Survey for study on withdrawal

Waffled on where to put this.

Help study dependence & withdrawal from benzos, antidepressants etc. Take a survey ? Beyond Meds

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I took it. It is mostly free form. You don't have to provide personal info.

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I don't think I am invited to take the survey as I have never really had negative withdrawal effects. Paxil was the worse one which involved two weeks of flu like symptoms. Nothing horrible.
Just in the past two weeks I did have a little trouble with Effexor withdrawal. I tapered off over the course of three weeks. I can't describe the symptoms other than to say I just felt horrible all over for a few days. I have been Effexor free for four days now with currently no withdrawal symptoms. In fact I feel really good today.

Now benzos is a different matter. I had never taken them before but recently started as I was having such bad anxiety. They didn't want to give them to me but I told my pdoc I felt it was unethical because it was the only thing that worked and he gave me klonopin. I only take .5 mg in the morning and .5 mg at night. It has totally knocked out my anxiety. I do not look forward to eventually having to go through withdrawal someday from all the horror stories I have heard.

I have never had any withdrawl effects from anything I've taken including effexor or paxil. I'm currently on Klonopin .5 three times a day (but I usually only take two a day) and also am concerned when I have to come off of it. I've been on xanax before and had no trouble coming of off it, either, so I hope it won't be too bad.

Is there a survey for the people who have killed themselves because of severe, biological depression they refused to take medication to treat?

Oh. No, there isn't 'cause they're dead.

Sister, your twisted.

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Maybe so. And realistic.

I know for some people withdrawal is bad, but lots of the things attributed to withdrawal could also be the illness itself, the same with side effects too. I came off Effexor in 10 days, 375mg to nil. I did have some bad effects but it was about the same as being drunk and let's face it how many of us have got or still get drunk despite knowing what it does to us?

I could not tell you what is relapse and what is protracted. I didn't...

Have major depression every 2-3 years. More like low grade every few years (I wasn't exactly counting.)
Have symptoms of bipolar such as hypomania
Need to go into the hospital.
Experience side effects of any kind
Worry about my cognitive health (which is a very big deal to me)

...before I agreed to an AD all those years ago. I think life lessons and dbt would have worked just fine but that wasn't and isn't a first level treatment. Just saying... My opinion.


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I've never had severe withdrawal from meds either.

I have not had major withdrawal symptoms from meds either. I was on Paxil and then Lexapro (prescribed by my GP a while back) and when I came off each I don't recall it being that terrible. There were brain zaps and flu like symptoms, but it wasn't that memorable. Interestingly, I had once suggested going back on paxil to my current pdoc and he was against it because of the bad withdrawal. He felt better using an MAOI than Paxil. And he has never even mentioned Effexor.

They are including benzo's:

"The Council for Evidence-based Psychiatry (cepuk.org) has been invited to contribute evidence to a project at the BMA (British Medical Association) which will review the issues associated with dependence upon prescribed drugs, including benzodiazepines, sleeping pills, pain relievers and antidepressants."

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I'm curious about the people with no or next to no withdrawal issues.

How long did you take it?
Did you replace it with another drug?
Why did you end it? Side effects? Or it did nothing or something else.
Did you taper or go cold turkey?

I think the reason they are asking for bad experiences is because groups with vested interest are able to come up with people like yourselves. But there are drugs that have been recalled because only a portion of the patient experience major problems. I read that iatrogenic deaths caused by prescriptions is the 4th leading cause of death. I'd want to fact check that but even if it is the 6th I'd be bothered. Iatrogenic means the treatment caused the death not the disease.

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I've taken countless meds over the years, and generally I have taken them from anywhere to 6 months to several years. The antidepressants have been the ones that I have had to switch out the most. I have bipolar disorder, and AD's have a tendency to just poop out on me after awhile so we switch to a different one. I generally am taken off of them quite quickly with absolutely no withdrawal problems. The only AD to give me even slight withdrawal symptoms was effexor xr, but even that was very short lived and nothing that couldn't be tolerated for a couple of weeks.

I have never had bad withdrawal effects from benzos either. I have certainly had my share of addiction problems as you know in the past, but those were alcohol and street drugs. I did do benzo's and codeine when I could get my hands on it but I don't think I was ever that addicted just short term use like a couple of months. I definitely did have withdrawals from the codeine. I just muscled through that though for a couple of weeks.

