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El-Mallakh, 2011 Tardive dysphoria: The role of long term antidepressant use in inducing chronic depression


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#1 Altostrata

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Posted 18 May 2011 - 11:26 AM

Again, this study based on a survey of the literature cannot take into account the misdiagnoses of antidepressant withdrawal syndrome for "chronic depression."

Med Hypotheses. 2011 Jun;76(6):769-73. Epub 2011 Apr 2.

Tardive dysphoria: The role of long term antidepressant use in inducing chronic depression.

El-Mallakh RS, Gao Y, Jeannie Roberts R.

Source

Mood Disorders Research Program, The University of Louisville Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA.

Abstract at http://www.ncbi.nlm....pubmed/21459521 Full text here.

BACKGROUND:

Treatment-resistant and chronic depression appear to be increasing. The recent identification of antidepressant tachyphylaxis, the loss of antidepressant efficacy over time, is only a partial explanation. This is an emerging evidence that, in some individuals, persistent use of antidepressants may be prodepressant.

METHODS:

A literature search of PubMed utilizing the terms: antidepressant tachyphylaxis, treatment-resistant depression, chronic depression, and antidepressant tolerance was performed, and relevant articles were used.

RESULTS:

Depressed patients who ultimately become treatment resistant frequently have had a positive initial response to antidepressants and invariably have received these agents for prolonged time periods at high doses. Parallels between this course and tardive dyskinesia are noted. It is proposed that neuroplastic processes related to dendritic arborization may underlie the treatment resistant depression that occurs in the setting of chronic antidepressant use. Since the prodepressant effect is seen after prolonged antidepressant use, the term tardive dysphoria is proposed.

CONCLUSIONS:

Tardive dysphoria, needs to be considered in studies of treatment resistant depression, and should be examined in blinded, randomized antidepressant discontinuation trials.


-------SELECTIONS FROM THE PAPER--------

Depressive disorders affect over 6% of Americans and 5% of all humans on the planet....

For many patients recurrence of depressive symptoms may occur despite ongoing antidepressant treatment. When optimization of treatment fails, such patients are noted to have treatment-resistant depression (TRD). TRD may comprise 30–50% of people with major depressive illness. The cause of TRD is unknown, but its prevalence appears to be increasing. In 2006, a meta-analysis reported that nearly 40% of depressed patients had TRD. However, in the early 1990s it was reported that only 10–15% of patients had TRD....There are reasons to believe that antidepressant treatment itself may contribute to a chronic depressive syndrome....

Tachyphylaxis (also known as antidepressant tolerance, antidepressant ‘‘poop-out’’, or ‘‘breakthrough depression’’) is a condition in which patients experience a good initial antidepressant response which is lost over time with repeated or prolonged antidepressant treatment....Up to 80% of patients diagnosed with major depressive disorder will experience a recurrence of depressive episode despite constant maintenance dose of an antidepressant. Attempts to treat these individuals frequently result in poor response and the rise of TRD....

Once initial treatment response is lost, subsequent improvement is unlikely. If patients with TRD respond to a subsequent antidepressant, the extent of improvement is inferior to the initial response. Patients who lost response to a MAOI not only did not respond to subsequent treatment, but reported greater extent of depression after relapse than before the new treatment was initiated....

It is proposed that tardive dysphoria (TDp) is an abnormal dysphoric state that develops in some predisposed individuals with prolonged antidepressant treatment. Patients with this syndrome may comprise a significant fraction of TRD subjects. TDp is defined as a chronic, frequently treatment resistant, depressive state with onset in the setting of ongoing, persistent antidepressant treatment....The depressive state is perpetuated (and possibly worsened) by continuing the antidepressant. It is believed that SRI antidepressants might be selectively associated with the development of TDp. Discontinuation of the antidepressant results in a slow and gradual improvement of the chronic depressive symptoms. However, in some individuals who have experienced TDp for a very prolonged period of time, discontinuation of antidepressant may not result in reversal of the symptoms.....
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#2 cinephile

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Posted 08 June 2011 - 01:07 PM

