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Dr. Bob is Robert Hsiung, MD,
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Posted by Cseagraves on January 28, 2009, at 12:59:03
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
Dear New Question,
OMG - I can't believe I found this post. I just posted a new thread below under "Marplan users update" I stated below that I was beginning to wonder about the same thing you posted.
I have GAD, agoraphobia and panic. The difference is that I have only been this way for a couple of years. (I'm 41) This just started a couple of years ago, but was still able to function outside of the house (grocery shopping, traveling, etc.) up until a year ago, then things got worse. Started on Zoloft about 9 years ago, took it for a couple of years, but then pooped out at 50mgs. When pdoc tried to raise the dose to 100mgs, anxieties got worse.
When I came off of it, things got better, so I didn't take anything for a while. Anxieties came back a couple of years ago so I started going through the other ssri's, but had awful side effects on each one and am worn out going on and off each one.
My last ssri was lexapro (have been off it now for over a month. Tried trazodone and remeron for sleep and had bad effects from both of those also. So I haven't taken anything since Jan. 12th. Pdoc is thinking about starting me on Marplan on Feb. 5th as he thinks I have become sensitive to ssri's.
Had all of the physical effects that you described with your meds and am still having numbness of arms and legs, but is getting better. Also having what feels like electric shocks going down my arms to my hands.
I mentioned in my post that I was thinking that instead of starting on the Marplan just yet, maybe giving my body and brain a break and see what happens. I still have my zanax as back-up.
I already have a good diet, start back exercising regularly and just try to cleanse myself of all this awful stuff to see what happens. Had all blood work done recently and everything came back fine.
Along with my aminos, I am taking extra doses of Gaba, L-theanine, L-taurine, Choline and Phosphatidyl Serine.
Although I haven't been off of meds long, I can tell physically I am not as sore and my arms and legs aren't going numb as much. I can also tell that my memory is getting better.
Have been reading up on some studies now that ssri's have been out for a while and they are saying the same things about there effectiveness and long-term side effects.
Interesting that others are starting to feel the same way. Please note that i am not encouraging anyone else to come off their meds, but for me I might try and see what happens if I take a break and see if my brain can heal itself.
Want to see if I can do this myself. If it doesn't work then I guess I will try the Marplan.
Thank you for your post and know that I think that what you are feeling and thinking might be true.
Please keep us informed on what you plan to do and how you are feeling.
Courtney
Posted by Connor on January 28, 2009, at 13:04:22
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by MChain on January 28, 2009, at 3:07:10
Also m.chain I noticed you posted on that one board for pssd. Funny because I did the exact same thing asking about the exact same problems. This was before I had any sexual problems. The sexual problems suddenly occured when I stopped the medication.
Posted by MChain on January 28, 2009, at 22:47:40
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Connor on January 28, 2009, at 10:13:10
Wow, so you're saying its been 3.5-4 years since you've touched a psychotropic and you still feel this way? That is discouraging, and makes me lean even more toward trying that Wellbutrin tomorrow if things just remain the same.
I know exactly what you mean about the constant boredom, inability to get excited etc., I can't even manage to get myself excited about the superbowl this week and I used to be the hugest of football fans. And basically that indifference extends to all areas of my life. I went through that period of hyper-emotionality too around 6 months after my last dose, but things just kind of stabilized although I think im doing better than while on the medication (except for terrible anxiety). Sometimes it seems like i feel sadness the way I did before I ever started the medications but never the same unbridled joy and enthusiasm for things.
Since its not one of your major complaints I assume that the cognitive problems cleared up for you a bit? That's reassuring because for me at the moment every time I say or write something I question whether it makes sense and often forget common words. When did that stuff go away?
Also, what are the supplements that allow you to function (leave the house i think you said)? The only thing i take is fish oil and I really don't notice a difference whether I take it or not, although I tried several things like ginkgo a few months ago but couldn't really gage if they were having an effect. And bottom line we shouldnt have to depend on supplements to function. I'm trying to find something that assists with brain repair like nootropics, I don't know if you have any experience with those or not.
haha yeah, except the people in the ssrisex group are so absorbed seemingly by their sexual problems that they don't even notice these other symptoms or don't think much of them. I feel like my post was more or less ignored.
