Addiction Tapering SSRI antidepressants

[Jabberwocky]

I had a really horrible withdrawal starting like a month after I got off an SSRI. Several months since then, I'm doing pretty well in the realm of depression. Thought it might help to share.

Interesting that the withdrawals took a month to start, that must of been a shock after thinking you were over the worst of it. Which SSRI was it? how long were you on it for? and the most obvious one...are your depression levels better now than they were when you were taking the SSRI?

 

[AlphaMethylPhenyl]

^Yes, gave me quite the start!

It was Zoloft. I was on 300mg of it for maybe six months total (including citalopram).

I would say that I'm at 80%, but in some ways better than when I was taking it. Pros and cons, alas.

 

[plumbus-nine]

@Sergeant Absent The irony is that pregabalin is easy in comparison to get off if I wanted to (I don't because then the anxiety reappears, irony wants that the substance I'm most dependent on helps me the least), I've been on and off it a few times, even morphine was comparatively easy to quit, granted with help of powerful tools, specially memantine but still, for that they told me 'you'll need to stay forever on morphine, you know?' Withdrawal took a week and was painless. For SSRI tools are limited.. I will try to get kanna again but didn't find yet somebody shipping to MX.

The pregabalin should be soluble in water, the content of these capsules contains a big amount of talcum and pregabalin as tiny crystals, what you want are just the crystals, the remaining can be discarded, I'd try a coffee filter. But for me pregabalin is more easy to stay on, I get no side effects to speak of (until it turned out to contribute to high prolactin/low testosterone as well but so far I didn't read about a connection).

@AlphaMethylPhenyl Yeah, the problem is that SSRI w/d is so long lived, if it'd be just 2-3 days it'd be manageable but not weeks, months. I was on Zoloft as well, was the only one which didn't give me abstinence but also no help and probably it was shoveled out of my brain by p-Gp or whatever way.

 

[Jabberwocky]

@Sergeant Absent The irony is that pregabalin is easy in comparison to get off if I wanted to (I don't because then the anxiety reappears, irony wants that the substance I'm most dependent on helps me the least), I've been on and off it a few times, even morphine was comparatively easy to quit, granted with help of powerful tools, specially memantine but still, for that they told me 'you'll need to stay forever on morphine, you know?' Withdrawal took a week and was painless. For SSRI tools are limited.. I will try to get kanna again but didn't find yet somebody shipping to MX.

The pregabalin should be soluble in water, the content of these capsules contains a big amount of talcum and pregabalin as tiny crystals, what you want are just the crystals, the remaining can be discarded, I'd try a coffee filter. But for me pregabalin is more easy to stay on, I get no side effects to speak of (until it turned out to contribute to high prolactin/low testosterone as well but so far I didn't read about a connection).

@AlphaMethylPhenyl Yeah, the problem is that SSRI w/d is so long lived, if it'd be just 2-3 days it'd be manageable but not weeks, months. I was on Zoloft as well, was the only one which didn't give me abstinence but also no help and probably it was shoveled out of my brain by p-Gp or whatever way.

It's interesting that you found Pregabalin not so difficult to come off. I've been on it 3 and half years now, the max dose I was on was 600mg per day for neuropathic pain, and at one point I did try to get off of it because of the zombie feeling stopping me from having conversations properly and forgetting everything, and the withdrawals for me were horrendous...worse than when I came off Citalopram or Amitriptyline (both of which which I eventually went back on and the Pregabalin as well) So now I know I need the pregab/amitrip for pain management...even though they're not great at that either but better than not taking them, and with the SSRI I don't like the fact that I need it at all. But I also don't see requiring an SSRI as an addiction, if I was seeking it compulsively to purposely reach excessive levels exceeding the prescribed dose to achieve some kind of high then yes obviously that's an addiction, but taking them as prescribed to try and manage something, even though the body now requires it and would have withdrawals if stopped...that's not an addiction. I'm saying this again because I noticed you referred to the SSRI intake as an addiction, I don't think you should see it that way because basically it isn't. I'm not trying to argue here, I'm just saying what it is. Having withdrawals from stopping a substance is not an addiction, there's other criteria that also need to be met for this to be true. Pregabalin for example I agree is highly addictive because it produces a high that compels people to obtain higher doses and results in euphoria seeking behaviour, whereas SSRI's do not. Citalopram or Sertraline don't give you a high that makes you want to seek more to increase a euphoria that isn't there in the first place.

 

[plumbus-nine]

@Sergeant Absent Maybe it's the duration, what pregab does is basically inducing an enzyme which converts glutamate into GABA, and of course blocking a2d calcium channels but this activity isn't what makes the dependence. First time I've been on it, I indeed felt stupid and cognitively limited. Now, many years later, it feels like nothing but makes me able to go outside without any anxiety. Probably the culprit is dissociative tolerance (so, tolerance to them, much of it) which only leaves the GABAergic effect in action. Withdrawal isn't pretty and feels like from an opioid but with memantine or kratom it's manageable. That I tend to use everything possible and available to cover withdrawals (for myself, and for not to induce kindling) will also having played a role but first time after 3-4 months on 600mg I just tapered down within 1-2 weeks and nothing.

SSRIs on the other hand seem to be resistant to any normal tapering scheme in me but as said, been on them for 10+ years now. Given that after 7 years they say every cell has been replaced by a new one, I guess nature will build tolerance in too, and then it's HARD to reverse it. I have like 10x tolerance to dissociatives (requiring/tolerating 10x the dosage) and strangely/amazingly it does nothing to my sober state. Maybe take some motivation but not much. That's pretty unique among drugs.

Oh, other speculation was that HIGHER doses of pregabalin are EASIER to quit because over ~900mg it begins to block glutamate transporter 1, thus counter acting it's own GABAergic mechanism and POSSIBLY less withdrawal. There's little to lose in trying it if you have enough capsules, high dose pregab is fun.