If you are replacing it with a different ad or even an AP you probably would not have withdrawal because they ultimately effect the same chemicals. If one is increasing dopamine instead of serotonin it doesn't matter because the primary purpose of dopamine is to increase serotonin. Normally your brain produces more or less dopamine/serotonin depending on how much you need. The med are like turning on a hose and letting it run. Turning off the hose means your brain has to learn how to regulate again. This is one reason for withdrawal. Speaking of I so wanted to go biking today and I have been hold up in a dark room with a screaming headache. I just took another tiny bit of Zoloft hoping for some relief. I never get headaches and Tylenol didn't even help. another day nearly wasted.

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How long did you take it? A year or more except for wellbutrin which i could not tolerate.
Did you replace it with another drug? Yes sometimes SSRI to SSRI, sometimes SSRI to SSNRI, sometimes SSNRI to SSRI, sometimes SSNRI to SSNRI. Mood stabilizers. Tegretol went off cold turkey after many years of use. Abilify (antipsychotic) went off of cold turkey and started taking Lamactil (mood stabilizer) Trazadone on and off cold turkey a few times.. Remeron on and off cold turkey a few times.
Why did you end it? Side effects? Or it did nothing or something else. They always pooped out. Except wellbutrin. That is the only one I have ever stopped due to side effects.
Did you taper or go cold turkey? i always started the new one right away and usually always tapered off the old one for just a week. Recently I took longer with Effexor as I was having some effects three weeks for that one. Wellbutrin cold turkey after two weeks on it. Went to effexor again i think after that one.

Have never had many problems with side effects or withdrawal effects.

I am not sure I buy the theory that because you are starting a new similar one you don't get withdrawal effects. My pdoc did say that at the last switch. I have to think about that some more and research it more before I buy it. It does make sense on the face of it.

I don't think that is true. Seems to me dopamine serves alot of very important functions in the brain. Primarily in regulating the pleasure center. I am not sure though. Need to do more research. There is also nor epinephrine to throw in the mix.

You're right. I did misunderstand the role of both neurotransmitters. Withdrawal is do to the effect on serotonin not side effects so I'm not sure why you would question switching from one to another. The article describes it. If they are right about AD usage increasing the incidence of relapse after 6 months to 60% I am not happy. I took the first one for about a year. Didn't for a long time then fell into depression again. It had been long enough and there were situational factors that I was sure it was not a relapse. Now I am not so sure. Now I have been on the second round for almost a year. If they are right I am going to have to be much more aware going forward. Dammit. I remember arguing with the PA about coming off before two years too. Where does that number come from anyway?

http://www.psychologytoday.com/blog/...dive-dysphoria

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I am to tired to read the article right now.

Isn't it true though that most people who experience bad withdrawal coming off of one are also starting another. Shouldn't the new one mitigate the withdrawal of the old one. I would be willing to bet that most of the cases of bad withdrawal and tapering very slowly off of one that they are also starting a new one at the same time. That would kind of blow that theory out of the water in those cases.

And I am wondering why you are not getting any responses from those who have experienced bad withdrawal. I know they are out there and it is a real phenomenon. If they posted we could ask them if they were starting a new one and switching from what to what. Maybe it is not as common as you think I do not know.

I don't know that either. I do think withdrawal is going to be worse if you are not replacing it. Ssri do very similar things. Your brain adjusts to it and needs to adjust without it. I know I am starting to be concerned about Zoloft because I had to re-up my dose today due to a horrible, horrible headache. I could be paranoid but I was not sure it was a good idea in the first place, became ok with it and am now regretting it.

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I read the article and another that tryinhard posted on antipsychotics.
It is certainly possible that it applies to me. Possible but I do not think so and here is why.

(This got really long. I am a little manic as my new meds are kicking in and I could not stop typing. I don't blame anyone if you don't want to read all of this. There is a summary at the bottom.)

I only took an antipsychotic, abilify, for two years and I never had any side effects or the TD with ticks and spasms or whatever. Of course it could have damage I have no way of knowing. No symptoms I am aware of.

The arsenal of antidepressants are far from ideal I believe that. The chemistry, biology, and mechanisms of action in the brain with depression and mental illness are far to complex and little understood. The chemical imbalance theory and pre synaptic cleft and serotonin is only a very small part of the picture. I know you think it has totally been debunked but I think it is a part of the picture. I am aware of the studies that say SSRI's are no more effective then placebo. The clinical data however shows that 50% of the people who take them are helped. I trust it more. It could however be flawed as maybe it doesn't look at long term results and relapse rates and so on. Anecdotal evidence from my pdoc says that he has alot of patients that come in in crisis condition, he puts them on an antidepressant and he never sees them again. Only calls in refills. He says they are doing great. He doesn't know if it total placebo effect or not he just knows they haven't relapsed.

