Tablets are dangerous.

have you actualy suffered with depression and anxiety ??

Uh, yes - I was always lacking confidence, had low self-esteem starting at puberty, was always a sensitive one.  Developed bulimia at 16, was never "happy," always negative.  At 30, started Prozac, figured I was broken and maybe the Happy Pill would work its wonders on me.  That was the mid-90's after all the Prozac hype.  Then the next one was Wellbutrin, the current wonder-drug on TV. That did nothing. Then was Effexor, starting 12 years ago.  Never did much either, but numbed me out and I plodded along taking the drug even though I was not "Happy," still had the negative thinking but just didn't care anymore.

 I had worse bouts of depression ON the drug than I ever had before drugs.I had a failed attempt to come off nearly 2 years ago, and withdrawal threw me into the worst symptoms I have experienced in my life, to where although I didn't WANT to die, I couldn't stand going on living like that.  I ended up on Remeron, which didn't work, and then Effexor was added back and within one hour, presto, I was feeling back to my "normal."  A junkie getting a fix.I still didn't recognize that I had been in protracted withdrawal for 10 months because I didn't have the bad WD symptoms that people usually have up front; things built to a crescendo months out.  Doctors don't acknowledge this.  

I only learned about protracted withdrawal after reinstating.  I have been slow tapering off both meds ever since, about a year now, and am on subtherapeutic doses of both now, and feel better than I have in 20 years.  I began learning about withdrawal, and what these meds do to the nervous sytem physically, the remodeling and the long term negative consequences of taking these meds, which I won't go into here because I don't want to scare people, but if you'd ike to know I'd be happy to PM about it. 

So, I've been in the trenches, still am.  I have since begun CBT, meditation/mindfulness, and used other helpful techniques to deal with the old wires in my brain that led me to my same old thinking.  I am breaking those wires and developing healthier ones in their place.  I no longer feel worthless, undeserving.  I have made greater strides in the last year than 20 years on meds.

Hi there,

I would like to point out that you and I must have been looking at different data if you say that AD response is same as with placebo. there is a huge placebo effect when looking at trials of AD's. However, there are many many studies for each of these drugs showing and increase well beyond that of placebo. The trials are double-blind and placebo controlled for good reason !! 

It is also well known among physicians that one of the first things to improve is ''motivation'', circa 3 weeks into therapy with AD's. I you have a very depressed patient who prev. lacked any motivation then they were not in a position to carry through their suicidal ideation. However. very poorly patients should be closely monitored for the first month, as motivation returns there is a higher chance they may carry out their previous suicidal ideation. this is why they should be in close contact with CPN's, getting CBT or other talking therapy whilst waiting for CBT. It is also known that the other elements of depression and anxiety are treated later than the 3 weeks at which motivation returns. 

I agree with you on the pharmacolgy as I too have a degree in that area. 

I also stated that Receptor Theory is the current best thinking at treating depression / anxiety....but is not the entire story.

Of cousre pharma companies have made a lot of money with these drugs in the past, just as the global obesity epidemic now means statins and Type II diabetes drugs are the meds that keep the shareholders happy !! ( only have oursleves to blame for those !)

These drugs do work well beyong placebo and benefit a LOT of

people, who prev. may have been given TCADs, with horrid side effects and high risk of overdose ! or even worse given ECT !!

I do also agree that CBT and Mindfulness are very useful tools, and that the best long term solution is a combination of both AD's and CBT/Mindfulness therapies.....I have done both, I personally like Mindfulness and would recommend to anyone, I find it a useful tool with the meditation CDs after the 8 week course I went on, for focusing the mind and settling anxiety.

Just remember that before the advent of SSRIs, ''mummy's little helper'' was a dose of diazepam ! then the drs had to try and wean averyone off those some years later.....depression is not necessarily a new thing, and we shouldn't try and stigmatize something that has taken decades for people to feel open and happy to talk about their worries etc and seek help.

