NHS antidepressant fixation

[Fingersfan]

Been lurking a while, but had to post this.

After 15 years of numerous prescribed anti depressants and the numb void life that goes with it, a couple of years ago I made the decision to put the work in, change my lifestyle and situation and worked my way off the pills. It took nearly a year, but I got there. I know it’s nothing like the struggles some of the folks on here have been through, but it’s been my struggle and it’s great to be out the other side.

My point, now I’ve eventually got to it; my younger brother, a hard working Straight and as anti drug person as you’d ever meet has been struggling with back pain and sciatica. The gp recommended amitryptaline (totally unsuitable as he works in a safety critical industry), or Duloxetine.

The literature says that it’s mildly more effective than placebo on back pain. I find it shocking that a GP would give this pill to anyone.

I told him to think carefully, as my experience with it gave me fucked up moods, no actual enjoyment of life and some shite withdrawals.

Sorry for the rant, it’s just my way of saying how sick I am of the way that the NHS treats people.

 

[Vastness]

Yeah, the UK in general is extremely substance-phobic when it comes to things NHS doctors will prescribe. If you have ADHD that's become less of an issue somewhat recently since the introduction of right to choose legislation which - although in itself a sensible idea - has enabled US-style prescription-for-profit institutions to gain a foothold, which so far is noticeable with the huge uptick in prescription stimulants.

Just remember it isn't the NHS that is at fault - it is successive Conservative governments that have ruthlessly stripped funding from the NHS, while generally advocating for a status-quo drug-phobic, prohibitionist, punitive position on anything harder than aspirin otherwise, which creates a multitude of barriers to the NHS which is already starved of resources being able to liberalise and rationalise it's policy on prescription drugs. Prohibitionist drug policies and substandard health healthcare are not disconnected issues, anywhere in the world.

What you need to be sick of is the way UK governments have treated the NHS, and by extension, the average UK citizen. That's the only way this problem ever gets solved.

 

[LoginNotSecure]

Like any profession, you get some who are good, some average and some terrible. NHS doctors are overworked, underpaid, and accountable for far too much. You are able to ask for a second opinion. Exercise this right.

 

[Bicycle Tripper]

I've been on a few different AD meds over the past 4 years, Sertraline, Fluoxetine and Citalopram. I have to admit they have helped but at the expense of motivation and the usual side effects. Doctors I have seen have been generally unhelpful although I think a lot of it is down to them not really having the resource to do much other than prescribe anti-depressants.

Currently tapering off Citalopram and making sure I replace it with a good diet and lots of exercise.

 

[BeeInMyBonnet]

My first post here. Just popping in to agree with the title, yes NHS has a FIXATION on anti-depressants and I DO NOT TRUST IT. Can I please make a short rant from frustration?

Anti-depressants cannot be stopped suddenly or you experience adverse effects. The NHS website states this is not withdrawal, yet if you don’t wean slowly you have negative adverse effects. I’ve experienced these effects, known many people who have experienced the effects, and have read about the effects. Such as brain zaps, sweats, anxiety, shivers, flu-like body pain, and more. They are LYING when they say this is not withdrawal.

So if hundreds of thousands of people are experiencing chronic pain and we are told no opioids because of risk of addiction, why are we being offered another addictive alternative that is less effective? They are particularly obsessed with amitriptyline.

Anti-depressants completely alter the brain over time, this is a proven fact with many medical science articles discussing it. They reduce sex drive. Cause weight gain and suicidal ideation. They cause dependency in a literal sense because stopping taking them causes negative adverse effects.

You must take them every single day, whereas opiates would only be taken as needed. So with an opiate, you have more control over when you take it and if you are responsible you can take it on the worst days and skip it on less bad days to avoid dependency. But the very nature of the antidepressants means you CANNOT AVOID DEPENDENCY.

So the question is, WHY do they want us all dependent on antidepressants?

And I strongly believe there needs to be a patient’s rights movement to demand the right to pain relief. Even the right to self-prescribe (with perhaps a general aptitude test and basic biology exam). It’s honestly medical tyranny and a violation of the right to self determination and bodily autonomy.

