antidepressants - s&d, CoD, evil bitches, cash cows and saviours of sanity

It sucks when you can't tell what comes from raw emotions or (partially) induced by meds. Hope Ef is more kind to you this time around, E. Rough day for you iirc (fb) so there might be that, too. Hugs <3

TIL that from 2013 to 2016, US physicians accepted $24.94 billion from pharmaceutical companies, in nearly 41 million transactions, and there is a searchable web database where you can find out if your doctor has accepted any payments, from whom, how much, and the nature of the payment.

https://openpaymentsdata.cms.gov

I am here because after coma/severe tbi i had too much siezure risk to go back to Wellbutrin, so they put me on Cymbalta. Been on it for 2.5 yrs, I often commented that i’d always notice if i missed a dose because id get these weird moments of parasthesia, loss of proprioception, eyeball movements- it can even be very slightly euphoric but without the realy pleasurable part of euphoria. It’s ~weird~.

Ha, so now i know it has a name, ‘brain zaps.’ Never even heard the term before. Not sure what to do about it, but i had two days without meds and it got to be pretty uncomfortable. Anyone done a full withdrawal from this type of thing?

“Seizure”, “really,” grr.

Diff meds but I've the same, brain zaps, if I forget a dose. I hear you on the slightly euphoric thing, but most of the time it feels like being pushed out of reality for a short time. It's a sensation alright, though mostly a highly unpleasant one tbf.

I don't think there is anything you can really do about it, except take another dose asap. It's also what's keeping me from withdrawal tbh, it destabilizes like a motherfucker.

thx. when i first experienced these brain zaps, i was just finally recovering from really severe bouts of vertigo, and i was terrified i was having relapses of that (because that was highly, highly, highly, unpleasant for me), but these were never intense or nauseating or spiralling- more like odd, floaty dissociating feelings, so i knew it wasn't bppv.

Jesus, that must have been a mind fuck: recovering from bouts of vertigo and having brain zaps as a replacement....

It's a bit of an ongoing, dragging thing in my life now tbh. Do I still *need* anti-depressants? I wouldn't say so. Not depressed, anxiety under control for five plus years. And I do desire being without the meds (they scrape off 10% of sensitivity and emotion, not bad in itself, but eh...). But when is the right time? It never is. If stories on other forums are to be believed I'd need four weeks to go through withdrawal symptoms, a worsening, until it gets better and I find peace again. Who has four weeks to do fuck all? Hardly anyone. It's a gordian knot tbh. I want off them, I think in all honesty I can say I *can* do without them, but they make it so that it is *extremely* difficult and unsettling to do so...

Anyone done a full withdrawal from this type of thing?

Have mentioned it elsewhere in this thread I think but I have, yes. Twice. Once I did it cold turkey (had no other choice) and I was a mess for about a week but fine after that. The 2nd time I gradually reduced my dose and didn't experience any withdrawal symptoms at all.

I admire you all the more for it, E. I'm on 150mg effexor, and (at least over here, for some reason) the first one down the ladder is 37,5mg. Which is a pretty big step. I could take three of those, and then two, and then one etc. But when's the right fucking time? Even without any real drama in my life it felt like a no-go. Now there's a lot of drama in my life and I want 'out' even more, but... Just that feeling of being trapped/hooked against my will rubs me up the wrong way.

Did you do it in full compliance/consultation with an MD? Made a plan together, stuck to it, maybe even called in sick? Sorry for all the q's, just curious, as I don't see a way to tackle this.

I’ve done full withdrawals but I did it in a way where I took less and less of the med to ween myself off it.

x-post

Yes, that's exactly what I did. It was Effexor too btw. I'm on it again now which I'm fine with but I successfully weaned myself off of it and stayed off for about 2 years exactly as you described here - "I could take three of those, and then two, and then one etc" as that's what the doctor advised me to do. We made a plan together and I reduced the dosage over a couple months (would step down the dose every two weeks iirc) and I believe I was on at least 225mg at that point. I didn't have any symptoms at all doing it this way so I never had to call out or anything.

great to know, thanks all. stay well.

i don't plan to go off duloxetine/cymbalta, as i don't think any it's problematic for me, whatever my other issues are. however, i often wish to go back to "the way i was before," and i keep getting tempted to req a change back to old treatment (i will say add tho, i'd much rather deal with brain zappiness than the likely outcomes of any seizure incident/s, based on my limited understanding of those, so...). i don't think there's any going back on mine, there's just onward.

