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Re: Time to get off meds?

Posted by Racer on September 8, 2008, at 17:05:37

In reply to Time to get off meds?, posted by mattye on September 8, 2008, at 14:46:10

You'll hear a lot of differing opinions on this, so be prepared to weigh a number of very diverse views in making this decision.

Here's my answer, worth only as much consideration as you choose to give it:

Yes, the flat feeling is reported not infrequently with SSRIs like Lexapro. That probably is part of the problem. If you do discontinue the medications, you may experience some rebound depression/anxiety/insomnia. Knowing in advance that this is a possibility may make it easier for you to tolerate discontinuation.

That said, there's also the question about whether you should discontinue them at all. Over the 20+ years I've taken antidepressants, the view on that has changed. The first time I took meds, back in the '80s, the recommendation was to stay on meds for about six months post remission. Then, by the time I was on meds in the early '90s, that had changed to remaining on meds for at least six months post remission -- unless you had a history of recurrent episodes of depression, in which case a minimum of two years post remission was strongly recommended.

These days, some people are told flat out that if they ever go off meds, they're virtually certain to experience a recurrence of depression, and the recommendation is to stay on meds indefinitely as prophylaxis. Whether or not we act according that advice is our choice, of course, and I've chosen at times to discontinue meds because the adverse effects outweighed the benefits, knowing that eventually I'd experience another depression, and expecting to go back on meds at that time. I just crossed my fingers and hoped it was a good long time before that happened. (It wasn't.)

Even if I were tempted to go off meds right now -- if I had achieved that theoretical state called "euthymia" -- I know that the circumstances of my life are too stressful for that to be a good idea. In fact, at this point my life circumstances are so stressful that even on meds I'm nowhere near remission. My doctor describes it as being beaten up by life, and says that there really aren't any meds likely to stand up to that. So, life circumstances are also an issue to consider.

Bottom line:

If this is your first episode of depression, if the medications you've taken have brought you to remission, if your life circumstances are manageable for you, then I'd say it's worth a try. I don't know if the two year rule really makes that much difference, but if your depression was extended before going on meds, then I'd say stick it out the full two years.

And, if you have a history of chronic, recurrent, and/or treatment resistant depression, talk to your doctor and be guided by his advice.

Good luck.


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poster:Racer thread:851028
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