The recent furore caused by publication of evidence about the serious nature of antidepressant withdrawal made me reflect on the lasting damage that can sometime be done by prescription drugs, and how it has often taken concerted efforts by users of these drugs to bring these effects to public attention.
Historically, the medical community has been slow to appreciate the extent to which drugs can interfere with and alter normal brain and body functions in both predictable and unpredictable ways. It took psychiatrists a long time to acknowledge that tardive dyskinesia was caused by neuroleptics, and they tried hard to pin it on something else (schizophrenia) (1). It has taken three decades for the withdrawal effects of antidepressants to be taken seriously. The prescription opioid epidemic in the United States continues despite mounting evidence that the drugs can exacerbate chronic pain rather than relieve it (2).
Withdrawal effects
Withdrawal effects are, in themselves, an indication that the body has been altered by the ingestion of a drug. We associate withdrawal effects with long-term use, but in fact, the body can change, temporarily, even after a single dose of a drug. Animal studies show that one acute treatment with an opiate provokes a period of heightened to pain (known as hyperalgesia), which follows after the direct analgesic effect of the drug and lasts for a few days (3). Similarly, taking sleeping pills for just one or two days improves sleep initially, at least slightly, but when the pill is stopped, people find it even more difficult to sleep than they did before they took it (4). This sometimes referred to as ‘rebound’ insomnia, and ‘rebound’ is the general term used to describe these compensatory-type effects that occur after the acute effects of a drug have worn off.
When drugs have been taken for long periods, withdrawal symptoms can be more severe and longer-lasting. They usually last for weeks, even if the drugs are reduced gradually. After discontinuation of some drugs, however, the effects can sometimes go on for months and even years. In these instances, the body is taking a long time to return to its pre-drug state, and it seems that in some cases it never quite does, and the drug-induced alterations are permanent.
Protracted withdrawal following benzodiazepine cessation was recognised back in 1991 by Heather Ashton (5). She documented withdrawal symptoms such as anxiety, tinnitus, paraesthesia (burning pain, tingling and numbness), that lasted for many months and sometimes years. In most, though not all, instances there was a gradual improvement over time. Drugs like alcohol and opiates seem less likely to cause protracted withdrawal, but the hypersensitivity to pain that is a recognised feature of opiate withdrawal took up to five months to normalise in an experiment with recently detoxified opiate addicts (6).
Evidence on antidepressant withdrawal suggests a picture similar to the benzodiazepines. There is a range of intensity and duration of withdrawal, with not everyone experiencing debilitating or even noticeable symptoms, but there are numerous reports of withdrawal symptoms being severe and protracted. An analysis of respondents on an antidepressant withdrawal web forum that I conducted with some colleagues revealed that withdrawal symptoms following reduction or cessation of Selective Serotonin Reuptake Inhibitors (SSRIs) were reported as lasting an average of almost 2 years (91 weeks) and those associated with Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs) lasted just under a year on average (51 weeks) (7). Although people resorting to an online forum are likely to be those experiencing most difficulty with withdrawal, this nevertheless shows that long-lasting effects are a significant problem for some people. As Davies & Read concluded in their recent review, it is difficult to estimate an overall average duration of symptoms from current research, especially as most studies were not set up to assess this directly, but reports of symptoms lasting several months are common across many recent studies (8).
Most reports suggest that symptoms of benzodiazepine and antidepressant withdrawal usually improve gradually even years after the drugs are stopped. Worryingly, however, Ashton’s initial description of protracted benzodiazepine withdrawal includes one or two cases where symptoms were still problematic several years after withdrawal, in some cases even when people had resumed benzodiazepines. This suggests that occasionally drugs can induce permanent changes in brain functioning.
