Mental Health

[alldiz]

Hi,
Interesting comments regarding Europeans perspective, scary to think it is looked down upon worse than here.
Mental illness is no joke.

I am a 46 yr old female. In my observations Women with anxiety/ depression/ ADD tend to shove their feelings down. (In my case literally with food). Men tend to not push there feelings down, however don’t express easily what is actually happening so anger and visible frustration is more evident.

My childhood was no picnic with an abusive alcoholic father who in hindsight was totally ADHD at the very least.

I always knew I was “different” like my brain just must work different only explanation for the hamster wheel cycle of my life.

So at 46 I realize I am clinically depressed and have been for years. I realize this because I thought I was going to die. Took every depression test and perfect score. My body was shutting down. Fight or flight response just from waking up in morning. Lost 10 pds could not eat at all. Throat shut, gas, bloating etc. my dad died from colon cancer and had throat cancer at 48 so I figure I’m a goner and make appt at colonoscopy DR.

In the meanwhile I can barely hold it together at work anymore. Crying between patients.... on patients who I have a long relationships with. My co worker who knows I take Xanax sometimes to sleep tells me to take one. I’m like no not during day blah blah. She insists and says take round the clock over weekend. So that wknd I took half in morning and while at night and by Monday I could eat again.

So I find some great forums online about depression just like these wonderful boards. I feel optimistic for the 1st time. I go to the DR and he gives me Prozac 20mg.

Ok just to back up for a second.... I was avoiding antidepressant for a while because I read that they can cause weight gain and increase sweating. Well my hamster wheel is gaining and losing 100 pds.... (on my 3rd go around) and I sweat like a farm animal sitting down. So yes I was terrified of it. But I tried....

And OMG can you say Magic Kingdom. That is how I describe it. For the 1st time in my life I felt fully happy. I LOVED myself..... that has NEVER happened!!!! I STOPPED SWEATING!!!! I repeat..... I have worked with a fan blowing on me since I gave birth..... GONE.... mind blowing.

So now months goes by I had some random anxiety side effects. At this point my therapist tells me she thinks I am ADD and she thinks I should try adderall. I am like hell no.
Mind you I am no angel.... for some reason I can smoke pot no worries.... drink a bottle of wine... stiff drinks....I will have more than you always.... (self medicate u say) BUT pills... he’ll no I will not mess with that stuff.

Ok long story she convinced me and god bless my DR for giving me them.
Can you say life changing. I take adderall and I can focus sit still and take a nap. In fact 3 wks into adderall I had to get a breast biopsy. Lay on table.... have boob hanging thru table like a cow... compress boob with mammogram and then we biopsy...AND oh yea... you can’t move for an hour
Now I’m like ***.....how do I Medicare.... Xanax.... pot..... NO I realize the adderall calms me like nothing ever has and that is what I took.
Long story short. The meds have saved my life and anyone who thinks people just need a little more motivation.... karma will find you....
Peace
Kerri
Edit.... oh yea how could I forgot most important part. The Prozac has helped my OCD immensely. My obsession was FOOD is COMPLETELY gone!!! I have lost 65 pds just because of this!!!!

 

[cobright]

And drugs such as Reboxetine and Moclobemide are accessbile to us yet are NOT available in the US, despite being very varied and actually safer than standard SSRIs.

Well...
Rebox was outed in 2010 as being less effective than prozac but having more side effects. Pfizer had buried the data from trials to get it put through in the UK. An American law passed in 2007 that required drug companies make ALL trial data available was used to get the data and expose them. (http://healthland.time.com/2010/10/...nt-study-shows-antidepressants-actually-work/) A study published by the British Medical Journal concluded "Conclusions Reboxetine is, overall, an ineffective and potentially harmful antidepressant. " (https://www.bmj.com/content/341/bmj.c4737)

But I agree with you about moclobemide. It's main problem is that up until pretty recently SSRIs were considered just as good. Now moclo has gone generic but to be sold in the US requires some extensive and expensive testing and without getting a promise of a provisional patent, no one's going to bring it to this market. Even if they could get the protections to sell it as a brand name drug here for some time, the PR nightmare begins where they are selling the same drug here for $150 a month and charging Brits $5.50 for the same thing. I've read on the drugs use in panic disorder cases in particular and it has the benefit (imo) of not being yet another form of SNRI that seem to be all that's coming out these days.

