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SSRI & Adverse Effects

L

lewdawgdude

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Jun 14, 2012
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6
Not sure if this is the right place for this. But basically, I'm very resistant to take any type of psychiatric drug, or more specifically, SSRI even though I "need" them. I basically hate everything about them, and every time I look SSRI's up on the internet I find a million reasons not to take them. But meanwhile, I'm sitting here doing nothing with my life. I've done mostly every other possibility.

The thing is, I put a very high emphasis on how it would effect my intelligence, especially anything that wouldn't be reversed when you stop the medicine. I'm a fairly smart dude at a great university, but I did have to take a leave of absence for psychological reasons. It almost seems like I'm forced to take these SSRI's because even if it had some sort of bad effect, even if it was brain damage, that's supposed to be better than doing nothing. Not sure about that.

Anyone know how these really effect you? Is there anyone whose life is mostly based on mental functioning, like a lawyer or doctor or some sort of scientist or mathematician, whose had good experiences withe SSRIs. How do these truly effect cognition, and could they ever cause brain damage?
 
I can't really tell you exactly what I do for work but I work at quite senior level in the technology sector.

I'm guessing your from the UK as SSRIs are so popular with doctors here, over the last 2-3 years I've experienced some serious issues with depression and anxiety and have tried a number of different ADs including 4 SSRIs. Unfortunately they do not agree with me at all, I've had everything from hallucinations, severe increase in suicidal thoughts to just plain old projectile vomiting.

I've tried other types of AD and had some problems with those as well, I have been through periods of time without medication but my depression has been such that I have persisted in trying yet more ADs, currently I'm on an SNRI, Venlafaxine it has it's side effects but overall it has stabilised me and enabled me to go through a course of CBT which has helped greatly in me dealing with my condition.

The case for SSRIs has become increasingly shaky, with numerous reports indicating how ineffective they are with some study groups, it seems the general consensus is that they are not effective for those showing mild symptoms of depression but have some value nearer the acute end. I don't find this surprising given that depression is very much an umbrella term, there is no physical test or the illness and its root causes will be complex and vary greatly from patient to patient.

As for brain damage I've never read anything about long term problems but have suffered cognitive issues with both SSRIs and other ADs especially in the first few weeks of use.

My best advice is that if you don't feel the medication is working for you go back to your doctor and say so and keep repeating this until you find something that does work, if your doctor isn't supportive of you find a new doctor (I'm only familiar with the UK system so I'm basing my approach on that). I'm also assuming you are suffering from depression, if so I would recommend CBT, you may have to wait sometime for this treatment but push your doctor to put you on the list, it may not work for you but it does not come with a long list of side effects :)

Best Wishes
 
How significantly did it effect your cognition after the first few weeks? And I never mentioned this, but the SSRI would be for anxiety. I'm not a fan of the benzos or whatever. And I've been doing CBT, which worked great, until things got more stressful. Right now I'm basically "cured" every other month, but there is no real significant stress or demands in my life right now. So it's not good enough for going back to school.
 
It varied from one AD to another and it's not easy to give a fully objective answer given I was suffering from acute clinical depression. I have a list below that shows my reactions to different ADs:-

Citolpram - made me suicidal and caused hallucinations, really not a pretty , the physical nausea paled into insignificance compared to the rest of the side effects.

Lofepramine – really bad dreams and I'm not normally bothered by such things, that and circulation problems, very cold feet and hands as well as making me really apathetic,
Chlorpromazine - Added whilst on Lofepramine -= made me non functional zombie

Prozac - Just made me throw up violently on first use

Sertraline - Seemed OK for a few weeks albeit made me feel very emotionally compressed then I had some internal bleeding which required a hospital visit so it was ceased.
-
Mirtazapine - Made my derealisation much worse, ended up having a car accident.

Venlafaxine – Some typical symptoms of nausea and headache in the first week or so but been on this for sometime now and I feel its doing more good than harm for now but I do intend to come off over the next 12 months due to the compressed emotional state and other undesirable side effects,loss of appetite libido etc.

I've never been on an SSRI for that long, Sertraline probably the longest, I don't think it effected my cognition at all, the effects of ADs vary wildly from one user to another, but it does seem in general side effects lessen after the fist couple of weeks. I think it's something you can only judge for yourself, but I've never heard of permanent brain damage being suggested in any studies.