Posted by Connor on January 28, 2009, at 23:10:40
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by MChain on January 28, 2009, at 22:47:40
> Wow, so you're saying its been 3.5-4 years since you've touched a psychotropic and you still feel this way? That is discouraging, and makes me lean even more toward trying that Wellbutrin tomorrow if things just remain the same.
>
> I know exactly what you mean about the constant boredom, inability to get excited etc., I can't even manage to get myself excited about the superbowl this week and I used to be the hugest of football fans. And basically that indifference extends to all areas of my life. I went through that period of hyper-emotionality too around 6 months after my last dose, but things just kind of stabilized although I think im doing better than while on the medication (except for terrible anxiety). Sometimes it seems like i feel sadness the way I did before I ever started the medications but never the same unbridled joy and enthusiasm for things.
>
> Since its not one of your major complaints I assume that the cognitive problems cleared up for you a bit? That's reassuring because for me at the moment every time I say or write something I question whether it makes sense and often forget common words. When did that stuff go away?
>
> Also, what are the supplements that allow you to function (leave the house i think you said)? The only thing i take is fish oil and I really don't notice a difference whether I take it or not, although I tried several things like ginkgo a few months ago but couldn't really gage if they were having an effect. And bottom line we shouldnt have to depend on supplements to function. I'm trying to find something that assists with brain repair like nootropics, I don't know if you have any experience with those or not.
>
> haha yeah, except the people in the ssrisex group are so absorbed seemingly by their sexual problems that they don't even notice these other symptoms or don't think much of them. I feel like my post was more or less ignored.1. Yes it's been that long and I can't say I've really improved. Even whilst going on exercise sprees, the only benefits I get are short lived.
2. About getting excited, ya I don't get excited about anything anymore really, I use to get super hyped for a lot of things and that just doesn't happen anymore.
3. My cognitive problems have cleared up with the aid of nootropics. Without them they would still be present I believe. They are honestly the only reason I am able to tolerate life. I take them anytime I want to feel somewhat normal, mostly in social situations. The most effective supplement I have tried is Piracetam. It helps bring back my personality, it seems to make me smarter, helps with the flowing of my ideas, makes me wittier, etc, etc. Others that have helped include gingko, ginseng, 5-htp and taking multi-vitamins. While these supplements help my cognitively, emotionally I still feel pretty dull, so I'm looking for something to correct that. I've been abusing certain drugs to help compensate for my emotional emptiness.
4. Ya I know what you mean. The thing is if you search that group there are several posts about what you posted about, but honestly I think it's sad to say that that group, while it has many members it seems to only have a handful of active users.
Posted by MChain on January 28, 2009, at 23:44:39
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Connor on January 28, 2009, at 23:10:40
Yeah after that long it just seems like things aren't going to improve on their own after what drugs have done to you and I, so maybe this whole "natural approach" thing isn't going to cut it.
The only other way I look at it without feeling extremely hopeless is that perhaps instead of some kind of damage our brains have just shut off the regions responsible for feeling pleasure and it won't be turned on without the aid of a different type of drug. I've been trying to avoid this kind of thinking but I really can't live like this and I know you can't either. I think there are people who never took SSRIs who feel like us, so it seems like our minds have been made to mimic theirs' and we need to follow a similar type of treatment etc.
I hate to be dependent on a drug and worry about poop out, long term brain damage but as I wait to get better on my own the meaningless days continue to pass by.
BTW have you trade any of the other racetams, hup-A, choline, Lecithin (sp?) or just Piracetam? Some of those supps seem promising but I'm pretty sure 5-htp is going to screw us up more though.
Posted by Connor on January 29, 2009, at 10:35:51
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by MChain on January 28, 2009, at 23:44:39
>
>BTW have you trade any of the other racetams, hup-A, choline, Lecithin (sp?) or just Piracetam? >Some of those supps seem promising but I'm pretty >sure 5-htp is going to screw us up more though.It is my opinion that 5-htp is pretty safe. It works differently then ssri's, in that it just naturally creates more serotonin, it's not intrusive like ssri's are. I don't take it too much though.