On the other hand, I think there's a cultivated aversion to traditional tranquilizers, that seems to have become evident right around the time those meds went generic and "newer, better, and more expensive" brand name SRIs and SSRIs came on the market. Rather all of a sudden a medicine which, when used as prescribed, has little if any side effects and is practically impossible to overdose to death on. Put it this way, the estimated LD50 for Valium, the amount it would take to kill 50 percent of lab rats tested on the drug, is 1200–1240 mg/kg. At this rate, a 180-pound man would need to ingest nearly 100,000 mg of Valium to fatally overdose. Similarly, the lethal dose for ambien can only be guessed at but is over 2000mg.

Not to sound like benzos and speed or whatever are the end-all for mental health. Whatever it takes to treat and relieve the symptom and heal the cause is my motto. But I'm suspicious whenever I encounter a cultural opposition to certain forms of treatment, and that's what I see when I talk to Brits about some medicines used more often in the US. It is a knee-jerk reaction that usually manifests in some expression of, "But those are so dangerous." Which is oddly enough the same language used by the pharma companies to move people onto things like Tri-cyclics and more recent treatments like SRI, SSRI, SNRIs etc. Progressing along that chain we get medicines that are arguably better at treating some conditions, but come with a growing list of side effects as well.

After 17 years, my anxiety condition is managed with a bottle of 30 Klonopin. I refill it about once sometimes twice per year. When I was on Seroquel, I had no anxiety at all but I slept 20 hours a day. When I was on Effexor my anxiety managed pretty well but my sex-life didn't and when I went to quit I nearly went insane with the withdrawal syndrome. Quitting a SNRI, like Reboxetine or Effexor, even when you taper it off slowly can and often does cause debilitating pain. Something they don't tell you when the doctors are recommending it. Here's a blog post from someone trying to quit rebox giving up and settling for half doses just to keep the discontinuation syndrome in check. (https://www.mandycharltonphotograph...withdrawal-from-mental-health-medication.html) If I go a month taking klonopin every night to get to sleep (it's happened) and then stop suddenly, you know what happens? Nothing. No sudden suicidal thoughts. No debilitating tremors or auditory hallucinations.

Here's an example or two of why, in my view, this is a cultural issue. Ketamine. Ketamine has been called the most important breakthrough in pshychological health in over 50 years. People suffering from deep deep treatment resistant depression have been brough back from the abyss with a series of ketamin injections that last for months. A nasal spray treatment of the stuff has shown to relive accute and suicidal depressive episodes within hours.(https://www.independent.co.uk/news/...ntal-health-clinical-trial-yale-a8304431.html) And yet the NHS website quickly labels it a "party drug" and states "It is highly unlikely that ketamine will ever be prescribed in the same way as antidepressants." (https://www.nhs.uk/news/mental-health/ketamine-tested-as-severe-depression-treatment/)

Why not? Is it a prejudice against medicines (like benzos) seen as a recreational drug? Or is it because ketamine (like most benzos) is a generic drug and too much money is made pushing expensive but sometimes less effective SSRIs and SNRIs? From a national policy perspective, the NHS has an obligation to pursue the safest and most effective and cheapest methods of treatment. I think, in general, it's pretty good about that. So why such a bias against a form of treatment currently being pursued by the best research universities and hospitals in the USA where it is showing amazing promise?

Likewise psilocybin mushrooms for PTSD or salvia divinorum for depression? Treatments showing great promise that aren't even being considered abroad.

A cultural puritanism against recreational drugs.

