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New York Times: Many People Taking Antidepressants Discover They Cannot Quit

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Shep

An excellent article from the New York Times on antidepressant withdrawal problems:

 

Many People Taking Antidepressants Discover They Cannot Quit

 

Key findings:

 

  • Long-term use of antidepressants is surging in the United States, according to a new analysis of federal data by The New York Times. Some 15.5 million Americans have been taking the medications for at least five years. The rate has almost doubled since 2010, and more than tripled since 2000.

 

  • Nearly 25 million adults, like Ms. Toline, have been on antidepressants for at least two years, a 60 percent increase since 2010.

 

  • Some scientists long ago anticipated that a few patients might experience withdrawal symptoms if they tried to stop — they called it “discontinuation syndrome.” Yet withdrawal has never been a focus of drug makers or government regulators, who felt antidepressants could not be addictive and did far more good than harm.

 

  • “Some people are essentially being parked on these drugs for convenience’s sake because it’s difficult to tackle the issue of taking them off,” said Dr. Anthony Kendrick, a professor of primary care at the University of Southampton in Britain.

 

  • The Times analyzed data gathered since 1999 as part of the National Health and Nutrition Examination Survey. Over all, more than 34.4 million adults took antidepressants in 2013-4, up from 13.4 million in the 1999-2000 survey.

 

  • Still, it is not at all clear that everyone on an open-ended prescription should come off it. Most doctors agree that a subset of users benefit from a lifetime prescription, but disagree over how large the group is.

 

  • Antidepressants are not harmless; they commonly cause emotional numbing, sexual problems like a lack of desire or erectile dysfunction and weight gain. Long-term users report in interviews a creeping unease that is hard to measure: Daily pill-popping leaves them doubting their own resilience, they say.

 

  • Patients who try to stop taking the drugs often say they cannot. In a recent survey of 250 long-term users of psychiatric drugs — most commonly antidepressants — about half who wound down their prescriptions rated the withdrawal as severe. Nearly half who tried to quit could not do so because of these symptoms.

 

  • In another study of 180 longtime antidepressant users, withdrawal symptoms were reported by more than 130. Almost half said they felt addicted to antidepressants.

 

  • At a 1997 conference in Phoenix sponsored by drug maker Eli Lilly, a panel of academic psychiatrists produced a lengthy report detailing the symptoms, like balance problems, insomnia and anxiety, that went away when the pills were restarted. But soon the topic faded from the scientific literature. And government regulators did not focus on these symptoms, seeing rampant depression as the larger problem.

 

The article continues on with more examples specific to different types of antidepressants. And finally, the article details a long-term trial of withdrawal done in New Zealand in which it was found that "some people’s symptoms were so severe that they could not bear to stop taking the drug."

 

This article is a very honest accounting of what is going on and very much worth a read. 

Edited by Shep
fixed spacing problem

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Rosetta

Good catch, Shep

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bheb

I was so happy to see this outside of SA. Hopefully media coverage gets even better

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Henosis

It was so great to read this today!!!

 

be sure to fill out the survey!

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FarmGirlWorks

“You’ve got this huge parallel community that’s emerged, largely online, in which people are supporting each other though withdrawal and developing best practices largely without the help of doctors."

 

Yes, indeed. Thanks so much for posting this, @Shep

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Hibari

Wow!  A top story in the New York Times about how difficult it is to come off of antidepressants. I am stunned and gratified to see this:  am trying to post the link. https://nyti.ms/2GK795C

 

Hibari

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degen12

There is a survey on the page too. I filled it out.

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wantrelief

Thank you so much for posting this, Shep.  I am so pleased this is being covered in the NYT!!   I am so hopeful this story will make a difference.  If anything, it gives us something from a well respected periodical to show people around us that we are not making this stuff up.

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Littlegrandma

Glad to see you posted this. I was trying to figure out how to post the link. My daughter sent it to me. I forwarded it to some skeptical family members. 

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Happy2Heal

yessssssssss so good to see that the word is getting out!

 

 

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DrugfreeProf

At long last, the truth is coming out into the mainstream. This after decades of denial and vilification of big pharma's victims. I'm surprised the big $$ advertising in the NYT didn't try to put the kabosh on this article.  Let's wait for all the "rebuttals" singing the praises of "life-saving" ADs and claiming that the kinds of negative WD reactions discussed in the article are "rare."