These are all GOLD alto! I especially like the newest one -- looks like Whitaker's work is FINALLY bearing fruit! Can I get a big "told ya so?" from everyone on this forum? :P
Been on SSRIs since 1998:
1998-2005: Paxil in varying doses
2005-present: Lexapro.
2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!
APA=FUBAR
FDA=SNAFU
NIMH=LMFAO

Currently tapering Lexapro ~10% every month:

STARTING: 15 mg
11/7/10: 13.5 mg
12/7/10: 12.2 mg
1/6/11: 10.9 mg
2/3/11: 9.8 mg
3/3/11: 8.8 mg
4/1/11: 7.8 mg
4/29/11: 7 mg
5/27/11: 6.4 mg
6/24/11: 5.7 mg
7/22/11: 5 mg
8/18/11: 4.5 mg
9/14/11: 4 mg
10/13/11: 3.6 mg
11/9/11: 3.2 mg
12/7/11: 2.6 mg
1/3/12: 2.1 mg
2/2/12: 1.8 mg

#3 summer

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Posted 08 June 2011 - 01:36 PM

This makes total sense to me also... On second thought I have a question - what could be the difference between dealing with depression which is ongoing, has returned or relapse, and the symptoms of withdrawal?

Wellbutrin: 150mg.

Xanax: .5 once daily

 

Charter Member 2011


#4 Altostrata

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Posted 08 June 2011 - 03:25 PM

In withdrawal, the state of your nervous system and overall neurochemical balance is abnormal. In natural depression, if your overall health is good, your nervous system and neurochemical balance are also healthy. The theory that depression indicates an imbalance or disease in the brain is a myth.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#5 Nadia

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Posted 12 July 2011 - 10:20 AM

In withdrawal, the state of your nervous system and overall neurochemical balance is abnormal.

In natural depression, if your overall health is good, your nervous system and neurochemical balance are also healthy.

The theory that depression indicates an imbalance or disease in the brain is a myth.


I wonder what causes depression, then? I can't remember now where I read that maybe it doesn't have to do with neurotransmitter levels, but rather with how neuron receptors work. God, it could be anything... the limbic system is such a complicated thing.

Allopathic medicine just ignores how we are complex ecosystems and goes at everything with a hatchet. All my years of taking ADs, though I feel in so many ways I truly did cope with life in a healthier way because of them, were just wishful thinking that this wasn't going to have a down-side in the future. At most I thought the meds would make me permanently less sensitive, and I actually thought that was a good thing. I just wanted to be able to function like everyone else. It really disturbs me how sickly involved drug companies are in health practices and in studies. Organizations like the FDA should be protecting us, but instead they are pretty much bought out by the pharmaceutical industry. I knew this, and yet my desire to be a normally functioning individual blinded me anyway.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#6 Altostrata

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Posted 12 July 2011 - 10:26 AM

I guess we all wanted to believe we could take a pill, like a vitamin, to cure our problems. I remember way back when I rationalized it as "all they do is add serotonin, that's a natural hormone, it's no big deal." Of course, all that serotonin imbalance thing was a huge lie. Moods do not depend on serotonin or even neurological actions solely in the brain. The entire body is involved, there's even feedback from the gut. Memories and attitudes are extremely important. Relearning cognitive framing has been shown to be more effective than drugs on depression and anxiety.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#7 Nadia

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Posted 12 July 2011 - 07:21 PM

Yes... the appeal of the magic solution. Why eat well if you can just take a pill to lower your cholesterol? So tempting... but in the end, there's no such thing as a free lunch. I totally bought into the chemical imbalance thing. It seemed to make so much sense. Alas.

'94-'08 On/off ADs. Mostly Zoloft & Wellbutrin, but also Prozac, Celexa, Effexor, etc.
6/08 quit Z & W after tapering, awful anxiety 3 mos. later, reinstated.
11/10 CTed. Severe anxiety 3 mos. later & @ 8 mos. much worse (set off by metronidazole). Anxiety, depression, anhedonia, DP, DR, dizziness, severe insomnia, high serum AM cortisol, flu-like feelings, muscle discomfort.
9/11-9/12 Waves and windows of recovery.
10/12 Awful relapse, DP/DR. Hydrocortisone?
11/12 Improved fairly quickly even though relapse was one of worst waves ever.

