve been happier than I’ve ever been. However, social Security is reviewing my case now, and I’ve started to exhibit panic attacks because I connect the pills to my childhood and the abuse I suffered. This creates a really bad situation because after the withdrawals from multiple treatment plans, combined with the uncertainty of insurance, I’m scared shitless to go back on the drugs. I can hardly follow directions on the pills, off the pills it’s the same. I was diagnosed with bi polar disorder, however there seems to be no effort to repair my learning disability, and the underlaying causes of my physical, sexual and verbal abuse.
I have to face the possibility of a retail job for the rest of my life, and while that’s Ok for some people, I feel I can do better and it’s frustrating. If it’s the only way to avoid another withdrawal, then that’s what I might have to do.
The professional business of x-ray technology and patient care I’m in doesn’t agree with meds side effects and ingesting into mouth anything that would prevent singing or natural speaking voice.Also trusting in a man or woman with unproven.Chemical imbalance and genes choice .
EDEMA CAUSED BY PAXIL TITRATION? Are there any reports of someone titrating down dosage of Paxil slowly, and developing edema of the extremities (right calfs/ankles)? 60 year old male, generally healthy, eats well, no cardiovascular disease, exercising, eating healthy. No edema prior to tapering down. I can’t find any valid posts/info on this. THANK you. Dosage of Paixil: 10 mg per day, over a few years. Titrating down 2.5 mg from 10 mg to 7.5 mg with no edema first 30 days, went to 5 mg and edema started. Wondering if there could be a connection?
In July, 2015, the psychiatrist who was treating me left the clinic where he practiced. The clinic did not replace him. I live in a rural area. There were only five or six doctors or clinics within reasonable driving distance. None of them were taking new patients when I called to find a new doctor. I got a last prescription from the last clinic, so I had four to five months worth of Zoloft, lithium, and Zyprexa.
To buy some time, I started missing doses every third day. After a few weeks, I noticed I was a bit less groggy, so I started taking the Zyprexa less often, every other day. (I haven’t mentioned yet, but at that point I’d been on these meds for nineteen years.) I guess I’d forgotten what it was like to not be sedated because I loved the new clarity, and I decided to try to come off the meds. I went very slowly. I stopped taking Zyprexa after four months. I continued taking the Zoloft and lithium for a couple more months.
It’s been a year now since I stopped the meds. I’ve had a few times when I’ve felt depression coming on, but I learned how better to cope with negativity via talk therapy. It hasn’t been idyllic. In fact, a recent rough patch was pretty rough, but I don’t want to be on meds because the side effects are too insidious. I plan to stay off them unless my depression becomes as severe as it became way back when.
As I came off the meds, two issues became clear:
1) Medical psychiatry is mostly guess work.
2) Because of #1, psychiatrists are haunted by fear of lawsuits.
If I ever meet any of the three doctors who treated me over those nineteen years, the question I would ask each is this: Why did you never encourage me to try less meds? My last doctor, when I first started seeing him in 2009, increased my daily lithium dose from four a day to six a day. I’d always taken four. My lithium blood levels were always at .4, but neither of the first two doctors felt the need to increase the dose because I was stable taking four a day. The third doctor told me he wanted my blood level to be at least .5 so that if I went off my nut or tried to kill myself, he wanted to be able to show the authorities that he had done the right thing. Well, after a few weeks on six lithium caps a day, I started getting lithium poisoning. I wanted to go back to four, but the doctor prescribed five. I ended up taking four, taking five a day during the two weeks before I had my blood drawn. My readings were .5.
My experience has left me jaded about psychiatry, about medical science in general, wary about pharmaceutical meds, and disdainful towards lawyers or others whose first reaction to misdiagnosis or to a med not working is to sue. I know, we need to have legal recourse of some kind, but thee seem to be too many factors to allow one party to be blamed for someone getting hurt in the course of treatment. Suffering patients desire miracle cures, researchers provide and doctors prescribe medications which may help the problem, but which create new problems in side effects. We participate it this travesty even though we know of the pitfalls. It seems to be a system designed to maintain suffering rather than decrease it. Are we really better off in this age of science and the humanities? Are there any medieval barbers out there?
I don’t recall any real mention of antipsychotic withdrawals, but that has been a issue for me this past 12 months with Geodon (I have bipolar disorder). I had been on 160 mg for eight years and then developed a nasty case of akathisia. My psychiatrist started transitioning me to Seroquel XR. It has been almost 1 year trying to get off Geodon because of the withdrawals, vacations, and mood episodes. I’m finally almost to 0 mg. This process required significant increases in the Seroquel XR.
Soon I will need to gradually get off Ativan, a benzo we used for the akathisia (all other akathisia treatments didn’t work or had bad side effects). I’m not looking forward to that. At least my Ativan dose isn’t too high.
These drugs are useless and harmful. Unless you are hurting others why take them in the first place? I know they ruined my life. The stigma, it follows me everywhere, even to the Dentist chair!
I even got kicked out of a social work program because of stigma for depression and having to take all this crap for nothing. Twenty years later, I am still unhappy and miserable due to my abuse. Drugs aren’t the best thing for workplace abuse and long-lasting effects.
It’s time to get rid of these drugs and psychiatrists. They should only be used for mental health hospital patients. People need to change their attitudes and behaviours and start treating others with respect, and then there would be no need for all these drugs. Workplaces need to be held accountable for bullying workers. The bullys should be given the drugs, they are the ones doing the harm to others.