![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 14 to 38 of 58. Go back in thread:
Posted by Philip N. on September 29, 2006, at 21:46:21
In reply to Returning to antidepressants? Above for (nm) » Philip N., posted by SLS on September 29, 2006, at 21:34:41
It may be either that or ending up in the hospital. My doc doesn't think I can weather much more and I'm thinking she may be right. My hope then if I get some relief would be a long slow taper down the road. I saw her today and she's pretty concerned. I thought I could willpower this into reality but it may take more than that!
Posted by SLS on September 29, 2006, at 23:03:23
In reply to Re: Returning to antidepressants? Above for » SLS, posted by Philip N. on September 29, 2006, at 21:46:21
> It may be either that or ending up in the hospital. My doc doesn't think I can weather much more and I'm thinking she may be right. My hope then if I get some relief would be a long slow taper down the road. I saw her today and she's pretty concerned. I thought I could willpower this into reality but it may take more than that!
Can you willpower appendicitis?How does someone with type 1 diabetes taper off of insulin?
If you are going to try to discontinue medication again, I would recommend that you wait 12-14 months. In the meantime, perhaps you can have some psychotherapy so that when you discontinue medication, you will be less likely to relapse. If you don't know where to start, perhaps you can browse the Psychology board for some ideas as to what type of therapy would best suit your needs.
If you do relapse again within a matter of months, then you must consider the possibility that you should remain on medication indefinitely. The alternative is to be on and off medication. However, your brain might not allow you this as an alternative. Many people become resistent to treatment after multiple exposures to medication. So, coming off of medication repeatedly really is double jeapordy. You risk relapsing and seeing you and your life deteriorate, plus, you risk not responding to medication once it is restarted.
Knowing me, I think I would probably try twice to discontinue medication. Two relapses would be plenty to show me that I had a brain disorder.
- Scott
Posted by jules354 on September 29, 2006, at 23:19:36
In reply to Re: Returning to antidepressants? Above for » SLS, posted by Philip N. on September 29, 2006, at 21:46:21
Philip,
i've been off remeron for about 7 months now after taking it for about 6 or 7 years. i feel like some of my depression has come back, but i'm not sure if it's biological or not. i'm continuing to work on it with therapy and alternative medicines. i've found that it's incredibly important to have a support network and ways to take care of yourself (careful eating, exercise, rest, etc.) to ease the withdrawal and also give yourself a safety net if the depression comes back. i'm working on giving myself a deadline for if things don't get better i'll try medication again. i may just try it for a time, i may be on it indefinitely. i'd like to avoid it if i can, but i want to have a good quality of life, too.
take care,
jules
Posted by jules354 on September 29, 2006, at 23:23:36
In reply to Re: Returning to antidepressants? Above for » SLS, posted by Philip N. on September 29, 2006, at 21:46:21
p.s.: it's pretty clear to me based on everybody's experiences on this board and in conversation with other people that discontinuation syndrome can definitely last a lot longer than the doctors say it should. so i do think that could be contributing to how you're feeling (and maybe me, too). it's hard to make the call, though. i hope you feel better soon!
take care,
jules
Posted by johnnyj on September 30, 2006, at 10:09:22
In reply to Re: Withdrawal from long term antidepressants, posted by Philip N. on September 29, 2006, at 17:41:41
Hello:
I started medication in 1992 at the age of 27. I was on a benzo, lithium, and nortyptline. I had a relapse after pneumonia in 2001 and my meds didn't seem to be working. I struggled for years and then tried remeron which allowed me to sleep but brought on other problems.
My new pdoc thinks I was not treated correctly with the right meds though. I have sinced weaned off everything except lunesta for sleep which I have been on for a few months. I just stopped my last dose of lithium last week.
But, I have a new twist in my illness. After years of tension and sinus problems I have severe allergies and have been helped greatly the last few days. The tension in my head was horrible. I don't know right now where I am headed but we will see.
You have gotten great advice here an Scott is very knowledgable. I added exercise and therapy to my mix along with acupuncture too. I believe these things helps some people and then for some are just an adjunct to meds, i.e., they help feel better WITH meds.
Personally, that this is just me, I don't believe severe withdrawal last over 9 months. Of course this depends on what and how much you are taking. Yes, there might be withdrawal symptoms but to have severe ones after many many months may not be withdrawal but the original condition. This is unique to us all though. Hang in there bud.
johnnyj
Posted by SLS on September 30, 2006, at 10:27:59
In reply to Re: Returning to antidepressants? Above for » Philip N., posted by jules354 on September 29, 2006, at 23:23:36
> p.s.: it's pretty clear to me based on everybody's experiences on this board and in conversation with other people that discontinuation syndrome can definitely last a lot longer than the doctors say it should.
Yes. But for how long do you think a withdrawal rebound depression might last? And, should it get worse over the course of months instead of getting better? And should there be a latency; that is, should it appear some months after discontinuation rather than immediately? Those are the questions that are salient in this particular case. As described by Philip, I believe that the answers to these questions indicate relapse.
I am not a pill pusher. In fact, as initially described, I would have questioned Philip's initial choice to use antidepressants. However, as later described, his history of adolescent depression and alcohol use would indicate a more biological MDD diagnosis with recurrent course for which his choice was probably the right one. I can't predict the future, but I believe his experiment has already produced results that can now be interpreted. I feel giving the experiment more time will not change the results. I could be wrong, of course. Getting a second opinion at this juncture would be advisable if there is any doubt in his mind as to what to do. Delaying things at this point might lead to serious consequences. Decisions have to be made now. Get a second opinion now, try psychotherapy, try alternative biological treatments, or set a date by which you either feel better or begin drug treatment.
Thats what I think.
Sorry, Philip. I was talking about you in the third person instead of directly. If I were you, I would either go back on the drug that you were on last if you feel it worked 100%. If you don't think it worked 100%, and anxiety is a major part of your depression, I would then try either Effexor, Paxil, or Nardil. Was it Lexapro that you were on? Good drug. They are all good if they end up being a good match for your particular neurochemistry. Each is slightly different. That makes all the difference.
