I can't help but to weigh in.
SSRIs and SNRIs are not a 'cure' or even an effective treatment for most people.
It can be a damned miraculous treatment while taking the medication.
But I have read that about HALF of patients who take them experience worse depression after they stop taking the drug.
And this is backed up by data that shows worse HPA Axis function.
Where is the cure?
Some doctors have said that only 30% of people can be effectively treated with these drugs.
Other doctors hold the astonishing belief that since the medication seems to be effective during use, this constitutes 'effective treatment' even if the patient has to continue taking the medication for the rest of their life!
And there are people that have been on Prozac for almost 30 years...
Some will go on and off, a practice known as 'maintenance therapy'.
If this is used to control terrible withdrawal symptoms, it is justifiable....as long as complete discontinuation is ultimately achieved.
But of course the withdrawal depression, as I've said, can be WORSE than it ever was prior to taking the medication.
So these people might bounce on and off the stuff for years and years.
All of this is done with the understanding that SSRIs and SNRIs down-regulate serotonin receptors in the frontal lobes and the prefrontal cortex!
For this reason some doctors, and neurologists, consider serotonergic drugs to be quite risky or even medically arrogant.
Not only are half of patients NOT CURED of the psychological condition that lead them to the medication...
But 60-80% of them suffer loss of libido or other sexual side-effects at some point during treatment.
And I know a number of people who switched from Prozac or Zoloft onto Lexapro and immediately experienced a complete loss of ALL genital sensation and libido.
They are indeed the minority, but the damaging effect that SSRIs can have on sexuality is profound, shocking, maddening.
They can take well over two years to regain function and normal emotions!
Again - SSRIs can be very effective during usage.
Early on in treatment people often experience an incredible emotional response, including blossoming socially.
And improved sexual function - at first.
The increase in serotonin in the higher brain targets dopamine into the greatest of your cognitive and emotional circuits. The PFC is the ultimate target - not an easy goal as it is the furthest region of the brain from all the nuclei...the ancient bundles of nerves that provide both serotonin and dopamine to the rest of the brain.
SSRIs are not releasers, yet they do cause some release of serotonin.
Conversely, MDMA is primarily a releaser...but is also an agonist.
The important point is that SSRIs do not increase serotonin supply - they simply move around the existing supply to the higher brain. Over time this causes serotonin levels to FALL.
This is the reason that most SSRI users will have to escalate their dosage at least once in the first 6 months.
Pushing serotonin into the cortex actually represents an imbalance which causes the brain to respond by down-regulating receptor sites. This is ironic considering the old theory that a preexisting imbalance of serotonin is the cause of the problem.
This theory still has merit - there is plenty of data that suggests that neurotransmitter levels in different brain regions play a direct role in depression and anxiety disorders. The theory of the cause is not the problem.
The 'treatment' is.
The biggest problem with SSRIs is that they actually WORK really well, at first.
This extreme effectiveness is what makes them so tempting to use on a long-term basis.
Even while the down-regulation is occurring - the person cannot tell there is 'damage' being done because they are still feeling the effects of higher dopamine and prolactin levels.
But the adaptation that is happening can indeed be viewed as 'damage'.
Taking anti-inflammatory drugs like ibuprofen (NSAIDs) actually stop SSRIs from working.
That is because SSRIs induce inflammation in the brain!
It is part of how they work...
It is the 'withdrawal' symptoms that are most damning of all.
All the other data aside, the crippling and horrific experience that SOME patients have to endure upon quitting seems to be irrefutable evidence that the 'treatment' is a mistake.
Blackstorm - there is a little bit of good news mixed in here for you.
The fact that the medication has any effectiveness at all is a good sign.
This is actually an indication that you have surviving axons in the higher brain regions to transmit serotonin.
Yes, the medication can cause sprouting of new axons before down-regulation begins.
It can cause growth...
But many former MDMA users fail to respond to SSRI treatment at all.
And some of them report very negative effects like akathesia, increased Dp/Dr, general restlessness.....
This places them in a small minority of SSRI patients that experience the worst reactions (like 15%).
Akathesia reactions are considered a significant risk factor for suicidality!
If you are experiencing any inner feelings of restlessness, this is a sign of severe dopamine imbalance.
And it can get a lot worse.
It is a clear sign that you need to stop taking the medication ASAP.
With a tapering plan that involves your doctor!
To answer your main question - will you recover?
Honestly YES.
I have lots of experience reading MDMA research including psychological evaluations and follow-up.
I have also counseled a good twenty BL members over the last year on the matter, and heard from many others that have been there before and recovered.
Clinical symptoms tend to resolve within 12-24 months even among heavy long-term users.
Up to 3 years there is solid data that suggests a continuing deficit in endocrine and serotonin function, combined with modest verbal recall deficits.
Some BL members have claimed it takes many many years to fully recover - so research up to three years is insufficient in my opinion.
Among former SSRI users that suffer severe sexual dysfunction and emotional detachment, it is also common to see recovery occur between the 1 and 2 year marks.
This overlap strongly suggests a trend for rewiring of the brain over a semi-predictable timeline.
The reason you don't feel normal yet is because of the medication you are taking.
I PROMISE you this is the case.
SSRIs do NOT re-wire the entire network, even if they do have an influence.
And the rewiring of the whole brain is what recovery from MDMA toxicity is ALL ABOUT.
I strongly suggest that you withdraw from the medication very slowly.
And expect to suffer more, not less.
It may be several months before you detect any improvements.
And it could be another two years before you really feel recovery occurring.
You have to believe my advice and TELL your doctor what you are going to do.
Do not ask their opinion.
If they tell you that you might need to keep taking it indefinitely - find another doctor.
You have no choice here if you ever want to recover.
I have heard several opinions from other BL members in recovery from MDMA that taking an SSRI made them worse, or cost them lots of time. I recall a post long ago where someone said they lost an entire year because of it.
But eventually they did indeed recover.
The only treatment that really works is exercise.
You need to work out every day.
For the next year.
No exceptions.
I have read hundreds of studies and consulted countless people online, some of them privy to the TOP neurologists in Europe and America. They agree - SSRIs are not the treatment. There is no treatment, other than time.
And exercise.
Even healthy diet will not come close to the healing properties of tearing muscle fibers.
It will sprout new axons in the re-wiring brain-gut circuitry of yours.
Serotonin, by the way, resides in the gut and controls digestion.
It just so happens to be the most dense and intricate neurotransmitter in the brain.
Influencing countless brain functions without being directly responsible for any of them!
Let me know if you have any questions.
You have my strong advice and a sincere belief in hope.
If you support the brain, regardless of the extent of your suffering, it is very likely to recover.
Stop hindering it with foolish medications.
Get to the gym, or just do pushups every night. Lots of them.
You can do it.
FBC