 

[Domo]

Well...
Rebox was outed in 2010 as being less effective than prozac but having more side effects. Pfizer had buried the data from trials to get it put through in the UK. An American law passed in 2007 that required drug companies make ALL trial data available was used to get the data and expose them. (http://healthland.time.com/2010/10/...nt-study-shows-antidepressants-actually-work/) A study published by the British Medical Journal concluded "Conclusions Reboxetine is, overall, an ineffective and potentially harmful antidepressant. " (https://www.bmj.com/content/341/bmj.c4737)

But I agree with you about moclobemide. It's main problem is that up until pretty recently SSRIs were considered just as good. Now moclo has gone generic but to be sold in the US requires some extensive and expensive testing and without getting a promise of a provisional patent, no one's going to bring it to this market. Even if they could get the protections to sell it as a brand name drug here for some time, the PR nightmare begins where they are selling the same drug here for $150 a month and charging Brits $5.50 for the same thing. I've read on the drugs use in panic disorder cases in particular and it has the benefit (imo) of not being yet another form of SNRI that seem to be all that's coming out these days.

On the other hand, I think there's a cultivated aversion to traditional tranquilizers, that seems to have become evident right around the time those meds went generic and "newer, better, and more expensive" brand name SRIs and SSRIs came on the market. Rather all of a sudden a medicine which, when used as prescribed, has little if any side effects and is practically impossible to overdose to death on. Put it this way, the estimated LD50 for Valium, the amount it would take to kill 50 percent of lab rats tested on the drug, is 1200–1240 mg/kg. At this rate, a 180-pound man would need to ingest nearly 100,000 mg of Valium to fatally overdose. Similarly, the lethal dose for ambien can only be guessed at but is over 2000mg.

Not to sound like benzos and speed or whatever are the end-all for mental health. Whatever it takes to treat and relieve the symptom and heal the cause is my motto. But I'm suspicious whenever I encounter a cultural opposition to certain forms of treatment, and that's what I see when I talk to Brits about some medicines used more often in the US. It is a knee-jerk reaction that usually manifests in some expression of, "But those are so dangerous." Which is oddly enough the same language used by the pharma companies to move people onto things like Tri-cyclics and more recent treatments like SRI, SSRI, SNRIs etc. Progressing along that chain we get medicines that are arguably better at treating some conditions, but come with a growing list of side effects as well.

After 17 years, my anxiety condition is managed with a bottle of 30 Klonopin. I refill it about once sometimes twice per year. When I was on Seroquel, I had no anxiety at all but I slept 20 hours a day. When I was on Effexor my anxiety managed pretty well but my sex-life didn't and when I went to quit I nearly went insane with the withdrawal syndrome. Quitting a SNRI, like Reboxetine or Effexor, even when you taper it off slowly can and often does cause debilitating pain. Something they don't tell you when the doctors are recommending it. Here's a blog post from someone trying to quit rebox giving up and settling for half doses just to keep the discontinuation syndrome in check. (https://www.mandycharltonphotograph...withdrawal-from-mental-health-medication.html) If I go a month taking klonopin every night to get to sleep (it's happened) and then stop suddenly, you know what happens? Nothing. No sudden suicidal thoughts. No debilitating tremors or auditory hallucinations.

Here's an example or two of why, in my view, this is a cultural issue. Ketamine. Ketamine has been called the most important breakthrough in pshychological health in over 50 years. People suffering from deep deep treatment resistant depression have been brough back from the abyss with a series of ketamin injections that last for months. A nasal spray treatment of the stuff has shown to relive accute and suicidal depressive episodes within hours.(https://www.independent.co.uk/news/...ntal-health-clinical-trial-yale-a8304431.html) And yet the NHS website quickly labels it a "party drug" and states "It is highly unlikely that ketamine will ever be prescribed in the same way as antidepressants." (https://www.nhs.uk/news/mental-health/ketamine-tested-as-severe-depression-treatment/)

Why not? Is it a prejudice against medicines (like benzos) seen as a recreational drug? Or is it because ketamine (like most benzos) is a generic drug and too much money is made pushing expensive but sometimes less effective SSRIs and SNRIs? From a national policy perspective, the NHS has an obligation to pursue the safest and most effective and cheapest methods of treatment. I think, in general, it's pretty good about that. So why such a bias against a form of treatment currently being pursued by the best research universities and hospitals in the USA where it is showing amazing promise?