Good luck.
- Scott
Posted by Philip N. on September 30, 2006, at 11:20:56
In reply to Re: Returning to antidepressants? Above for, posted by SLS on September 30, 2006, at 10:27:59
Hey Scott. My last 2 years I was on Lexapro and it did seem to work throughout that time. My doctor (saw her yesterday) and I are thinking of reinstuting therapy with Prozac as I may want to try a slow taper if successful (long taper). My only rationale in that is from what I've read about Prozac withdrawal vs the other SSRIs. Even though I don't recall any severe withdrawals when I stopped back in December I really didn't know enough to be looking for them. My fear now is that if I start on something like Effexor (which my doctor would have preferred), it will add to the burden down line if I feel I am strong enough to stop again.
So much of this has been a jungle for me. Many studies claim the benefits of the medicines while the opposite warn of the dangers. I don't know what a person can do otherwise when your *ss is against the floor!
I have taken them for 9 years without much thought until this period in my life. I think the main thing for me know is to think as much of my family as I am myself. I have a checkered past all my life of stessful events and coping skills. When the ADs came along I truly felt that it was a step in the right direction. And it may be that I am having to come to grips with what is common for many others, that our Depressive natures don't fade away. I would like to think that they could but alot of the data points in the opposite. I've been giving this a good fight and it may be that after all this time I'm not programmed to deal with normalcy without the medicine.
I've also learned that my way of stopping the medicine is highly unrecommende after such long use. I don't know if a long taper would have made any difference in relation to where I'm at now or not. I'm wondering if we adapt at all by going to an absolute minimum dose and staying there for some time? Or it could be that any amount of an SSRI keeps our psyche running off of it. I never questioned this before and it may prove fruitless anyway.
Most of what I read says that a third major depression should be treated from 3-5 years and after that you can pretty much expect a 90% relapse rate. Not very encouraging if you've had this stuff in life (I think the 1st round is 9 months with a 25% chance at relapse and a second is 18 months with a 50% chance of relapse).
Does anyone really know from the science what effect these medicines have on the nuerotransmitters physically. I've read that untreated depression will start to harm the brain and everything else too so what would be the argument for staying in a bout and holding out hope of some turning point? It seems that either way we are going to be challenged to do someting.
Do you think the Prozac rationale makes any sense? I started out on it in the beginning and it seemed alright from what I can remember from those days! Thank You.....let me know
Posted by Philip N. on September 30, 2006, at 12:16:28
In reply to Re: Withdrawal from long term antidepressants » Philip N., posted by johnnyj on September 30, 2006, at 10:09:22
Hi jonnyj. I've always managed with minimal doses before now. My doctor and I are thinking of me starting back on Prozac as it has been years since I've taken that and try some Amitrytpiline at night to help with sleep initially. I think that TCA has historically been associated with sedation so maybe that would help me to get past the first stage of potential anxiety. I have diagnosed Anxiety Disorder (I think alot of this runs concurrent) and am sensitive to meds.
There was a time when I took Prozac but I started while I was still drinking alcohol and I don't recall alot of startup problems but thta may not be the case now. I also have about 3 weeks worth of benzos left and my doc thinks that if the Prozac works then I can stop them without much fanfare.
From what I've read on benzos I'm leary of hanging with them very long but they do a hell of a job on insomnia, at least when I have used them over the past month (not every day). I could see where I would almost just say let's stay with the benzos for all this anxiety but they say when you are hooked it causes hellish anxiety not to take them. It's a damn double edeg sword! I have not gone over 1mg of lorazepam yet at a time but even on regular low dosage thay say it can be wicked after a time.
I've tried to educate myself on alternatives but I think that my timing at this point would not allow for too much experimentation. My doctor also says that for the large part of people who the medications really work well for I won't find them as much on the internet because they are doing OK. Much of what I find on the sites seems negative but I also look at the alternative to untreated Depression/Anxiety. I think the damage from that if left untreated is far worse than keeping it in check.
I've always been a "what if" personality and I always look for the negatives and then expound on that in my head. The truth is from where I am at right now compared to this point last year I would have to opt to go back to when it was working. I know several people as most of us do in our circles who take ADs and are going about their lives day to day making it work. The ones I have talked this over with say that I need to get back on the train and ride it some more. Italmost sounds too simple.
I think it has just been the realization that this thing is alot larger and broader than I once thought and I am caught up in it kinda dulled me even more. The percentage of people who successfully stay off medication after any prolonged use from what I am hearing is slim at best. Now does that mean that the illness is that strong and progressive or that we have acclimated our psyche to the use of the medications? The experts claim it both ways depending on what side of the fence we're on. But then I look at the history of untreated Depression before there was any therapy available and I certainly wouldn't want to opt for that! I think the majority were just put away somewhere. And being down and holding out hope for some big turn of events seems almost comparable to that!
You see the thing to me is that there are no set answers and that just illustrates to me how complicated this really is (Not to mention that we are still trying to live our lives). It's also true that I have never experienced this degree of Depression/Anxiety and I want to at first blame it on the medications. My doctor trys to get me to see the other side of this thing. That my condition is what it is now because of the Illness and as we get older the data says that for most depressives the degree gets worse when it returns or reveals itself.I know I want to believe that I am tougher than all that but my history wouldn't convince myself that is the case. The Ads came in earnest after long periods of excessive alcohol abuse and I know there is residual from that in life. I wasn't much for any drugs but I sure thought I could drink and that is many times indicative of someone trying to self medicate according to my doc. And I do know I have been anxious all my life.
My thinking right now is to put more trust in my doc and try to pull myself back up and then maybe see where I'm at again later on. I could at least try a long drawn out taper and watch for signs of recuurrence then as I try to build from a better position. I don't like the idea of side effects but at least that might let me move forward some. I'm also convinced that the side effects of letting this go on anabted would be more severe.