What do you mean by you are "cured" every other month, sorry it's early and I may be missing the point :)
 
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They don't make you stupid in the same way an antipsychotic does. If your doctor thinks you need them, give them a shot. I'm very suspicious of psychiatry too, but SSRI's are generally safe and they can do a lot of good for people suffering from severe depression.

But you need to stop self-medicating with drugs if you want your psychiatrist to have any real idea at all of what drugs you may need.

Everybody and their sister is on zoloft. It's not a sign of weakness. It will help you stop self-medicating with alcohol and marijuana, etc.

I was put on fluoxetine for a little bit as a youngster and it gave me feelings of weirdness and real akathisia, a side-effect I'm very sensitive to (St. John's Wort gave me tremors for christ's sake!). The akathisia would prevent me from sleeping, making me feel even weirder from sleep deprivation, etc. But I was also smoking a lot of pot at that time and interactions between the cannabinoid and serotonergic systems in the brain is VERY poorly understood.

That's why our doctors are always like "you need to stop smoking pot and drinking!" Because smoking pot and drinking interacts with the medications in unknown ways.
 
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^^^

I didn't get the impression the OP was self medicating with anything:?
 
atm23 said:
^^^

I didn't get the impression the OP was self medicating with anything:?
Click to expand...

I didn't either but this is a drugs forum and if he's smoking pot and drinking beer the way most people do it'll make his psychiatrist's job that much harder. SSRI's are poorly understood as it is without throwin cannabinoids and GABA-fucker-uppers into the mix.
 
Do "most people" smoke pot and drink beer then ?...I'm not trying to be picky it just seemed like really odd response. I don't drink or smoke anything and I know lots of other people just the same and this is a Harm Reduction forum, no swimming pools here ;)

In the past I've done both, to excess, however there are many different treatments for anxiety in years gone by I found cannabis quite an effective self medicating treatment for a time and some do find short term use of Benzos useful for serious episodes.

All drugs have their good and bad sides illicit and otherwise, I agree its not ideal for someone to be using any other drugs when a doctor is trying to deal with mental illness but unfortunately drug abuse and depression and anxiety often go hand in hand and breaking the cycle isn't always very easy. In my case I have been in a position where I had to stop drinking in order to get the therapy I wanted but in the mean time I did have access to ADs and the support of an addiction centre as well as my doctor who dealt with my situation in a non judgemental manner.

In this case I really didn't get the impression the OP was using any other substances as he is so concerned about his mental welfare.
 
I have a dual degree and I have bipolar disorder. I take a combination of medications, including Celexa, Abilify, and lithium. Sure, they have their side effects, but nothing I would consider overtly adverse or particularly difficult to deal with. I'm not certain what you mean about "brain damage" as a result of being prescribed any SSRI. Can you define your terms?

One thing I do know is without these medications I cannot function in the way I need to. I am in and out of emergency rooms, rehab, and hospitalization in psychiatric units. I trust my psychiatric's efforts in keeping me well. We have a dialogue.

It sounds have as if your psychiatric condition has adversely affected your life, and I would encourage you to consider taking medication positively, and not something that you have been forced into. The fact that I have been to university and completed an advanced degree really doesn't matter. People from all walks of life struggle with exactly what you are struggling with right now.
 
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Well since I have anxiety, a lot of CBT is to just do what makes you anxious to get better. So I would just do everything, ( which is very hard) and get to where I'm 'fine', and then I'd get some sort of panic attack and be starting over. That's what I meant by cured every other month. And I'm not really doing that self-medicating thing, but I can see how that can make everything a lot worse.

I have no question that the srri would improve my condition or mood overall, even if they had other bad effects related to that. I'd really just be worried about how it'd affect cognition, and I think there's no way psychiatrists could know everything about these things. I would hate to take it for a good period of time and then see some study later on that says everyone who once took them are screwed. And by brain damage I guess I'd mean any permanent cognitive decline?
 
I am not aware of any study showing the negative effects upon cognition attributable to SSRIs. In fact, it has been shown that in people with MDD treatment with an SSRI improves cognitive functioning.

