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Rhiannon

How psychiatric drugs remodel your brain

33 posts in this topic

This is something I posted somewhere else and then saved. I know it's all stuff I've said before, but it bears repeating and further discussion. A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

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So how do you start to do that? Your post makes absolute sense. But what can be done - once the drugs have been completely stopped - to help the brain return to something like normal?

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Good post, Rhi.

 

A knowledgeable doctor describes this as the drugs leaving a footprint. The footprint does eventually fade as the nervous system goes back to its factory settings.

 

Dinah, we have many topics about neurogenesis and neuroplasticity. The brain grows new neurons all the time (but not as fast as we'd like) and adapts to present conditions. What we want to do is use our understanding to create good conditions to train those newborn neurons -- taking care of ourselves, good nutrition, calming activities, learning to manage neuro-emotions (those exaggerated emotions generated by our hypersensitive recovering nervous systems).

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That's a really helpful explanation. Even knowing most of it already, it helped me to read it. Thanks!

 

I'm wondering if there might be a relationship between the time it takes for a drug to lose its effect or poop out, and the time it takes to recover from withdrawal. I noticed taking Zoloft that almost always after two years of taking it I would not longer feel the benefit. I suppose that was my brain compensating. So maybe it will take two years or so for my brain to compensate back. Or maybe that is just wishful thinking... it's probably a lot more complicated than that.

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It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

 

 

I like the comparison!

 

Thanks a lot for this Rhi. Good post. Makes a lot of sense to me.

 

Yeah, it seems to be a common misconception that we just need to get these drugs out of our systems.

 

It sounds a bit daft but I am really proud of my brain for healing as much as it has done! I was put on drugs at a young age, have been on several drugs (Seroxat, Prozac and a Benzo) and also spent quite a lot of years on drugs.

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Hmmm....that trellis simile....very familiar!

 

Good image, Rhi.

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hi RHI,

 

i agree all you explain,

 

what is your theory about why brain remodels with very nasty waves and not linear; and also why all is not remodelt in spite of years;

 

for me we overestimate the capacity of brain to do a well homeostasis (he has not been create to build a new homeostasis, he has not the tools), the brain can think a bad homeostasis is ok ; so at a time, improvements seem to stabilize, in spite all is not repaired, or i will say better, sometimes bad repaired and some areas worse than 2 years off (for example);

and we have only one solution: wait if this damn brain will understand we are bad and there is work he has not do well

hopefully it is often one or two ares only, the rest has been well repaired

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As I understand it, the nervous system can't fix itself all at once; it fixes itself in small patches. When there are enough small patches fixed, you feel it as a lurch forward. The bad homeostasis may try to reassert itself, you feel that as a lurch backward -- but not as far backward as before. So healing is a series of small improvements, some so small you can't feel them.

 

Rhi, what are your thoughts on this?

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Another question is, what happens when you have a bad reaction?

 

Some, like me, have only a small amount of pills, still face wave and windows for months. Do the drugs work so fast, that even one pill might bring a change? It seems so.

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Maybe, I think I might have mentioned this before. A small percentage of the population is genetically hypersensitive to increases in serotonin and will have severe adverse reactions after only a few pills. This is the same population that is driven to a psychotic reaction by exposure to LSD.

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Yes, Alto, I remember. The question though is, what happens after the reaction? The symptoms seem to be very similar to "normal" wd symptoms. The only category that I did not experience were, besides anxiety, mental problems like depression and mania.

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Right, they are "normal" withdrawal symptoms. Your nervous system has taken a jolt.

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Yes, Alto, I remember. The question though is, what happens after the reaction? The symptoms seem to be very similar to "normal" wd symptoms. The only category that I did not experience were, besides anxiety, mental problems like depression and mania.

 

hi Maybe,

 

some people say you have had a "mild" serotonin syndrome (with the real we can death)= adverse reaction

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Hi Stan,

 

Ah well, I guess it doesn't help to know as we cannot do anything about it :(

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Brilliant explanation  from Rhianna, bumping to the top for newbies.

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So true, my doc looks at me like i have 3 heads when i told him it is not about just getting it out of your body. He also said noone ever complained about coming off paxil.

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Hi guys. I have been on Prozac for 6 months and then Lexapro for 1 year and am off 2 months now. My friend is telling me that I am not normal for crying and doubting things and being unhappy since I was only on the meds 1.5 years. It takes time for the brain to heal right?

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'coopergirl1' Its normal to cry and doubt things in Ad withdrawal .yes it takes time for the brain to heal

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DLB,

I totally agree.

It is not just about the drug being out of your body within a certain period of time.

It is frustrating when I hear Doctors say that .

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Rhiannon, thanks for the post - that makes sense and now I can see why a slooowww taper is neccessary, albeit frustrating.

Growing new cells has got to take time!

And it explains why it makes sense to only taper one drug at a time, if possible.

 

Thank you. 

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> It's a matter of, as I describe it, having to grow a new brain.

 

Wow; thank you for that image. With this in mind, and having started Effexor at the age of 16, tapering slowly makes a great deal of sense to me.

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Hi

Great. Post especially the comparison with a plant and trellis.

 

How long do you think it takes to grow a new brain or retrain your existing one.

 

I suppose that's like asking how long is a piece of string.

 

Suppose it depends on so many factors.

 

I would just like some reassurance.

 

I've been doing a slow taper now for 15 months. I'm down to .7. Ml of Prozac . Reducing 5% every three weeks.

Am I going to fast for my brain? I so want yo be AD free for my 50th birthday in August. But reading your post I think I need to go slower?