I had no illusion I'd go back to the "way I was before" because it'd been six years or so and my life wasn't remotely the same otherwise, tbh

anxiety brain is still present, but the way I interact with it has changed

xpost to ENBB - definitely the support of a doctor or counsellor is crucial. I explicitly told my counsellor I would be weaning off lithium, largely because it turned me into a humorless zombie and made me angry when i didn't take it.

i was med free for 6 years but i'm now back taking anti-depressants because i want to be happy and need a buffer

So ... I have been taking paroxetine forever. Currently 30 mg. My therapist encouraged me to see this psych nurse in her practice because she doesn't think my medication is that effective at this point.

So the pysch nurse first prescribes 20 mg latuda as an add on. My insurance won't cover that so she next prescribes 2 mg of abilify as an add on.

What are the general thoughts on add ons? I am very hesitant to add another med to what I am currently taking. It seems like it would just be easier to increase the dose of paroxetine and see if that helps.

I have no experience with these newer drugs and I am hesitant.

Do you think your current regimen is effective? Have you had episodes of major depression in the recent past while on your current dose? How much "headroom" is there for you in the approved dosages of paroxetine?

I can't tell you what to do with the answers to those questions but that's what I'd be asking myself. I also have no experience with the latest generation of options, have been on citalopram for 10 years and have been at the max approved dose for several.

as a general rule i max before adding on (unless higher doses have intolerable s/e)

My psychiatrist, a long time ago, briefly mentioned prescribing me Ritalin to deal with my extremely low energy (I’m on citalopram and seroquel) but then never brought it up again. I want to ask her about this without sounding like someone who’d abuse it. I’d be b v responsible with it! I’m v v responsible with my klonopin prescription! But I seriously don’t have energy for life at all and it’s a pretty huge bummer.

xp - i think paroxetine max recommended dose is either 40 mg or 50 mg?

what are the symptoms of it no longer being effective? Is it mostly depression stuff or anxiety stuff or ...?

my experience is that there's no clear sign when they stop working. that's the insidious thing about when they stop working - since one of the symptoms of depression can be over-thinking/over-worrying, i would tend to suppress all the thoughts of "maybe they're not working like they used to" because those kinds of thoughts can be a self-fulfilling prophecy, only to find out they really had stopped working and i was just in denial about being suicidally depressed :(

I sometimes think if I shld quit Sipralexa. But for now I will continue. No way am I going back to anxiety attacks. They were horrible.

my experience is that there's no clear sign when they stop working. that's the insidious thing about when they stop working

hahahah! last year I had several months of major anxiety symptoms, that at the time, I just ascribed to stress, because my job and life were pretty fucking stressful at that point. Then came 5 straight days of feeling useless and horrible and lying in bed and crying ... around day 3, I realized that it might be that my meds stopped working.

Thanks for the feedback! My symptoms are depression and exhaustion. Luckily anxiety is not really a thing I deal with. I was thinking I was feeling that way because my life sucks but maybe my life sucks because I am depressed? Hard to tell! There's actually nothing much wrong with my life (theoretically) at the moment--I just feel horrible and have to force myself to do everything. But I was kind of thinking to myself this was my problem to solve, or my fault.