Likewise psilocybin mushrooms for PTSD or salvia divinorum for depression? Treatments showing great promise that aren't even being considered abroad.

A cultural puritanism against recreational drugs.

All I can say is I'm privileged to have been treated in the UK. I have a team of experts, all working with me, from my GP, NHS doctor and psychiatrist and even private psychiatrist and they have settled on a treatment for me. You see, time and time again, I get feedback from America that I find worrying or depressing. More often than not the Holy Trilogy of drugs are used, Fluoxetine, Sertraline and Citalopram, even when they are just simple go-to drugs. Bear in mind that there are tonnes of drugs available, each working in different ways. Yes, I know that Quetiapine can be harmful, but any half goof psychiatrist would know the danger signs and that it's usage can be extremely beneficial. I hear often in the States tranquillisers and hypnotics are used as long term solutions, whereas now we over here know that more than 7 nights on one is hazardous.

Little things like that.

So yeah. I just feel more in touch with my NHS psychiatrists than I do most American psychiatrists, if reports are anything to go by.

YMMV.

 

[BrinkofSunshine]

When I was on Effexor my anxiety managed pretty well but my sex-life didn't and when I went to quit I nearly went insane with the withdrawal syndrome. Quitting a SNRI, like Reboxetine or Effexor, even when you taper it off slowly can and often does cause debilitating pain. Something they don't tell you when the doctors are recommending it.

This terrifies me.. I was just put on Effexor last week. Citalopram was giving me bad side effects and my PCP told me that this wouldn't. I was having terrible stomach/chest pain from anxiety and this has finally made it go away. I don't want to be on these pills forever. But now I'm worried about coming off of it when I get to that point. Should I try and switch to something else now? I know you're not my doctor but do you have any advice??

 

[Domo]

This terrifies me.. I was just put on Effexor last week. Citalopram was giving me bad side effects and my PCP told me that this wouldn't. I was having terrible stomach/chest pain from anxiety and this has finally made it go away. I don't want to be on these pills forever. But now I'm worried about coming off of it when I get to that point. Should I try and switch to something else now? I know you're not my doctor but do you have any advice??

Trust me, there are so many drugs out there, there's one just for you, be it Reboxetine, Moclobemide, Duloxetine or Mirtazapine... the list is endless. I turned out to be treatment resistant and as such undergo rTMS therapy and six other drugs, one of them an MAOI. I'm not depressed but I'm not bouncing off the wall happy. I'm just... good. Remember, if it doesn't sit right with you or doesn't a punch, look into others. Perhaps only try one or two drugs of each category? SSRIs, NARIs, RIMAs, SNRIs... Then there are complimentary drugs that enhance antidepressants, such as Prazosin, Sodium Valproate and more.

 

[gemini2727]

Hi,
Interesting comments regarding Europeans perspective, scary to think it is looked down upon worse than here.
Mental illness is no joke.

I am a 46 yr old female. In my observations Women with anxiety/ depression/ ADD tend to shove their feelings down. (In my case literally with food). Men tend to not push there feelings down, however don’t express easily what is actually happening so anger and visible frustration is more evident.

My childhood was no picnic with an abusive alcoholic father who in hindsight was totally ADHD at the very least.

I always knew I was “different” like my brain just must work different only explanation for the hamster wheel cycle of my life.

So at 46 I realize I am clinically depressed and have been for years. I realize this because I thought I was going to die. Took every depression test and perfect score. My body was shutting down. Fight or flight response just from waking up in morning. Lost 10 pds could not eat at all. Throat shut, gas, bloating etc. my dad died from colon cancer and had throat cancer at 48 so I figure I’m a goner and make appt at colonoscopy DR.

In the meanwhile I can barely hold it together at work anymore. Crying between patients.... on patients who I have a long relationships with. My co worker who knows I take Xanax sometimes to sleep tells me to take one. I’m like no not during day blah blah. She insists and says take round the clock over weekend. So that wknd I took half in morning and while at night and by Monday I could eat again.