You're actually suppose to combine choline with the racetams. Choline doesen't do much anyway for me, but supposedly that's how you make the racetams effective. I have tried Piracetam for a while, but I am about to try Pramiracetam which I suppose to be a super charged verson of Piracetam. And I hear it's the most effective.
Posted by Deputy Dinah on January 29, 2009, at 22:15:09
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Garnet71 on January 17, 2009, at 21:19:12
My sincere apologies on interrupting.
Dr. Bob has a policy requesting that posters not post more than three posts in a row without interruptions, except for a few specific exceptions included in the FAQ.
http://www.dr-bob.org/babble/faq.html#civil
I'm afraid that as his deputy, I'm going to have to ask you to please follow his guidelines. If you wait until someone replies, or fit your posts into one of the exceptions in the rules, or perhaps combine a few studies into one post?
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Dr. Bob is always free to override deputy decisions. His email is on the bottom of each page. Please feel free to email him if you believe this decision was made in error.
Dinah, acting as deputy to Dr. Bob
Posted by MChain on January 30, 2009, at 3:44:14
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Connor on January 29, 2009, at 10:35:51
I just read somewhere that Dopamine system recovery can take about 4 years to fully occur...so maybe you're right around the corner from getting better.
Also, do you ever wonder if after a prolonged period of time in this state you've healed but are so discouraged that you develop a depression similar to the original symptoms? By no means does this mean go back to pharmacology, but have you tried other counter-depression measures besides the supplements? I'm sure you have, but in the off chance you've given up hope in traditional methods for combating stress/anxiety like CBT.
I don't doubt that our nervous systems/brains have been compromised, and someone gave me a recommendation for a neuropsych that acknowledges drug induced neurological problems so I may give him a try though it'll be expensive.
Anyway, keep me posted on your developments, feel free to e-mail ([email protected]) so we don't have to go through this message board for a more or less two way correspondence.
Posted by TimeLord on January 31, 2009, at 13:31:57
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by MChain on January 30, 2009, at 3:44:14
The mind/CNS is resilient and has fantastic regenerative properties, but it's slower than a snail at the DMV.
I've been off my meds for eight months now. Eight. I feel somewhat better and can tell I am healing, but it's an uphill battle. I eat well, I exercise (for a living (I'm a martial artist/instructor)), so I am sure that lifestyle plays a part in how we heal, but rest assured that we do eventually heal.
SSRI use sucks, but your CNS is raw and compromised. Give it a chance to catch up! :)
Posted by NewQuestions on February 2, 2009, at 9:08:27
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by TimeLord on January 31, 2009, at 13:31:57
Clearly, the long term use of SSRI's have change my system. Is there any reason to thing ECT will "reset" my system? Or does ECT only work for a specific sub-set of people, perhaps people that never found any relief from drugs?
Posted by MChain on February 3, 2009, at 8:27:11
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 2, 2009, at 9:08:27
Yeah a miracle could happen but you also run the risk that it makes you irreparably worse.
Posted by SLS on February 3, 2009, at 17:40:42
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 2, 2009, at 9:08:27
> Clearly, the long term use of SSRI's have change my system. Is there any reason to thing ECT will "reset" my system? Or does ECT only work for a specific sub-set of people, perhaps people that never found any relief from drugs?
The irony is that people who don't respond to a bunch of different drugs don't usually respond to ECT either. Still, there are some people who report responding to drugs after ECT that had not worked for them before ECT. I would be reluctant to subscribe to the intuitive notion that ECT somehow resets a system. Often, one much go for maintenance treatments every month or so.
I am not certain how I feel about ECT. I don't think it is a black-and-white issue, as there are obvious examples of its utility. I went for 15 treatments. They didn't help. I am unclear what role ECT should have in the treatment of mental illness. I know some people who consider ECT to be a godsend. I can't imagine wanting to be responsible for taking it away from them.
