Treatment Online

Many Suffer From Antidepressant Withdrawal
> 10/25/2006 10:19:36 AM

An article in the current issue of Primary Psychiatry magazine tackles a problem that faces a distressing number of medicated patients: antidepressant discontinuation syndrome. Though these medications are not addictive in the traditional sense, doctors now recognize that patients who take SSRI's (selective serotonin reuptake inhibitors, the most commonly prescribed form of antidepressant) can suffer from withdrawal-like symptoms after discontinuing or significantly decreasing their dosage. Patients do not experience a noticable craving for the drugs in question, but in other ways this form of withdrawal closely resembles that experienced by alcoholics and opiate addicts, where those affected suffer from potentially debilitating physical and psychological symptoms such as nausea, dizziness, dramatic mood swings and panic attacks.

Because these drugs boost the presence of the regulatory hormone serotonin, abruptly abandoning or even gradually tapering medication will ultimately result in lower levels of serotonin as the body moves to restore normal brain functions. Serotonin greatly affects mood, appetite and sleep patterns, and decreasing levels can disrupt the brain's delicate chemical balance and lead to unpredictable changes in state of mind. Not all patients experience these extreme symptoms. Those who've taken the drugs for longer periods of time or in larger doses are usually more susceptible as their bodies build up a chemical dependence. Long-term treatment with SSRI's has also been shown to decrease the presence of the neurotransmitter norepinephrine, which helps to regulate anxiety and impulsivity.

Around ten percent of Americans have taken SSRI's at some point, and most can gradually discontinue their prescriptions awith little or no side effects. But those who respond negatively to the change can experience symptoms that may be even worse than those for which they were initially medicated. Some then mistakenly believe that the solution to this problem is resuming the medication, which can then restart the cycle. Drug manufacturers insist that discontinuation syndrome is minor and only affects one or two patients for every thousand who go through the cessation process in an "appropriate" way. But serious study on this problem is almost nonexistant, and an increasing number of reported cases indicate tht it is very real and difficult to ignore.

Comments
Anyone who is not aware of the consequences of stopping antidepressants is probably ignoring their patients! My personal experience, with SSRIs and Effexor, is that many of the basic side-effects seem linked to changes in blood level. That is, they are dramatically worse when starting or increasing dosage, but also when reducing or discontinuing the dose. Moreover, they spike if I'm uneven about timing of my dose (much less miss a dose).This was generally matched by the anecdotes I heard, way back when I ran a depression-support list.

Posted by: David Harmon 11/4/2006 4:44:09 AM
I began taking Zoloft (50 mg) over eight months ago for "mild" depression. I took it for nine weeks and then tapered off per doctor's instructions for one week. About two weeks after starting the Zoloft, I began having sleep problems and discomfot in my head and have been taking AmbienCR since that time. In December I was referred to a Neurologist. Both my doctor and the Neurologist discount any possibility of a SSRI withdrawal syndrome and on the my third vist to the Neurologist I was "dismissed" as being "psychosomatic". The feeling seem to be waning but I still have it and I still cannot sleep without a pill. Is this a withdrawal problem or is it "just in my head"?

Posted by: robert o'neal 4/13/2007 9:06:02 AM
Dear Robert,To answer your question, Is this a withdrawal problem or is it "just in my head"?, literally it is a withdrawal problem centered in your head/brain.I have probably taken every SSRI or SNRI on the market and have done so as a "lifestyle" drug for more than ten years. I went from anxious and depressed to calm, confident, and happy! I figured I had a clinical problem with neurotransmission and would need the drugs for the rest of my life. Unfortunately, each drug would slowly lose efficacy. How did I know that? Because at each dosage, without changing anything, I would slowly begin to have the classic antidepressant withdrawal syndrome as you are experiencing. The physicians answer was, of course, to increase the dosage. At the point where I was taking the maximum dosage of a particular antidepressant, my physician would, of course, switch to another one with purportedly fewer side effects. I have finally realized that I cannot take these drugs for my entire lifetime and have decided to completely stop. Under a physicians supervision I tapered off the last drug Cymbalta. It has been two weeks since my last dosing and frankly I feel so bad that I wish I would just die mind you I am not suicidal! These past two weeks I have been desperately searching for information on how long this will last for people taking antidepressants for at least one year. I have one more week to go before I go back and complain to my doctor but sometimes I wonder if I will make it that long. If anyone has experience with this please please lets here it!

Posted by: Brian A 5/12/2007 10:23:09 AM
You can go to PaxilProgress.org to find tons of information on antidepressant withdrawal syndrome. It is a very real problem, and it is what you are suffering from.I was put on Zoloft on 1997 for situational panic attacks. After about a year on the drug, I found I could not get off without debilitating brain zaps and dizziness. So I stayed on it. In 2005, I was told by a doctor that I could just stop the drug over a week tapering period. I had not had a panic attack in years and the "situation" I was having them in was long gone. But I have been disabled ever since. I had to quit my job and lost my income because I have been so sick. I suffer 24/7 from dizziness/vertigo, brain zaps, head pressure and pain ( I never had a headache in my life until coming off Zoloft ), joint pain, muscle pain, depression ( I was never depressed prior to, or while on the drug )severe panic attacks...way worse than what I was originally put on it for, back spasms, blurred vision, balance problems, insomnia, hormonal problems, ears constantly ringing, hair falling out, bone cracking, weakness, fatigue....all of which I never had until I came off this drug. The really bizzare thing is that after I came off the drug and went into a florid withdrawal, I became extremely sensitive to any other chemicals and medications. I can't even tolerate a vitamin. I tried reinstating the drug and then other drugs, but was unable to tolerate anything without feeling like I was being poisoned and dying. So I've been forced to ride this out on my own with no help from the medical community.I've been made to feel like it is all my own underlying issues, that I am a freak, and I am crazy for thinking the drug did this to me. Not one single doctor believes me. I am 1,000 times worse than I was before I took Zoloft. At paxil progress, there are hundreds of other people suffering terribly from coming off SSRI's...not just Paxil.

Posted by: Pam G 7/10/2007 5:46:12 AM