1/13 Best I've ever felt.

3/13 A bit of a relapse... then faster and shorter waves and windows.

4/14 Have to watch out for triggers, but feel completely normal about 80% of the time.


#8 areyouthere

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Posted 15 August 2012 - 02:24 PM



Relearning cognitive framing has been shown to be more effective than drugs on depression and anxiety.

Like it!
Fall 1995 xanax, zoloft. switched to Serzone
1996- spring 2003serzone/ xanax/ lightbox.
b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b]
2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax
November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b
Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax
My mantra " go slow & with the flow "
3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day)

4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day.
10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro.
1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms.
1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. :) 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut.

#9 aza

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Posted 17 November 2012 - 06:18 PM




Relearning cognitive framing has been shown to be more effective than drugs on depression and anxiety.

Like it!


Cognitive therapy allowed me to overcome my anxiety. And without drugg therapy.

#10 LoveandLight

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Posted 04 January 2015 - 04:13 PM

The last statement that scares me, that is what I'm trying to get at in my thread in symptoms. But there is no way of knowing which 'camp' I'll be in until I'm off and that scares me too. Is there any research that anyone has found that natural remedies may help reverse if that indeed, is the case.
2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!

On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.

Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.


Nightmare that could have been avoided!

#11 degen12

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Posted 22 January 2015 - 12:16 AM

The theory that depression indicates an imbalance or disease in the brain is a myth.

 

I don't think it's that simple. The brain is not separate from the body, and nor is it separate from the mind. I agree that antidepressants aren't the answer. They can't protect you from sh*tty life circumstances, and they can't cure physical illness. Depression can be construed as a physical illness. I don't think it's possible to separate the two. Psychology and disease may lead to the same biological underpinnings that lead to depressive behaviour.

 

Full text for this review is available.

 

1. Nat Rev Neurosci. 2008 Jan;9(1):46-56.

From inflammation to sickness and depression: when the immune system subjugates
the brain.

Dantzer R(1), O'Connor JC, Freund GG, Johnson RW, Kelley KW.

Author information: 
(1)Integrative Immunology & Behavior, Department of Animal Sciences, College of
Agricultural, Consumer and Environmental Sciences, University of Illinois,
Urbana-Champaign, Illinois 61801, USA. dantzer@uiuc.edu

In response to a peripheral infection, innate immune cells produce
pro-inflammatory cytokines that act on the brain to cause sickness behaviour.
When activation of the peripheral immune system continues unabated, such as
during systemic infections, cancer or autoimmune diseases, the ensuing immune
signalling to the brain can lead to an exacerbation of sickness and the
development of symptoms of depression in vulnerable individuals. These phenomena 
might account for the increased prevalence of clinical depression in physically
ill people. Inflammation is therefore an important biological event that might
increase the risk of major depressive episodes, much like the more traditional
psychosocial factors.

PMCID: PMC2919277
PMID: 18073775  [PubMed - indexed for MEDLINE]

 

Here is the study regarding anti-inflammatory drugs. Full text is also available.

 

1. JAMA Psychiatry. 2014 Dec 1;71(12):1381-91. doi:
10.1001/jamapsychiatry.2014.1611.

Effect of Anti-inflammatory Treatment on Depression, Depressive Symptoms, and
Adverse Effects: A Systematic Review and Meta-analysis of Randomized Clinical
Trials.

Köhler O(1), Benros ME(2), Nordentoft M(2), Farkouh ME(3), Iyengar RL(4), Mors
O(1), Krogh J(2).

Author information: 
(1)Research Department P, Aarhus University Hospital, Risskov, Denmark2Lundbeck
Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus
University Hospital, Risskov, Denmark. (2)Mental Health Centre Copenhagen,
University of Copenhagen, Copenhagen, Denmark. (3)Zena and Michael A. Weiner
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New 
York5Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre of
Excellence, University of Toronto, Toronto, Ontario, Canada. (4)Zena and Michael 
A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New 
York, New York6School of Medicine, St George's University, St George's, Grenada.

