SSRIs, to take or not to take

[Missykins]

I think that the bottom line is that if you have tried everything else--good, effective proactive therapy like mindfulness, CBT, etc.-- and you still cannot get past that deadening kind of depression that saps all motivation, then it is worth exploring ADs. They come with so many dreadful side effects that they should always be a last resort IMO. But a last resort is still a viable strategy. Depression and anxiety are both debilitating when they are extreme. Finding non-drug ways to conquer them is obviously optimal but only you will know if this is possible or not. Good luck in your decision. Your thread has certainly generated some well thought out replies and I hope they help you as you explore what is best for you.

I know that you mean well, Herbavore, by suggesting alternatives, but I couldn't disagree more. Depression is a disease of the brain. Why should someone suffer through weeks of ineffective therapy when an antidepressant or other mood stabilizer will improve their condition much more rapidly? Many depressed individuals are unable to even engage in therapy until a mood stabilizer/antidepressant has begun to exert some effect. Rapidly stabilizing one's mood becomes even more important for those with major depressive disorder, bipolar disorder, and schizophrenia with suicidal ideation, and is unlikely to be achieved through mindfulness and CBT alone. Therefore, to suggest to a clinically depressed individual that antidepressants/mood stabilizers should be used as a "last resort" is irresponsible.

 

[DexterMeth]

^I agree, but Neophyte said it best. It's ultimately up to the individual, including herbavore. No one has all the right answers for you, but outside input helps a lot. There's no sense in being so quick to brush off the ideas of people that are just trying to help, even if they are wrong. Perhaps enlightening them to this concept is all the help some people need.

Glaive, if you decide to go on an SSRI, give it plenty of time to work. If it's not for you, don't just stop taking it. Tell your doctor you want to stop and have them properly titrate you off of it, and don't stop checking up with them.

 

[Znegative]

I feel like Effie pretty much said everything I would have, albeit more eloquently, but I'll chime in here as I have some experience with this kind of thing.

I agree that antidepressant's, mood stabilizer's and anti-psychotics are way over prescribed. I've seen people with minor depression problems litterally turn into completely lethargic, hollow people from being prescribed unnecessary anti-depressants. At the same time, I think for some people, they really do help, and are critical in fighting a mental illness. When I was ten years old I was pretty much debilitated by Obsessive Compulsive Disorder, I wanted to kill myself because I thought I was going insane, and I was stuck in a children's psych ward. Eventually I was accepted into this special program that was part of NYU, where they treated me with Zoloft and cognitive behavioral therapy. While the CBT did help, the three weeks or so that it took the Zoloft to kick in we're still pretty horrible, but I remember riding the train with my mom one day, and realizing that I felt happy, and that my OCD seemed to have completely disappeared. I did continue to go to the CBT session's too, and those helped me with what the Zoloft didn't quite cover, and I feel like the combination of the two was really usefull at that time in my life.

What I did not like though, was that the Zoloft made me gain a lot of weight, so a few years later I dropped it and I shed all the extra pounds. The OCD came back within month's when I was in highschool, but this time it manifested as BDD (Body Dysmorphic Disorder), which was in some ways even worse for me, because I began to feel as if my own eyes were betraying me, and I couldn't tell if what I was seeing was the truth or not. Instead of seeking treatment for this, I began to drink and use drugs, and down the path developed a heroin addiction too. Currently I havnt used hard drugs in a while, and I don't take any anti-depressants. I still have symptoms of both OCD, and BDD, but they are sort of stifled, as I take buprenorphine for my heroin problem, and it acts as an anti-depressant for me.

I can definately understand not wanting to take SSRI's and the like, due to strange side effects, but I think it would be smart to talk it over with your prescribing doctor, and possibly looking in to changing medication's. Sometimes people really need a very specific anti-depressant to get all the benefits from them, and it can take a little bit of time to figure out what it is that works. It's really unfortunate that the vast majority of these drugs take so long to take effect, as waiting can seem like pure hell.

I wish you the best of luck.

 

[xHippiexchildx]

Anti-Depressants have always made me more depressed, and in worst cases, suicidal. I tend to stay away from them. Idk why they do that to me.. maybe my brain is just wired differently.

I'm also no doctor, so I can't really give any good advice. The only thing I can say is DO NOT combine prescribed medications with psychedelics. It'll only end nasty for you.

 

[SimplyLuminous]

It's funny, this post made me sign up here so I'll add my two cents. Psychiatrists are in my history notoriously difficult to actually listen to me. I've been medicated since 4 1/2 years old. thats nearly 24 years of near constant medication for either ADHD, anxiety, and Depression. I've been on quite a number of SSRI's over the years, the newer ones that have come out the past few years unfortunately are unaffordable even with Insurance. Here's a list that is not in order.

Citalopram
Lexapro
Luvox
Paroxitine
Sertraline

And drifting into the SNRI Catagory I have also been on Venlafaxine.


I hated them, not because they seemed to work, but because every single one has caused the side effect that I will not tolerate, Sexual Disfunction. "Hey I'm happy, but I can't perform in bed! Awesome..."

Oh and Sertraline caused what the Emergency Room Doctor to call "Pseudo-seizures"...

So I quit it all for two years where I compensated with Drugs, alcohol etc.