Some accounts indicate that protracted withdrawal followed from abrupt discontinuation of the medication in question (9). Within addiction services in the United Kingdom there seems to be increasing appreciation that rapid withdrawal of benzodiazepines is undesirable, although I can find no discussion of a possible link between rapid detoxification and protracted withdrawal effects in any official literature or guidance. However, Ashton’s description of persistent withdrawal states mostly involved people who were undergoing, or had completed, a slow reduction, so it may be that although abrupt discontinuation is likely to be more risky, gradual reduction may not always protect against experiencing a complicated and prolonged withdrawal.
Tardive dyskinesia
We have known for decades that some psychiatric drugs can produce permanent and detrimental changes to brain function. Tardive dyskinesia, the syndrome of abnormal movements that is associated with a degree of cognitive impairment, was recognised back in the 1960s to be a consequence of neuroleptic administration (1). It was noted that it persisted after neuroleptics were stopped, sometimes for months and even years, depending on how long people were followed up for.
It has been proposed, although never demonstrated, that tardive dyskinesia is caused by ‘supersensitivity’ of dopamine receptors. The abnormal movements are similar to those of Huntingdon’s Chorea which are associated with excessive dopamine activity (10). The fact that tardive dyskinesia often occurs while people are still taking neuroleptics, suggests that the brain overcompensates for the effects of dopamine-blocking drugs. In attempting to balance out their effects, the body overshoots, and disrupts normal mechanisms for movement control along with more general functions that impact on cognition.
The recently characterised condition termed opioid-induced hyperalgesia may represent a similar situation, with the body over-adjusting to the presence of pain suppressing drugs resulting in increased levels of pain (2). Although opioid-induced hyperalgesia typically occurs during opioid therapy, there is little research on whether or not it persists after the drugs are withdrawn.
Post SSRI sexual dysfunction
Further evidence of long-lasting changes associated with antidepressants, in this case, comes from the emerging literature on post-SSRI-sexual dysfunction. It is well established that SSRIs commonly impair sexual function while they are being taken, but there are mounting reports of persistence of some difficulties following cessation of the drugs for months and sometimes years (11). Persistent sexual impairment is also demonstrated in male rats treated with SSRIs during adolescence (12, 13). It is difficult to estimate the prevalence of persistent sexual dysfunction given the currently limited data, but one survey identified that 34% of respondents showed evidence of possibly having the condition, and 4.3% showed a high probability of having it (14). I have heard some psychiatrists protest that post SSRI sexual dysfunction is ‘psychological’ and simply a re-emergent symptom of an underlying depression, but the fact that it is consistent with known acute effects of SSRIs and with animal research into lasting effects makes it difficult to uphold this position. It seems more likely that it is another example of a long-lasting, and possibly occasionally permanent, change to normal bodily functions induced by some prescribed psychiatric drugs.
Increased risk of mania and psychosis
Research that suggests the discontinuation of some drugs can increase the risk of having an episode of an underlying psychiatric disorder, such as mania or psychosis, also indicates how long-term use of some prescribed drugs can cause significant changes to brain processes. The evidence is most clear for lithium, where studies show that in people with a diagnosis of manic depression (bipolar 1), the risk of having an episode, especially of mania, is higher after stopping lithium than it was before lithium was started (15-17). This is true despite the fact that lithium is not commonly reported to provoke a severe, acute withdrawal reaction. Despite this, it seems the removal of the neurological suppression produced by the sedating effects of lithium can trigger the state of hyperarousal known as mania, possibly through a delayed rebound type of effect. Some research suggests a similar picture in people diagnosed with psychosis or schizophrenia who have been treated with long-term antipsychotics. Evidence shows that the risk of relapse is heightened in the first few months following discontinuation, and declines thereafter, suggesting that discontinuation is not just revealing an underlying tendency, but is provoking an episode that might not otherwise have occurred, at least at that point (18). Thus it seems that the alterations produced by long-term treatment with certain sedative drugs increase a person’s vulnerability to having an acute episode of mania or psychosis. Some argue that this effect also occurs with antidepressants (19), although the evidence for this is less clear.