 

[BeeInMyBonnet]

I've been on a few different AD meds over the past 4 years, Sertraline, Fluoxetine and Citalopram. I have to admit they have helped but at the expense of motivation and the usual side effects. Doctors I have seen have been generally unhelpful although I think a lot of it is down to them not really having the resource to do much other than prescribe anti-depressants.

Currently tapering off Citalopram and making sure I replace it with a good diet and lots of exercise.

Just curious if you have an update on how it’s going getting off AD? Have you tried St John’s Wort when you need a mood lift? As for diet, is it possible that your brain is starved of B vitamins and healthy fats? I went down the carnivore diet rabbit hole, and although I did not end up adopting a strict carnivore diet, the information they presented has me fully convinced that the brain needs animal protein and fat to function properly. My brain comes to life when I eat more steak, for example. Things a GP will never suggest. If my brain feels sluggish, St John’s Wort and Gingko Buloba really help me. I’m about to try Methylene Blue for the first time, it’s something worth looking into for energy/focus and mood.

 

[50shadesofDave]

Well Fk the No Hope Service to me, after a traumatic period in my life and a chat with my gp, i left with a script for effexor × 2 daily and a mirtazipine at night, after a 20 min chat?

Should someone be given these substances off the bat?

Put it this way, it cost me months off work and i still bear the scars on my face from the blackouts with no recolection of the day prior, or why i was waking up in random places of my gaff in pools of blood, with no idea of the time of day/night.

My gp claimed i needed more time on them and possibly could be someone who needed them for life!!!

I had an awful couple of months CT from this combo, i went back and accused the gp of taking cash from the makers of these drugs, i've had little interaction with the nhs since, and i need help now, with nowhere to turn.

Currently changing gp surgery.

Best wishes to those in need.

 

[Bleaney]

Like any profession, you get some who are good, some average and some terrible. NHS doctors are overworked, underpaid, and accountable for far too much. You are able to ask for a second opinion. Exercise this right.

NHS GPs earn 70 to 100k +

I don't know how much Drs in hospitals earn, but it's probably a lot more than that.

I wouldn't say that is underpaid, although I know the workload and hours can be overwhelming, and there are so many years of study to be paid for at the start.

I mean compare it to teachers, who also have to fund 3 years of uni, plus extra teacher training years on top, and they only earn 25K or so. They also have overhwelming workloads and stress. Drs are laughing in comparison to teachers, at least when it comes to salaries.

 

[sadasaulna]

They are LYING when they say this is not withdrawal.

Anti-depressants completely alter the brain over time, this is a proven fact with many medical science articles discussing it. They reduce sex drive. Cause weight gain and suicidal ideation. They cause dependency in a literal sense because stopping taking them causes negative adverse effects.

But the very nature of the antidepressants means you CANNOT AVOID DEPENDENCY.

This has been my bug bear. I've been on SSRIs for over 15 years. At no point was dependency mentioned. I was told they were completely safe. I cannot get even a tiny benzo script (like 3 x 5mg tabs) for a panic attack, yet they will dole out these drugs that have absolutely crippling withdrawals that go on for months, in some cases over a year.

About 6 months ago I ran out of benzos having had a "habit" of 5mg per day for 3 months. As I got to my last strip I reduced to 2.5mg/day and then nothing. I had two weeks of heightened but tolerable anxiety and then was clean of the stuff for the next 6 months (I only started again recently to reduce my alcohol intake, which has worked very well).

Compare and contrast to when I tried to quit Sertraline I was then on. I tapered gradually over 3 months and still the withdrawals were crippling. After dose was zero the withdrawals were still in full swing and absolutely debilitating. I've known people who had hard drug habits quit them who cannot withdraw from SSRIs. One Psychiatrist I spoke to seemed far more sane on the subject, I brought it up and he said yes it would be possible but given the length of time I'd been on, the taper might take 1-2 years.

They even think its funny. I was once with a psychiatrist, a nurse and a trainee psychiatrist who was along to learn. I likened SSRIs to an abusive partner: "They're fine with you so long as you're under their control, then when you try to leave them, they beat the shit out of you." All three of them were in almost tears of laughter. They thought it an apt analogy, but when you think about it, it isn't funny at all.