Tyhank You.....let me know
Posted by jules354 on September 30, 2006, at 12:39:36
In reply to Re: Returning to antidepressants? Above for, posted by SLS on September 30, 2006, at 10:27:59
>Yes. But for how long do you think a withdrawal rebound depression might last?
Hi Scott,
honestly, i don't know. that's why i'm going to stay off meds if i can but go back if my therapist and i feel that's the best course. i was speaking more out of a frustration for the lack of respect and empathy people receive from their doctors when withdrawal symptoms last longer than a few weeks. i would say this is a major problem with the way ADs are prescribed and managed, regardless of different people's experiences with relapse. we need a major overhaul of how mental illness is treated in this country.
in the meantime, i'm with you on wise use of biological treatment when needed in the system that's available. remeron likely saved my life.
take care,
jules
Posted by SLS on October 1, 2006, at 5:20:23
In reply to Re: Returning to antidepressants? Above for » SLS, posted by jules354 on September 30, 2006, at 12:39:36
> >Yes. But for how long do you think a withdrawal rebound depression might last?
>
> Hi Scott,
>
> honestly, i don't know. that's why i'm going to stay off meds if i can but go back if my therapist and i feel that's the best course.You know what my greatest wish is for you and Philip? It is that you both find some key to a door in life that opens up a world of freedom that had been eluding you for years without the need for drugs.
As for me, I unlocked and opened all of my doors long ago, as I began in my early twenties a self-actualizing transformation with the aid of psychological tools that I had learned in college and crafted on my own. I keep those doors open with the aid of group and individual therapies and vigilence. The only thing holding me back from a very, very healthy and wonderfully rewarding life is my neurological dysfunction. The people who know me personally can't help but to be puzzled by anyone who remains resistent to the biological explanation of major mental illnesses. I am that transparent.
- Scott
Posted by SLS on October 1, 2006, at 8:13:46
In reply to Re: Returning to antidepressants? Above for » SLS, posted by jules354 on September 30, 2006, at 12:39:36
Understand, though, that many depressions result from an interaction between biological vulnerabilities to Major Depressive Disorder and psychosocial stresses produced by all sorts of things including maladaptive depressive thought styles. It can become very confusing when one has come to have a depressive thought style because it might exist during and between biological Major Depressive Disorder episodes. Therefore, the MDD episode just feels like the usual depressive thought style getting worse. "Why should I treat my usual psychological condition with drugs just because I'm having a tougher time with it right now?" You know?
That being said, it can happen that if you treat the psychological psychosocial stress well enough, you can reduce the pressure on the brain enough so that its function can improve. The question is, how long do you give it before intervening with biological treatments? Obviously, the answer will be different for each individual and each situation. Perhaps you can watch for a trend. What can you use as a measurement tool? I have one on my website you can try. It is really for use with drug treatment, but it might have some value to you:
http://home.att.net/~sl.schofield3/medicine/mood_chart_beam.pdf
- Scott
Posted by musky on October 1, 2006, at 11:36:09
In reply to Re: Withdrawal from long term antidepressants » musky, posted by Philip N. on September 29, 2006, at 9:52:02
>
Hello Philip
Yes I understand what you are saying, but I think that anxiety itself "distorts" our view of life. There is a saying that goes "If you think it , so shall you be" ... something like that.
I know that anxiety will take its toll on the body /mind which is exactly my point. We want to get at the anxiety ,, not just block it as meds will ultimately do.. Sure you may feel fine when on meds(in my case not).. but are you REALLY??? I mean did issues really get dealt with? personal issues, etc.
Pay attention to your thoughts.. cognitive therapy has taught me that our feelings are ultimately stemming from our thoughts. Think of when you feel anxious, depressed... ask your self , what were you thinking just at that time?? I bet if you wrote this thought(s) down that you would find its NEGATIVE self defeating.
We can CHOOSE how we think.. that is what is inherent in us.
When a person is under alot of anxiety they tend to have negative distortion thoughts.
We think we are victims of anxiety and feel hopeless, helpless. Our tendency as human beings is to retreat into a hermit like state, like a wounded animal.. this is a sign that our bodies are giving us to tell us something is wrong.. but of course we know this, that is why we feel this way.
But we have to get at the "root " of the anxiety. Alot of time anxiety/depression is just a manifistation of what the REAL issues are going on in our lives. If we really do some soul searching we find what is truly bothering us in life..)personal issues, self esteem and overall health all play an important role.
You say that the "experts" say that untreated anxiety can take its toll, well everyone knows this including yourself. but if you only choose one path for treating anxiety, such as meds then you will always end up with the same result.
I hear ya when you say you want to be around for your family... that is yourwill to live talking which is good!! but i disagree when the so called experts(who dont take the med themselves) say that withdrawls dont last that long.. Sorry I dont believe it..
There is also alot of proof out there with peoples testimonies that say it does occur despite the "experts" .. Experts dont live in your body, experts dont experience the drugs effects, experts dont live in your relationships.. so how could they know about what you are feeling??? Sure they may have facts, based on "certain data", but they still dont really know how all this works... Statisitics and data can show anything you want it to show.. but it doesnt get at the root of our problems..
Our body/mind /spirit connection is very complex. and we each are different but I am just saying that meds dont cure the problem.. mask it maybe, but take the med away and you still have the same problem.. much like the alcoholic who takes that drink to "feel " better.. did it cure his depression?? ya maybe for that few hours, but then when the booze wore off they were depressed again.. and the problem was still there. so you see, we can take all the "happy pills" we want and use this as a crutch if you will, but to me that is no way to live.
Yesterday after 4months of Remeron free and fairly stable mood, I had a bit of a downswing in mood... I at first was worried and really feeling scared and down. but I am just riding it out.. cause I know this will passs.. I dont let my negative thinking suck me into believing I need a drug to stay happy, which in my case it didnt make me feel anything but numb/nonexistent.. I would rather feel panic/anxiety/ depressed states and work through it and OVERCOME them , than to be trapped on pills.