HI there, 

I do agree from a pharmacological stand with some of what betsy says, but I think she is taking it to the opposite extreme. Please read my response. the one major thing I would disagree with her on is that effects on sypmtoms of depression / anxiety are same with AD's as with placebo - they are NOT ! I have never seen that data and I have seen many double-blind placebo controlled trials. What is correct is that compared to other illnesses there is a HUGE placeo response when looking at trials for AD's, roughly 40% of patients will report improvements on a sugar pill !! ( no one said that AD's are the whole story ), however when trial are double-blind randomised it means that neither the patient nor the dr knows whether they have been given the placebo or drug, this is good scientific practice. 

As I said no one claims to have all the answers, but data I have seen generally shows 60 -70 % efficacy compared to placebo at roughly 40%. For most illnesses the placebo response is gnerally much lower ! It just shows what the power of suggestion can do. patients then need to have symtoms measured against recognised scales such as HAM-D etc, at diff. time intervals.....the WHO used to recommend that even once patients felt ''okay'' that they should continue AD treatment for a further 4-6 months to limit relapse.

There are many negative thought processes we all get into, mine was worsened by chronic pain...and poss. some of the meds I take for it !! I attended a Mindfulness Course for 8 weeks locally in UK, they gave us the resources as went along and CD's and taught us meditation which is very good at helping with anxiety.

Have you read Anatomy of an Epidemic, Holly?

I meant my reply to be to you holly, did you see it?

I cannot say that I have, but I have got a 2i in Pharmacology from a good university in UK, and worked in mental health arena for 14 years.

see I was in a position where one AD shouldn't have been prescribed to me and made me very very unwell indeed then for 1 month of didn't take anything tryna get the one tablet I took out my system.

but my symptoms got worse and worse.

I couldn't sleep I woke up with anxiety so bad on would be freaking out, I lost appetite, strange thoughts, panick attacks every day for no reason, shaking could concearntrate was so agitated, then deep depression set in the heavy cloud, was unbelievable despair I felt, I was suicidal wanted to live but felt I couldn't go on . cried couldn't stay at home alone at all. just a mess.

went back to dr, now I had to go on AD , I was scared but was also afraid I would loose my mind if I did nothing about it.

so sertraline it was, and of course got worse for a bit about 3 weeks of more depression, anxiety through the roof, but 4 1/2 weeks later was getting better, I prayed a lot , and now 7 months on I'm a lot better and fatter lol.

so I really don't know what to say about AD to be honest I don't understand it all, yes they made me ill and also made me better. I would love to come off , but I'm truly scared.

what do you make of that? ?

Hi again ....i can understand your concerns....

your dr obv. felt the need to ''wash out'' the first drug out of your system before introducing another. I never had this personally, I had cipramil 10mg a day ( a sub therapeutic dose anyway !) which gave me a horrid episode of mania within the week, I thought I knew anxiety, and it's only because of my experience in the arena of mental health that I recognised the symptoms and stuck it out till Monday a.m. over the weekend. For whatever reason it did not suit me, but there was no reason to know this before I was given it. 

It desn;t surprise me that you felt no better for first 2/3 weeks as it's well known that it takes this long for them to start to become effective. 3/4 weeks to start to notice any effects. Some drs choose to prescibe something short term for patients with severe anxiety for the first month, but this will vary between drs,( eg. diazepam or similar ) as short term these meds are fine, it's only when taken long term that you can issues with tolerance and dependance.

two things re weight, I have a friend who is a dr who reckons that sees a lot of people who gain weight on sertraline. Best thing is to watch diet stays healthy and exercise. Exercise is good too as it releases endorphins, natures feel good chemicals, so you control your weight, keep trim and healthy and get a good felling from it ! It can also be said that some people with depression have decreased appetite and that restoring mood means that eat more and return to what weight would be. Personally, I think there is an element of both, and varies from one person to another, I know I carry extra weight too !

I would be hesitant about coming off yet, due to chances of relapse. The World Health Organisation used to rec'd that patients take AD's for 6 months after they feel ''better'' to prevent relapse, I don't know if that is still the current advice, but I expect similar advice.

what dose of sertraline are you on ? I take 150mg, but I have dropped to 100mg in the past and still okay, so am going to try dropping down again this month, since UK weather as good as it gets really !! and days brighter etc, as I get SAD too. 