Lack of research
It is astonishing that iatrogenic problems such as persistent diseases and dysfunctions induced by prescribed drugs have received so little attention from the research community. We remain uncertain about the proportion of people who can expect to experience an adverse withdrawal-related reaction following different lengths of treatment with different drugs. We know very little about how long such withdrawal reactions are likely to last, and indeed whether they may sometimes be permanent. We do not know for certain whether rapid reduction increases the risk of protracted withdrawal, nor whether very gradual reduction can prevent its occurrence. The occurrence of post SSRI sexual dysfunction is probably unknown to most prescribers, and there is little research on its prevalence or duration.
The mechanisms of these effects also remain obscure. There is research on the mechanisms of acute withdrawal from opiates and benzodiazepines, there is little research into what produces states of prolonged withdrawal. There is no research on the mechanisms underlying antidepressant withdrawal or post SSRI sexual dysfunction.
Yet is has been estimated that around 16% of the population of the United Kingdom are taking antidepressants currently (20) and the latest data from the United States, from 2011-2014, put the figure at 12% (21). If even a small proportion of these people experience protracted withdrawal or post SSRI sexual dysfunction, it is a sizeable problem! Furthermore, recent figures from the England show that prescriptions have doubled in the last decade, now topping 70 million for a population of 56 million. It is unbelievable that the leaders of the medical profession are so unconcerned about this situation that the president of the Royal College of General Practitioners cautioning against viewing the increase in prescriptions ‘as a bad thing’ (22).
Implications
There is a large-scale failure to appreciate the risks involved in taking drugs that alter brain function on a long-term basis. Some of these risks are foreseeable, some less so. We should have been able to anticipate that SSRIs and other new drugs for depression and anxiety would produce withdrawal syndromes, although once again we were taken unawares, and there seems to have been no research into this possibility before the drugs were launched. A syndrome like tardive dyskinesia, or opioid-induced hyperalgesia should remind us, however, that the effects of drugs cannot always be predicted, and that we must always be vigilant for complex and unusual reactions.
The fact that it has taken single-minded and dedicated campaigners, many of them users of the drugs concerned, to bring these effects to the attention of the scientific and professional community is shameful, and highlights the naivety of the medical profession.
To anticipate some of the criticism I will receive from people who feel that medication has helped, I am not saying that these drugs should never be considered. I have certainly seen situations in which someone has managed to stop drinking harmful amounts of alcohol through using small doses of a benzodiazepine, for example, and benzodiazepines are definitely the least dangerous option in this situation. I also believe that neuroleptics, despite their many noxious effects, are sometimes preferable to a severe and intractable psychosis. People must have all the facts though. Doctors must understand and explain that drugs change the brain, and other parts of the body, in ways that we do not fully understand, that are almost always harmful to some degree, and that may, even, be irreversible.
References:
- Moncrieff J. The Bitterest Pills: the troubling story of antipsychotic drugs. London: Palgrave Macmillan; 2013.
- Velayudhan AB, G.; Morely-Forster, P. Opioid-induced hyperalgesia. Continuing Education in Anaesthesia, Critical Care and Pain. 2014;14(3):125-9.
- Celerier E, Rivat C, Jun Y, Laulin JP, Larcher A, Reynier P, et al. Long-lasting hyperalgesia induced by fentanyl in rats: preventive effect of ketamine. Anesthesiology. 2000;92(2):465-72.
- Soldatos CR, Dikeos DG, Whitehead A. Tolerance and rebound insomnia with rapidly eliminated hypnotics: a meta-analysis of sleep laboratory studies. Int Clin Psychopharmacol. 1999;14(5):287-303.
- Ashton H. Protracted withdrawal syndromes from benzodiazepines. JSubstAbuse Treat. 1991;8(1-2):19-28.
- Treister R, Eisenberg E, Lawental E, Pud D. Is opioid-induced hyperalgesia reversible? A study on active and former opioid addicts and drug naive controls. J Opioid Manag. 2012;8(6):343-9.