IMPORTANCE: Several studies have reported antidepressant effects of
anti-inflammatory treatment; however, the results have been conflicting and
detrimental adverse effects may contraindicate the use of anti-inflammatory
agents.
OBJECTIVE: To systematically review the antidepressant and possible adverse
effects of anti-inflammatory interventions.
DATA SOURCES: Trials published prior to December, 31, 2013, were identified
searching Cochrane Central Register of Controlled Trials, PubMed, EMBASE,
PsychINFO, Clinicaltrials.gov, and relevant review articles.
STUDY SELECTION: Randomized placebo-controlled trials assessing the efficacy and 
adverse effects of pharmacologic anti-inflammatory treatment in adults with
depressive symptoms, including those who fulfilled the criteria for depression.
DATA EXTRACTION AND SYNTHESIS: Data were extracted by 2 independent reviewers.
Pooled standard mean difference (SMD) and odds ratios (ORs) were calculated.
MAIN OUTCOMES AND MEASURES: Depression scores after treatment and adverse
effects.
RESULTS: Ten publications reporting on 14 trials (6262 participants) were
included: 10 trials evaluated the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) (n = 4258) and 4 investigated cytokine inhibitors (n = 2004). The pooled
effect estimate suggested that anti-inflammatory treatment reduced depressive
symptoms (SMD, -0.34; 95% CI, -0.57 to -0.11; I2 = 90%) compared with placebo.
This effect was observed in studies including patients with depression (SMD,
-0.54; 95% CI, -1.08 to -0.01; I2 = 68%) and depressive symptoms (SMD, -0.27; 95%
CI, -0.53 to -0.01; I2 = 68%). The heterogeneity of the studies was not explained
by differences in inclusion of clinical depression vs depressive symptoms or use 
of NSAIDs vs cytokine inhibitors. Subanalyses emphasized the antidepressant
properties of the selective cyclooxygenase 2 inhibitor celecoxib (SMD, -0.29; 95%
CI, -0.49 to -0.08; I2 = 73%) on remission (OR, 7.89; 95% CI, 2.94 to 21.17;
I2 = 0%) and response (OR, 6.59; 95% CI, 2.24 to 19.42; I2 = 0%). Among the 6
studies reporting on adverse effects, we found no evidence of an increased number
of gastrointestinal or cardiovascular events after 6 weeks or infections after 12
weeks of anti-inflammatory treatment compared with placebo. All trials were
associated with a high risk of bias owing to potentially compromised internal
validity.
CONCLUSIONS AND RELEVANCE: Our analysis suggests that anti-inflammatory
treatment, in particular celecoxib, decreases depressive symptoms without
increased risks of adverse effects. However, a high risk of bias and high
heterogeneity made the mean estimate uncertain. This study supports a
proof-of-concept concerning the use of anti-inflammatory treatment in depression.
Identification of subgroups that could benefit from such treatment might be
warranted.

PMID: 25322082  [PubMed - in process]

 

Depression may lead to a vicious inflammatory cycle.

 

1. BMC Med. 2012 Jun 29;10:66. doi: 10.1186/1741-7015-10-66.

Depression and sickness behavior are Janus-faced responses to shared inflammatory
pathways.

Maes M(1), Berk M, Goehler L, Song C, Anderson G, Gałecki P, Leonard B.

Author information: 
(1)Maes Clinics @ TRIA, Piyavate Hospital, 998 Rimklongsamsen Road, Bangkok
10310, Thailand. dr.michaelmaes@hotmail.com

It is of considerable translational importance whether depression is a form or a 
consequence of sickness behavior. Sickness behavior is a behavioral complex
induced by infections and immune trauma and mediated by pro-inflammatory
cytokines. It is an adaptive response that enhances recovery by conserving energy
to combat acute inflammation. There are considerable phenomenological
similarities between sickness behavior and depression, for example, behavioral
inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic
(fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In
clinical depression, however, a transition occurs to sensitization of
immuno-inflammatory pathways, progressive damage by oxidative and nitrosative
stress to lipids, proteins, and DNA, and autoimmune responses directed against
self-epitopes. The latter mechanisms are the substrate of a neuroprogressive
process, whereby multiple depressive episodes cause neural tissue damage and
consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory
pathways underpin the physiology of sickness behavior and the pathophysiology of 
clinical depression explaining their partially overlapping phenomenology.
Inflammation may provoke a Janus-faced response with a good, acute side,
generating protective inflammation through sickness behavior and a bad, chronic
side, for example, clinical depression, a lifelong disorder with positive
feedback loops between (neuro)inflammation and (neuro)degenerative processes
following less well defined triggers.