- Scott
Posted by NewQuestions on February 4, 2009, at 14:25:08
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by SLS on February 3, 2009, at 17:40:42
I just read this on another site. It may explain some of the problems I am having:
In my humble opinion, discontinuation syndrome is a form of hypothalamic-pituitary-adrenal (HPA) axis dysregulation. One way to look at it is as induced hypercortisolemia or even pseudo-Cushings Syndrome. See Gillespie, et al, Hypercortisolemia and Depression, Psychosomatic Medicine 67:S26-S28 (2005), full text available at http://www.psychosomaticmedicine.org...plement_1/S26:
"...More than 40 years ago, a significant number of patients with depression were noted to exhibit both hypersecretion of cortisol (1,2) and its metabolites (3). The observation that patients with Cushings disease or syndrome often experienced severe depression and anxiety, and the increased production and secretion of glucocorticoids such as cortisol in healthy people exposed to stress, in part contributed to the modern stress-diathesis hypothesis of depression in which excess secretion of cortisol is thought to play a significant pathophysiologic role in the etiology of depression....
... Currently, several novel approaches to the treatment of depression are being evaluated based on the present understanding of HPA axis dysregulation in mood disorders. The CRF-1 receptor antagonist R121919 has shown promise in the treatment of depression (43) but was subsequently withdrawn from clinical trials due to hepatotoxicity. More recently, the glucocorticoid receptor antagonist, mifepristone (RU486), has been reported to be effective in the treatment of psychotic depression (44). These compounds may be effective in treating depression through the interruption of reverberating neuroendocrine loops involving the HPA axis and several areas of the brain (prefrontal cortex, amygdala, hippocampus, and hypothalamus) that become excessively activated in response to stress driven perhaps by hypersecretion of CRF. Such interruption of a positive feedback loop may allow the system to return to a more adaptive set point associated with remission of depression (45)...."
One of the researchers looking at glucocorticoid receptor antagonists as described above is Dr. Owen Wolkowitz at the University of California San Francisco (See Wolkowitz and Reus, Treatment of Depression With Antiglucocorticoid Drugs, Psychosomatic Medicine 61:698-711 (1999), see full text at http://www.psychosomaticmedicine.org...full/61/5/698).
Aside from antiglucorticoids, including RU486 aka the abortion pill, Drs. W. and Reus discussed high doses of the glucocorticoid dexamethasone:
"...If short-term, high-dose dexamethasone treatment proves to have antidepressant effects, how might this be reconciled with antiglucocorticoids having similar effects? Antiglucocorticoids and dexamethasone administration could both have antidepressant effects via 1) their common effect of lowering cortisol levels (with resultant upregulation of brain corticosteroid receptors); 2) altering levels of other adrenal steroid hormones; or 3) increasing ACTH levels (with short-term, high-dose dexamethasone treatment, this might occur after dexamethasones acute inhibitory effects are terminated and the suppressed adrenal axis signals increased ACTH output). Additionally, recent evidence suggests that dexamethasone is actively excluded from brain and does not replace endogenous corticosteroids at hippocampal mineralocorticoid and glucocorticoid receptor sites (144). Its behavioral effects, therefore, may result from indirect effects of dexamethasone-induced ACTH suppression on the balance between the two corticosteroid receptor types in the hippocampus (144). Long-term dexamethasone treatment has also been shown to result in an increase in glucocorticoid receptor mRNA levels in hippocampus, an effect that parallels changes observed over the course of antidepressant treatment (33, 145)...."
Steroids are used to treat many illnesses, including autoimmune diseases, and people do take them for quite a while. Doctors do know how to use them, but they usually prescribe them in very high doses that have serious side effects. Note that I have been emphasizing a LOW DOSE approach.
I believe the HPA axis dysregulation resulting from discontinuation syndrome makes us hypersensitive -- we don't need much of anything to tip into HPA overdrive. A physiological dose rather than a therapeutic dose of anything can go a long way with us. The large doses of steroids that doctors usually prescribe are way, way too strong. Taking the hyperreactivity of the HPA axis into account, a tiny bit of something could help break the cortisol feedback loop -- "the self-propagating response" -- and help the HPA axis stabilize.
Posted by Garnet71 on February 4, 2009, at 15:18:55
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 4, 2009, at 14:25:08
Hey New Questions,
I keep coming back to this thread too. I have to admit that I cannot read that whole thing right now. Do you think this is worth bringing to my endochronologist next week, or would she just roll her eyes if I presented it?
Is the pituitary gland that one at the base of your neck? I was going to start a new thread about a symptom I've had for a few months now-lots of fluid sounds and sensations coming from the back of my neck/base of my head. Or does everyone have that?