The language the NHS has used around SSRIs seems to be carefully worded to avoid potential litigation.

It is also worth noting that GPs are not experts in psychotropic substances. Only a psychiatrist is qualified in this regard. A GP cold turkeyed my sister from longish prescription of pregablin and she got psychosis.

 

[emkee_reinvented]

Well Fk the No Hope Service to me, after a traumatic period in my life and a chat with my gp, i left with a script for effexor × 2 daily and a mirtazipine at night, after a 20 min chat?

Should someone be given these substances off the bat?

Put it this way, it cost me months off work and i still bear the scars on my face from the blackouts with no recolection of the day prior, or why i was waking up in random places of my gaff in pools of blood, with no idea of the time of day/night.

My gp claimed i needed more time on them and possibly could be someone who needed them for life!!!

I had an awful couple of months CT from this combo, i went back and accused the gp of taking cash from the makers of these drugs, i've had little interaction with the nhs since, and i need help now, with nowhere to turn.

Currently changing gp surgery.

Best wishes to those in need.

Mirtazepine, especially when underweight and having trouble sleeping. As anti-depressant should be 1 st choice.

Edit: it has, i speculate also a effect on generalized anxiety. But was taking diff things att.

Venlafaxine [ Effexor] can drive a small percentage of the people crazy, one dose, so prescribing these.
After a 20 minute chat is imo not professional. Worse if its without a combination of monitoring and a Therapy.

 

[ChemicallyEnhanced]

Been lurking a while, but had to post this.

After 15 years of numerous prescribed anti depressants and the numb void life that goes with it, a couple of years ago I made the decision to put the work in, change my lifestyle and situation and worked my way off the pills. It took nearly a year, but I got there. I know it’s nothing like the struggles some of the folks on here have been through, but it’s been my struggle and it’s great to be out the other side.

My point, now I’ve eventually got to it; my younger brother, a hard working Straight and as anti drug person as you’d ever meet has been struggling with back pain and sciatica. The gp recommended amitryptaline (totally unsuitable as he works in a safety critical industry), or Duloxetine.

The literature says that it’s mildly more effective than placebo on back pain. I find it shocking that a GP would give this pill to anyone.

I told him to think carefully, as my experience with it gave me fucked up moods, no actual enjoyment of life and some shite withdrawals.

Sorry for the rant, it’s just my way of saying how sick I am of the way that the NHS treats people.

The issue is, when it comes to certain things - primarily pain or anxiety - the NHS will try and give you ANYTHING but the medications designed to treat those conditions. I have severe anxiety and panic attacks. Diazepam (moderate dose) completely cured them and Lorazepam made a MASSIVE improvement. But do they prescribe them to people? Do they fuck. I got offered various anti-depressants, anti-psychotics and anti-histamines instead. None of which work.
Same with pain. They'll suggest acetaminophen (Paracetamol) which is NO better than a placebo effect*, ir Ibuprofen. If I'm in such severe pain that I need to see a doctor about it because I can't work/function...ibuprofen or aspirin ain't gonna do shit. And yeah, if you keep insisting, you MIGHT get like 500/15 co-codamol, or anti-depressants, or anti-seizure meds.
It's so stupid.
I had to call my doctor, crying, and admitting I was feeling suicidal from the pain to finally be offered a whole 20mg/day of Morphine...I HATE that doctors seem to have this power-trip going on with gatekeeping meds. And it's because it's all NHS, so it's not like somewhere like America, where you can just see a different doctor.

*In adults, it IS effective for pain in children under 12

 

[Pissed_and_messed]

it has, i speculate also a effect on generalized anxiety.

absolutely.

 

[sadasaulna]

Mirtazepine, especially when underweight and having trouble sleeping. As anti-depressant should be 1 st choice.

Edit: it has, i speculate also a effect on generalized anxiety. But was taking diff things att.

Venlafaxine [ Effexor] can drive a small percentage of the people crazy, one dose, so prescribing these.
After a 20 minute chat is imo not professional. Worse if its without a combination of monitoring and a Therapy.