PMCID: PMC3391987
PMID: 22747645  [PubMed - indexed for MEDLINE]

 

CBT, or "cognitive framing", as you call it, is certainly effective, but it can be a way to lie yourself to happiness in the same way that SSRIs are a way to "I don't care" yourself to happi... la la land.

 

If my life sucks, which it does, I can go to a therapist who practices CBT and have him "reframe" my outlook on my life so that it seems good, but in the end, it still sucks. (Says the back of my mind, but outlook on life is subjective, although I can't help but make seemingly objective evaluations of my own.)

 

The reasons why people are depressed usually aren't hard to find. I prefer psychoanalytic therapy, but all talk therapy, regardless of mode, has been shown to improve depression. CBT is the most well studied. Hell, I recently read about dance therapy for depression.


April / 2016: Cipralex 10 mg, Mirtazapine 30 mg, Lyrica 600 mg, Diazepam 20 mg, Bystolic 5 mg

April / 2016: Mirtazapine 30 mg -> 15 mg


#12 degen12

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Posted 22 January 2015 - 12:26 AM

Discontinuation of the antidepressant results in a slow and gradual improvement of the chronic depressive symptoms.

 

Having been on an SSRI since age 7, this brings me sorely needed hope. Thank you for finding this article and posting it.


April / 2016: Cipralex 10 mg, Mirtazapine 30 mg, Lyrica 600 mg, Diazepam 20 mg, Bystolic 5 mg

April / 2016: Mirtazapine 30 mg -> 15 mg


#13 LoveandLight

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Posted 22 January 2015 - 01:33 AM

Funny, selective reading. I chose to focus on the gloomier aspect and totally disregarded the above quote.
2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!

On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.

Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.


Nightmare that could have been avoided!

#14 Altostrata

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Posted 22 January 2015 - 02:47 PM

degen, is it possible that when people feel unwell, even if only vaguely, that might affect mood?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#15 degen12

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Posted 22 January 2015 - 04:58 PM

degen, is it possible that when people feel unwell, even if only vaguely, that might affect mood?

 

Almost certainly, even if they don't know it.

 

The factors that affect mood are so numerous and layered that it's futile to try and pin it down to one thing. Of course that's what drug companies and their researchers are trying to do. I posted some studies that try and connect inflammation and sickness behaviour to depression. It's definitely interesting to read but trying to create a "unifying theory" for depressive behaviour is impossible. There will be no E=mc. Heck, how your mother fared during her pregnancy can affect susceptibility to almost anything.


April / 2016: Cipralex 10 mg, Mirtazapine 30 mg, Lyrica 600 mg, Diazepam 20 mg, Bystolic 5 mg

April / 2016: Mirtazapine 30 mg -> 15 mg


#16 Altostrata

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Posted 23 January 2015 - 04:42 PM

That's exactly how all those studies finding a correlation between inflammation and "depression" are confounded -- no one is sure which came first, the inflammation or the "depression."

 

In addition, "depression" is so sloppily defined and diagnosed that no one knows what was called "depression" in those studies. They usually use multiple-choice quizzes to identify "depression," but these have a host of problems.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#17 westcoast

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Posted 19 February 2015 - 11:45 AM

I love that word, "prodepressant."

But what about all those people who comment on drug stories in the newspaper (nytimes.com, etc) saying "effexor and lithium saved my life!" It's so complicated. Some might be shills, of course.


2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:


#18 Altostrata

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Posted 19 February 2015 - 12:00 PM

Some people like the effects of psychiatric drugs. They are psychoactives, after all.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#19 WiggleIt

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Posted 21 February 2015 - 02:18 AM

OMG this is obviously a credible conclusion. I don't think there is a need for "trials."