So I find some great forums online about depression just like these wonderful boards. I feel optimistic for the 1st time. I go to the DR and he gives me Prozac 20mg.

Ok just to back up for a second.... I was avoiding antidepressant for a while because I read that they can cause weight gain and increase sweating. Well my hamster wheel is gaining and losing 100 pds.... (on my 3rd go around) and I sweat like a farm animal sitting down. So yes I was terrified of it. But I tried....

And OMG can you say Magic Kingdom. That is how I describe it. For the 1st time in my life I felt fully happy. I LOVED myself..... that has NEVER happened!!!! I STOPPED SWEATING!!!! I repeat..... I have worked with a fan blowing on me since I gave birth..... GONE.... mind blowing.

So now months goes by I had some random anxiety side effects. At this point my therapist tells me she thinks I am ADD and she thinks I should try adderall. I am like hell no.
Mind you I am no angel.... for some reason I can smoke pot no worries.... drink a bottle of wine... stiff drinks....I will have more than you always.... (self medicate u say) BUT pills... he’ll no I will not mess with that stuff.

Ok long story she convinced me and god bless my DR for giving me them.
Can you say life changing. I take adderall and I can focus sit still and take a nap. In fact 3 wks into adderall I had to get a breast biopsy. Lay on table.... have boob hanging thru table like a cow... compress boob with mammogram and then we biopsy...AND oh yea... you can’t move for an hour
Now I’m like ***.....how do I Medicare.... Xanax.... pot..... NO I realize the adderall calms me like nothing ever has and that is what I took.
Long story short. The meds have saved my life and anyone who thinks people just need a little more motivation.... karma will find you....
Peace
Kerri
Edit.... oh yea how could I forgot most important part. The Prozac has helped my OCD immensely. My obsession was FOOD is COMPLETELY gone!!! I have lost 65 pds just because of this!!!!

I'm so happy that you found the right combination to work for you after suffering for so long!

 

[alizesmom]

Fascinating how a discussion on improving how society view mental illness has turned into a my country is better than yours. I’ve been treated (in the US) for chronic depression for over 30 years. Acceptance swings back and forth. It comes down to whether or not I can accept my illness. That’s all that matters. As to who gives the better treatment I think I’ll compare once my country gets it right.

 

[alldiz]

I'm so happy that you found the right combination to work for you after suffering for so long!

Thanks. I still wait for the other shoe to “drop”. But it is a pause..... not a spiral.
Kerri

 

[Soldier's*Sweeties]

I think this train of thought is common and is a root of a lot of the misunderstanding on some issues like anxiety disorders and clinical depression.
Anxiety is a normal reaction to stress, everyone experiences it. And... as often as not, if I mention my anxiety disorder I will get sympathetic remarks from people who suffer from anxiety disorders ... and also from people who want to tell me about things that make them anxious. Which is nice, but getting flustered because you have to drive through Gary Indiana during rush hour does not indicate a disorder.

I finally got it through to my brother in some small way. He was giving me the "Sometimes you just have to learn to live with it." speech and commented how as a plumber sometimes he has to go on the roof of houses. He's deathly afraid of heights and his heart races and he sweats buckets and can barely talk the entire time he's on the roof. But it has to get done so he just learns to live with it and gets the job done. I said, "Ok, now suppose you had that same reaction to walking around on the ground outside your home, and whenever strangers wanted to talk to you, and whenever the phone rings, and every time you had to drive somewhere... Imagine every waking moment of your life feeling like you feel up on that roof." He looked at me like I was pulling his leg, then took a second and said, "I'd have killed myself within the first year."

I can't count the number of times I've heard someone relate to someone with depression by stating some things that make them sad. Being sad isn't depression, it's a symptom. Depression is the inability to have appropriate feelings.

I think maybe you misunderstood me or maybe I wasn't clear. I suffer from GAD myself (no I didn't self-diagnose). I was simply saying that not everyone who has those symptoms is suffering from a mental health problem, that it's very common... They might just be having a hard time and that's okay! It's nothing to be ashamed of whether it is a long term thing or not. I definitely didn't mean to be dismissive. I'm sorry if I came across that way.