 

Edited by ChessieCat
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Dude

Thanks for posting this! The New York Times has finally brought attention to the issue. They wrote a lot about psychiatry and the DSM in the past and about psychiatric drugs in general. But what has been missing has been a serious article on withdrawal. About time!

 

I filled out the survey too. I have to admit that I only mentioned having been on antidepressants. Because if for some reason they actually print my submission with my actual name and location, I do not want Seroquel to be mentioned, considering that it's an antipsychotic and the conclusions people might draw from it. You never know who might read the article after "googling" your name online (for example, future employers, insurance representatives, acquaintances and "enemies" (if you have any)). And that might be damaging to one's reputation in several contexts, considering the fact that most people still don't know that psychiatric "diagnoses" aren't real medical diagnoses and that one can be prescribed all sorts of junk without any real justification.

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Snowyowl16

Very interesting article. Anyone have any insight on the website quoted, TWP?

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Dude

Hi Snowyowl. Yep, The Withdrawal Project is a project which was recently launched by Laura Delano and her team. She's been an "antipsychiatry" activist for years and has ties to "Mad In America" and Robert Whitaker (amongt others, I assume). She launched another project a few months ago (simultaneously with TWP) called the Inner Compass Initiative. The idea behind both websites is similar to the one behind this forum in that it provides information on psychiatric diagnoses, psychiatric drugs, coming off psychiatric drugs and withdrawal. I think there is also a forum on each site similar to this one.

 

Here are the links:

 

Inner Compass Initiative: https://www.theinnercompass.org/

 

The Withdrawal Project: https://withdrawal.theinnercompass.org/

 

 

Personally I regard those projects as complementary to SA and not the "competition", by the way.

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ChessieCat
12 hours ago, Dude said:

I filled out the survey too.

 

I couldn't find this.

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ChessieCat

I've just been reading some of the comments to this article on the site.

 

If you don't want to set off your anger and anxiety, I suggest you don't read them.  Some of them are very triggering.

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Dan998

A really good article that describes what all of us on here already know. Shame about the comments though. Still too many people believing the insulin for diabetics defence of long term prescribing of SSRI's. At least the message about how difficult withdrawal can be is slowly getting out there.

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Dude
11 hours ago, ChessieCat said:

 

I couldn't find this [i.e., the survey].

 

Hiya Chessie

 

The survey "window" is embedded within the article itself, round about in the middle. If it doesn't show up on your computer at all it might have something to do with your computer's settings (activated programs etc.).

 

I've actually had second thoughts about my participation in the survey with regard to the content of my submission. They asked what your experiences were have been with antidepressant withdrawal, what you've been on and what you had originally sought help for. But they also ask you to give your real name, age and location (as I've mentioned above). And I think that because of my enthusiasm with regard to the publication of this article and my long-term desire to help raise public awareness of this problem (even in small ways), I acted a bit too hastily and gave more information than I should have (still suffering from a bit of cognitive impairment probably didn't help either...).

 

I didn't go into too much detail, but I'm not comfortable with it since there's a chance it might be published (according to the Times themselves). And I don't want anyone who ever google's my name (for whatever reason) to have access to such information. If I were ever to go public with my own story, I'd want it to be after I've completely recovered and not while I'm still dealing with the problem. Anyway, long story short, I've emailed the author to ask if he could ensure that my submission does not get published (if possible) in order to protect my privacy and will see what his reply will be. And although I think the survey is a good idea in general, I'd urge anyone who's considering taking part not to divulge too much personal information for your own sake.

 

As for the comments, well, people will always have their opinions. It's going to take some time for the truth to become common knowledge just as it took the "chemical imbalance" theory a good while to become (wrongly) considered true by the public. I've read a couple of the comments, and now that I've recovered a good bit and have a little bit more distance to the issue (at times that is, not always) and don't take the expression of such opinions as personally as I used to, I have to admit that I can understand the logic behind some people's arguments (i.e. those who approve of psychiatric drugs) even though I don't agree with them. And I think the problem is simply that they don't know enough about the subject (i.e. are ignorant), which can't be held against them as individuals. What is needed is simply more public education in the form of articles like the one published and via other channels. I'm still glad there are some commenters on that site who are doing there best to set the record straight. For now I want to stay out of it though.