Maybe someone will come along and interpret the article you posted. I hope you are closer to finding a solution to your health issues!!
Thanks,
Garnet
Posted by SLS on February 4, 2009, at 15:55:00
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 4, 2009, at 14:25:08
> In my humble opinion, discontinuation syndrome is a form of hypothalamic-pituitary-adrenal (HPA) axis dysregulation.
Maybe we can put our humble heads together and come up with a more comprehensive theory. I feel that something must precede the HPA dysregulation. I suggest that the withdrawal syndrome is the result of neural hyperactivity in several areas of the brain, including the amygdala, the fear center of the brain, thus producing anxiety as one of the symptoms. I think it might be the kindling of glutamatergic pathways that leads to the persistence of withdrawal syndrome after discontinuation seen in some people.
It is my suggestion that it is a kindling effect that a rapid discontinuation of a SRI drug induces that makes one more sensitive to drugs subsequently.
Somewhere in here is, of course, serotonin. It is probably the loss of serotoninergic inhibition of glutamatergic pathways that allows for the withdrawal syndrome to manifest.
- Scott
Posted by NewQuestions on February 4, 2009, at 16:04:15
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by Garnet71 on February 4, 2009, at 15:18:55
Thanks Garnet. My sense is that you are not experiencing what I am experiencing. My body has adapted to the drugs, I have become hypersensitive to them, I am now off of them and my body is stressed because of the withdrawal, and the HPA axis is not in balance. My sense with you is that you are still struggling to find the right drug to begin with. Therefore, the information might not be of much value to you.
Posted by SLS on February 4, 2009, at 16:32:45
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 4, 2009, at 16:04:15
> Thanks Garnet. My sense is that you are not experiencing what I am experiencing. My body has adapted to the drugs, I have become hypersensitive to them, I am now off of them and my body is stressed because of the withdrawal, and the HPA axis is not in balance. My sense with you is that you are still struggling to find the right drug to begin with. Therefore, the information might not be of much value to you.
There is always the "spit test". It is a quick way to get a cortisol level. In depression, cortisol is often elevated. This test used to be used routinely in the 1980s in some clinics.
There is also the dexamethasone-suppression test (DST) to evaluate the state of the HPA axis. The subject takes a single dose of dexamethasone, a corticosteroid. In a healthy person, this will produce a negative feedback loop that reduces (suppresses) the amount of ACTH released by the pituitary gland. This can be assayed in the blood. In many depressed people, ACTH secretion is not inhibited. So, dexamethasone non-suppression is an indication of major depressive disorder.
- Scott
Posted by SLS on February 4, 2009, at 16:36:58
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 4, 2009, at 14:25:08
Hi NQ.
I sometimes suggest that people make three lists:
1. Drugs that produced a positive response, regardless of the length of time or how robust.
2. Drugs that produced a negative response, making one's depression more severe.
3. Drugs that had no effect on depression.
What drugs have you had some sort of positive response in the past. Sometimes it is as simple as combining partially drugs to produce a full remission.
- Scott
Posted by Garnet71 on February 4, 2009, at 21:50:52
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 4, 2009, at 16:04:15
> Thanks Garnet. My sense is that you are not experiencing what I am experiencing. My body has adapted to the drugs, I have become hypersensitive to them, I am now off of them and my body is stressed because of the withdrawal, and the HPA axis is not in balance. My sense with you is that you are still struggling to find the right drug to begin with. Therefore, the information might not be of much value to you.
--------------------------
So NewQuestions, for me, I am almost convinced now (esp after hanging out here for a while!) that my problems are more endo related and a combination of long-term heavy stress, anxiety (which totally drains you physically & exhausts your system), ADD cognitive type, and just having had the PTSD/depressive episode almost a decade ago; also having the genetic disposition of these problems have all led up to my current state of well being. I also think use of anti-depressives does screw up your endo system, especially with all the other variables listed.I think back, and when the heavy depression dissipated, I was off drugs and was temporarily assigned to an extremely stressful job for one year. I won't go into too much detail..but it was a job that had a whole special shift and safety parameters due to its highly stressful nature. You could not even go to the bathroom for at least 6 hours after you started because if you missed one little detail...you could easily lose track of all the operations. Much of the time you had to make split-second decisions to decide what major issue you should make a decision on first, there was so much fired at you nonstop; it was multitasking on steriods. I kicked a$# at the job and loved it. I think I overdid it. I was medication free at the time.