 

[cabanafrau]

HOWEVER.

America provides the psychiatric world with a wealth of investment. Many treatments would not exist without the USA.

One of the most important progressions has been rTMS, a replacement for ECT. It's non-invasive, revolutionary and extremely effective. It's been a lifesaver for me and to many others who have tried it.

So yeah. I just feel more in touch with my NHS psychiatrists than I do most American psychiatrists, if reports are anything to go by.

YMMV.

IMO if more resources were directed towards mental health efforts it's likely we wouldn't need as many resources and solutions as we're scrambling for in other areas. I would much rather my money be used to helping people live happier and more productive lives than incarcerating people and endlessly trying to break addiction cycles.

Respectfully, it doesn't seem you've ever been treated by an American psychiatrist. It's also both a bit insulting, as well as speaking out of both sides of your mouth to suggest that the American psychiatric community doesn't understand how to treat people properly while simultaneously bearing a great share of the load investing in and developing new treatments.

It doesn't matter where good treatment comes from. It benefits humanity.

 

[Domo]

It doesn't matter where good treatment comes from. It benefits humanity.

This is so true.

 

[Domo]

TBH, there is something rotten with the whole psychiatric care system... at least over here.

Meds go through three stages: Patent, Generic and Retirement.

They start off life patented, drugs like Sertraline (Lustral, Zoloft). Drugs are effectively "owned" by companies who can charged whatever they damn well please. Expensive.

Eventually the patent expires and they become generics, drugs like Dosulepin (Prothiaden). This means that anyone can make the drugs, so competition opens up. The drugs become cheap as chips (Prothiaden sells for a handful of pounds).

Finally they are retired. When a drug becomes too old they become through no fault of their own outdated, drugs such as Tranylcypromine (Parnate). Maybe they're tricky to administer, maybe they have too many side effects, maybe they have just been superseded. Fewer and fewer companies make it, pushing the price up. Tranylcypromine for example is only available in India and they charge a small fortune for the privilege for it.

Eventually the drug dies a death and those on it need to change to a different drug. Thus the lifespan of a medication completes. It's rather rotten, but that's it I guess.

 

[cobright]

So now months goes by I had some random anxiety side effects. At this point my therapist tells me she thinks I am ADD and she thinks I should try adderall. I am like hell no.
Mind you I am no angel.... for some reason I can smoke pot no worries.... drink a bottle of wine... stiff drinks....I will have more than you always.... (self medicate u say) BUT pills... he’ll no I will not mess with that stuff.

It's funny you bring this up. My first major breakthrough treating my anxiety was going on adderall. I was diagnosed with ADD back in '86 and was treated with Ritalin for a while but my dad lost his job and we lost healthcare and the meds were too expensive, so I just learned to deal with it. Then in 2001 I was in NYC when the towers came down and in the following weeks I lost it altogether. A few years later I'm thinking about finishing up my education and when I get into my first semester of gradschool, none of the behavioral tricks I had learned could get me through a weekly reading list of 800-1600 pages and a monthly writing workload of 100-300 pages. Started adderall and within 3 months I had all but stopped taking Klonopin. Then over course of the next year I titrated my dose of zoloft to the lowest pill they sell, eventually stopped it.

I hear often in the States tranquillisers and hypnotics are used as long term solutions, whereas now we over here know that more than 7 nights on one is hazardous.

Generally hypnotics are prescribed for short term use. I get a bottle of 30 ambien but my insomnia triggers for only 3 or 4 days at a time. The research I can find on long term use of benzos show that at therepeutic doses the risks are far less than those caused by daily anxiety. In general, early tranquilizers like benzos are tolerated far better than modern anti-depressents. When used to treat anxiety I think these new anti-depressants are over used to the point of danger. That's why two of the drugs you mention are so common, Prozac and Zoloft are very effective and extremely well tolerated. I agree that mental health is a job and a psychiatrist has a responsibility to work at it to find the best solution but having your first line course of treatment be something the average patient can afford is a big plus over here. (yeah, that's another issue for another day maybe)

Fascinating how a discussion on improving how society view mental illness has turned into a my country is better than yours.