I believe that we all can heal and maybe the few percentage( and I mean very few) of people who truly have an organic disorder (like your psychic killers, etc.) maybe, need meds. But majority of your anxiety, depressive cases truly are just cognitive and can be treated with cognitive therapy very sucessfully.. the "experts" should know this!!!
Sorry this is my opinion.. do what you have to.. I strongly urge you to think about this before making a decision.. If you only think that meds is the answer for your well being , then you have already narrowed your choices.
We all want to feel well, and Im sure you have tried , but dont think negative about something before it happens.
You say you want to be med free, yet you say BUT.. therefore you have already locked yourself into a choice of meds only.. I know this may sound harsh, but sometimes we have to just kick %%%** and fight our way through... If you keep telling yourself you are not one of those strong ones, then you wont be.. if you keep telling yourself you are strong, over and over then you will be..Good luck in whatever you decide.
I know for me its med free, and I am glad Im off of this Remeron for 4months now... I will suffer throught the mood stuff..no matter what..
Musky
Hi Musky.
>
> I hear exactly what you are saying. The problem I've encountered is that in this fight I have lost ground. I'm now concerned about the effects this is having on my mental and physiacl well being. The is alot of proof that untreated Depression/Anxiety can extract a heavy toll on us up to and including killing us.
>
> Right now I think I'm having a hard time coming to an acceptance that I may not be one of those who has an episodic form of this stuff that you just kick *ss on and move on. I have never in my life been in this shape and many "experts" are saying that enough time has passed for it to be a discontinuation from meds. Even though I don't have a true opinion on that I know that at my current rate I won't last to make 2 years to find out.
>
> I'm at that point of considering the lesser of the 2: Waste away untreated or find some remission and rejoin my family so I can still be there for them. What is the ideal situation? Many including myself would say to be med free but that may bring with it some consequences that are worse than being on the stuff. I just celebrated my 30 year wedding anniversary by retreating to my bed to see if I could go to sleep.
>
> I don't smoke or drink alcohol (8 years sobriety) or life a wild life. I try to eat right and look at alternatives and such but at the same time the grip this thing has on me is becoming too paralytic. I don't want to lose it all trying to reach a plateau that for now is set too high. Maybe by relenting to medication I can rejoin my own life. Does any of this make sense?
>
> Thanks....let me know
>
Posted by musky on October 1, 2006, at 11:58:22
In reply to Re: Returning to antidepressants? Above for » Philip N., posted by SLS on September 29, 2006, at 23:03:23
> >First of all, diabetes and high blood pressure are KNOWN diseases.. they have blood tests SPECIFICALLY for measuring levels of blood glucose and blood pressure. The drugs developed for these conditions are SPECIFIC and then shown to work by further measuring these levels.
Antidepressents are NOT specific and affect MANY downstream pathways in the brain... They "think" that it affects serontonin but not definite on how this occurs. There is no specific serontonin test(that is a regular blood test, like one for blood sugar). So how can they "measure " the effectiveness of the drug??? The research out there shows peoples reports based on surveys which are actually very generalized questions which dont really get to a specific problem..
YOu cant compare diabetes to mood problems.. these are two totally different things.. So doctors shouldnt use this and an example to treat there patients or to justify using an a/d..What puzzles me is if everyone was so happy on these meds.. why why is so many trying to get off?? and why this site in the first place..
We are always trying to analyze things too much maybe... I think just let things go, take care of yourself (body mind and spirit) and stay positive..
I bet if you talked to the average joe on the street, they would have some "sort of disorder" according to the docs manual... so maybe medicate everyone???
Sorry, dont mean to be cynical but I just get frustrated to see so many people suffering and in a med mess .I mean if you want to stay on meds.. feel free,
I know its not for me... I'll be curious to see what happens in 6months ..if they found the golden pill... I doubt it..Musky
It may be either that or ending up in the hospital. My doc doesn't think I can weather much more and I'm thinking she may be right. My hope then if I get some relief would be a long slow taper down the road. I saw her today and she's pretty concerned. I thought I could willpower this into reality but it may take more than that!
>
>
> Can you willpower appendicitis?
>
> How does someone with type 1 diabetes taper off of insulin?
>
> If you are going to try to discontinue medication again, I would recommend that you wait 12-14 months. In the meantime, perhaps you can have some psychotherapy so that when you discontinue medication, you will be less likely to relapse. If you don't know where to start, perhaps you can browse the Psychology board for some ideas as to what type of therapy would best suit your needs.
>
> If you do relapse again within a matter of months, then you must consider the possibility that you should remain on medication indefinitely. The alternative is to be on and off medication. However, your brain might not allow you this as an alternative. Many people become resistent to treatment after multiple exposures to medication. So, coming off of medication repeatedly really is double jeapordy. You risk relapsing and seeing you and your life deteriorate, plus, you risk not responding to medication once it is restarted.
>
> Knowing me, I think I would probably try twice to discontinue medication. Two relapses would be plenty to show me that I had a brain disorder.
>
>
> - Scott
Posted by musky on October 1, 2006, at 12:04:06
In reply to Re: Returning to antidepressants? Above for » Philip N., posted by jules354 on September 29, 2006, at 23:23:36
> Hi jules
Glad to hear u are still Remeron free... and again I agree it is long withdrawl effects.. these are VERY powerful drugs and it takes a long time to recover.. You say uyou were on Remeron for 6/7yrs?? yes, well of course it will take a long time to get back to balance.
I think uyou are on the right track... I was on for three years so I dont expect to feel llike me totally for 3yrs..hopefully it will be sooner but I will be patient...
We all have ups and downs and no one is 100% feeling good all the time... maybe all of our expectations are too high at this time.. we need to lower the bar and just keep going.Im off 4months now.. a down time yesterday but a bit better today... just going to work through it
musky
p.s.: it's pretty clear to me based on everybody's experiences on this board and in conversation with other people that discontinuation syndrome can definitely last a lot longer than the doctors say it should. so i do think that could be contributing to how you're feeling (and maybe me, too). it's hard to make the call, though. i hope you feel better soon!