I would be in no rush to drop dose again for a while, until I see how I get on on 100mg. 

I think you just have to go with how they make you feel, if you feel good on your current dose of sertraline then great. Just remember don't try coming off unless you feel confident, I would try and get some CBT and / or Mindfulness Course lined up too. Worth the effort is you can find a good one. Are you in the UK ? 

Need to gradually decrease the dose and really taper down when you do come off.....and be prepared that you may get some GI side effects such as nausea, stomach cramps etc...probably best to occupy the mind when you come off, as focusing on it always makes you more acutely aware of it....hope this helps....

hi holly thanks for your reply.

no I didn't want to take any AD that's why I went a ninth with out anything , but thee symptoms never went they just got worse and worse.

that's why I went back to a different dr and told her what had happened and that an antidepresant made me this I'll what can I do.

she said that was unfortunatel and I should never have been prescribed it as I was not depressed . so now that I was I had no choice but to go on sertraline.

anyway I'm on 50mg and doing well, I just got the both ends of AD I guess ,

just don't understand how it all works? ? and yeah I'm not going to come off them yet, as I have broken my foot on Saturday so I'm going to be in plaster for at least a couple months, don't want to go down hill again.

I understand about cbt and therapy yoga, I really want to try mindfulness. but with out AD I would have prob ended my life, and also it was an Ad that made me feel that way.

if anyone can explain the science in that, it would be great lol

thanks holy x

Hi there,

No one is going to be able to tell you why an AD made you feel suicidal and another one helped you. There are subtle differences between the SSRI's, eg. fluoxetine can cause more anxiety as a side effect more than the others, and is thought better for depressed patients who are withdrawn without high elements of anxiety. Conversely other SSRI's are thought to be more anxiolytic, and may have more clinical trials showing efficacy in this area. 

I think you are wise to stay on for a while longer, get well and feel ''able'' before you ever think of cutting back. Glad you are doing well on 50mg, I had to take 100mg to get any response, and eventually settled on 150mg, but am trying dropping to 100mg as I did last summer and was ok until dark winter months set in !!

If you are in UK then I can rec'd a Breathworks Mindfulness Programme I myself have been too. It is run by Buddhists, but they take the religion out of the programme, it's all about Mindfullness and Meditation, essentially listening to the bosy and ''living in the moment''....I tried with book / CD at first but can honestly say the 8 week course , 3 hrs a week was best. You can find them on the internet. Vidymala Burch has also written books with others and by herself on the subject ( can get on Amazon ) and can get books / CDs with meditation on net too. If not in UK then I am sure somewhere else will do something similar. Excellent for anxiety, especially if you do it on a course rather than try and do by yourself.

Good luck x

thank you, I will.look into that, and yes I'm in the UK.

It was actually the best think a psychologist from the pain clinic told me about, as me and him didn't actually see eye to eye ! lol. The people who run the courses do if for free, thus cost isn't too bad and is income related, and they invite you back to do refresher courses at no cost / or a donation in the future which is useful. The main centre is Manchester, but they do run them out of their Buddhist ( Western ) centres all over the UK, and run in small group of no more than about 6/8 people. Would def. recommend, I am Christian but no relieon mentioned, they actually cover over anything religeous, it's just a calm space with nice and generous thoughful people ( if you take lunch though, it's veggie and often take to share, I found cous-cous and salads a lovely light lunch with them ). All the best x

 

Yo rafiel, you have been on it for four years, just out of interest what dosage are you on now? Glad it's worked well for you, as it has with me...

how long have you been on the sertraline? when do you intend to come off?

I've been on sertraline for 3.5 years... In the summer I'm down to 50 mg, on a good summer 0 mg.. In the depths of winter I am up to 150mg, it's a seasonal thing mostly..

oh I see fo u not find it difficult coming off and on?

Not too bad, just a little anxiety for a while!