I saw an awful psych who tried to push me onto venlaxfaxine. I'd been put on Sertraline at one point even though I'd always had Citalopram. I think the GP said at the time something like "Its pretty much the same." (I think, in retrospect, it was just slightly cheaper) It wasn't, I did horribly on sertraline, causing me to try a 3 month taper. This went horribly wrong, crippling anxiety and panic attacks and horrendous withdrawals. Then I went on mirtazapene and I hated it, I'd been sober almost 2 1/2 years by then and it felt like I was on a constant booze cruise when I was on Mirtazapene. In the end I had a complete breakdown on it and tried to kill myself while on it. After that I saw the psychs, they'd tried to push me at "Mindsmatter" but thankfully they refused citing I was too high a suicide risk and so I got in front of an actual psych. I asked to be put back on Citalopram as it had been the drug I'd been most stable on before. She told me she'd be prescribing Venlafaxine, which she said was an SSRI. They hate it when you correct them but I couldn't resist. "It's an SNRI", I told her. She didn't take that well* I then pointed out that giving me a drug where you can get severe withdrawals from missing even a single dose was daft when I had mentioned that I have poor compliance with either remembering to take my meds or sometimes trying to get off them. That she'd be putting me on a drug considered to have some of the worst withdrawal symptoms while my aim was to reduce my dependence on them at that time.

I repeated I wanted to be put back on citalopram and she gave in. Venlafaxine just seemed to be the trendy new drug with the NHS at the time, when I was in Acute Theraphy Service after a suicide attempt landed me in intensive care many of the people there (in there for the same reason as me) had been put on Venlafaxine and I heard horror story after horror story about it. They'd also seen the same psych as me and described her as an evil witch.

*This was the woman that had herself sitting in a high chair and her patient in front of her desk on a low chair almost like one for a kid so that there was a clear height difference between us both. Sadist.

 

[sadasaulna]

The issue is, when it comes to certain things - primarily pain or anxiety - the NHS will try and give you ANYTHING but the medications designed to treat those conditions. I have severe anxiety and panic attacks. Diazepam (moderate dose) completely cured them and Lorazepam made a MASSIVE improvement. But do they prescribe them to people? Do they fuck. I got offered various anti-depressants, anti-psychotics and anti-histamines instead. None of which work.

Basically they f***ed up with benzos in the 60s giving them out like candy. So the NHS went down the new route that SSRIs were not addictive and that is true only in the most technical sense. Addictive no, full blown dependency yes, and far harder to taper from than any addictive drug I've ever used. Vast numbers of people are on very long term SSRI scripts. They did everything possible to deny withdrawals were serious, minimized patients own experiences, and when they did slowly acknowledge it after decades they use a lot of carefully coded language to try and stave off the potential backlash.

Meanwhile instead of accepting that Benzo's do need careful prescribing but were a viable proposition they ran away screaming from them as if they were the devil themselves.

Consider that one of the most valid uses for Benzos is for short term cessation of extreme anxiety, and then consider that the NHS has recently updated its guidelines to say that they will not prescribe minute scripts for phobias. Eg, it used to be perfectly normal to get say 3 or 4 diazepam prescribed if you were going on a flight and had huge anxiety of flying, or if you were undergoing a procedure that would also cause extreme anxiety - dental appointments, MRIs etc. So its a flat out "computer says no" know for such perfectly reasonable (ideal?) uses of that class of drug.

I may have mentioned this before elsewhere but (love or loathe him) when Jordan Peterson went crazy it was partly cost he cold turkey-ed a 4mg clonazepam habit. The bigger part behind that story is he was on the clonaz because he had discontinued an SSRI and was going through agonizing withdrawals. My theory is he was battling both post acute withdrawal from the SSRI and the benzo at the same time. He has been noted and often mocked for crying in interviews... during all the times I have tried to withdraw from SSRIs that was one of the most common symptoms for me, I would cry at absolutely anything. I would break down in tears at even the slightest emotional provocation. Sometimes it was divine, like a sunset that would have me crying like a baby.