>
> take care,
> jules
Posted by Philip N. on October 1, 2006, at 12:09:16
In reply to Re: Withdrawal from long term antidepressants, posted by musky on October 1, 2006, at 11:36:09
Hi Musky!
Thanks for your words bof encouragement!
Do you know anyone who took ADs for any length of time that was able to stay off for more than 1 year after stopping? I mean if it got to where I just stop altogether I don't think I will have a choice. It may be that I can continue to work with all this even though I'm still relying on medication.
I'm starting to worry about the untreated aspects of all this! My doctor has already made her mind up but she is being patient with me longer than she wants to. She has been my doc throughout the time that I have been on ADs.
This has become the hardest thing that I have had to fight and when I look at the symptoms vs diagnosis I feel that maybe I'm now fooling myself!
Posted by musky on October 1, 2006, at 12:25:03
In reply to Re: Returning to antidepressants? Above for » SLS, posted by jules354 on September 30, 2006, at 12:39:36
>
Hi jules
I agree with u on totally changing how we view mental illness and the management of meds..
Its almost the snake oil of the 21st century.. here take a pill to feel better.. We need to educate people better , and much earlier in life how to cope with stress and life events and just deal with issues not to avoid .. We need to teach people about self esteem and also encourage support systems..
Everyone has anxiety to some degree or another we just need to know how to manage it successufully and not keep putting bandaids on things(with meds)..
The human body is very complex and it is a SYTEM which of course will cycle... we all have cycles and if we just accept this is the life then maybe our depressive symptoms, anxiety and panic around all this will subside..
Dont fear the fear or it becomes bigger..
FEED the Good wolf(an old indian legend).Hang in there
Musky
>Yes. But for how long do you think a withdrawal rebound depression might last?
>
> Hi Scott,
>
> honestly, i don't know. that's why i'm going to stay off meds if i can but go back if my therapist and i feel that's the best course. i was speaking more out of a frustration for the lack of respect and empathy people receive from their doctors when withdrawal symptoms last longer than a few weeks. i would say this is a major problem with the way ADs are prescribed and managed, regardless of different people's experiences with relapse. we need a major overhaul of how mental illness is treated in this country.
>
> in the meantime, i'm with you on wise use of biological treatment when needed in the system that's available. remeron likely saved my life.
>
> take care,
> jules
Posted by johnnyj on October 1, 2006, at 12:31:42
In reply to Re: Withdrawal from long term antidepressants, posted by musky on October 1, 2006, at 11:36:09
Musky:
I feel you are trying to justidy why meds are always bad. If you were not put on AD's for depression or anxiety how do you know they never work for such conditions?
So only pyschotic people have chemical imbalances? I don't understand your thinking at all. If that is true couldn't a chemical imablance cause anxiety or depression too then? We know during anixety attacks things are chemically changed in the body.
Yes, high blood pressure and diabetes problems can be measured in the body. Just because they haven't figured out how to measure neurotrasmitters yet doesn't mean an imbalance doesn't exist.
If someone has been helped by AD's doesn't this means they have worked? NOT all drugs are like remeron.
Sometimes I feel you think your experiences should be the same for everyone and they are not. Med free is the goal but may not work for everyone. We each have to choose our OWN path.
A lot of my problems are due to allergies. If those had not been treated I would be in a world of hurt. My point is we can measure some body processes and others we cannot YET.
You are lucky that you have been doing fine off of meds. Some of us are not that fortunate.
johnnyj
Posted by musky on October 1, 2006, at 12:34:16
In reply to Re: Withdrawal from long term antidepressants » musky, posted by Philip N. on October 1, 2006, at 12:09:16
>
Hi Philip:Yes I do know people (some personal friends of mine) who have VERY SUCESSFULLY have been and remain free of a/d.. after taking long term..
They are fine.. they have good attitudes and a sense of humor, they keep active and dont dwellon things.. they dont let fear take over.. they just live their lives and dont worry about the WHAT IFS.. they stay in the moment..
I am trying to adopt these beliefs more and more and it truly helps.Remember.. uyour doc is speaking from her viewpoiont only ( and trained to prescribe rxs) . its like a programmed computer... when this .. rx this..,, if this doesnt work rx this..
you cant really blame them.. they are trained this way much as you train anyone to believe anything. Yet you talk to a traditional chinese acupuncturist who beleives the eastern Philosophy and see the amazing results from this tretament.. you begin to wonder... and this culture has been practicing there treatments for thousands of years longer than western mediicine..
I have yet to see the orientals suffering from anxitey/ depression. panic attacks.. anyone I know they are fully functioning people..
Im sure there are some ,but probabley a lot less than our society.... everTake care
Musky
Hi Musky!
>
> Thanks for your words bof encouragement!
>
> Do you know anyone who took ADs for any length of time that was able to stay off for more than 1 year after stopping? I mean if it got to where I just stop altogether I don't think I will have a choice. It may be that I can continue to work with all this even though I'm still relying on medication.
>
> I'm starting to worry about the untreated aspects of all this! My doctor has already made her mind up but she is being patient with me longer than she wants to. She has been my doc throughout the time that I have been on ADs.
>
> This has become the hardest thing that I have had to fight and when I look at the symptoms vs diagnosis I feel that maybe I'm now fooling myself!
Posted by jules354 on October 1, 2006, at 14:54:59
In reply to Re: Returning to antidepressants? » jules354, posted by SLS on October 1, 2006, at 5:20:23
Hi Scott,
> You know what my greatest wish is for you and Philip? It is that you both find some key to a door in life that opens up a world of freedom that had been eluding you for years without the need for drugs.Thank you. I appreciate that.
> The people who know me personally can't help but to be puzzled by anyone who remains resistent to the biological explanation of major mental illnesses.