Reflex

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Hi Reflex,

 

Frustratingly, no one really knows how long it takes. 

 

However, I believe this site can offer you reassurance that MANY people have completely healed. 

 

Your question about whether you are going too fast, I have two thoughts: 

1. Goals can be useful, but as advocate Will Hall says, they can set us up for not being as flexible when we need to be flexible. 

(For me, having a "timeline" goal is one of the things that made me listen to my doctor when he rec'd tapering off 18 years of Paxil in one month.) 

 

2. How are your symptoms? I would think 5% is admirably conservative. What are your brain and body telling you? 

 

(I am better at trying to help others be patient than I am to myself!! lol) 

 

It sounds like you are doing a well-informed taper, and I wish you the best of luck.  :)

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"true, my doc looks at me like i have 3 heads when i told him it is not about just getting it out of your body.."  DLB March 2015

Just read this whole thread for the first time. This quote about having 3 heads struck me, as there is more and more research out there on our "second brain" which is our gut. Currently suffering from nearly total GI dysfunction, I am painfully aware of the effect these meds have on our guts, as many here suffer with. I wonder if the same concept of brain remodeling has to go on in our gut as well. The saying "go with your gut" was never so poignant to me before I became aware of this connection. My GI doctor wants me to take a potent motility drug. When  I balked, he said. "It doesn't cross the blood-brain barrier. It goes right to your gut." I did not even respond. Our gut is called our enteric nervous system. It WILL affect my brain when it communicates w/ my gut. I thought this was an excellent article explaining our second brain, further  helping us understand the neuro-physiology of our w/d symptoms.
 

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Hi all,

 

I am new (long time reader though) and this post was very interesting to me (and worrying). I'm currently in withdrawal, on 5mg at the moment, have been on that for months now, but I am getting pulsing head aches, tingling in my hands and feet and sometimes weakness/pain in my hands - could this be a side/withdrawal effect? I've had a brain scan that showed a 3 milligram calcification on my brain but the dr didn't think that would cause the headaches and seemed very blase about that. I am extremely worried about what these side effects could mean, which is of course stressing me out even more than withdrawal. I worry I'll never recover or be the same again. The dr of course said, oh no it wouldn't be withdrawal, because I've been on the same dose for ages but I of course don't trust dr's anymore at all. Any help or advise would be much appreciated, I'm looking at getting an MRI next as I'm stressing about this a lot.

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Really good post Rhiannon,

 

I didn't exactly taper as slow as I could have, partly because the symptoms on the drugs were unbearable and scary, and partly because I was guided a taper which lasted no more than a few weeks.

 

Iv'e been told its not too late to reinstate the drugs for me at the moment but Iv'e thrown them away and don't plan on going to ask for more. Am I still likely to recover fully and "grow my new brain", albeit more slowly?

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Just found this brilliant post, whose explanation is so true to my experience. I now know that fluoxetine does cause w/d symptoms in some people. I'm near end of three-year, painstaking taper off 20 mg, which I'd been taking since early 1990s. Have had many problems discussed extensively here: flu-like symptoms, paresthesia, neuroemotions (intense anger, irritability, sadness, crying, etc.). Am also newly menopausal and on estrogen blocker after breast cancer, so hormone changes have complicated my picture.

 

Like many people, I've wondered whether I was imagining these symptoms, especially since my SSRI has a long half-life, and maintenance dose was moderate, not high. But several days ago, on making most recent cut, I immediately experienced intense anger and irritability...mean, critical thoughts, worry, etc., and tingling and numbness in extremities. I remember the (wonderful) moderators here telling me a couple of years ago that symptoms could be more marked near end of w/d, getting closer to zero.

 

I recognize these symptoms. Just want to add my voice to testimony of those who know that even fluoxetine can cause them in some people. 

 

Tapered off a benzo several years ago. Am moving forward day by day, taking care of myself and looking to time when my system is healed. This feels like a long and winding road! Thank you again for this helpful post.

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great post, I am currently 8 months off Effexor I tapered off it for about 18 months, I understand that my brain has to get used to doing things that cause me stress, without the crutch of the medication, I am going through the horrors right now but reading these posts has put things into perspective.

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With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This is a really great post, thank you for sharing. 

I'm concerned because I seem to meet all of the criteria for "well, it can't be good"... I was put on medication at 8 years old, and switched between a few different ones before finally going cold turkey 20 years later. If only a forum like this existed back then, what a wonderful support system this is!

 

It's been 8 years since I took my last pill, and have been really noticing some degradation in my cognitive function. I'm not sure if it's related to my past med experience, but after browsing through this forum am starting to really lean in that direction.

 

I've been looking for information on how I might be able to remodel my brain.. or even how I might go about finding a professional someone who can help me with this (not even sure what type of doctor would specialize in this).

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Come onnnn, brain!  I must have suffered a lot of damage, or my brain is exceptionally large...(joke)

 

Wonderful post.

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Does anybody have any links to studies that support this? I believe it is true - heck, I'm living it right now. But my wife gets her moments of doubt - especially when I get sudden symptom surges. She has been asking to see studies that show that taking these drugs causes synapses to die.

Is there some hard evidence I can use to show her that we know this to be true beyond anecdotal life experience?

SJ

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Thanks so much for this clear explanation of the brain and receptors. I had some vague idea of what happened in the brain but couldn't quite put it all together.  Really helpful for me to read this and now I can explain to others why the taper/withdrawal is so difficult.  My fear is that I started on antidepressants at age 19 and have been on one type or another every day for 28 years.  I don't think my brain is going to grow back - well maybe a little, but not much and definitely not quickly.  

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