- Stockmann T, Odegbaro D, Timimi S, Moncrieff J. SSRI and SNRI withdrawal symptoms reported on an internet forum. Int J Risk Saf Med. 2018;29(3-4):175-80.
- Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addict Behav. 2018.
- Anonymous. Rapd withdrawal and misprescribing of a benzodiazepine leads to £1.35m settlement for Luke Montagu, CEP co-founder. 2015 [Available from: http://cepuk.org/2015/07/18/rapid-withdrawal-misprescribing-benzodiazepine-leads-1-35m-settlement-luke-montagu-cep-co-founder/.
- Cepeda C, Murphy KP, Parent M, Levine MS. The role of dopamine in Huntington’s disease. Prog Brain Res. 2014;211:235-54.
- Bala A, Nguyen HMT, Hellstrom WJG. Post-SSRI Sexual Dysfunction: A Literature Review. Sex Med Rev. 2018;6(1):29-34.
- de Jong TR, Snaphaan LJ, Pattij T, Veening JG, Waldinger MD, Cools AR, et al. Effects of chronic treatment with fluvoxamine and paroxetine during adolescence on serotonin-related behavior in adult male rats. Eur Neuropsychopharmacol. 2006;16(1):39-48.
- Simonsen AL, Danborg PB, Gotzsche PC. Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies. Int J Risk Saf Med. 2016;28(1):1-12.
- Ben-Sheetrit J, Aizenberg D, Csoka AB, Weizman A, Hermesh H. Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship. J Clin Psychopharmacol. 2015;35(3):273-8.
- Cundall RL, Brooks PW, Murray LG. A controlled evaluation of lithium prophylaxis in affective disorders. PsycholMed. 1972;2(3):308-11.
- Baldessarini RJ, Tondo L, Viguera AC. Discontinuing lithium maintenance treatment in bipolar disorders: risks and implications. BipolarDisord. 1999;1(1):17-24.
- Suppes T, Baldessarini RJ, Faedda GL, Tohen M. Risk of recurrence following discontinuation of lithium treatment in bipolar disorder. ArchGenPsychiatry. 1991;48(12):1082-8.
- Viguera AC, Baldessarini RJ, Hegarty JD, van Kammen DP, Tohen M. Clinical risk following abrupt and gradual withdrawal of maintenance neuroleptic treatment. ArchGenPsychiatry. 1997;54(1):49-55.
- Fava GA. Can long-term treatment with antidepressant drugs worsen the course of depression? JClinPsychiatry. 2003;64(2):123-33.
- (DHSC) DoHaSC. Hansard- prescription drugs: written question 128871 London2018 [Available from: https://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2018-02-21/128871/.
- Pratt LA, Brody DJ, Gu Q. Antidepressant Use Among Persons Aged 12 and Over:United States,2011-2014. NCHS Data Brief. 2017(283):1-8.
- Guardian T. Antidepressant prescriptions in England double in a decade. London: The Guardian; 2019 [updated 29th March 2019. Available from: https://www.theguardian.com/society/2019/mar/29/antidepressant-prescriptions-in-england-double-in-a-decade.
Joanna Moncrieff 
Thank you for your work Christina Graham
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Reblogged this on Chrys Muirhead .
Hi Joanna. Thanks. BW Fernando
Em seg, 1 de abr de 2019 às 05:21, Joanna Moncrieff escreveu:
> joannamoncrieff posted: ” The recent furore caused by publication of > evidence about the serious nature of antidepressant withdrawal made me > reflect on the lasting damage that can sometime be done by prescription > drugs, and how it has often taken concerted efforts by user” >
Good post, but hard to understand the many reasons why these ideas are so often overlooked or dismissed in clinical practice. The result is more prescriptions, higher doses and life-long treatment.