 

[emkee_reinvented]

I saw an awful psych who tried to push me onto venlaxfaxine. I'd been put on Sertraline at one point even though I'd always had Citalopram. I think the GP said at the time something like "Its pretty much the same." (I think, in retrospect, it was just slightly cheaper) It wasn't, I did horribly on sertraline, causing me to try a 3 month taper. This went horribly wrong, crippling anxiety and panic attacks and horrendous withdrawals. Then I went on mirtazapene and I hated it, I'd been sober almost 2 1/2 years by then and it felt like I was on a constant booze cruise when I was on Mirtazapene. In the end I had a complete breakdown on it and tried to kill myself while on it. After that I saw the psychs, they'd tried to push me at "Mindsmatter" but thankfully they refused citing I was too high a suicide risk and so I got in front of an actual psych. I asked to be put back on Citalopram as it had been the drug I'd been most stable on before. She told me she'd be prescribing Venlafaxine, which she said was an SSRI. They hate it when you correct them but I couldn't resist. "It's an SNRI", I told her. She didn't take that well* I then pointed out that giving me a drug where you can get severe withdrawals from missing even a single dose was daft when I had mentioned that I have poor compliance with either remembering to take my meds or sometimes trying to get off them. That she'd be putting me on a drug considered to have some of the worst withdrawal symptoms while my aim was to reduce my dependence on them at that time.

I repeated I wanted to be put back on citalopram and she gave in. Venlafaxine just seemed to be the trendy new drug with the NHS at the time, when I was in Acute Theraphy Service after a suicide attempt landed me in intensive care many of the people there (in there for the same reason as me) had been put on Venlafaxine and I heard horror story after horror story about it. They'd also seen the same psych as me and described her as an evil witch.

*This was the woman that had herself sitting in a high chair and her patient in front of her desk on a low chair almost like one for a kid so that there was a clear height difference between us both. Sadist.

Thats an very sad example how we are treated, prescribed a drug, while someone is more or less is un-accountable.
But don t warn, you and/ or your care takers about side effects.

Especially an increase in suicidal tendency, goes for lot of anti-epileptic/ moodstabelizers too. No clue why this is not done.

Not that it matches my low dose regimin 15 mg a day. But Mirtazepine seemed very benign. Unlike anti-convulsants like Levetiracetam or Valproic acid. A SSRI like drug i wouldn t even consider a option even when depressed.

 

[ChemicallyEnhanced]

Basically they f***ed up with benzos in the 60s giving them out like candy. So the NHS went down the new route that SSRIs were not addictive and that is true only in the most technical sense. Addictive no, full blown dependency yes, and far harder to taper from than any addictive drug I've ever used. Vast numbers of people are on very long term SSRI scripts. They did everything possible to deny withdrawals were serious, minimized patients own experiences, and when they did slowly acknowledge it after decades they use a lot of carefully coded language to try and stave off the potential backlash.

Meanwhile instead of accepting that Benzo's do need careful prescribing but were a viable proposition they ran away screaming from them as if they were the devil themselves.

Consider that one of the most valid uses for Benzos is for short term cessation of extreme anxiety, and then consider that the NHS has recently updated its guidelines to say that they will not prescribe minute scripts for phobias. Eg, it used to be perfectly normal to get say 3 or 4 diazepam prescribed if you were going on a flight and had huge anxiety of flying, or if you were undergoing a procedure that would also cause extreme anxiety - dental appointments, MRIs etc. So its a flat out "computer says no" know for such perfectly reasonable (ideal?) uses of that class of drug.

I may have mentioned this before elsewhere but (love or loathe him) when Jordan Peterson went crazy it was partly cost he cold turkey-ed a 4mg clonazepam habit. The bigger part behind that story is he was on the clonaz because he had discontinued an SSRI and was going through agonizing withdrawals. My theory is he was battling both post acute withdrawal from the SSRI and the benzo at the same time. He has been noted and often mocked for crying in interviews... during all the times I have tried to withdraw from SSRIs that was one of the most common symptoms for me, I would cry at absolutely anything. I would break down in tears at even the slightest emotional provocation. Sometimes it was divine, like a sunset that would have me crying like a baby.