I still contend that we don't here of many success stories because it goes against human nature. We as humans are hard wired as negative feed back loops. You don't pay attention to your head or think about it until you get a bad head ache and then all your attention goes to it and you try to intervene to fix it. Our bodies have pain and symptoms for a reason. The people who are really helped by meds are not paying attention to it. They go on and live their lives and don't think to come back here and report to us. Although some do. If they relapse they will remember these boards and come back for help. Totally natural. I have been exposed to more success stories than most because I have been around the recovery community for so long. Many many people in AA also suffer from depression. Very common. I have personally known many that have went on AD's and did great. Never upped dosage never relapsed have done just fine for years. I have not kept track of them all and maybe they have relapsed years later I do not know. I do know that to them it was a miracle cure. We had our own support group within a support group ad hoc for people with dual diagnosis and there are many.

Specifically to my case....
It doesn't explain the family history. Alcoholism and mental illness run rampant in my family. Many specialist will tell you that alcoholism/addiction and mental illness run hand in hand. There is a link. Like I said there are a huge number in AA with dual diagnosis.
My great grand father on my mothers side spent the last seven years of his life in a deep depression. He never left his room, only to come down to dinner and once in awhile to watch a ball game with my grandpa. the rest of the time in his room for seven years. Luckily my grandparents were able to take him in. Otherwise they would have thrown him in the state hospital and forgot about him. My mom lived there so she saw it. She believes he committed suicide but no one really talked about it.
My grandpas sister was major bi polar. Had severe manic episodes. Her onset was later in life. Her daughter was schizophrenic.
My grand mother on my mothers side is Finnish and two of her siblings were major alcoholics. I witnessed this myself. There are lots of stories about mental illness on that branch of the tree but back then no one talked about it much. It was ignored or people were shoved in state hospitals. My cousin from that side keeps telling me she is discovering more and more that there was a lot of mental illness on that side.
My Fathers side. My Dad is an alcoholic and his Dad was an alcoholic. My grandma on my dads side had two siblings that were major alcoholics. I witnessed this.
Back then so little was known and it was ignored and not talked about so it is hard for me to have a clear picture. I just listed what I know about. I suspect there was alot more going further back.
My brother is a recovering alcoholic addict. My sister suffers from depression but has done very well on Wellbutrin for years.

It doesn't explain why I started getting severely depressed in 7th grade before alcohol and drugs. Even after I started using alcohol and drugs to self medicate I still went into severe depressions.
I have had moderate to mild depression 90% of the days of my whole life since 7th grade. My normal is much lower than the mean for society. I felt i was functional because I was able to hold down a good job but the other areas of my life were dysfunctional. I never drank or used when I was in a severe depression only rarely. As soon as I started feeling better and got up to moderate I would start drinking again. I believe the self medicating actually kept me from going into a lot of severe depressions and from them lasting as long. Self medicating actually does work for a period of time, years, until it doesn't work. Then I was in a very deep depression. This is all before SSRI's were even barely invented. I admit it is complicated with all the drinking and using, primarily drinking for most of those years. Nevertheless I suffered from depression. Severe and moderate. I was lucky being in the construction trades where they put up with a lot of stuff. I new the owners well. I drank with the owners. I was always able to hold down a job even though every other area of my life was a mess.

I got clean and sober and I have told the story about the meth withdrawal and mental hospital and psychosis and all that. When all that cleared up I really thought the depression would go away. At that time I thought the drugs and alcohol caused it and not the other way around. In reality it is all mixed up. But I really thought it would go away. Not.

By this time I had started taking Effexor. I believe Effexor played a big role in helping me get clean and sober and stay that way. After a couple of years of things balancing out my depressions fell into a pattern. After being clean and sober for a couple of years and over all the PAWS it was much easier for my pdoc and I to sort things out. For about 14 years the depression followed a specific pattern. My pdoc called it a diurnal rhythm. Not SADS. Every spring when it first started getting hot like in the 90's I would go into a three week severe depression. Toward the end of summer I would go into a severe depression but this one never lasted as long. Every November I would go into a severe depression. this one would last longer into January. I was lucky in that in the winter I could take more time off of work. It was slower and it rained a lot in CA that time of year. They are wimps in CA and don't want to work in the rain. I was lucky too that the job I had all those years I had a boss that would put up with me missing three weeks or a month of work in the spring when it got really busy. I was that valuable to him over all and I could do a lot of things from home on my computer. This exact pattern went of for 14 years. All the times that I was not in severe depression I was in mild to moderate depression. I could force myself to function to a certain degree. i went to all my AA meetings and therapy and went head long into recovery and therapy. i was newly divorced and had girl friends. The serious relationships would end because they could not handle the severe depressive episodes.