A really good post. One reason for this huge problem is that doctors are trained to ‘collect symptoms’ and treat them with pills. They aren’t trained to ask what has happened to the person and deal with that. Distressed people should not go to the doctor first. Patients are then left on antidepressants for a very long time without the prescription being monitored as you would do for hypertension. (Retired GP)
Cash cow for docs!
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The legal director of Action Against Medical Accidents said urgent research must be carried out and said that, if the results of larger studies confirm Professor Lader’s research, the government and MRC could be faced with one of the biggest group actions for damages the courts have ever seen, given the large number of people potentially affected. People who report enduring symptoms post-withdrawal such as neurological pain, headaches, cognitive impairment, and memory loss have been left in the dark as to whether these symptoms are drug-induced damage or not due to the MRC’s inaction, it was reported. Professor Lader reported that the results of his research did not surprise his research group given that it was already known that alcohol could cause permanent brain changes.
Thank you for this piece. Shame on these torturers indeed! I am still withdrawing from ONE sertraline pill I took 4 months ago! I am still not 100% back sexually! I trust I will soon.
What will it take for these poisons to have proper warnings? Let the patient decide is the risk is worthy! I wouldn’t have certainly taken them had I know this! And if in a year or so I’m not completely back in gonna sue their asses. It seems may be the only way.
I use these forums. Pssdforum.org. etc.. the antidote is left on the hands of the tortured patient! What a shame for the “respectable” “medical” community! And “psychiatry”!
Many people suicide… these torturers have blood upon their hands…
We need more of these pieces published everywhere!
Thanks again.
The suicidality is not brought upon a direct influence of the “antidepressant” not the melancholy..
it’s a conscious decision after people are left basically disabled and/or mutilated and/or crippled and/or chemically castrated for long periods of time! The horror some of these people go through is indescribable! I don’t wish it upon anyone!
When the label says “can cause suicidal thoughts” now we know why!
Love helps us all.
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I have been totally destroyed by these meds I’m now coming up to 4 years off and my life has been ruined every day I pray for death from the relentless suffering only to be told by the so called professionals that it’s all in my head and withdrawal doesn’t last this long I believe if I die and go to hell it will seem like a holiday compared to the suffering that I am going through now I truly could not wish this life on another living person
I am so sorry to hear this- how terrible. I wish you all the best. Don’t given up hope. Most people say it gets better even if its slow
I have too. I am nearly 5 years out…nearly died last year of severe malnourishment due to digestion issues and food sensitivities, was on a feeding tube in April, somewhat better but completely numb from head to toe, vision issues, and still cannot eat anything unless it is bland or baby food. My life is completely destroyed. Former distance runner to cripple, completely dependent on my husband.
I suffer severe and long-lasting, possibly permanent complications from the use of and withdrawal from Paxil. I wanted to share my story, hoping to bring comfort to others in similar situations and an understanding that they are not “crazy” nor alone.
There are countless documented cases of severe untoward reactions related to paroxetine that, when taken together, show a failure of the pharmaceutical industry to identify inherent problems with SSRIs and withdrawal them from the market. That said, admitting there is a problem would open the industry to litigation, which frankly, is the only way that progress will be made on this issue.
Due to inadequate research, many psychiatrists, GPs, and family doctors alike are unaware of the severity and magnitude of problems inherent with SSRIs. Reported complications are attributed to anything other than SSRIs. Many patients are labeled histrionic. Others simply misdiagnosed and treated erroneously. My symptoms, broad, numerous, and severe, have resulted in numerous psychiatric diagnoses, where only one existed before. Medical diagnoses as well. That said, I have made a habit of informing health care practitioners of the actual pathogenesis of my complaints so they can attempt to treat me accordingly. Unfortunately, all treatments to date are palliative (versus curative) or ineffective.
Where I came from says a lot. I am a psychiatric nurse who worked in acute care, intensive care, and geriatrics (all psych) for ten years. I founded IMC, a home health staffing, private duty care and medical health and wellness company, with seventy clinics in Florida. I also had a one-third stake in Fusion HealthCare, a Medicare-certified home health agency group.
