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Question about short term SSRI use and brain chemistry

What that individual is referring to as withdrawals might not actually be "withdrawals", as much as it is rebound depression/resumption of normal depression because the SSRIs were beneficial to their brain chemistry (maybe effects concerning things like brain derived neurotrophic factor that their depressed brains run low on) which anyways, means that their anti depressants were successful in the first place. There really are no "negative" withdrawals from a drug that didn't help you in the first place. Anyways, the remodeling he is talking about takes place over many years. They do not happen during short periods of time, which is honestly unfortunate because it takes so incredibly long for our current depression treatments to take effect. This works to your benefit in this moment however.

For lots of people I think their problem is too much serotonin, SSRIs don't really help these people and these people will do better without them. A drug like an ssri that desensitizes (down regulates) their serotonin receptors if given chronically (years) is a good thing, but that time line of usage affects both their "good" and "bad" serotonin and has implications for withdrawals. If you only take anti depressants for a couple weeks they start to downregulate your "bad serotonin" but they haven't been increasing serotonin concentrations nearly long enough to down regulate your "good serotonin", "withdrawal" will be a completely different matter concerning this timeline. Once you are off the drugs you will have minorly down regulated bad serotonin but you won't be without your good serotonin. Someone who's been on them for years would be running low on the good serotonin department for a while after coming off them. The missing the "bad serotonin" (5-HT2A) will never be a problem, but at some point it will rebound (assuming it's been down regulated) and people with 2A over density could see problems a month out with this rebound of bad serotonin.

Just to be clear as mud, these "withdrawals" people are speaking of might not be a matter of not having good serotonin, but might be due to rebound of bad serotonin. This is likely why it anecdotally takes a couple weeks for these people that have been on SSRIs for years. I theorize being chronically on SSRIs for years and years will increase the amount of 5-Ht2A synapses even if it brings down the number of receptors per synapse while you're on SSRIs but the over density of 2A will be truly revealed when you go off anti depressants and the receptors on all those 5-Ht2A receptors up regulate after a couple weeks. Personally I think it's better to just take a medication to antagonize the bad serotonin directly instead of relying on the SSRIs being administered chronically to downregulate the 5-HT2A receptors.

The important thing is that you've only been on them for a tiny tiny bit and your brain will not withdraw like these people are suggesting because your brain hasn't changed mechanisms to reach homeostasis with the drug in your system. Which is the long term benefit of being on SSRIs. I have a feeling that website is probably no good. There are probably a lot of people that have had bad experiences with SSRIs there and whatever it was about their brain chemistry that gave them bad experiences with SSRIs I wouldn't assume apply to you :) plus they were probably on them forever. It's pretty rare for someone to only be on anti depressants for a couple weeks.

Anyways there's a lot more to depression than serotonin and I think you're actually having horrible anxiety that leads to depression, other people (like on that website) might have more first order depression issues, their chemistry (and hence their withdrawal experiences) are going to be different.

The thing to remember about someone who is taking SSRIs for primary depression (and not taking them for say, anxiety/OCD) is that they are going to have more problems coming of anti depressants because their serotonin/chemistry is their problem, but for people whose problem is really anxiety the thought patterns are much more important and these are more psychological.

I hope that makes sense, that people with a "biological depression" are more likely to have a hard time related to anti-depressant withdrawals rather than someone with "psychological anxiety". Not trying to say you don't have depression, but I think your root cause of your problems is not a lack of serotonin, it's possibly too much in some ways.
 
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Cotcha Yankinov said:
What that individual is referring to as withdrawals might not actually be "withdrawals", as much as it is rebound depression/resumption of normal depression because the SSRIs were beneficial to their brain chemistry (maybe effects concerning things like brain derived neurotrophic factor that their depressed brains run low on) which anyways, means that their anti depressants were successful in the first place. There really are no "negative" withdrawals from a drug that didn't help you in the first place. Anyways, the remodeling he is talking about takes place over many years. They do not happen during short periods of time, which is honestly unfortunate because it takes so incredibly long for our current depression treatments to take effect. This works to your benefit in this moment however.

For lots of people I think their problem is too much serotonin, SSRIs don't really help these people and these people will do better without them. A drug like an ssri that desensitizes (down regulates) their serotonin receptors if given chronically (years) is a good thing, but that time line of usage affects both their "good" and "bad" serotonin and has implications for withdrawals. If you only take anti depressants for a couple weeks they start to downregulate your "bad serotonin" but they haven't been increasing serotonin concentrations nearly long enough to down regulate your "good serotonin", "withdrawal" will be a completely different matter concerning this timeline. Once you are off the drugs you will have minorly down regulated bad serotonin but you won't be without your good serotonin. Someone who's been on them for years would be running low on the good serotonin department for a while after coming off them. The missing the "bad serotonin" (5-HT2A) will never be a problem, but at some point it will rebound (assuming it's been down regulated) and people with 2A over density could see problems a month out with this rebound of bad serotonin.