I am taking meds this whole time. I was med treatment resistant right from the start. They never stopped me from having that same pattern. They helped to a certain degree with the moderate. Some worked better than others. Sometimes they would work and drag me out of a deep one or prevent me from going into a deep one. Overall in the big picture i think they helped. I would not still be taking them if not. I saw others doing very well on meds and I was pissed. The constant moderate depression really started to wear on me. You can only force it and fake it for so long and then you get really tired of it. So I don't think meds have made it worse because I was fairly treatment resistant from day one. And the pattern was exactly the same for all those years. Not worse not better. Except for sometimes when a certain combination would work better than others.

That brings me to recent years. My boss for all those years closed up shop. I joined the plumbers union. A very good gig if they had work. The economy crashed. The union had a lot of good work for a couple of years because it is all commercial and it lags behind residential. Building hospital mainly. Then the work dried up and lots of lay offs. A lot of time on unemployment. A lot of down time. This contributed greatly to my depression. Only making half the money on unemployment so the financial pressures got bigger and bigger. That is my biggest trigger not being able to pay bills. Get a six month call and then get laid off again. In the union you can't go out and get another job plumbing or they will kick you out. It has to be union work. It was such a good gig with all the benefits and pay I thought it best to stick it out. And besides there was no other work out there. I was laid off for two years straight and on unemployment the whole time. Way to much down time. And the finances kept getting worse and worse. I did a lot of under the table side work which is not really ethical while collecting unemployment and against the union rules, but I did as much side work as I could. That started drying up. No one was remodeling their homes when real estate prices were crashing.
My depressions were getting worse and worse and lasting longer and longer.
All situational triggers. i got called back to work for a big prison hospital job. I was having huge anxiety. This was totally new to me. I muscled through the anxiety and no sleeping and drove from Michigan back to CA to go back to work. I has spent the previous two years in Michigan laid off where all my family is and I have my own little place. I couldn't afford to stay in CA anymore on my own. So I drove back and went back to work and got a place and got re established. I did well form Jan until mid summer and my usual depression hit. I missed three weeks of work. I came out of it and did very well again. They wanted to make me a foreman but I declined because I knew I was not that stable. In Oct. the depression started creeping back. I forced myself to go to work everyday knowing I couldn't miss anymore work. My performance was steadily going down hill and everyone was noticing. I made it to Dec. and then crashed hard. I missed three weeks of work and finally they fired me. A week later I took another work call that I should have never taken. I worked one day. The next day I drove to work and say in the parking lot and had a total break down. Panic attack. Crying uncontrollably. I could hang.

I had good insurance at the time but my pdoc sucked. He gave me two weeks of disablility and no more. Basically told me to snap out of it and go back to work. I should have been hospitalized. At the time I was extremely suicidal. I was able to get on unemployment yet again but it was not enough. I was broke in debt with no job and very suicidal. Didn't have enough for rent and I was renting from a very good friend and didn't want to ruin our friendship. I called my family and told them the whole story. They told me to pack it up and get my *** back to Michigan. My brother was kind enough, because he has the means, to offer to pay for TMS treatment. I did six weeks of this and it did not work. I went into a serious, deep, very suicidal, six month long depression. Actually really Oct. 2012 until June 2013. One day I snapped out of it like a switch went off. It had nothing to do with meds because I was on the same meds. I had a very good 4 or 5 months and then it started creeping back in slowly in Oct. 2013. It has not been near as deep but I am just now coming out of it in April. This time it is definitely the new meds that are bringing me out of it.

To sum up. The reasons I don't think meds have caused my depression or made it worse.

Family History, genetics
Initial onset 7th grade
Many years of depression before ever going on meds.
Got clean and sober and went on meds and had basically the exact same pattern of depression for 14 years.
It has gotten much worse in recent years but this is totally due to very stressful situational reasons.
Current new meds are working surprisingly well and I am coming out of a long one.
I think meds while not super effective for me have overall helped.
I have done a ton of very hard work over the years in recovery and in treating depression. From that I have a lot of self awareness. I know my experience, my body, and my mind very well. I believe I would intuitively know if they were harming me or making things worse.

Edit- I should also add that a year and a half ago or whatever it was when I lost those last two jobs and was in a deep depression. I hit a major emotional wall. I just gave up and lost all hope. I have been battling so many years and doing all the things I was supposed to do with all the meds and all the therapy and all the AA and all the Alanon and on and on. And yet the depression persists. I gave up all hope that anything would ever make anything any better. Not a fun place to be. Since my family wanted me to move back to Michigan and my brother offered to pay for the TMS I went through the motions. But I had no hope I had given up. Why try. So of course this attitude exacerbated the depression immensely. The longest and deepest ever. Suicidal each day for over six months. I don't think this has anything to do with meds. I hit a brick wall. My whole life had been slowly shattering around me for the last four years due to depression and the economy and my situation. I wasn't even that aware of what was happening. Also I am 50 years old and am not nearly as resilient as I was when I was younger. Not as much pride. I used to just bull through things. I was just plain tired. My pdoc has told me that age does play a factor in worsening depression.