I'm not sure if you meant "anyone" to refer to me, but I think you and I are more or less on the same page about biological explanations and treatments. Maybe more than you think, I wonder.take care,
jules
Posted by jules354 on October 1, 2006, at 14:55:36
In reply to Re: Returning to antidepressants?, posted by jules354 on October 1, 2006, at 14:54:59
Posted by SLS on October 1, 2006, at 20:28:29
In reply to Re: Returning to antidepressants? Above for, posted by musky on October 1, 2006, at 11:58:22
> > >First of all, diabetes and high blood pressure are KNOWN diseases.. they have blood tests SPECIFICALLY for measuring levels of blood glucose and blood pressure. The drugs developed for these conditions are SPECIFIC and then shown to work by further measuring these levels.
Ok.
> Antidepressents are NOT specific and affect MANY downstream pathways in the brain...
How do you know whether they are upstream or downstream? Scientists haven't decided that yet.
Insulin is not treating the disease. The disease in in the pancreas. As you say, it is affecting things downstream.
If it works, it works. Right?
So, anyway...
> They "think" that it affects serontonin but not definite on how this occurs.
I don't know who you think "they" are. If you take a look at the more recent work on depression, you will find that there are many different areas of investigation. I don't think that most scientists conceptualize depression as being the result of a simple reduction in "serotonin levels". That is an old and primordial way of thinking. However, it is still a commonly used explanation of depression for the lay public. Nothing more.
> There is no specific serontonin test(that is a regular blood test, like one for blood sugar).
Well, actually, blood platelets contain neurotransmitter receptors and transporters. The binding of some of these receptors vary in depression and some anxiety disorders. Although there is no consensus as to which receptors yield the most consistent associations, I don't doubt that a test might be developed soon. Some are even experimenting with blood platelet characteristics in order to predict treatment response. So, yes, blood test may be possible.
A blood test has been in existence for over 20 years. Known as the dexamethasone suppression test (DST), it involves the measurement of cortisol in response to steroid challenge. I had it done in 1982 and I tested positive. This test probably fell out of favor because it did not detect all types of depression. It is unfortunate that it was not pursued as a test for treatment choice. My guess is that people who test positive to the DST are more apt to respond to certain drugs - TCA, MAOIs, and Effexor perhaps.
> So how can they "measure " the effectiveness of the drug???
You ask the patient how they are feeling.
- Scott
Posted by musky on October 1, 2006, at 23:11:46
In reply to Re: Returning to antidepressants? Above for » musky, posted by SLS on October 1, 2006, at 20:28:29
> > > >First of all, diabetes and high blood pressure are KNOWN diseases.. they have blood tests SPECIFICALLY for measuring levels of blood glucose and blood pressure. The drugs developed for these conditions are SPECIFIC and then shown to work by further measuring these levels.
>
> Ok.
>
> > Antidepressents are NOT specific and affect MANY downstream pathways in the brain...
>
> How do you know whether they are upstream or downstream? Scientists haven't decided that yet.
* Exactly my point .. they dont know ...
You want to get specific over upstream downstream, it doesnt matter as the chemical pathways are AFFECTED and not just the serotonin pathway.. that is my point and this is what worries me.
> Insulin is not treating the disease. The disease in in the pancreas. As you say, it is affecting things downstream.
***I know this but my point being we know that insulin regulates blood sugar and if the pancreas isnt making it properly or if the cells are not producing insulin then this is a DIRECT effect. this has been proven with SPECIFICALLY testing for insulin levels ... With mood disorders , etc, etc. they dont know what each receptor is responsible for.
>
> If it works, it works. Right?
****If it worked we wouldnt have so many people still trying meds on and on.. and we wouldnt be here debating on this post.
>
> So, anyway...
>
> > They "think" that it affects serontonin but not definite on how this occurs.
>
> I don't know who you think "they" are. If you take a look at the more recent work on depression, you will find that there are many different areas of investigation. I don't think that most scientists conceptualize depression as being the result of a simple reduction in "serotonin levels". That is an old and primordial way of thinking. However, it is still a commonly used explanation of depression for the lay public. Nothing more.
****Exactly my point .. they meaning all your scientists but mainly the docs who get these reports from drug company funded research. As you say they dont know ,, they are just speculating what they think may be happening.. and it is foolish to mislead the public/patient this way.. so many out there are buying into the theory that their serontonin levels are off.. maybe soo. but prove it I say.. and also why are they classifying the drugs as SELECTIVE SERONTONIN REUPTAKE INHIBITORS???!!!! falsy suggesting it is selective for serontonin only... not true.. it affects serontonin in the long run, (maybe)so they speculate but only after affecting many more signalling events in the cell... This is the fact here.
>
> > There is no specific serontonin test(that is a regular blood test, like one for blood sugar).
>
> Well, actually, blood platelets contain neurotransmitter receptors and transporters. The binding of some of these receptors vary in depression and some anxiety disorders. Although there is no consensus as to which receptors yield the most consistent associations, I don't doubt that a test might be developed soon. Some are even experimenting with blood platelet characteristics in order to predict treatment response. So, yes, blood test may be possible.Again my point.. if there is serontonin in other cells how can they possibly say that these a/d are affecting ONLY the neurotransmitters/receptors in the brain.. so in essence when taking the med it affects ALL areas of the body.. EVERY Cell.. Many other factors affect the binding of receptors from protein-protein interactions to recruiting of adaptor proteins, and the list goes on. Also the very genetic makeup of each individual is so different that one cannot say that the drug is specific for depression, anxiety.. one would have to genetically engineer a magic pill for every person/s genetic makeup and that simply is unrealistic I would say... and then you have environmental factors playing a huge role and the the persons age, weight, and sex and culture.. but do they consider these?? no and this again worries me.. Its a one size fits all.
They keep calling these drugs SELECTIVE yet they are NOT...With insulin it is only made in the pancreas... therefore will be targeted there.. thats the difference.