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Hibari
6 hours ago, Dan998 said:

A really good article that describes what all of us on here already know. Shame about the comments though. Still too many people believing the insulin for diabetics defence of long term prescribing of SSRI's. At least the message about how difficult withdrawal can be is slowly getting out there.

Great point about the comments Dan998.  

I had to stop reading them because I started to get upset.  I did post a few supporting the article under an alias because it bothered me so much but now have to get distance. 

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Snowyowl16

Some of the comments are very disheartening

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DrugfreeProf

But a lot of the comments support our position here on SA. I'm finding reading them more validating than not.

Of course you are going to hear comments from people invested in the chemical imbalance meme and "like insulin for diabetes" myth.

But to a large extent--at least larger than what we've seen in previous mainstream coverage--the article and comments support our thesis that

ADs are addictive, ineffective, and extremely difficult to get off.

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Hibari
On 4/8/2018 at 9:45 PM, ChessieCat said:

I've just been reading some of the comments to this article on the site.

 

If you don't want to set off your anger and anxiety, I suggest you don't read them.  Some of them are very triggering.

I agree Chessie, I had to stop reading them because I was getting triggered, both angry and anxious.   I did respond back under an alias to a few but then had to stop.. 

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Shep

The "Opinion Letters" to this article were published yesterday from the so-called "experts": 

 

New York Times article on antidepressants - OPINIONS

 

Ronald Pies is up to his old tricks, stating that, "Finally, some of the apparent 'withdrawal' symptoms discussed in the article — like low energy and diminished creativity — may represent a recurrence of the depression." Actually, when you reinstate a drug and the symptoms go away, that's not a recurrence of depression but it is a sign of drug dependency since low energy and diminished creativity are withdrawal symptoms and signs of a destabilized nervous system. 

 

And Michael Serby, another psychiatrist, states, "Withdrawal symptoms are readily avoided or minimized by careful tapering over a number of weeks."  And then he writes, "When there was a scare about the alleged potential for antidepressants to cause suicide, the number of prescriptions for these medications dropped, and the suicide rate rose correspondingly."  

 

Yes, the suicide rate will rise when you withdrawal people quickly from an AD over "weeks" as he wrote, and not months as advocated here. Not much logic in that opinion. Wonder how many of his own patients have died from that unfortunate assessment? 

 

And the retired psychiatric nurse who writes, "I’ve been taking them on and off for more than 50 years. When I don’t take them, the depression returns. I am 80, happy and taking four antidepressants." FOUR antidepressants at 80 years old? I don't know if I even buy that as anywhere near legitimate. 

 

And the spin continues . . . . 

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GentleSteps

The Times has published 4 letters to the editor responding to the article on SSRI withdrawal.

 Here's a link: https://www.nytimes.com/2018/04/09/opinion/antidepressants.html

 

All four letters are critical of the article for suggesting that people who have been prescribed SSRIs would want to get off of them and repeat oft-heard talking points regarding how "rare" or "short lived" withdrawal symptoms are and how so many people tagged with DSM diagnoses (MDD, GAD, et al.) must take SSRIs for life else risk recurrences of these "chronic" conditions .   Three are from psychiatrists affiliated with research universities (Columbia College of P&S, Weill Cornell, Ichan School of Medicine/Mt. Sinai, Tufts/SUNY (Ronald Pies). One is from a woman identifying as a long-term SSRI user who declares: 'Depression is a brain dysfunction that antidepressants alleviate, much as diabetes is a pancreatic dysfunction that insulin alleviates. So why should one taper off antidepressants?' 

 

This collection of published letters seems to have been curated in a somewhat one-sided manner.

 

 

 

 

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Shep

I read a web forum for psychiatric students. The moderators are psychiatrists with years of experience and education (i.e. indoctrination into a failed and dangerous system). 