Thats my story and I am sticking to it. But it may change.

LOL, it is very long! I didn't read the whole thing because I don't have time right now but I have a couple notes.

The article says that people who initially respond well are the ones that are most likely to develop TD if they continue for 6 months or more (the rate goes up, doesn't mean everybody does). I'm thinking the "initially did well" factor has to do with it being an indication the brain responded to the medication. This would be a problem if they are treating something that works fine. Iow, they are on the wrong path. From what I read it sounds like this is not you.

It is obviously much easier to identify TD in somebody who did not have MDD prior. So while I see you on the far side of the spectrum I think it is difficult to know if there is validity to the TD theory... In your case. I'm being agnostic about it.

I am not in any way questioning the significance of your experience or the efforts you have made. If, however, TD is a factor it has made treatment that much harder. That is the thing that angers me to no end. More so with people that have gone from relatively mild to moderate depression to chronic depression. No, I don't buy chemical imbalance. In particular because big pharma companies have, for the most part, dropped the research. We don't have to agree on that to avoid an argument though

That's all I have time for now. I'm glad you're coming out of it. Me too. If it is warm enough I plan to bike to work tomorrow

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It is hard to tell with me because my initial treatment was with Effexor right before I got clean and sober. I felt it helped me a great deal at first to get clean and sober. When I went into treatment I was definitely not in depression any more but the previous depression I was in was mostly due to come down from meth. When I went into treatment I was so stoked about getting treatment and I was feeling so good but it may have not had anything to do with the Effexor. I had experienced a huge psychic and spiritual shift the moment I made the phone call to go to treatment. Then two weeks later the meth post acute withdrawal thing kicked in and lasted a year of full bown mania. i was flying high and I loved it. The point is there were so many variables going on there was no way to know how the initial treatment went. We had to wait a couple of years for me and my pdoc to see how I was going to respond to AD's alone after everything had balanced out. It was from this point that I know I was pretty treatment resistant based on the following patterns.

I had so many years from 7th grade on and before meds of bad depression. The onset happened before the alcohol and drug use. It is complicated because of the drug and alcohol use but they were very often effective antidepressants and allowed me to function at a certain level. You are agnostic but I don't think it applies.

I went from initially severe to all the time moderate or mild to cycling severe. I mentioned above that I have spent 90% of my days since 7th grade in mild to moderate depression. My normal is much lower then the society mean. When I was younger it was much easier to force myself to do things to feel better. To get out to meetings and therapy and do my photography, do sports social stuff. Often I felt better for awhile. I always dropped back into the moderate though. I am an loner by nature so it was easy to isolate a alot. But I was much more resilient and I had learned to live with moderate. Now the moderate is harder and I am tired of forcing myself and fake it till you make it.

So for the sake of argument lets say I do have TD. What the hell am I supposed to do? The Fetzima and Lamactil are working very good right now. I can't remember ever responding this well to a set of meds. I am sure I have though at some points in the past. I don't know how long it will last. Based on past experience until about Oct. or Nov. But lets say I am good on these meds for a year or two and then they poop out like what always happens to me. Then the depression comes back and gets much worse.

So lets say I have TD and when the above happens what I am supposed to do then? I slowly go off meds forever? My brain is permanently whacked for life? The depressions will keep getting worse and more frequent?

I know there a some pdocs advocating these theories and gathering together evidence and some new studies. I haven't really read much on it or checked the sources and evidence. I will keep my eye on it.

I will look more to what NIMH, Harvard, Mayo Clinic, John Hopkins have to say about it. The debate is gonna rage. Hopefully much better meds will come out of it is my hope.

Like I said somewhere far above I don't think the current arsenal of AD's are much to brag about I agree on that.

Its funny you say I am on the far end of the spectrum. In therapy they called me high functioning. Probably because I was holding down a good job and they were comparing me to some hard case. I didn't think I was high functioning. There is a lot more to functioning then holding down a job. On a scale of 0 - 100 I would say I am a 75 or 80. Some people stay in deep depressions for years.

I am scared to death social security is gonna say, look you worked all those years in spite of the depression....Denied. They have gotten so much longer and deeper though. how can you hold down a job if you are in a major depression 8 months out the year regardless of the reasons for it.