Some can't stop antidepressants

Discussion in 'Fibromyalgia Main Forum' started by lenasvn, Nov 13, 2006.

  1. lenasvn

    lenasvn New Member

    http://msnbc.msn.com/id/14126142/


    MSNBC.com


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    Some can't stop antidepressants
    Syndrome makes it impossible for some patients to wean off medication
    The Associated Press
    Updated: 9:07 a.m. PT Aug 31, 2006
    When Gina O’Brien decided she no longer needed drugs to quell her anxiety and panic attacks, she followed doctor’s orders by slowly tapering her dose of the antidepressant Paxil.

    The gradual withdrawal was supposed to prevent unpleasant symptoms that can result from stopping antidepressants cold turkey. But it didn’t work.

    “I felt so sick that I couldn’t get off my couch,” O’Brien said. “I couldn’t stop crying.”

    Overwhelmed by nausea and uncontrollable crying, she felt she had no choice but to start taking the pills again. More than a year later she still takes Paxil, and expects to be on it for the rest of her life.

    In the almost two decades since Prozac — the first of the antidepressants known as SRIs, or serotonin reuptake inhibitors — hit the market, many patients have reported extreme reactions to discontinuing the drugs. Two of the best-selling antidepressants — Effexor and Paxil — have prompted so many complaints that many doctors avoid prescribing them altogether.

    “It’s not that we never use it, but in the end I will tend not to prescribe Effexor or Paxil,” said Dr. Richard C. Shelton, a psychiatrist at the Vanderbilt University School of Medicine.

    Patients report experiencing all sorts of symptoms, sometimes within hours of stopping their medication. They can suffer from flu-like nausea, muscle aches, uncontrollable crying, dizziness and diarrhea. Many patients suffer “brain zaps,” bizarre and briefly overwhelming electrical sensations that propagate from the back of the head.

    “It’s almost like pins and needles, and jittery on the inside,” said a New York children’s entertainer who asked that his name be withheld to protect his professional reputation.

    Though not exactly painful, they are briefly disorienting and can be terrifying to patients who don’t know what they are experiencing. There are case reports of people who have just quit antidepressants showing up in hospital emergency rooms, thinking they are suffering from seizures.

    Toni Wilson certainly didn’t know how unpleasant going off Zoloft could be when her doctor recently switched her to Wellbutrin, telling her that the new drug would “take the place of” the old one. The two antidepressants actually work on entirely different neurochemical systems, so going straight from one to the other was equivalent to quitting Zoloft cold turkey.

    “After about three days I felt real anxious and irritable,” Wilson said in an e-mail message. “I would shake, not eat much, it felt like little needles in my body and head.”

    After two weeks, Wilson said, she was rescued from the brink of suicide by a friend who recognized the severity of the situation and took her to the hospital. That was where she learned what had happened to her.

    Few doctors know enough about weaning
    Cases like Wilson’s would be virtually nonexistent if physicians took more care in weaning their patients off antidepressants, said Philip Ninan, vice president for neuroscience at Wyeth, the maker of Effexor.

    “The management of discontinuation symptoms is relatively easy if you know about it,” Ninan said, and noted that Wyeth had made efforts to educate both physicians and patients.

    Yet surprisingly few doctors know enough about SRI discontinuation to manage it effectively. A 1997 survey of English doctors found that 28 percent of psychiatrists and 70 percent of general practitioners had no idea that patients might have problems after discontinuing antidepressants. Awareness may have increased since then, but the phenomenon is so little studied that no one has done the necessary research to find out.

    Impacts more than mood
    So little is known about it that researchers aren’t even exactly sure what causes antidepressant discontinuation syndrome. It must be related to the fact that the brain chemical affected by most of the antidepressants on the market today, serotonin, does a lot more than regulate mood. It is also involved in sleep, balance, digestion and other physiological processes. So when you throw the brain’s serotonin system out of whack, which is essentially what you’re doing by either starting or discontinuing an antidepressant, virtually the whole body can be affected.

    Generally the drugs that are metabolized most quickly cause more severe symptoms, Shelton said. Effexor, with a half-life of just a few hours, is one of the worst SRIs in that regard; Prozac, which has a half-life of about a week, is considered the best.


    Some doctors have been able to minimize withdrawal symptoms in patients who are quitting Effexor or Paxil by gradually switching them over to Prozac, then tapering them off the more easily discontinued drug.