 

This is the thread where several of them are discussing the Times article:

 

Student/Doctor Forums - Antidepressant Withdrawal (NYT Article)

 

Lots of spin, but what is so frightening is what the "experts" advocate:

 

Quote

In general if you follow the guidelines of getting off an antidepressant (same rate as you would increase it. E.g. Sertraline you increase 50 mg/day/week, 50 mg daily x 7 days, 100 mg daily x 7 days, 150 mg daily x 7 days, same thing but in reverse order) you shouldn't get it but biology is never 100%. Some people, however few, could still get it so if you want to be extra cautious do it half-speed.

 

Even doing that "half-speed" is way too fast for many people. And since dependency comes with no warning, you don't know who is going to be in the group that needs to go very slowly and cautiously. 

 

 

Quote

If anything I blame that doctors can do very poor practice and still get away with it, the shortage of psychiatrists creating a vacuum non-specialists are trying to fill, the shortage is also creating a situation where hospitals know they have a bad psychiatrist but won't replace them cause they can't find another, and that managed care has created a new treatment model where doctors don't explain things to patients. They just throw a med at them, but again this is a problem more systemic and bigger than just blaming antidepressants.

 

The above is another comment from that thread. There is logic to this.

 

I think the Times could have done a better job in messaging, such as listing the rise in disability in depression correlated with the rise in prescribing (such as Robert Whitaker did in Anatomy of an Epidemic). 

 

The article should have also mentioned the research that's already been done not just on withdrawal, but also on tardive dysphoria

 

Quote

Anyway, the profound disabling nonspecific symptoms I would bet are more characteristic of the underlying mood or personality disorder than the drug withdrawal. The study they describe where pts and providers were blinded to whether they were really tapering or not will be v interesting - and seems premature to report the article without the findings.

 

The above quote from that thread is disturbing because there already have been studies on this. Although they don't all have the "blinded" aspect (getting any type of research on withdrawal is difficult due the pharmaceutical industry's influence), there are enough reports of problems that at some point, it would be nice if doctors understood their patients better and became advocates for them (it's clear from that thread that some of these psychiatrists don't even like their patients).

 

This is a withdrawal study that Alto just posted:

 

Ostrow, 2017 Discontinuing Psychiatric Medications: A Survey of Long-Term Users

 

And some more: 

 

Papers about prolonged antidepressant withdrawal syndrome

 

How can they expect patients to research their drugs when the medical profession obviously isn't doing that? Are they really waiting for the New York Times to do that for them? 

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Lloyd

Eventually the medical world will be forced to acknowledge the severe harm these drugs induce. As more and more people are prescribed these drugs the rates of prolonged discontinuation syndrome will grow to a point where they can no longer sweep it under the carpet. Until then the only 'fix' they have is to prescribe more drugs to mask the symptoms.

I honestly believe pharma have no clue on how these drugs operate actually operate. All they appear to know (loosely) is that when re-uptake is inhibited symptoms of depression, anxiety, & obsessive disorders appear to improve (generally) due to increase of serotonin /  nor ephedrine availability in the synapse. Apparently that's good enough to get a green tick for mass distribution. Would someone not wonder WHY nor ephedrine and serotonin re-uptake occurs naturally? Obviously it happens for a reason & messing with it is going to have flow on effects - especially after long periods of drug use.

 

 

 

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Shep

Rxisk.org put out an article today about the NYT article:

 

Dependence on Antidepressants and The New York Times

 

Some key statistics:

 

  • Something is wrong when over 10% of the population is taking these drugs.  
  • Between 80 – 90 % are on them for over year and a quarter of those on them have been on them for ten or more years.

 

They also mention Alto and and the work SA does. 

 

I now understand why Dr. David Healy is researching PSSD and has a $100,000 prize for anyone who can cure PSSD:

 

Quote

The RxISK Prize focusses mainly on PSSD and PGAD.  Our hunch though is the mechanisms that lead to PSSD in some are very close to the mechanisms that lead to protracted withdrawal symptoms in others.  Both PSSD and complex withdrawal are legacy problems with a degree of overlap in symptoms.  Find what is causing PSSD and we will be a long way to finding what is happened in withdrawal.

 

The restless genitals of PGAD seems closely linked to the restlessness of akathisia. Find the answer to one and we will likely have the answer to the other.

 

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peng

Thanks, Shep.  Interesting and worthwhile link.

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Shep

Thanks, Peng. I'm finding many, many discussions about this article appearing all over the web. It certainly sparked a conversation. And that's good. 