Where I am says even more. After an eight-year battle with opioid addiction, I’ve lost everything, millions in net worth. Opioid addiction took me down; Paxil has kept me there. I am incapacitated from, for lack of a better term, Paroxetine toxicity, otherwise, I would have recovered from addiction and resumed a lucrative career in health care. As it is, I write books about my experiences, making light of the situation using humor, satire mostly. Better to laugh…
Clinical History
I began Paxil 20 mg in 2015 for major depression with mild depressive psychosis. Fortunately, I gained 50 pounds (180 to 230) and developed Type-II Diabetes, forcing me to discontinue Paxil. After one year on paroxetine, while under the care of a psychiatrist, I began tapering using a digital scale, shaving off a fraction of a milligram at a time. Regardless of this slow tapering, I experienced severe withdrawal symptoms. The doctor prescribed Zoloft 50 mg to assist in the withdrawal. After completing the withdrawal from Paxil, I used the same method to withdrawal from sertraline without issues.
Within thirty days of cessation from both medications, the onset of withdrawal symptoms reoccurred (see symptom list below), resulting in a restart of Paxil. I have attempted stopping paroxetine four times, each time unsuccessful. The longer I stayed off, the more severe the consequences. And as of today, although off paroxetine, I remain floundering in Paxil’s murky waters. Zoloft is unable to cover the damage.
A Critical Point
While tapering from Paxil, and after discontinuation, I experienced severe cardiac symptoms: palpitations, shortness of breath, arrhythmia, angina. Using empirical knowledge, specialist consultations, intense research, and trial and error, I was able to determine that small fragments of paroxetine, especially powder, absorbed through the mouth (or esophagus) caused a toxic reaction. And it is in this way that Paxil has damaged both my central and autonomic nervous system. Long-lasting or permanent damage is the only question remaining. Any drug that requires a multi-year withdrawal is toxic (poisonous) to the human body. Complications persist despite using Zoloft and other antidepressants, with the notable exception of one drug: Paxil itself. To be clear, restarting paroxetine renders my condition benign. This anecdotal is diagnostic for Paxil toxicity/poisoning.
It is important to note that during severe episodes of major depression, with and without psychosis, the bulk of these symptoms did not exist. The symptoms that did exist were less severe. Therefore, the symptoms and complications listed below are directly attributed to Paxil.
All medical and psychiatric remedies have failed, both to diagnose and to treat. With one notorious exception: Paxil. The drug that brought it on in the first place.
Symptom/Complication List (partial)
• Frustration and stress intolerance, severe to profound
• Anger turns to rage within seconds
• Obsession compulsions
• Psychosis: atypical, constant voice-like clutter, tinnitus, hallucinations (shadows, lights, etc.)
• PTSD-like features (hypervigilance, radical reaction to external stimuli)
• Extreme mood swings/lability
• Negative bias of thought (severe)
• I often think and say the opposite of what was intended (symptomatic of brain damage)
• Dementia: slow thoughts, severe S-T memory impairment, measurable L-T memory impairment, indecision, etc.
• Chronic postprandial fatigue syndrome (not an actual diagnosis): I become stuporous after eating, regardless of quantity, type, or frequency of meals
• Uncoordinated (lifelong competitive athlete/drummer)
• Unable to type efficiently or at all (use dictation)
• Food intolerance: my stomach cramps, hurts, and contracts like a boa constrictor
• Heat intolerance–I live in Florida
• Vision: red, blue, and yellow dots occlude by 50% night vision
• Stamina: unable to improve cardiorespiratory status
• Absolute insomnia
• Skin sensitivity: I can feel dust impacting my face
• The signal to urinate has been dramatically reduced, at times cut off
• Palpitations occur intermittently and always after exercise, continuing for eight to twenty-four hours
• Heart arrhythmias
I invite your comments and stand ready to listen and share.