Now that I look back, it was after this time I started feeling my worst and went back on ADs for severe anxiety.
So-I was thinking about if your situation relates to mine and remembered a class I once had. Economists have actually done research on your profession, and the little I saw concerned the newbies in your line of work who had to work rediculously long hours and put in like 500% for a few years until they reached a certain milestone for the firm. Of course, it's uphill from there. I forgot to ask you about that last time we spoke.
Have you been under a lot of chronic stress--long-term? I could be totally wrong, but I think your symptoms are more similar than when we discussed them last time.
I'm going to an endochronologist next week, and last we talked--you were thinking about doing the same. I've been medication-free for a couple of weeks now; don't want to skew any test results. It may (or may not) be a matter of getting treatment for multiple issues rather than letting a psychiatrist alone determine my destiny.
I'll check back on this thread and let you know how it goes! Until then, hang in there!
Posted by Garnet71 on February 4, 2009, at 21:55:11
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by Garnet71 on February 4, 2009, at 21:50:52
New Questions - forgot to say, if you want, I can email the professor who published that research and get a copy for you. It's very interesting :)
Posted by SLS on February 5, 2009, at 1:52:52
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by SLS on February 4, 2009, at 16:36:58
Forgot the word "effective".
"What drugs have you had some sort of positive response to in the past? Sometimes it is as simple as combining partially effective drugs to produce a full remission."
A good friend of mine was smart enough to do this. She had partial responses to Effexor and Wellbutrin given as monotherapy. She described Wellbutrin as giving her more energy, and Effexor as giving her the "wanna do's". In her mind, she superimposed the feelings that the two drugs produced separately and asked the doctor to be placed on both in combination. Bingo.She has since tweaked her regime by swapping Effexor for Lexapro and adding Geodon. Geodon can be energizing.
- Scott
Posted by SLS on February 5, 2009, at 1:54:57
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by Garnet71 on February 4, 2009, at 21:50:52
Posted by NewQuestions on February 5, 2009, at 9:35:50
In reply to Re: Long Term SSRI Use Has Destabilzed Me » SLS, posted by SLS on February 5, 2009, at 1:52:52
Assuming it is the glutamatergic pathways, how do I fix it? My most distressing symptons are cognitive decline (memory, abstract reasoning, learning) and lack of energy.
Posted by SLS on February 5, 2009, at 13:52:29
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on February 5, 2009, at 9:35:50
> Assuming it is the glutamatergic pathways, how do I fix it? My most distressing symptons are cognitive decline (memory, abstract reasoning, learning) and lack of energy.
That sounds like depression to me, my friend. Often, we confuse withdrawal for relapse. Is there anything that leads you to believe that you are not experiencing a relapse?
I think using anticonvulsants or benzodiazepines might help mitigate an ongoing withdrawal syndrome if kindling is to be avoided. Actually, a more rational approach is not to let the withdrawal syndrome develop in the first place. I believe this can be done with a flexible-dosing strategy. Please see: http://www.dr-bob.org/babble/wdrawl/20081229/msgs/877349.html
Please write back. I'd like to get to the bottom of this.
- Scott
Posted by NewQuestions on February 5, 2009, at 17:08:08
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by SLS on February 5, 2009, at 13:52:29
Winter 1994: start Zoloft, work up to 200mg, no atypical side effects
August 2002: Zoloft side effects change dramatically--more lethargic, less muscle energy, brain fog, confusion, heaviness, mentally lazy, nonrestful sleep, more withdrawn, physically grooming worsens. It was still "working" on my depression but the side effects were overwhelming. What was the cause? Is this poop out or something else?
Winter 2003: wean off zoloft and onto Lexapro--very difficult--seem to experience withdrawal effects from zoloft and SSRI side effects from Lexapro at same time--confusion, muscle energy, fogginess
Winter 2004: I finally got off zoloft, and some of the heaviness and confusion was gone. However, still experiencing similar side effects on Lexapro. Tapered from 20 mg to 10 mg of Lexapro and experience new clarity and energy. However, experienced withdrawal--nausea, lack of energy and anxieties come back. So I stayed on 10 mg of Lexapro and tried Cymbalta. Very energizing but caused anxiety. Wellibutrin and TCA's caused hypomania.