Recreational drug and alcohol use leads to chronic depression. They are psychoactive and alter the same stuff in the brain as psych meds; therefore psych meds pose the same risks.

It would be cruel and unusual to subject people to trials of these meds. This is one situation where I believe the research conclusions can be made based on common sense.

If we were talking about cancer or some other kind of illness, I'd be all for clinical trials, but I think there is enough evidence here that a reasonable causal conclusion can be made.

-Dual cold turkeys off TCA & Ativan in October 2014. Prescribed from 2011-2014, off-label for pain

-Meds were prescribed for an "autoimmune chronic pain disease."  It was a MISDIAGNOSIS, but did not find out until AFTER meds had caused total damage.  All med tapers & cold turkeys directed by doctors 

-Nortriptyline from May 2012 - Dec 2013

-Desipramine from Jan 2014 - October 2014. 60 mg reduced by 10 mg each month. Held 30 mg for 3 months. Rapid taper over 1 week from 30 mg down to 20, 10, 0

-Lorazepam 1 mg per night in 2011. In 2012, used 1 mg per month or less.  Lorazepam on & off Dec 2013 - Aug 2014, did not exceed 1.5 mg, did not exceed 3x a week

-On desipramine had muscle tremors & rigidity. Were they side effects or withdrawal effects as I reduced desip throughout 2014? Or was I in WD from nortrip as I was on desip? First muscle/dystonia side effects started on nortriptyline, but docs were too stupid to help me figure it out

-Last dosage desip 10 mg on Oct. 29, 2014. Last dose lzpam 1 mg, Nov. 2, 2014. Paradoxical reactions to benzos after quitting TCAs

-Tardive dystonia, dyskinesia, myoclonic jerks ALL over body, ribcage wiggles, facial tics, twitching tongue & fingers, tremors/twitches of arms, legs, cognitive impairment, throat muscles semi-paralyzed & unable to swallow solid food, brain zaps, ears ring, dizzy, everything looks too far away, insomnia, numbness & electric shocks everywhere when I try to fall asleep, jerk awake from sleep with big, gasping breaths, wake with terrors & tremors, severely depressed.  NO HISTORY OF DEPRESSION, EVER. Meds CREATED it.

-Month 7 off meds: hair falling out; no improvement in vision; still tardive dystonia; facial & tongue tics returned
-Month 8 off meds: thrown back to acute, including Grand Mal seizure-like episodes. New mental torment, PGAD, worse insomnia
-Month 9 off meds: tardive dystonia worsened, dyskinesia returned. Unable to breathe well due to dystonia in stomach, chest, throat.
-Month 13 off meds: Back to total acute, brain zaps back, plus developed eczema & stomach problems. Left leg no longer works right due to dystonia, meaning both legs are now damaged


#20 WiggleIt

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Posted 21 February 2015 - 02:23 AM

ESPECIALLY now that so many psych meds are being prescribed off-label to patients with no history of depression prior to meds. THERE'S the evidence.

Honestly, I'm developing such a disrespect for medical science.

-Dual cold turkeys off TCA & Ativan in October 2014. Prescribed from 2011-2014, off-label for pain

-Meds were prescribed for an "autoimmune chronic pain disease."  It was a MISDIAGNOSIS, but did not find out until AFTER meds had caused total damage.  All med tapers & cold turkeys directed by doctors 

-Nortriptyline from May 2012 - Dec 2013

-Desipramine from Jan 2014 - October 2014. 60 mg reduced by 10 mg each month. Held 30 mg for 3 months. Rapid taper over 1 week from 30 mg down to 20, 10, 0

-Lorazepam 1 mg per night in 2011. In 2012, used 1 mg per month or less.  Lorazepam on & off Dec 2013 - Aug 2014, did not exceed 1.5 mg, did not exceed 3x a week

-On desipramine had muscle tremors & rigidity. Were they side effects or withdrawal effects as I reduced desip throughout 2014? Or was I in WD from nortrip as I was on desip? First muscle/dystonia side effects started on nortriptyline, but docs were too stupid to help me figure it out