>
> A blood test has been in existence for over 20 years. Known as the dexamethasone suppression test (DST), it involves the measurement of cortisol in response to steroid challenge. I had it done in 1982 and I tested positive. This test probably fell out of favor because it did not detect all types of depression. It is unfortunate that it was not pursued as a test for treatment choice. My guess is that people who test positive to the DST are more apt to respond to certain drugs - TCA, MAOIs, and Effexor perhaps.
* And cortisol levels are controlled by the adrenal glands.. so there are many different causes for cortisol to be off.. even obesity.. , diet etc.. so this test isnt specific enough to justify messing with receptors in the brain and elsewhere in case it affects the mood.
>
> > So how can they "measure " the effectiveness of the drug???
>
> You ask the patient how they are feeling.
> * Again my point.. this is all subjective and very generalized.. Have you taken the Burns anxiety survey before.. its very biased and the other surveys they give at docs offices, psyche clinics all have very general questions which lead into into answering one way or the other,,, again to "FIT" the way they want the survey to turn out.. They only Give so many choices for the patient to check off.. so it boxes you in...not a true indication of the real you.. too generalized.
Also what one persons interpretation of a feeling depressed may be very different for the next person.. how can they summarize this accuratley on a survey..
>
> - ScottMusky
Posted by SLS on October 2, 2006, at 7:45:55
In reply to Re: Returning to antidepressants? Above for, posted by musky on October 1, 2006, at 23:11:46
> > > > >First of all, diabetes and high blood pressure are KNOWN diseases.. they have blood tests SPECIFICALLY for measuring levels of blood glucose and blood pressure. The drugs developed for these conditions are SPECIFIC and then shown to work by further measuring these levels.
> > Ok.
> > > Antidepressents are NOT specific and affect MANY downstream pathways in the brain...
> > How do you know whether they are upstream or downstream? Scientists haven't decided that yet.> * Exactly my point .. they dont know ...
I was just curious how you came to identify downstream pathways when scientist had not done so yet, that's all.
I think this will help a lot:
It is not the objective of medicine to understand biology. It is the objective of medicine to get people better. Very often, this means using a drug that it doesn't understand how it works. Actually, this has been the whole history of medicine up until the last 50 years or so. People couldn't wait around for biological science to figure out how penicillin worked when it was first discovered by accident. That wasn't to happen for many years. There are still many, many drugs for which the exact mechanism of action is not understood. Just open up the PDR and have a look. Should people wait around and die while these medical discoveries are researched by biologists?
Very often, people want to discontinue medication precicely because it has worked. It is not the proposition upon the initiation of drug treatment that it be for a lifetime. It is often agreed that a patient will discontinue drug treatment after he feels well for a certain number of months. Of course, we are going to see so many people wanting to discontinue their antidepressants. They worked.
> > If it works, it works. Right?
> ****If it worked we wouldnt have so many people still trying meds on and on.. and we wouldnt be here debating on this post.
As we could also say of psychotherapy.
Of course, there are treatment failures. 30-40% of people will need to discontinue their first drug to go on to a second drug. 30% of those will need to go on to a third drug or have drugs added as combination treatments. Still others who are extraordinarily treatment-resistant end up here. These people switch drugs frequently in a desperate effort to find something that works for them. This is unfortunate, but it is not unprecedented in the field of medicine. Even antibiotics are sometimes applied in a trial-and-error format.
That a series of drug therapies fail to treat an ailment does not prove that the ailment doesn't exist. I believe that my ailment is biological. There is finally overwhelming evidence to demonstrate this, in my opinion. Although I didn't need to see this proof, it does help to know that it helps fuel research into finding biological cures for a biological illness.
You are entitled to believe differently.
- Scott
Posted by musky on October 3, 2006, at 1:42:43
In reply to Re: Returning to antidepressants? Above for » musky, posted by SLS on October 2, 2006, at 7:45:55
> > > > > >First of all, diabetes and high blood pressure are KNOWN diseases.. they have blood tests SPECIFICALLY for measuring levels of blood glucose and blood pressure. The drugs developed for these conditions are SPECIFIC and then shown to work by further measuring these levels.
>
> > > Ok.
>
> > > > Antidepressents are NOT specific and affect MANY downstream pathways in the brain...
>
> > > How do you know whether they are upstream or downstream? Scientists haven't decided that yet.
>
> > * Exactly my point .. they dont know ...
>
> I was just curious how you came to identify downstream pathways when scientist had not done so yet, that's all.# I was using the term downstream to make a statement , not a conclusion.. thats all. As I work in a research lab that studies signalling events in a cell , it makes sense and yes there are upstream as well as downstream events.
>
> I think this will help a lot:
>
> It is not the objective of medicine to understand biology. It is the objective of medicine to get people better. Very often, this means using a drug that it doesn't understand how it works. Actually, this has been the whole history of medicine up until the last 50 years or so. People couldn't wait around for biological science to figure out how penicillin worked when it was first discovered by accident. That wasn't to happen for many years. There are still many, many drugs for which the exact mechanism of action is not understood. Just open up the PDR and have a look. Should people wait around and die while these medical discoveries are researched by biologists?# Well I think it better be the objective of medicine to understand biology after all, we are biological systems. And how can you get people better if you dont understand the biology of the system in the first place.. Using a drug that we dont understand exactly how it works or just plain how it works is dangerous.. giving people drugs and not knowing how it works is just using humans as guinea pigs.. Drugs need to be further tested. As for penicillin the proof was right there that it worked.. by killilng the bacteria in culture.. and they did find out how it works, they know the mechanism of action.
If you read the PDF manual as well most a/d that are in there they do not say how it works or the long term effects of the drug.. Im curious as to why they dont follow up on the thousands of patients that are on the drug.. LONG term I mean or follow up on patients that are coming off the a/d.. You never see reports of this.. hmmm
And no people shouldnt wait around and die while waiting for medical research,, but guess what they are already dying by drug hopping and overdosing and the sheer anxiety surrounding trying to find the right cocktail.. so we cant come to the conclusion that people will die if they wait for research.. there are alternatives to waiting... alternative treatments..