In your case, I would expect the decreased anxiety that you could expect on the appropriate medication could have only a positive effect upon your cognition, as all of your mental energy would not be devoted to battling anxiety as it is now. I remember when experiencing severe anxiety my memory (a measure of cognitive functioning), without treatment, would be decreased.
 
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Missykins said:
In your case, I would expect the decreased anxiety that you could expect on the appropriate medication could have only a positive effect upon your cognition, as all of your mental energy would not be devoted to battling anxiety as it is now. I remember when experiencing severe anxiety my memory (a measure of cognitive functioning), without treatment, would be depressed.
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If you're depressed, it's usually all the time, and for sure the meds would improve cognition. But anxiety only happens in certain situations. So I would basically be wondering how it would effect someone who is fine or not depressed. I wouldn't want to be worse off most of the day, to be better for just a part of the day. Well, it could be worth it, but right now off the meds, and still getting anxiety in situations, outside of them my cognition is great.
 
Like I said though, atleast for me, not really. Only in anxious situations. The medicine might have more potential to lower cognitive functioning. Just trying to be honest so I can make the best decision.
 
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I have experience with almost all of the SSRI's, AAP's and many SNRI's out there. My personal experience has been characterized more by difficulties in the physical spectrum, such as lack of energy, increased/decreased appetite and spells of sickness (vomiting, tremors, diarrhea, constipation, etc.).

I found an article that claims that SSRI's are associated with memory impairment, but cannot attest to this for myself.

SSRIs and cognitive performance in a working sample

Best of luck,

~ Vaya
 
So far I've been put on:
Fluoxetine at 20mg daily, which sort of just gave me zero memory and zero emotion for the 6 months I took them, so I wouldn't recommend Prozac.

Citalopram, i think it was 10 or 15mg, but they just gave me internal bleeding. Little worrying to see that twice on the same SSRI thread, even if it was for two different ones :/

Now I'm on Sertraline 100mg, which has allowed me to be awake sometimes (without them, i'm pretty much asleep 24/7 as I learnt this week). From experience, even reading recreationally was a massive challenge but now after taking them I can actually lug my way through some assignments and whatnot. It's definitely dependent on how severe your depression is, and they can be really person-dependent. If I were you I'd rather not have to get into the inevitable swapping and changing that comes with SSRIs but I guess you'd have to do that regardless of what medication route you decided to take.
 
Well I guess memory is kinda important, but not the most important. I would more wonder about ability to think well. As for Missykins, I haven't made up my mind. But I want to make a good decision. So I'm going to be objective, and I won't blindly say the medications are amazing. They could be though, that's what im trying to figure out. And CBT is really good, but it does take a good bit of time. And I guess it was working great until I was trying to do stuff that was demanding and stressful and overcome my problems at the same time.
 
It's a tricky one all round, I see your dilemma, its a case of what, overall gives yo the best mental function over a long period, ADs or coping with the anxiety.

Personally, having read numerous papers on SSRIs, if your saying you only have the occasional but severe panic attack with no associated ongoing depression, I would not take ADs. This is my personal view SSRIs have found to be almost useless in mild cases of depression, performing no better than sugar pills.

I'm a bit concerned that you need to keep revisiting CBT, I accept you never stop learning and I would happily see my old CBT therapist weekly but that's just not possible, but he left me with the tools a feel I needed to start to change the way I react to things and deal with my personality.

I've (well I had until I busted my knee!) taken up Tai Chi as I'm not good a meditation, but some kind of activity that offers a way to calm a centre yourself maybe a better bet for you, I'm no long haired hippy, not that I have a problem with long haired hippies, as long as they wash;) but there are many well established ways to calm your mind. Long term AD use to deal with occasional panic attacks doesn't sound like a good option to me.
 
lewdawgdude said:
Well I guess memory is kinda important, but not the most important. I would more wonder about ability to think well.
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Then, as far as that goes, I'm inclined to tell you that you ought to be free from concern that SSRIs will affect your fundamental abilities to perceive, process new information and integrate that information into your working reality.

However, I strongly agree with Atm's statement below:

atm23 said:
Personally, having read numerous papers on SSRIs, if your saying you only have the occasional but severe panic attack with no associated ongoing depression, I would not take ADs. This is my personal view SSRIs have found to be almost useless in mild cases of depression, performing no better than sugar pills.
Click to expand...

~ Vaya
 
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