-Last dosage desip 10 mg on Oct. 29, 2014. Last dose lzpam 1 mg, Nov. 2, 2014. Paradoxical reactions to benzos after quitting TCAs

-Tardive dystonia, dyskinesia, myoclonic jerks ALL over body, ribcage wiggles, facial tics, twitching tongue & fingers, tremors/twitches of arms, legs, cognitive impairment, throat muscles semi-paralyzed & unable to swallow solid food, brain zaps, ears ring, dizzy, everything looks too far away, insomnia, numbness & electric shocks everywhere when I try to fall asleep, jerk awake from sleep with big, gasping breaths, wake with terrors & tremors, severely depressed.  NO HISTORY OF DEPRESSION, EVER. Meds CREATED it.

-Month 7 off meds: hair falling out; no improvement in vision; still tardive dystonia; facial & tongue tics returned
-Month 8 off meds: thrown back to acute, including Grand Mal seizure-like episodes. New mental torment, PGAD, worse insomnia
-Month 9 off meds: tardive dystonia worsened, dyskinesia returned. Unable to breathe well due to dystonia in stomach, chest, throat.
-Month 13 off meds: Back to total acute, brain zaps back, plus developed eczema & stomach problems. Left leg no longer works right due to dystonia, meaning both legs are now damaged


#21 westcoast

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Posted 21 February 2015 - 06:56 AM

Some people like the effects of psychiatric drugs. They are psychoactives, after all.

good point. Also, as someone pointed out, the folks who say that Effexor is saving their lives might have discontinued and gone nuts, and not known it was withdrawal.

2009: Cancer hospital said I had adjustment disorder because I thought they were doing it wrong. Their headshrinker prescribed Effexor, and my life set on a new course. I didn't know what was ahead, like a passenger on Disneyland's Matterhorn, smiling and waving as it climbs...clink, clink, clink.

2010: Post surgical accidental Effexor discontinuation by nurses, masked by intravenous Dilaudid. (The car is balanced at the top of the track.) I get home, pop a Vicodin, and ...

Whooosh...down, down, down, down, down...goes the trajectory of my life, up goes my mood and tendency to think everything is a good idea.
2012: After the bipolar jig was up, now a walking bag of unrelated symptoms, I went crazy on Daytrana (the Ritalin skin patch by Noven), because ADHD was a perfect fit for a bag of unrelated symptoms. I was prescribed Effexor for the nervousness of it, and things got neurological. An EEG showed enough activity to warrant an epilepsy diagnosis rather than non-epileptic ("psychogenic") seizures.

:o 2013-2014: Quit everything and got worse. I probably went through DAWS: dopamine agonist withdrawal syndrome. I drank to not feel, but I felt a lot: dread, fear, regret, grief: an utter sense of total loss of everything worth breathing about, for almost two years.

I was not suicidal but I wanted to be dead, at least dead to the experience of my own brain and body.

2015: I  began to recover after adding virgin coconut oil and organic grass-fed fed butter to a cup of instant coffee in the morning.

I did it hoping for mental acuity and better memory. After ten days of that, I was much better, mood-wise. Approximately neutral.

And, I experienced drowsiness. I could sleep. Not exactly happy, I did 30 days on Wellbutrin, because it had done me no harm in the past. 

I don't have the DAWS mood or state of mind. It never feel like doing anything if it means standing up.

In fact, I don't especially like moving. I'm a brain with a beanbag body.   :unsure:


#22 jimmy555

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Posted 11 September 2016 - 12:17 PM

This is worrying ,so it becomes permanent ?

 

Discontinuation of the antidepressant results in a slow and gradual improvement of the chronic depressive symptoms. However, in some individuals who have experienced TDp for a very prolonged period of time, discontinuation of antidepressant may not result in reversal of the symptoms.


Citalipram 2010 top 2105 10mg a day ,tapered off for 3 month still seemed to have withdrawal.

 

Went back on Citalopram for one month in Sept 2015 taper off more slowly

 

Sept 2016 prescribed sertraline ,been on for two days 50mg