    Critics of the pharmaceutical industry complain that drug companies downplay the severity of drug discontinuation symptoms. The prescribing information drug companies provide to doctors warns that patients occasionally experience mild symptoms when they stop taking SRI antidepressants, but imply that tapering off the medication can prevent problems. Medical journals describe the ill effects of going off the drugs as “mild and short-lived,” and usually avoidable if the dose is tapered.


    Not hard for everyone
    “I don’t think they’re difficult to go off,” said Alan Schatzberg, chairman of the department of psychiatry and behavioral sciences at the Stanford University School of Medicine. “The vast majority of people aren’t that sensitive.”

    Schatzberg recently chaired a Wyeth-sponsored panel of physicians that offered guidelines for how to manage “antidepressant discontinuation syndrome,” the preferred medical term for what a layperson would think of as withdrawal.

    Terms like “antidepressant discontinuation syndrome” demonstrate the pharmaceutical industry’s efforts to downplay the problem, charged Karen Menzies, an attorney who has been involved in litigation over the phenomenon.

    “Withdrawal is the word that is used in Europe,” she said.

    Feels like withdrawl
    But drug companies insist antidepressants can’t cause withdrawal because they are not technically addictive. Even so, many patients who have gone through the experience say it feels like withdrawal to them. Some can’t work, drive, socialize or do other everyday things for weeks.

    “You just feel awful,” said the children’s entertainer, who has taken a small dose of Effexor for eight years rather than suffer through the withdrawal experience. But he said the inconvenience is worth it for the benefits the drug provided him when he did need it.

    Taking SRIs indefinitely is not an attractive option for many patients because it means putting up with unpleasant side-effects such as weight gain and sexual dysfunction. For women who want to have children it’s an especially risky choice; researchers have documented withdrawal in newborns whose mothers were taking antidepressants, and some SRIs have been linked to birth defects.

    Having to keep taking Paxil makes O’Brien angry because she feels at the mercy of GlaxoSmithKline, the company that makes it.


    Though a GSK spokesperson said the symptoms associated with discontinuing Paxil are generally mild and manageable, in O’Brien’s eyes the company is profiting by having hooked her on one of its drugs.

    “If they ever did quit making Paxil I’d be in so much trouble,” O’Brien said. “What really makes me mad is if I can’t get off it, why am I paying them? They should be paying me.”

    © 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
    URL: http://msnbc.msn.com/id/14126142/


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    © 2006 MSNBC.com

  2. monkeykat

    monkeykat Member

    Hi Levasvn,
    Thanks for the article. I don't take antidepressants now but when i was first going to see doctors b/c I didn't know what was wrong with me, they put me on Celexa. It didn't help. I was on it for 2 years along with trying other SSRI's and my health kept getting worse.

    I decided to wean myself off the antidepressant b/c I never felt depressed to begin with. The pharmicist really yelled at me about weaning off the antidepressant when I called the pharmacy. I was so appalled.

    Anyway, I ended up being diagnosed with severe CFS, ANS dysfunction (POTS & poor sweat response), Fibromyalgia, and Multiple Chemical Sensitivity.

    I fight really hard to get well and sometimes I get weary. I never really let myself feel depressed but this year I've been getting depressed once in a while. It's tough and I've thought about getting on antidepressants but this article really helped me make my decision. My depression isn't every day and I can force myself to function most of the time if I have a day or two of depression.

    Anyway, thanks for the info...

    Keep hope alive,
    Monkeykat
  3. lenasvn

    lenasvn New Member

    I understand! I have chronic depression, but I have learned to cope with it. I have a counselor that I see on a weekly basis, and it helps keep things in shack just enough! The depersonalization I experienced with anti depr. wasn't worth it for me.

    There are ways to fight those things. I've been in the deepest holes a soul can experience, and I always made it out without any meds! people contact, some rest and small little do-goodies ( a favvo movie, a pound of chokolate, a good sob, or the like!) is just as good!


    [This Message was Edited on 11/13/2006]
  4. beachwalkerbill

    beachwalkerbill New Member

    I am a researcher for a private company my sister was an NIH researcher for UW. Research can be very skewed by whom ever funds the program. It’s not what is published , it is what is not published. The makers of Viox knew years ago that in double blind studies with Viox vs ibuprofen and naproxin sodium, there product Viox had much larger ratios of patients with heart problems. Why did they not publish these findings?
    Because they determined that since ibuprofen and naproxin sodium were anti coagulants (which they are) that those drugs were preventing the heart attacks, not that Viox was causing heart attacks. So there was no need to publish the findings on those test.
    This is why you should never vote for caps on law suits. Then these guys are able to calculate what your life is worth, then adjust the price of there product to pay for the pre-determined value of your life.