Next, tried Remeron which made me feel better, smarter, more cognitive energy, relieved the inner-tension but it made me incrediably tired during the day. I tried prozac (small dose) and for the first 4 weeks, it was great. It stimulated me and gave me cognitive energy. However, it suddenly sent me into a suicidal depression, which didn't go away until over a month later, i.e., when the prozac with its long half life exited my body. Yes, it was the drug, it was not environmental.
In September 2006, tried remeron again and it gave me a numbing depression. (Same drug different effect--did the prozac adverse reaction change me?) All of the benzos gave me a similar numbing depression (except Ativan). Then I tried effexor. Effective against depression but was hypersentitive to it. It caused jitterines, lack of inner well-being, some cognitive impairment. Worsened anxiety. Started to take Ativan regular to conteract jitteriness.
In November 2007, I stopped effexor. This was the first time I was off a sertonin boosting drug in 12 years. After a couple of months, I got depressed with feelings of hopelessness. I was also more obsessive, including sexually and extremely nervous. Tried a small dose of Lamictal and it seemed to help a little.
In April 2008, I tried stablon. It did not work and may make me worse.
In June 2008, I increased lamictal but it caused major cognitive impairment. Not only could I not finish sentences, but I couldn't even think. People thought I had ADD. In retrospect, the cognitive impairment maybe a delayed withdrawal symptom, due to lack of a sertonin drug (last dose in November of 2007) and not from the lamictal.
In July 2008, weaned off lamictal and start taking MAOI Parnate. Parnate helped with the depression, but the side effects were overwhelming including blurry vision, weakness, dry mouth, spiders crawling on skin, swollen ankles, insomnia, day time sleepiness, drugged feeling, apathetic, confusion, memory and learning impairment and extreme irritability. My guess at the time was the confusion was caused by the norepinhperine.
I went down to 1 pill (10 mg?) around the middle of November and immediately felt better. Then I tried a small dose of Adderall. I felt an adrenaline boost and I had more energy including cognitive energy. However, the adrenaline boost wore off and I felt the same confusion I felt on a higher dose Parnate.
Since reducing Parnate, noticed sexual obssession. Read online that some people who take Parnate experience sexual obsessions.
Last dose of Parnate was on December 18, 2008.
In January, 2009, I tried small dose of Inostiol--helped with obsessiveness but made me more depressed, especially in morning; tried small dose of 5-HTP--saw immediate improvement in skin and hair (retained oils), and helped with obsessiveness and anxiety, but made me depressed. Bad reactions to small doses of magnesium and choline too.
I am now off of everything except 1 mg Ativan.
Current symptoms:
Derealisation and depersonalisation (for 2 or 3 years)
irritability (last couple of years)
Vision problems, foggy vision, focus problems (more recent)
Cognitive problems, foggy brain, memory and concentration problems, inability to learn or think abstractly (memory, inability to learn and abstract reasoning within last year)
sexual obsessions (recent)
Muscle weakness, fatigue, low stamina (had this since Zoloft pooped out)
Apathy, lack of emotions (had this since Zoloft pooped out)
Sticky skin, waxy hair, skin rashes (had this since Zoloft pooped out)
Horrible sensations like heavy head, head pressures (more recent)
can't handle stress, racing thoughts (2 or 3 years)
Worse anxiety and depression than pre-ADs--its a physical anxiety (last year)
Dizziness in different ways, vertical and horizontal; major internal restlessness (2 or 3 years)
Inability to enjoy everyday things, including music, movies, etc (2 or 3 years)
personality change (gradually changed)I am extremely hypersensitive to sound, drugs, amino acids and B vitamins. Arguably, the hypersenitivity started when zoloft pooped out.
The only thing I take is 1 mg Ativan. The confusion and cognitive issues could a side effect of the Ativan but they are so extreme, I think they are related to the withdrawal.
WHAT IS HAPPENING TO ME?
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Dr. Bob is Robert Hsiung, MD,
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