Are SSRI antidepressants worthless in the long term?

Great Debates
221

My only point is that even those who are helped need to go in fully informed, because they may want to stop for many, many reasons, ones that they don’t even know how to articulate when they start out. You need to get back down the mountain to have summited. Those decisions are all personal and specific to the situation. They are all hard decisions which is why I say be careful and be well informed.

I do believe they help people. But it’s hard to get off of any psychoactive med. They make your system regulate differently and you do get hit badly if you just stop. This is a clue that they are doing big things in there, and you want to be informed.

222

This is silly. I’ve been on 8-9 different SSRI and never had any problem dropping any of them. They’re known for usually being easy to discontinue compared to other types of antidepressant.

Mirtazapine is not an SSRI, it’s pretty different from SSRI.

223

How did you transition from each SSRI? Are you on them now? Have you stopped cold turkey? How long was your taper(s)?

If you have just switched them, one after the other, and haven’t discontinued taking SSRIs then you don’t know how that will feel.

This info about prozac is on google: “Stopping “ cold turkey ” is ill-advised, especially if the patient is on a high dose or has been on fluoxetine for a long period of time, as the patient will be more likely to suffer more pronounced withdrawal symptoms.”

Mirtazapine is a common antidepressant, as well as used PRN for sleep and eating disorders. I agree it’s easier to get off SSRIs but if you are polydrugged, you have a more complicated profile. Mirtazapine can get prescribed as a “solution” to many problems you may present to a Dr.

224

I stopped every SSRI cold turkey and it wasn’t a problem. Going on them was harder than getting off them. They’re no big deal.

I also don’t take them anymore because they never helped me at all. In my personal experience they’re just placebos with some convincing side effects.

225

A lot of people and Drs don’t have that experience, and wouldn’t recomend it.

226

Don’t care. My experience is that I never had problems with it.

227

I care about others besides you. I agree that if you can do it, then cut it. But there is no screening for it beforehand.

228

Then you shouldn’t give people incorrect ideas about how it takes over a year to taper from an SSRI. I don’t know where you got that idea, but it’s incorrect

229

How long were you med free between medications?

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I agree the main problems in terms of years of tapering, would come from having more than one drug to deal with than the SSRI. (Sorry, I forgot the mission of the thread.) But the argument was made that “crisis” is the reason for the drugs. HMS I: You don’t sound like you were in a crisis. So why take them? There is a mission creep with SSRIs that you could see in the tv ads. It’s a bigger decision to me than to you I guess.

231

Yes, it may be the pharmaceutical companies’ goal to get as many on their meds for a long as possible. Every doctor I know, every nurse I know, every pharmacist I know makes it their mission to counter that. None of those three make any money off of unnecessary prescriptions. Full stop.

There is a way to predict who will have a good response, no response, a lesser response or an unfavorable response to whichever particular psychoactive drug. It is a cheek swab genetic test, given most often by a psychiatrist. Sent off to a lab, results back in 7-10 days. More than a dozen genes are mapped as to potential response to any one of many classes of drugs. Then the doctor knows which drugs in what dose to offer the most potential. Which to avoid. This is a recent, within 5 years, development. It probably is best acted on by a psychiatrist as the details are very specialized, detailed, interactive and highly, highly biochemical.

Having a general physician prescribe an anti-depressant for you, adjust the dosage over a sufficient period of time (that varies), that is reasonable and if you feel it helps, great, stay on that one. If it doesn’t, perhaps try one more from a different class-if that doesn’t work, then get yourself to a psychiatrist, ask for the genetic testing, trust their expertise to follow the science. If that doesn’t work ask if you might have treatment resistant depression and ask for a referral to a psychiatrist who specializes in treatment resistant depression. They are out there. This can all be done by telemedicine if your area doesn’t have specialists or psychiatrist.

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It has been been 60+ years since psychiatrists thought that lobotomies were acceptable practice and even then it was usually family that insisted on it. Other specialities thought some now unseemly stuff that many years ago too. So it is time to stop beating that drum-the statute of limitations has run out on it. Psychiatrists are the lowest paid speciality, so that isn’t why they do it either.