Another example is ecstasy .. it has killed more youths and caused more addictions.. yet it was a FAILED antidepressant.. so much for not wanting to wait and research the drug further.. no.. they wanted totry it right away... "save people from depression"" now look what it has done..
>
> Very often, people want to discontinue medication precicely because it has worked. It is not the proposition upon the initiation of drug treatment that it be for a lifetime.# Then why do so many doctors tell a patient they have to reamain on the drug indefinitely or for the rest of their lives... if its not the intention??
??//
It is often agreed that a patient will discontinue drug treatment after he feels well for a certain number of months. Of course, we are going to see so many people wanting to discontinue their antidepressants. They worked.
# Then why are there so many postings saying they want off because they didnt feel right on the drug.. you never see a post saying they feel great , so their stopping the meds.. they are saying that they cant stand the side effects and that they dont want to be on them anymore.or They are not feeling , thats the problem here.. no feelings/numb=translates into feeling well in a doctors perspective or to the family of the patient.. if they dont see you crying they think you are well. And if they worked then why are so many people trying more than one kind? I think its more it didnt work so WhY take the drug..
With penicillin it works because you take it once and then your done.. the infection is gone.. that bacteria was killed by the antibiotic.. you dont have to keep taking it .. and also usually your immune system does the job for you and if u are stressed or immune suppressed that is only when you need the xtra pencicillin/antibiotic. So with a/d it seems that people are on it for months /years and still feel/not right.. so this doesnt make sense to keep taking the drug.>
> > > If it works, it works. Right?
>
> > ****If it worked we wouldnt have so many people still trying meds on and on.. and we wouldnt be here debating on this post.
>
> As we could also say of psychotherapy.
# psychotherapy will work if u practice what yu learn... theres a difference between popping a pill and thinking... psychotherapy gets at the root of your thinking therefore getting the issue solved ,,not bandaging it up.
> ///
> Of course, there are treatment failures. 30-40% of people will need to discontinue their first drug to go on to a second drug. 30% of those will need to go on to a third drug or have drugs added as combination treatments. Still others who are extraordinarily treatment-resistant end up here. These people switch drugs frequently in a desperate effort to find something that works for them.# which again is my point.. the continued switching of meds is proof enough that this way isnt working for the patient.. why subject them to the continued anxiety and frustration of stopping and starting meds , not to mention the toll it takes on the physiological aspect of the body.. this cant possibly be healthy.. this in turn will affect the mind...
its like if you were making stew and just kept adding who knows what ingredient to get the taste"just right" and it just kept getting more and more stuff added into it, yet the taste just got worse and you couldnt get it right,, why would yu keep adding all the ingredients senslessly.. to me yu would throw it out and start with a NEW RECIPE or in the case of meds.. try other methods... not more meds.
This is unfortunate, but it is not unprecedented in the field of medicine. Even antibiotics are sometimes applied in a trial-and-error format.
## antibiotics dont mess with the brain/cognitive aspect of the person. and this trial and error is because there are more than one strain of bacteria out there. They dont know how the mood / chemical interactions work..
its like how can you know where you are going in a foreign country without a MAP??//
>
> That a series of drug therapies fail to treat an ailment does not prove that the ailment doesn't exist.#Oh the ailment exists allright, but the treatment is what is the problem..and I wouldnt say its an ailment, rather a manisfistation of a deeper rooted issue.. like i say.. there is more than one way to treat mood/ imbalances in the system. Alternative.. which just means OTHER THAN meds, etc.//
believe that my ailment is biological.#If you believe this then u have cornered yourself.. if you really believe you dont have a choice about your illness, then you have lost the battle.. Im not saying denial here, im saying just think outside the box..//
There is finally overwhelming evidence to demonstrate this, in my opinion. Although I didn't need to see this proof, it does help to know that it helps fuel research into finding biological cures for a biological illness.
## Biological cures mean natural not chemical and safer not harmful side effects.. have you noticed the black box warnings on the a/d rx these days?? Obviouslly there is a real danger out there. Especially to the adolescent population that are rx so readily too... increase in suicidal thinking and actions .. to me this is just another form of child abuse.. rx this stuff to teens.. again look at the ECSTACY drug hype.. Doctors "thought " it was safe..
>
> You are entitled to believe differently.
# yes I am as so are you.. enjoy your meds my friend.. and thanks for the debate.
After all its what we perceive as our own reality.. to me life is to be lived, not just exist... and thats what meds doo.. sure maybe they keep you alive.. numbed out but well alive...so this is something we should cherish???
like I said to each their own, but I hate to see the next generation after us all spaced out on meds all the time and not facing reality.
dont get me wrong.. I was down deep too.. very deep and if someone had said then to me just stop feeling that way i would have hit them too.. but on the other hand I needed to get tough on myself to survive.. yes you have to go through the emotions to heal, but there comes a time that you just have to get tough against the depression . anxiety.. and fight it not fear it .. ACCEPTANCE but not in a negative way like viewing oneself as a victim of mental illness, etc.. I dont like that term, I think of it as more of a dissarray of the soul, and we just need to be complete spiritually, physically, and emotionally. that is a journey we all take.
The very fact that they dont know alot about how the brain functions is all the more reason to PROCEED WITH CAUTION in the use of any meds affecting thought behavior.. ask all your drug addicts out there on the streets .Musky
>
>
> - Scott
Posted by SLS on October 3, 2006, at 8:17:00
In reply to Re: Returning to antidepressants? Above for, posted by musky on October 3, 2006, at 1:42:43
I don't wish to continue a debate regarding the substantiation of biological psychiatry. I believe that it is inconsistent with the theme of the Withdrawal board.
I do understand your concerns. I think we all wish that humankind had reached a point further along in the understanding of all things medical by now, but we have to do the best we can with what we have.
My only comment at this point is that many of the so called "natural" remedies are entirely chemical and should be treated with the same respect as any drug.
- Scott
Go forward in thread:
Psycho-Babble Withdrawal | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.