I think I'm being fair. Domo brings up, "Mental health is a misunderstood issue here in the UK" and I'm inclined to agree. And while I'm not suggesting that it's great over here, it's not, I did want to commiserate a bit on just how appalling it is in other parts of the world. I have a friend from Serbia who is so depressed his wife makes him stay at our place whenever she travels for work. But he will not go to the doctor for it. Visiting his family in Serbia last year I mentioned that I took adderal for my attention disorder and there was audible gasps. Talking to everyone I can on the subject, wherever I travel and mental health is simply not brought up much. Even in France and Germany the epicenter of early mental health practice, treating mental health with pharmaceuticals is shunned.

I think maybe you misunderstood me or maybe I wasn't clear. I suffer from GAD myself (no I didn't self-diagnose). I was simply saying that not everyone who has those symptoms is suffering from a mental health problem, that it's very common... They might just be having a hard time and that's okay! It's nothing to be ashamed of whether it is a long term thing or not. I definitely didn't mean to be dismissive. I'm sorry if I came across that way.

I wasn't trying to pick apart what you said. I'm sorry that I came off that way. I think what you said was 100% right. At the same time, a lot of time that same expression is used as a sort of dismissal. Everyone gets sad, everyone gets anxious. and I think it's so common that it ends up as a subtext in our normal understanding of things.

 

[cobright]

This terrifies me.. I was just put on Effexor last week. Citalopram was giving me bad side effects and my PCP told me that this wouldn't. I was having terrible stomach/chest pain from anxiety and this has finally made it go away. I don't want to be on these pills forever. But now I'm worried about coming off of it when I get to that point. Should I try and switch to something else now? I know you're not my doctor but do you have any advice??

If you were put on effexor last week then you are still on the starter dose. I won't pretend to be a doctor, so don't make any changes without talking to one of those. That said... My psychiatrist told me effexor would be fine, and when its time to stop I would take a tapering dose over a long time and it would be fine. Here's my experience...
The medicine works very well. I was on 75mg Effexor XR for 3 years. I have a bad habit of forgetting to refil my meds until the last minute and on a few cases I forgot altogether and ran out of effexxor. When you do this with prozac or zoloft ... you feel maybe a little on edge the next day? Sometimes? I never did and would regularly miss a day on those meds. With effexor, if you run out you start to feel it at the end of the first day. By the second day I was experiencing pain, and an audible/tactile hallucination that people coming off effexor have been calling "brain zaps". It is a descriptive term. Add to all that, emotional upheaval.

So I did my best not to run out. 3 years later, I'm in a pretty good place. Wrapping up my undergrad degree. I catch a 6 month work assignment in Korea that I'm looking forward to. But I can't get effexxor there. Okay I have 3 months until I leave I'll taper off. The doctor halves my dose. No sweat. a month later he halves it again. Easy peasy. I go back in a month and he tells me 37.5mg is the smallest dose. Just stop taking it. NOPE! Horrible withdrawal symptoms as previously described. Not only that but the doctor said breaking the capsules was a bad idea because the granule mix had to remain perfectly mixed. So he suggested taking a pill every other day and then once every 3 days and so on. Like I said, skipping a day isn't so bad, but nothing makes skipping 2 or more days bearable.

To give you an idea of just how sensitive my body was to the withdrawal. If I was hurting after being off it for 2 days, just taking 3 or 4 of those little granules out of a capsule and eating them would have me feeling better within an hour or so.

I ended up giving up my job in Korea. What I had to do to get clean of the stuff was buy a powder scale used by people who reload precision rifle ammunition. It's called a grain scale and it's incredibly precise. then I measured out the weight of the granules from 30 individual capsules. This to get the average weight of the mix. So I knew what the weight of a 37.5mg dose was, and I could repackage half that weight and make my own 18.75mg capsules. Then 3 weeks later I rolled my own 9.37mg. 3 weeks later I made my own 4.6mg capsules. At which point I'm putting like 7 of those little beads into each capsule. After 3 weeks on this dose I figure I can stop right? Nope. I do another 3 weeks at the same dose and try again. Still nope. So I make 2mg dose capsules and I take them for 2 months. When I finally quit that dose, I still felt a light version of the withdrawal. And for 6 months after that I would still get the occasional brain zap. During the whole process I found candied ginger was best at keeping me from throwing up and omega 3 supplements seemed to moderate the symptoms a little.