I am so sorry to hear this- what a terrible experience. The strange symptoms such as tinnitus, hypervigilance and hypersensitivity suggest the nervous system has been left in a chronic state of over-arousal
Thank you, Joanna. I agree. My guess is that the serotonergic system (and possibly other monoamine systems) has been dysregulated to the point that it can no longer counterbalance the excitatory action of dopamine, et.al. The inability to recover may suggest that gene transcription has been altered. Now, I am not a neuroscientist. But the desperation to recover motivates me to study research regarding these topics obsessively, including your NIH-published work. It is comforting to know that research is ongoing that will lead to a better understanding of the downstream/long-term sequela of SSRI/SNRIs.
Kevin, on SurvivingAntidepressants.org, we have hundreds of cases like yours. It is not unusual that reinstatement of the original drug, often at a low dose, will reduce withdrawal symptoms. The mechanism is the same across psychotropics: Regular ingestion brings about neurobiological adaptation, physiological dependency, tolerance and, when the drug dosing is reduced or discontinued, withdrawal syndrome.
Your having experienced several withdrawal syndromes — going off opioids the first — may have put your nervous system in a particularly vulnerable state.
We do see people generally recover, but it is very slow, on the scale of years rather than weeks or months.
If you would like peer counseling, please visit and register.
They overdosed me on these I had a severe nervous system reaction they blamed on anxiety seen a specialist who gave me the wrong drug then I have them all on recording covering it uo and blaming it on diabetes so went private got an EMG that proved no diabetes and that I now have ulnar nerve palsy in my hand and loads of other neurological symptoms my last neurologist likened to gulf war syndrome
Everyone has bullied and victimised me for complaining of illness or injury and it’s much worse than they claim
PATIENT SAFETY – THEY HARMED US AND LIED
Very happy to find this blog !… allas too late for me. I could have avoid criminal psychiatric supervision and destruction of my body and mind.
The START & 1st WITHDRAWAL : 9 month on paxil because of severe anxiety due to harassment at work and divorce. Failed withdrawal (conducted by my psychiatrist : cut the pill in half for a week then stop… I was on 20 mg). One year disability because of unexplained muscle pain and severe anxiety with panick attacks….put on Effexor
2nd WITHDRAWAL :
After 2 years on effexor, due to insomnia, my psychiatrist decided to put me on Remeron : stop effexor cold turkey and put on remeron… brain zaps and shaking so severe than I was unable to stand… After 7 days, my GP said : go back on effexor and stop remeron which I did. All symptoms disappeared except severe anxiety : 6 months disability, had to increase to from 75 mg to 150 mg effexor for another 3 years. 2 months disability.
3d WITHDRAWAL :
Aggravated insomnia (could stay awake for 72h in a row) and recurrent burn out, I went to another psychiatrist and ask for advices. He added remeron 30 mg. Slept better for 2 weeks but unbearable pain in my muscle (had to stop playing the violin in the orchestra, it was too painfull to may arms, neck and hands and had to stop sport), gained 10 kg and became prediabetic. Psychiatrist said : cut the pill in half for 2 weeks then stopped. Which I did… I became then obsessed by death (not even knowing why) and could no more function because of terrible anxiety which lead me to be put in a psychiatric ward. I explained my issues with drugs but they did not listen to me : they cold turkeyed me of effexor and put me on Wellbutrin… horrific withdrawal, brain zaps, vomiting, extreme dizziness, shaking… after I beg them for 10 days then put me back on effexor, all symptoms disappeared within a few hours… Went out of this clinic and looked for another psychiatrist. 4 months disability
4th WITHDRAWAL :
The new psychiatrist said I have been withdrawn much too quickly. So she plan a tapering over 9 months which I carefully did. Everything went quite well but at 75 mg I had memory loss and deglutition issues for 1 week. It went better and without issues until 37,5 mg. I became oversensitive to noise…. it also resolved within 2 o 3 months. We then drop from 5 mg to 0 mg after this 9 months course. I experienced rage at minimal conflicts (I never experienced this before !), then muscle pain and fever for a week then it was ok… I felt really great BUT…. the worse came 6 months later. I’ve been massively hit by a bunch of symptoms coming from nowhere.