Just to be clear as mud, these "withdrawals" people are speaking of might not be a matter of not having good serotonin, but might be due to rebound of bad serotonin. This is likely why it anecdotally takes a couple weeks for these people that have been on SSRIs for years. I theorize being chronically on SSRIs for years and years will increase the amount of 5-Ht2A synapses even if it brings down the number of receptors per synapse while you're on SSRIs but the over density of 2A will be truly revealed when you go off anti depressants and the receptors on all those 5-Ht2A receptors up regulate after a couple weeks. Personally I think it's better to just take a medication to antagonize the bad serotonin directly instead of relying on the SSRIs being administered chronically to downregulate the 5-HT2A receptors.

The important thing is that you've only been on them for a tiny tiny bit and your brain will not withdraw like these people are suggesting because your brain hasn't changed mechanisms to reach homeostasis with the drug in your system. Which is the long term benefit of being on SSRIs. I have a feeling that website is probably no good. There are probably a lot of people that have had bad experiences with SSRIs there and whatever it was about their brain chemistry that gave them bad experiences with SSRIs I wouldn't assume apply to you :) plus they were probably on them forever. It's pretty rare for someone to only be on anti depressants for a couple weeks.

Anyways there's a lot more to depression than serotonin and I think you're actually having horrible anxiety that leads to depression, other people (like on that website) might have more first order depression issues, their chemistry (and hence their withdrawal experiences) are going to be different.

The thing to remember about someone who is taking SSRIs for primary depression (and not taking them for say, anxiety/OCD) is that they are going to have more problems coming of anti depressants because their serotonin/chemistry is their problem, but for people whose problem is really anxiety the thought patterns are much more important and these are more psychological.

I hope that makes sense, that people with a "biological depression" are more likely to have a hard time related to anti-depressant withdrawals rather than someone with "psychological anxiety". Not trying to say you don't have depression, but I think your root cause of your problems is not a lack of serotonin, it's possibly too much in some ways.
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Thanks Cotcha! That makes sense, I just went to my doctor and he confirmed that everything that guy said is BS anyways. The original plan was to stop taking the SSRI's today, so I'm done and dusted with them now, there's probably no need to take the 2.5mg for the next four days. I think I'll listen to my doctor instead of some anti SSRI establishment with no credibility whatsoever.

And I agree, I don't have depression. I know that for sure, although I do experience depression with anxiety.

I still don't get why he said I should taper down 10% a month when I've been on them for a total of three weeks. Is it just me or is that totally ridiculous?
 
This is the link he told me to check out. I don't know whether to take this for gospel or if this is a load of shit. I just want to do the right thing for my body.

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

Basically it's saying I'm at higher risk because I'm tapering faster. Saying that my nervous system is going to get damaged or some shit.

Withdrawal symptoms represent neurological dysfunction. Severe symptoms can be distressing, debilitating, or even disabling. If you get prolonged withdrawal syndrome, there is no known treatment or cure. You will have to cope with it until it goes away.

Except -- it can take weeks to feel the full brunt of withdrawal symptoms from an initial drop. If you have already made two reductions from your original dosage, you will have reduced by about 50% -- and your symptoms may indicate substantial neurological damage. You could be suffering quite a bit for a long tim

Follow this harm reduction approach to starting your taper:
Initially, make a 10% reduction and hold there for a MONTH. It can take several weeks for withdrawal symptoms to emerge. Do that again the second month.
If you have very minor or no symptoms from these 2 reductions, you can try reducing by 10% (calculated on the last dosage) every 3 weeks. Do that twice. If no problems, reduce by 10% every 2 weeks. Do that twice.
If no problems after 4.5 months of very gradual reduction, you may be able to reduce by 10% every week.
If significant withdrawal symptoms appear, make smaller cuts or go slower. Listen to your body.
"Jump off" at the end when reductions no longer cause any reaction at all.
With this method, the fastest taper takes about 6 months.
 
Nobody's nerves get damaged by tapering too quickly off any SSRI independent of how long they have been on it (probably- I think we definitely should do gradual taper in many cases but always with common sense), this is real bullshit that just scares people without any true reason! I don't like the SSRIs personally, the side- and after effects, the protracted withdrawal are true in some cases but it is really dependent on how long you've been on the drug, on which dosage and your genetics. Nobody gets any serious irreversible symptoms from just being some weeks on a SSRI. Really. These brain zaps are nasty, but they're only dangerous probably for people with underlying seizure disorders. And you need to be quite some time on a serotonergic to get them anyways.

Just read the name of that page. Surviving Antidepressants. They're exacerbating. Why can't people just keep with the reality?
 
Ok then. Yeah I think there is a fair bit of scaremongering in there. The main thing that worries me is the 2-3 week delay period in withdrawals, although I've seen no evidence for this.