    I have had some real problems with SSRI’s it is not right for a significant group, yet very good for many others.
    Bill
  5. lenasvn

    lenasvn New Member

    Bill, you are right. Independent researchers (and make sure they are) seem to be the way to go.

    People's testimonies like in this article is always very enlightening, though. I just found the article (personal testimony) interesting and thought I'd share!
  6. Jeanne-in-Canada

    Jeanne-in-Canada New Member


    and this article doesn't begin to scratch the surface, though I'm glad you posted it and people are at least putting it on their radar.

    It doesn't mention w/drawal from the one I'm on, Wellbutrin, but I've had serious and painful w/drawal, and it lasts for mths from one dose adjustment. The big problem w/ Wellbutrin is it only comes in a few doses, and all pills are time released so you can't score them and increment your dose at all, so to dose up or down is usually a big 50 mg leap. You'd have to wonder why they make a drug so inconvenient? All the a.d.'s claim they are non addictive, but I think they know much more about their drugs than they'll ever admit.

    I hope the makers of Effexor and Paxil, which seem to be the super worst ones get a big fat zillion dollar lawsuit slapped on their greedy butts.


    Jeanne
  7. Jeanne-in-Canada

    Jeanne-in-Canada New Member


    and this article doesn't begin to scratch the surface, though I'm glad you posted it and people are at least putting it on their radar.

    It doesn't mention w/drawal from the one I'm on, Wellbutrin, but I've had serious and painful w/drawal, and it lasts for mths from one dose adjustment. The big problem w/ Wellbutrin is it only comes in a few doses, and all pills are time released so you can't score them and increment your dose at all, so to dose up or down is usually a big 50 mg leap. You'd have to wonder why they make a drug so inconvenient? All the a.d.'s claim they are non addictive, but I think they know much more about their drugs than they'll ever admit.

    I hope the makers of Effexor and Paxil, which seem to be the super worst ones get a big fat zillion dollar lawsuit slapped on their greedy butts.


    Jeanne
  8. matthewson

    matthewson New Member

    I weaned myself off of zoloft and had no problems at all and I was taking 150 mg (max. dose 200 mg.) I weaned myself off very slowly and was not bothered by any symptoms. I also never got that flat feeling that some people get with anti-d's.

    At 150 mg., I actually was ecstatically happy, so I knew it was too big of a dose! I was the life of the party so to speak, and I have had social anxiety all my life! I backed down to 100mg because I didn't want to totally change my personality, I just didn't want to be depressed!

    I really feel that anti-d's should only be prescribed to people who really need them, such as severely depressed or suffering from things like social anxiety. And they should be given at the lowest dose possible to prevent side-effects. And they should be weaned off slowly, very slowly.

    Sorry so many had bad experiences on them. They can be a god-send to people who are severly depressed. It can pull them out of a depression faster than therapy, and for someone who is suicidal, it can literally save their lives.

    Take care, Sally
  9. Redwillow

    Redwillow New Member


    I was put on Paxil for anxiety before my diagnosis of FM.

    When I was on Paxil I felt dopey and extremely hungry. I gained a lot of weight while taking it(the doctor forgot to mention that is a common side effect).

    The medication did nothing for my depression in fact I think it made it worse as I felt too apathetic to do anything.

    The doctor didn't want me to stop taking this medication and refused to send me to a specialist so I decided to take matters into my own hands.

    First I tried going off it cold turkey which was a mistake. I was so nauseous I couldn't lift my head from the bed without the room spinning.

    After 3 days of this I couldn't take the nausea and the pain any longer. I took a half a pill and felt a lot better within an hour which showed me that my body was going through major withdrawals.

    So instead I tried tapering off the medication gradually myself going from 30 mg to 20 mg down to 10 and finally 5.

    When I tried to stop that last 5 mg I was an emotional wreak. Uncontrollable weeping and emotions all over the place, nausea, etc.

    So I finally persuaded my doctor to send me to a psychiatrist who agreed that I didn't need to be taking Paxil and at 5 mg it wasn't doing me any good.

    He gave me a perscription for one Prozac pill to get me over the hump of the withdrawals. My pharmacist had never seen a script for such a small amount before, lol.

    That was the end of Paxil for me. Good riddance!

    hugs Redwillow