Antidepressant dependency

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T_Manchester
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Joined: Mon Oct 22, 2012 12:02 am
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by T_Manchester on Mon Oct 22, 2012 12:20 am

Antidepressant dependency

Hi

I have been on antidepressants (a range of SSRIs and currently an SNRI) for approximately 10 years. I was originally prescribed them for social anxiety. I wish I had never taken them and I feel they have , to some extent, dominated and diminished my life ever since. I did not visit a GP once in 20 years before taking them - ever since I have been a frequent visitor, seeking help which often only materialises in the form of medication changes, dose titrations and a few CBT sessions. I am currently on Cymbalta and experience rapid cycling in my moods - I am highly functional at work, outperforming expectations and achieving promotions. However, I feel wired, bordering on euphoric and, especially out of work and on weekends, unable to relax, with a sense that cognitively I am unstable - my mind cycles repeatedly through a series of thoughts - the repetitive nature of them distresses me. This then prompts me to plunge into depressive episodes and suicidal ideation. I have read the opinions of Peter Breggin MD among others and I am very scared that I have damaged my brain through the chronic intake of these drugs. When I try to wean off them I plunge into a state of hell, so I return to them and feel medicated. The theory is that they may permanently down-regulate serotonin receptors, rendering the brain dependent on them and in a state of chemical imbalance. I have also read of testimonies by people still experiencing withdrawals months, even years after discontinuing, contrary to what the pharma companies claim.

Realistically do I have any hope of getting off them and leading a normal life? I see other people living normally and I feel so envious. I feel mired in something which I don't know if I could tolerate for many more years.

I would be very grateful for any advise.

Yours.
T

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Dr Trevor Friedman
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Joined: Fri Oct 12, 2012 10:21 am
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by Dr Trevor Friedman on Mon Oct 22, 2012 9:04 am

Re: Antidepressant dependency

Hi. This is a complex issue and your account is also complicated so it is difficult to answer all of it in detail. As a psychiatrist who has prescribed antidepressants to many people over many years my personal experinence is that problems with dependency and withdrawal are a very rare problem. There are small proportion of people who do need to remain on antidepressants to prevent relapse but obviously it is good to know if thaey are really needed. I think that generally they are very safe. It seems that you are having a range of difficulties. It does not sound like you have had a course of properly skilled CBT. I would think it reasonable to ask your GP for a review by a local consultant psychiatrist - preferably somebody with an interest in psychopharamcology. There are many people who remain on medication longer than is necessary and they should be regularly reviewed.
Dr Trevor Friedman
Consultant Liaison Psychiatrist
BSc MB BS FRCPsych

http://www.talkhealthpartnership.com/on ... iedman.php

T_Manchester
Posts: 2
Joined: Mon Oct 22, 2012 12:02 am
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by T_Manchester on Mon Oct 22, 2012 4:22 pm

Re: Antidepressant dependency

Dear Dr Friedman

Thank you for your reply - it is greatly appreciated.

I will redouble my efforts to speak with a consultant with this specialism - it is exactly what I am seeking. Thank you for the advice. I also appreciate that there are complexities to my case. I am encouraged that withdrawal is very rare in your experience. It is interesting that the psychiatry profession seems divided on this issue with notable high profile critics of SSRIs such as Dr David Healy, Peter Breggin and Giovanni Fava. The latter has come up with an interesting (but also unsettling) concept of tardive dysphoria that really tallies with my experience - whereby long term use of SSRI can actually worsen the course of depression as the brain sets up compensatory mechanisms to counteract the flood of serotonin. There also thousands of people posting on the internet every year who are evidently finding withdrawal distressing. I doubt websites such as PaxilProgress would exist otherwise.

Best regards

T

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