I'm taking 30 mg paroxetine--I could go up to 40. That's what I assumed they would advise. I took the 2 mg of abilify today for the first time--no noticable effects yet. I sort of told myself that my way is not working so maybe I will give their way a try.

definitely worth a shot!

the thing that's weird to me with a lot of the newer drugs is that some of them sound like they are "downers" but are being used as "uppers" ... or idk ... realizing how much of my assumptions about psych meds come from the mandatory Reagan era "Just Say No to Drugs" class everyone had to take in the 1980s

I recently upped my paroxetine to 40mg, and my doc said that we could still go up to 60.

never liked the upper/downer terminology
i get that "stablization" or "regulation" doesn't quite have the same ring to it, though

i've been having terrible issues with dry mouth for a while now. i don't know if it's medications, anxiety, some combination of the two, but it's really driving my spouse up the wall, particularly the sound of it. i don't particularly want to change any of my meds, because they're working for me (aside from not really having any pharmaceutical options that work on my anxiety that is!)

it took me a while to understand how amphetamines were effective against adhd, precisely because of that "upper"/"downer" schema. well i say "understand" but i'm not a pharmacologist, "accept" really. i blame binary thinking and sapir-whorf but then i blame binary thinking for everything.

having a bit of a suboptimal time with venlafaxine. only on 70mg. it really worked to lift me out of a period of pretty bad anhedonia were i was spending all weekend lying around my house, isolating myself, being morose around my gf, and taking sick days from work for invented illnesses etc. so, that's great, that's honestly amazing, and i almost can't complain.

but otoh ive just been partying too much. like any opportunity for a late night rager I've been taking. I've had to decide not to drink at all for a while because it got pretty out of hand. now this might be because i am a heavy drinker and a lot of my socializing is around alcohol, but to be honest i do feel sort of wired and hyperactive, and am having some trouble sleeping also. then for more iltmi type content: I'm finding it super hard to orgasm, which is unfortunate. also I'm v sweaty.

that's one of the ones i've never done. are you seeing a therapist? when i get on ups i start to worry about crashing...

sweaty anorgasmic cru UNITE

jim, my experience with venlafaxine, which lasted about two-and-a-half years, was pretty similar to yours, it sounds like - i had to stop drinking entirely because being drunk on venlafaxine just felt terrible, like it took all the fun buzziness out of it and left a weird tinny hollow reproduction of drunkenness which was just... blecch

i found it a pretty decent mood stabiliser while i was on it (135mg for most of the time) and it definitely helped me get back on my feet but now that i'm a month or so off it i've realised just how much it sawed off the edges of every emotion and put me at a distinct distance from my own life - that was what i needed for a while for sure but now i feel much more connected to my emotions, for good and for ill

anyway, good luck with it - hope it helps get you where you need to be

sweaty anorgasmic cru UNITE

― michael keaton IS jim thirlwell IN ‘foetaljuice’ (bizarro gazzara)

not to get into iltmi territory but 20 years of PSSD on top of... other things... has changed my outlook

i used to worry about having my emotions blunted. either that's not happening with the sertraline or my emotions are so intense i appreciate having them blunted.

xp. thanks bizarro. venlafaxine hasn't made my drunkenness feel worse, but it gets me more drunk and gives me stamina to drink more than i should and stay up too late. which is also bad obv.

rusho, im not seeing a therapist. i keep meaning to get on that but while I'm not typically "cis man won't seek help or go to doctor because dumb male issues" - I'm very happy to go to my gp and am open with her about how I'm doing etc. - I'm sort of reluctant to talk to a therapist but i probably should.

i think my main issue with the idea of talking to a therapist is that generally there is nothing wrong with me and no specific issues I'm working through other than not enjoying everything and being anxious. I'm not really sure what id say to a therapist.

the therapist will know what to do
this does not sound like "nothing" other than not enjoying everything and being anxious
i can't tell you how many times i have heard a cry of distress followed by a walking back ("nothing wrong with me") and refusal to try therapy.

in fact, i used to be this person and i used to think this way and have since drastically reconsidered. i am better off for having changed my mind. can't speak for anyone else's experience but mine has been very helpful.