 

Here's another article about the Times article:

 

When it comes to antidepressants, getting to zero proves difficult

 

It's reassuring to read an article written by a doctor who lists all of the difficulties that patients have coming off these drugs and then states, "For these reasons, I've fine-tuned my medical advice to patients." 

 

I hope more doctors come to this conclusion. I just wish it would happen sooner. 

 

 

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FarmGirlWorks
On 4/10/2018 at 6:02 PM, GentleSteps said:

The Times has published 4 letters to the editor responding to the article on SSRI withdrawal.

 Here's a link: https://www.nytimes.com/2018/04/09/opinion/antidepressants.html

I checked Dollars 4 Docs and found that Stuart Seidman, psychiatrist in NYC, received $4212 betewen 2013-2015 from pharmaceuticals. Did not find info on the other letters but my lack of trust in psychiatrists is big.

 

 

 

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Shep
18 minutes ago, FarmGirlWorks said:

I checked Dollars 4 Docs and found that Stuart Seidman, psychiatrist in NYC, received $4212 betewen 2013-2015 from pharmaceuticals. Did not find info on the other letters but my lack of trust in psychiatrists is big.

 

Great idea to check Dollars for Docs.

 

Ronald Pies wrote one of the letters and he's on the editorial board of Psychiatric Times. Psychiatric Times runs pharmaceutical ads, so it's an extension of the pharmaceutical industry.

 

The Times should have pointed out the ties that Seidman and Pies both have to industry, as it's a conflict of interest. 

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GentleSteps

@FarmGirlWorks - Great scouting on Dollars for Docs.  While some may say that Seidman's receipt of about $4K over a few years is unremarkable or negligible in the context psychiatry's (and the medical profession's generally) systemic ties to the pharmaceutical industry, I still find it notable and worthy of note.  So thank you for the research.  Did Dollars for Docs indicate what companies or drugs he received money for?  There usually are notations specifying that information in the search results.

 

@Shep - thank you for tracing the Pies-Psychiatric Times connection.  Speculating freely here, but for all we know Psychiatric Times (at the urging of its ad clients perhaps) spoke to someone at the NYT's C-Suite after the WD article was published and initiated the process that resulted in such a monolithic cluster of (ostensibly independent) Pharma-defense  "letters to the editor."

 

As a friend likes to say, "these days I keep finding that I'm not cynical enough" (and he's very cynical).

 

A heartening "reply" to the biased collection of Letters to the Editor came in today's NYT, which published  a follow-up article by Ben Carey inspired by the 900 or so letters received in response to the initial article.  Some were, of course, from people grateful to have been put on antidepressants and to be able to stay on them for life.  But in today's article Carey re-iterates the point that the real experience of withdrawal is so much worse than most in the professions (and industry) lets on knowing about, and more interestingly, how there is now a generation of adults who were put on these drugs as children by parents who "came of age" in the SSRIs-Are-Good era.   He also emphasizes that the routine indefinite prescribing of SSRIs (life-long maintenance plans) was never subject to clinical trials, and so everyone on these medications has really just been part of a giant uncontrolled experiment.  And he even dismisses,  matter-of-factly, the "brain disease" theory of psychiatric diagnoses as a Pharma marketing ploy!  

 

It was very disappointing that Comments were not open in today's Carey piece.  I wonder if there will be another cluster of "Letters to the Editor" rebutting today's Carey piece. Odd that not one of the last ones was from an actual Pharma company.  One guesses the industry likes to launder its messaging through the prestige of its handmaiden, the psychiatric profession (or rather, those pyschiatrists and research universities and institutions that accept that role.)

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Altostrata

The pharmaceutical industry is not interested in withdrawal syndrome. In their minds, they have discharged their responsibility by putting warnings on package inserts, which doctors are supposed to know about. They have passed the responsibility for patient harm onto individual physicians.

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GentleSteps

This is likely true as far has their minds (or at least their liability and PR concerns) go.  Still, it does not seem unreasonable to suppose that mainstream publicity about withdrawal may be causing concern in the industry for its potential effect on prescribing rates, which is to say, the industry's sales numbers and profitability.  After all, without the individual physicians and psychiatrists prescribing the drugs, the industry would not be in business. 

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