I think the guy is an fucking idiot, but I also think he actually BELIEVES the crap he spouts and THINKS he is doing well. Like, most people like him are clearly coming from a maliciously ignorant place, but I feel like he's ignorant in a more classic definition of the word, in that he's misinformed and lacking knowledge/awareness. I don't think he has bad intentions, but he is doing harm and spreading misinformation nonetheless. Having said that, if he was withdrawing like that, I feel so bad for him and it would DEFINITELY explain the crying and lack of rationality. When I'm withdrawing from opioids or GABA drugs, the slightest thing makes me really emotional. Like, I'm normally very strong, but in withdrawal, anything can make me cry.
I got so pissed at the NHS because my grandfather has muscle pain in his back and is prescribed 20mg diazepam 4 times a day for it. Long term script. That isn't why I'm mad so much as *I* have debilitating anxiety and panic attacks and while he gets 80mg a day for muscle pain, I can't even get like 10mg/day for extreme anxiety.
I DO get Chlorpromazine, which works okay (not as well as a benzo) but anti-psychotics are WAY more harmful than benzo's. And I do have mental side-effects. Mostly suddenly going "blank" or having very sudden amnesia of the previous few minutes and it's embarrassing to have to say to someone I've been having a conversation with, "I'm sorry, I have absolutely NO IDEA what we've been discussing for the last several minutes, could you recap it all for me?".
I've been on Sertraline (SSRI) for a long time, too. A little over 14 years now.

 

[emkee_reinvented]

I think the guy is an fucking idiot, but I also think he actually BELIEVES the crap he spouts and THINKS he is doing well. Like, most people like him are clearly coming from a maliciously ignorant place, but I feel like he's ignorant in a more classic definition of the word, in that he's misinformed and lacking knowledge/awareness. I don't think he has bad intentions, but he is doing harm and spreading misinformation nonetheless. Having said that, if he was withdrawing like that, I feel so bad for him and it would DEFINITELY explain the crying and lack of rationality. When I'm withdrawing from opioids or GABA drugs, the slightest thing makes me really emotional. Like, I'm normally very strong, but in withdrawal, anything can make me cry.
I got so pissed at the NHS because my grandfather has muscle pain in his back and is prescribed 20mg diazepam 4 times a day for it. Long term script. That isn't why I'm mad so much as *I* have debilitating anxiety and panic attacks and while he gets 80mg a day for muscle pain, I can't even get like 10mg/day for extreme anxiety.
I DO get Chlorpromazine, which works okay (not as well as a benzo) but anti-psychotics are WAY more harmful than benzo's. And I do have mental side-effects. Mostly suddenly going "blank" or having very sudden amnesia of the previous few minutes and it's embarrassing to have to say to someone I've been having a conversation with, "I'm sorry, I have absolutely NO IDEA what we've been discussing for the last several minutes, could you recap it all for me?".
I've been on Sertraline (SSRI) for a long time, too. A little over 14 years now.

Your victim of being robbed of free will, dependent on [uneducated] others.

Its pretty global, your not the only one who gets this. Western world wide is where it started.
Its expanding to 2-nd 3-rd world countrys before you know, we have no saying anymore.
Only take it or leave it.

 

[Jnowhere]

The really sad part is, that many effective opiods and benzos are dirt cheap to make and to purchase in large quantities( for countries who buy in bulk)

I have trouble believing( not exactly positive) that the anti depression meds are nearly as cheap as many common opiods and benzos.

The sad part is( for me and my fellow Americans) is America is going this way.

So let me see if I understand this. The NHS will not give out dirt cheap meds( short term in most cases) that are made to handle and treat pain or anxiety. Because of a risk of addiction. They assume you can't handle them.

Instead you get inappropriate meds; that are guaranteed to cause addiction and are worse than opiods to get off, of and you suffer from not getting properly treated and suffer horribly, when you try to get off them?

 

[Bleaney]

Yeah the whole restrictive and frustrating thing just ends up driving people to the black market in many cases.

SSRIs are extremely expensive upon initial release due to patents. I'm not sure how long that period lasts before cheaper generics can be produced and sold. But I believe the time period is measured in years rather than months.

 

[Jnowhere]

Yeah the whole restrictive and frustrating thing just ends up driving people to the black market in many cases.

SSRIs are extremely expensive upon initial release due to patents. I'm not sure how long that period lasts before cheaper generics can be produced and sold. But I believe the time period is measured in years rather than months.

I used to know this but laws in different countries vary, but it is years.