If at any time during that process I wondered if this was just me, all I had to do was google effexxor withdrawal and find 100k other people going through the same thing. Which was comforting considering the shrink kept saying that side effects are almost unheard of and always very mild. I finally cornered him and asked how many of his own patients he had taken off of effexor and he couldn't think of any. A couple years later studies on "discontinuation syndrome" for effexor start getting published.

To be fair, and I said this earlier, effexor helped me through a really bad time, probably better than other meds would have. When I started taking it I was homebound, incapable of doing much for myself at all. But nothing made me want to die nearly as bad as quitting that drug. Not even close.

 

[BrinkofSunshine]

Thanks @cobright. That sounds absolutely awful. I did a quick google last night and scared myself looking at all the experiences. I’m going to find an actual psychiatrist (instead of my primary doc) to see what else I could try. I’m still on the starter dose and it’s been less than a week, so here’s hoping it won’t be so bad to get off of it/switch.

 

[Domo]

Venlafaxine didn't agree with me. But then again, one of my diagnoses was "treatment resistant" depression, so virtually every mainstream antidepressant had no effect on me, not even hardcore antidepressants such as Mirtazapine. I finally settled on an MAOI antidepressant, Parnate, which came with... penalties. Like no alcohol, cheese, smoked meats, yeast and so on. But by gum it works.

The thing to remember is that there are a TONNE of antidepressants out there and many work in very different ways. There will be one out there ideally suited to you, of that I have no doubt. It may take a little while, but the results are well worth it.

 

[kimmar067]

....one in TEN will hear a voice in the room, even when there is no-one around? Or that over 1% of people will be classified as psychotic at one point in their lives?....Many people don't even know what schizophrenia is! They think it has something to do with having a split personality! And those that experience anxiety will never seek help for it, feeling terrified of the prognosis.....

....I was convinced that I am psychotic and had to go for treatment, but my alter-ego talked me out of it....

 

[kimmar067]

...on a more serious note, we were sure that my DH's brother was bi-polar, because of his over-dramatic mood swings throughout his life. Unfortunately, we will never know, since he passed last year.

 

[Charlie2022]

Hi, saw this post and am wondering if someone could shed some light for me. I’ve been taking Prozac for approx. 6 months, it has really helped with my depression but caused horrible anxiety-my doctor prescribed mitrazapine additionally, which has helped, but caused me to gain 17kg in 3 months
My doctor has suggested I stop the mitrazapine, and instead double my Prozac dosage. Wondering if this would be a good idea, considering this is what caused the anxiety in the first place? Any advice would be appreciated!

 

[Domo]

Hi, saw this post and am wondering if someone could shed some light for me. I’ve been taking Prozac for approx. 6 months, it has really helped with my depression but caused horrible anxiety-my doctor prescribed mitrazapine additionally, which has helped, but caused me to gain 17kg in 3 months
My doctor has suggested I stop the mitrazapine, and instead double my Prozac dosage. Wondering if this would be a good idea, considering this is what caused the anxiety in the first place? Any advice would be appreciated!

From the point of view of a non-doctor, I would be wary of just increasing the ol' Prozac. A common side effect is anxiety and increasing the dose is not going to make it go away. Mirtazapine, however, is heavily sedating, so is good to control anxiety. Sadly as you found out, it makes you put on the pounds like there's no tomorrow. If I had to recommend anything, it would be another SSRI (the class of drugs Prozac belongs to). SSRIs have proven effective to you already and finding one with fewer side effects would be prudent. I might even go so far as to recommend one I know to be good for this type of situation - Celexa, maybe Lexapro?

[ETA] - If it has any help, I'd love to plug a website I run, free - a psychiatric resource. You can find it here: http://www.cocoa.uk.com/seratis/