Antidepressants

Short vs. long term use

Antidepressants are useful. Especially if anxiety makes it hard to get to work or therapy. But it makes sense to ask,

Are these a band-aid, masking the issue or do they actually heal something permanently?

When will I stop taking them?

After I stop, what will be different in my mind that will prevent anxiety attacks from resuming?

Is there anything I can do without drugs first?

“It took a year to come completely off – a year,” said Dr. Tom Stockmann, 34, a psychiatrist in East London, who experienced lightheadedness, confusion, vertigo, and brain zaps when he stopped taking Cymbalta after 18 months. To wind the prescription down safely he began opening capsules, removing a few beads of the drug each day in order to taper off.” ….

“She succeeded in her last attempt, in 2015, by tapering over months to 10 milligrams, then five, down from 20 milligrams and “finally all the way down to particles of dust,” after which she was bedridden for three weeks with severe dizziness, nausea and crying spells, she said. “Had I been told the risks of trying to come off this drug I never would have started it,” Ms. Hempel said. “A year and a half after stopping, I’m still having problems. I’m not me right now; I don’t have the creativity, the energy. She – Robin – is gone.”

New York Times (Apr 7, 2018) – Many People Taking Antidepressants Discover They Cannot Quit

“The term ‘discontinuation syndrome’ has progressively replaced ‘withdrawal syndrome’ in the SSRI literature. This shift was heavily supported by the pharmaceutical industry and was aimed at emphasizing that SSRI do not cause addiction or dependence, and symptoms are substantially different from the phenomena that take place with benzodiazepines. However, Nielsen et al. have demonstrated that there are impressive similarities between SSRI and benzodiazepines in this respect. Defining ‘withdrawal syndromes’ as those pertaining to benzodiazepines, antipsychotic drugs, and tricyclic antidepressants and ‘discontinuation syndromes’ as those of SSRI does not appear to reflect the evidence in the literature. Indeed, the use of this latter term has minimized the potential vulnerabilities induced by SSRI and has provided the ground for misleading indications (e.g., AD are to be preferred to benzodiazepines in anxiety disorders due to a lack of dependence).

Clinicians are familiar with the withdrawal phenomena that may occur from alcohol, benzodiazepines, barbiturates, opioids, and stimulants. The results of this review indicate that they need to add SSRI to the list of drugs potentially inducing withdrawal phenomena. The term ‘discontinuation syndrome’ minimizes the vulnerabilities induced by SSRI and should be replaced by ‘withdrawal syndrome’.”

Withdrawal Symptoms After SSRI Discontinuation: A Systematic Review (Feb 21, 2015)