– gastroparesis (lost 10 kg within 4 weeks)
– dehydration
– Gerd and diarrhea
– food intolerances
– light sensitivity
– heart arrythmia
– unstable blood pressure
– high C-reactive Protein (blood test)
– sleep apnea
– pins and needles all over my body
– severe anxiety
– severe agitation (I thought it was akathisia… felt terrified to the point willing to kill myself)
– mood swings with total dispair and crying bouts (never been like that in my life)
– eczema
… Put back in the psy ward… then paradoxical reaction to prazepam, to lorazepam… put back on paroxetin 30 mg.. 2 months in the psy ward. 1 year disability.
When I said it was related to withdrawal I have never been considered by doctors and nurses. They conclude I was an hypocondriac.
Gastroparesis went away, as well as anxiety, agitation and sleep apnea…
But 4 months later I experienced new symptoms :
– bradycardia
– swollen legs when standing for a long time
– asthenia
– unability to focus, memory loss, cognitive difficulties
– insomnia (again !)
– low blood sugar
– intolerance to physical exercise
– lack of emotions, lost of interest in life, no more creativity (zombified !)
– destroyed libido (and problems with my partner)
– hair loss
– facial hair growth
– menstrual irregularities
Went back to work but could not do more than half time job… with total exhaustion. Psychiatrist said maybe it’s due to anticholinergic effect but was not sure… Send me to a neurologist which said my issues were psychiatric and send me back to psychiatrist… who then send me to internist…
5 YEARS LATER :
Could reduced from 30 mg paroxetin to 14 mg very slooooowly. 15 mg reduction over 5 years… but…
– gastroparesis is back
– food intolerance never disappeared : If I eat gluten I’m left bedbound in a semi conscious state for days…but no doctor believe me, can no longer eat crab, nor fish, no drink a half glass of wine or even eat some fruits like having strange reactions that makes me bedbound for days… still no explanations.
– I have now Postural Orthostatic Tachycardia syndrome
– tinnitus (it comes and goes away without explanations)
– premenstrual disorder syndrom
– muscle pain
– joint pain
… Psychiatrists just destroyed my life. I’m jsut wondering what to do now and sometimes just consider my life is over and it would be better to end it.
My doctors do not understand me, my family do not understand me… just feel alone. But now, at least I know I’m not crazy as other people encountered the same issues with the same drugs.
I just wish doctors be better educated on prescribing more cautiously, on listening to the patients experience instead of dismissing them, on being more in a critical light regarding drugs side effects… in short : a more human health system.
Now ya tell them! What redress of grievances are to be found in Texas long after all of this permanent damage has caused permanent disability from practically all of this pharmaceutical “care” I received for greater than 30yrs when nobody cares about us or the suffering all that’s caused. Label me something they aren’t even medically qualified to diagnose? And is diametrically opposed to the diagnosis of “major clinical depression” also misappropriated bc that was caused by an abusive husband of 23yrs but they sure fixed me, permanently. While he’s still a sick abuser. — Algernon 🐁
Thank you for this. I was prescribed antidepressants at age 10 when I was hospitalized for an eating disorder. I was far too young to understand what was going on, and one would think the first step would have been to get me into proper therapy and working with a nutritionist BEFORE medicating me. It was only after I was on medication that I began feeling listless and depressed, setting in motion decades of appointments with psychiatrists, switching from medication to medication, none of which seemed to work. This highlights a very real problem which I am now faced with. I appreciate your insight and hope the medical community can resist the lure of the pharmaceutical company’s “a pill a day” money-making model, and look into routes that actually heal mental illness rather than simply treat symptoms.
I agree medications have their use, in CERTAIN situations. However, patients should be made completely aware of the uncertainties of what is being played with.