In 2008 I started back up again, same issues appeared. I have trouble with my memory due to reasons I cannot determine yet, however by November 2009 they had me on the following regemin:

Seroquel 3x Daily
Remeron 1x Daily
Citalopram (I've forgotten how many doses per day)
I am pretty sure the last one was Buspiron 15mg 2x daily.

Again it's hazy around that time period as you can imagine. But I felt completely lifeless, the only feeling I could feel was Extreme Anxiety. This led to a suicide attempt. "If I can't feel, why go on? Just erase me."

Two back to back Psych ward stays (the second because they didn't taper me off of the Citalopram which led to SSRI withdrawal symptoms including "brain zaps" which led to a near second attempt) and I was in rebuild mode. I took a short leave of absence to let the new regimin take effect and allow myself to start CBT.

I felt fucking great! That is until I realized I had gained 70 pounds from the Remeron... That I could not abide by so we switched from that to wellbutrin sr. It worked wonderfully... until all that weight disappeared and we did not take into consideration the amount of weight I had lost compared to the dosage of Wellbutrin I was on. Anyways after a few weeks of gradual hell (also feeling strung out because of the increased range of time between Klonopin doses) we agreed on this current regimin:

Wellbutrin XL: 450mg 1x daily
Buspar: 15 mg 2x daily
Trazadone: 50 mg at bedtime
Klonopin (this was the tricky one, after two years of being on it we are well aware that I am dependent on it) 1mg @ 6 AM, 1mg @4 pm and 0.5mg at bedtime)

So far so good, what has truly given me better tools for the behavioral side of things is CBT. With them combined it's an astonishing difference from where I was two years ago.

However we are running out of options other than moving on to Anti-Psychotics and Mood Stabilizers which I will not allow in my body.

My case is not the same as everyones, but I urge you to be completely honest with a psychiatrist and/or therapist. The chemicals that we take recreationally can have terrible side effects when combined with anti-depressants.


So that's my "small" introduction and my two cents. I'm by no means "cured". This disease last for a lifetime, we have to be strong enough to face that either with medication, or without, whatever path you choose.

 

[xHippiexchildx]

It's funny, this post made me sign up here so I'll add my two cents. Psychiatrists are in my history notoriously difficult to actually listen to me. I've been medicated since 4 1/2 years old. thats nearly 24 years of near constant medication for either ADHD, anxiety, and Depression. I've been on quite a number of SSRI's over the years, the newer ones that have come out the past few years unfortunately are unaffordable even with Insurance. Here's a list that is not in order.

Citalopram
Lexapro
Luvox
Paroxitine
Sertraline

And drifting into the SNRI Catagory I have also been on Venlafaxine.


I hated them, not because they seemed to work, but because every single one has caused the side effect that I will not tolerate, Sexual Disfunction. "Hey I'm happy, but I can't perform in bed! Awesome..."

Oh and Sertraline caused what the Emergency Room Doctor to call "Pseudo-seizures"...

So I quit it all for two years where I compensated with Drugs, alcohol etc.

In 2008 I started back up again, same issues appeared. I have trouble with my memory due to reasons I cannot determine yet, however by November 2009 they had me on the following regemin:

Seroquel 3x Daily
Remeron 1x Daily
Citalopram (I've forgotten how many doses per day)
I am pretty sure the last one was Buspiron 15mg 2x daily.

Again it's hazy around that time period as you can imagine. But I felt completely lifeless, the only feeling I could feel was Extreme Anxiety. This led to a suicide attempt. "If I can't feel, why go on? Just erase me."

Two back to back Psych ward stays (the second because they didn't taper me off of the Citalopram which led to SSRI withdrawal symptoms including "brain zaps" which led to a near second attempt) and I was in rebuild mode. I took a short leave of absence to let the new regimin take effect and allow myself to start CBT.

I felt fucking great! That is until I realized I had gained 70 pounds from the Remeron... That I could not abide by so we switched from that to wellbutrin sr. It worked wonderfully... until all that weight disappeared and we did not take into consideration the amount of weight I had lost compared to the dosage of Wellbutrin I was on. Anyways after a few weeks of gradual hell (also feeling strung out because of the increased range of time between Klonopin doses) we agreed on this current regimin:

Wellbutrin XL: 450mg 1x daily
Buspar: 15 mg 2x daily
Trazadone: 50 mg at bedtime
Klonopin (this was the tricky one, after two years of being on it we are well aware that I am dependent on it) 1mg @ 6 AM, 1mg @4 pm and 0.5mg at bedtime)

So far so good, what has truly given me better tools for the behavioral side of things is CBT. With them combined it's an astonishing difference from where I was two years ago.

However we are running out of options other than moving on to Anti-Psychotics and Mood Stabilizers which I will not allow in my body.

My case is not the same as everyones, but I urge you to be completely honest with a psychiatrist and/or therapist. The chemicals that we take recreationally can have terrible side effects when combined with anti-depressants.


So that's my "small" introduction and my two cents. I'm by no means "cured". This disease last for a lifetime, we have to be strong enough to face that either with medication, or without, whatever path you choose.

Seroquel AND Remeron? That is fucking nuts. I would be knocked out for two weeks if I took them together, and i'd probably sleep eat all the food in my house.