I dislike how therapy tends to put the onus on the patient when oftentimes depressive situations are unacceptable for reasons utterly beyond our control. Which isn't to say that nothing is to be done, but there's an undercurrent of victim-blaming that systematically comes to the fore when you're faced with a subpar therapist.

xp. by nothing wrong with me i more mean I'm not working through some specific issue(s). i feel those ways but i don't have a specific reason to. of people i have been close with who have gone to therapy they've been dealing with issues such as bereavement of parent at young age, dysfunctional family, childhood abuse and bullying, trauma, body dysmorphia, persistent suicidal ideation etc. ive had the great fortune of having a blessedly uneventful life.

i had a bit of a hallelujah moment the first time i heard about intergenerational trauma because my father had a very traumatic set of experiences in his youth as a political prisoner in chile, but i don't really know a) what the mechanism of the transferral of this trauma is supposed to be - my father seems to have struggled with undiagnosed ptsd for a decade or so but was a great dad - b0 what are you supposed to do about trauma you didn't actually suffer?

otm.

I am several years without a therapist now after my relationship with my last one ended extremely badly and while I miss it, it took a while for me to build that sort of trust again and it will be doubly hard next time. The absolute best who I moved away from was assigned to me by the NHS and she was genuinely life saving for me and I think of her guidance often.

in some sense i honestly appreciate therapy putting the onus on the patient because for me bemoaning the shitty state of the world in general was a pretty decent distraction from dealing with my actual problems (also so many people had it worse than me, etc etc). it's been good for helping me deal with stuff i'm responsible for without guilt and shame getting in the way and fucking up my ability to cope.

i have also found that therapy has been a very good complement to mood-stabilizing drugs and has helped them be maximally effective for me.

At its best it helps you snap out of defeatism. At its worst, however, it impels more guilt: 'So you think you've done everything you can to cope with the eradication of your soul? Well, you need to do more'.

So I kind of hate the psychopharmacologist I am seeing who is attached to my therapist's office. I have been taking the 2 mg of Abilify as she suggested, despite being really wary, and now the positive effects are kind of wearing off and I am left with only the side effects. So I asked if there was a withdrawal from Abilify and she said no. I then looked online and it seems there is a lot of withdrawal associated with it. She suggested I go down to 1 mg per day because I am still having trouble sleeping since I started (I wake up about 4-5 times throughout the night). I originally had more energy but jitteriness and now I feel like I have less energy again and am just am left with the jitteriness I think. She said if I have less energy from it I should go up to 5 mg but she thinks that I don't really want to do that, which I don't.

So all I want is for her to increase my paroxetine dose to 40 mg but she doesn't want to because she doesn't think it is helping me. However, she wants to add 10 mg the week before my period and for me to take birth control so I don't get my period bc now she is sure I have PMDD. She says that paroxetine doesn't help with energy, only depression. But I think if I am less depressed I would have more energy.

She's very combative with me and doesn't listen to what I want and she is super expensive. So frustrating! Has anyone tried going off of Abilify and did you have any side effects?

Also, this woman says she doesn't like paroxetine because it leads to weight gain, whereas in my research it seems Abilify if much more tied to weight gain. I asked her if she could suggest anything else for me and she was like no, because then we would have to taper you off the paxil (?!). So she's basically doesn't like Paxil but has no suggestions for me other than adjuncting with Abilify.

How do you find a good prescribing doc? This woman charges $250 per half hour! Previously I was getting meds from my GP and honestly it was a much better experience, and a whole lot cheaper.

The fact she thinks weight gain is the worst possible side effect is pretty telling

ditch her, she sucks and no one is worth 500 an hour, what the hell?? I'm so sorry

She sounds like someone who is not interested in learning anything new for the rest of her life, because thinking is hard, but being a credentialed 'expert' lets you off the hook for doing any new thinking ever again.

haha, thanks guys! my friend knows someone who takes my insurance so I will try and get an appointment with someone else. she's young too! like in her 30s...

The book Rabbits for Food has some pretty funny commentary on psych meds...the character says no to the exact same thing my psych prescribed to me.

I am a fan of psych nurse practitioners (and NPs in general). For most stuff I would take an NP over an MD every day of the week. Nurses rule.

She is an NP :( Just a very stubborn one. Hi Q!

Paxil seems like bad news, in a new way.

Coupland et al, 2019. Anticholinergic drug exposure and the risk of dementia: a nested case-control study. JAMA Int Med.