Also they posted a study which is below, saying that SSRI's seem to work alot quicker than we thought. See below

http://ils.unc.edu/bmh/neoref/this.dir.unneeded/schizophrenia/review/tmp/352.pdf

Once again, I'm not very good at making sense of these studies. This will be my last question as I have to head to the airport soon and won't have internet for two weeks! What does this study exactly say? Does it mean that
 
They sure do like the ten percent taper on SA
They would suffer less going cold turkey, especially when its the medication giving them the bad side effects
 
SSRIs bind to the serotonin reuptake transporter (that's how they inhibit the transporter) so a measure of how much of your total transporters have been inhibited is sort of a measure of how much your serotonin concentrations are being increased in the synapse, the idea behind a percentage taper is there is a weird dose response concerning how much dose you are taking and how much your SERTs are inhibited. So they are suggesting really slow tapers as a general rule of thumb - I don't think they actually know what they're talking about - to keep your brain cells supply of serotonin smoothly declining to avoid a drought of serotonin (because someone who has been on these drugs for years will have a drought of serotonin if they cold turkyed, because their receptors would still be down regulated but their SERTs are inhibited and therefore increasing serotonin concentrations in the synapse to make up for the lack of receptors, when you uninhibit the SERT it will do its job of clearing serotonin from the synapse (very likely a good thing in your case).

But the ONLY reason why any of that would matter is if your receptors had been down regulated, and a month or two just isn't long enough for that to happen, so a slow taper is a good idea for someone who's been on a high dose for a decade but for you individually you're doing just dandy :) I think they are just using their rule of thumb concerning tapering without understanding what's going on regarding down regulation.

Best of luck on your retreat :) calm that mind! You seem like an intelligent person but that can lend itself to the mind being too busy when it should be relaxing.
 
No problem :)
Yeah its nonsense, I mean setting aside that withdrawals only happen with chronic users (and not someone in your position, which is really important and the people on surviving antidepressants should've been keen to) withdrawals set in pretty fast after the last pill, if not during the taper itself. Citalopram has a fairly long half life (I think it was almost 40 hours) so this will help smooth things out as well. Tapering with a SSRI that has a long half life is very similar to doing a percentage taper.

What could be happening to some of these people who've been on anti depressants forever is that a couple weeks after their last dose is their "bad serotonin" starts to rebound or something else that's not directly related to serotonin is giving them problems which could be thought of as a resumption of their usual depression physiology. But they should be facing their deficit of "good serotonin" (their withdrawal) within a couple days of the last pill. Once again that's only in regards to people who have been on drugs forever :)

But anyways don't be worried about this whole "Permanent withdrawals" thing that seems to be going around on that website. You might possibly feel a little down for a week but then again you might not notice anything out of the ordinary, especially if the anti depressants never really made you happy in the first place. After all, if I gave you a drug that made you feel shitty for a long time, you would basically have an anti-withdrawal once you stopped it.
 
Cool. Thanks for the clarification there. I'm starting the retreat tonight NZ time which should be good so I'll be signing off in a few hours for a few week. Just got off my plane so have a few hours to kill!

Another thing that played on my mind today... Withdrawals wouldn't come back over a period of time would they? Like that would be impossible yeah? It's another 'what if' I have haha.
 
Oh yeah it would be impossible, they wouldn't really be withdrawals if anything, you would just be back to your normal self. If your normal self is shitty... well.. hahaha. Anyways, you can rest assured your not going to face any consequences or anything from the SSRIs. These people on surviving antidepressants got you coiled up good. I hope everything goes well at the retreat, anxiety takes a long time to chip away at but slow and steady does it. Try to let your mind relax :) If you ever need anything like a recommendation of a med to help you sleep or anything let me know. Peace
 
HEY aren't you supposed to be relaxing on your retreat ;p My perspective is withdrawal coming back means that there was an initial withdrawal, and an initial withdrawal implies that you've been on the drugs a really long time, so you, as a person who took them less than one month, have nothing to fear :) I don't know exactly what's going on with these people that have extended withdrawals but they all seem to have had major depression issues all their life (implying there is something major league wrong) and then they spend years on many different anti depressants, and then they have a bad withdrawal. So don't fret about these people :)
 
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Just have to say:

If ur taper lasts longer than the duration of use originally then I think there's a chance you are doing it wrong...
Being on a ssri for less than a month means the short taper done should be fine if it is even needed at all. The sooner you got off the sooner u would avoid any withdraws if you do it right. Be safe and good luck finding some progress in your issues and maybe try non drug methods ....
 
Thanks Hiltoniano. I agree, it makes no sense to taper longer than the original amount of time I've been on them. It's absolutely retarded, that AltoStrata lady is batshit crazy I reckon. She is actually the one who replied to me on the forum telling me I was 'tapering too fast'. I actually posted a link to her article above.

Cotcha, haha yeah I am relaxing. I haven't been on the net in a few days, so I'm just left with my thoughts now - the aftermath so to speak. I still do have very limited WiFi access, like every few days or so just so I can keep in contact with people, but I've been keeping away from reading articles lol. The retreat has been pretty on though. I've had to go deep inside myself to resolve alot of stuff and it's been intense!

Was going to ask one more favor actually (or anyone). Do you mind checking this article out and letting me know if it's accurate or not? It's titled 'Does SSRI use cause a chemical imbalance? We think it does'. Link below.

http://mentalhealthdaily.com/2014/05/13/do-antidepressants-cause-a-chemical-imbalance-likely/

I'll be leaving the subject behind after this. Well my mind will probably be on it for a while, but I'm going to stop feeding it ya know ☺

Thanks again! If you're ever down under in New Zealand I owe you a few beers to say the least haha.
 
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