Benzos are notoriously difficult meds to get off of-vastly more so than anti-depressants. Especially if taken in combination with other types of psychoactive drugs. It took me 6 months or more to get off of Xanax. Cut dose by 25% for two months, another 25% for two months, 25% for two months, then stop. It was very unpleasant but all were glad I did it. So am I.

As I said several days ago, I have taken, over 40+ years, virtually every anti-depressant in every class. Which means I have had to get off of all but one of them. Never has it taken a year, usually two weeks, a month maybe depending on the med. No extreme side effects from discontinuation. None of them single-handedly change your brain forever. Sadly, there is no guarantee that there will be one out there to change your brain for the positive.

I finally had the genetic testing-sorted all the various classes and specific drugs into yes, no, maybe and never piles. Also, it turns out I have a gene that prevents me from making a certain precursor to crucial neurotransmitters implicated in depression. I could have taken many of the meds out there until the cows came home and it not help at all. Now I take a medical food supplement that allows adequate transmitters so my anti-depressant can work if it is going to. Plus it also identified which class of drugs I should try.

Psychiatrist+genetics+biochemistry+pharmaceuticals. Yes, it is rocket science. That’s why we ask scientists to do it.

No guarantees of desired + results. I educated myself, did it and have been glad I did.

BTW, I agree with the posters who suggested CBT or DBT, especially for long term relief. Takes a time commitment and a skilled group leader (Master’s level and licensed) but there are no potential harmless side effects. Hopefully meds can give you some relief while you are doing that, which offers long term benefits. I did this too.

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I’m not inclined to let you rummage through my medical history for your own amusement. Google on SSRI tapers.

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There’s been considerable research on genetic determinants of antidepressant response, with numerous published articles and ongoing studies, despite the Evil Machinations of Pharma which only wants to addict us all for life (insert rolleyes smilie here). Example:

Withdrawal from SSRIs can be a problem and there is debate about the frequency of significant discontinuation syndrome, but the following analysis found that 60% of patients had no significant signs/symptoms on discontinuation. They recommend a tapering period of 2-6 months which in their opinion makes serious problems highly unlikely.

236

Why you tried 10 of these, stoppiing after each one and deciding none were for you would be part of the story having to do with the efficacy and use of SSRIs.

You have an odd experience profile. You were lucky that you weren’t in crisis, then offered another med because it can start a cycle that Drs do not have control over. Those are the folks I am addressing. It can’t happen to you, I know. It’s others.

I don’t think it’s good to try meds on the chance that they make your life better, which sounds like what you were doing. I feel it’s dangerous.

237

What medical school did you go to again?

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I don’t agree that a practice that still has living victims should be considered from so long ago that it is irrelevant today. The fact that something so absurdly destructive was considered a popular and fun cure and even won a nobel prize (!) should continue to serve as a warning against trusting the field too much, especially when it starts talking about miracle cures.

The extreme hype about SSRIs (which has subsided quite a lot today) follows the same pattern, and being skeptical of claims that psychiatrists were making in the 1990s proved to be correct as they’re making much more modest and narrow claims today, 30 years later.

239

I have no idea what this means. They have no motive to need money?

I’m glad you did it too. You were very lucky. Some take years and some don’t get off. Some started late in life and can’t look forward as positively as you. (It can also be exacerbated by multiple attempts to stop: Kindling)

You are taking a risk to change your brain. And it is unknown as to exactly how and what changes are made. Doing it time after time sounds very confusing toi the brain IMO.

No, it is not a science. That is why it’s never called that by the people who do it. That’s why Dr appts and prescriptions in this matter do not have fixed or scientific protocols. It’s trial and error with humans.

240

So you observe the medical profession as holding the line against the Pharma companies heroically? Every last one that you know? Not one of them makes any money off Pharma? “Full stop” is supposed to stifle the laughter? It doesn’t.

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Drad_dog, what is your real motivation with this thread? There has got to be some sort of monetary compensation on your part to be so vocal for so many years. And I don’t buy that it’s to actually help anyone. You got a book or website ur hawking? Hell I usually get bored with a topic after a couple weeks, but multiple years? Only if I could make money.