Antidepressants - An Introduction
You and Your Antidepressant
When Your First Antidepressant Fails
When Your Second Antidepressant Fails
Antidepressants for the Long Haul
Tuesday, January 13, 2009
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About Me
- John McManamy
- I am an award-winning author and mental health journalist. I have been writing about mood disorders since being diagnosed with bipolar disorder in 1999, ranging from a website, an email newsletter, a book, articles for HealthCentral, and this blog. More recently, I have been producing videos. Writing about my illness has played a very strong role in my healing and recovery. Writing allows me to come to terms with my past, gives meaning to my present, and gives me the courage to face the future with hope.
2nd antidepressant...haha...Almost every antidepresant with everycombo of them with antipsycoticS and mood stabalizers and anti-anxiety...I am a rapid cyclining manic depressive, PTSD, anorexic. Most doctors would have trown me to the curb or even dug the grave for me i'm sure...luckly I have found the most patient understanding Doctor whosdtreated me 10 years with meds and therapy. She has had me hospitalized several times, got second oppions. She Has been frustrated. Ane I, I hAVE BEEN FRUSTRATED. i HONESTLY DON'T KNOW HOW IT IS i'VE LIVED THIS LONG. wHAT KEEP ME ALIVE IS MY 4 YEAR OLD SON i LOVE him GREATER THAN LIfE AT ALL TIMES. lIFE IS HELL, BUT i LIVE TO MAKE SURE MY SON'S LIFE IS NOT HELL.
ReplyDeleteHi, Write2s. Many thanks for sharing this. You might want to ask your pdoc about dropping the antidepressant from your cocktail. I'm not an MD, but I make every effort to ensure that the mood-treatment articles on my site reflect the most current thinking in psychiatry - and there clearly is a lot of skepticism about prescribing an antidepressant - even with a mood stabilizer - to people with bipolar, especially those who rapid-cycle.
ReplyDeleteYour pdoc may have a valid clinical reason, but you're entitled to demand a satisfactory answer.
I wanted to say, aw, sounds like shit to me. I think there are a lot of excellent facts in this article, but I can't help but feel like the person writing this has NO CLUE what it really is like for those of us who are still under the guinea pig feeling until the "right" drug comes by.... I was slightly offended when you, the writer, commented in parantheses about over ten years it can take to find the right med -stating that was rare...then what am I but a freak? It has been 20 years and I am still working as the guinea pig. I am labeled whatever they want to label me, knowing that I am actually major depression, but you know, I'm the one on the drugs, so really, does my comment count? My body, your study...it's not about cure, it's about lab work and progress, but for who? for what generation?
ReplyDeleteI have been a good patient and I'm still drown in hopelessness. I didn't see you comment at all on Electro Shock Therapy, what about that? I'm ready to have the brain reset, and hell, what's a little memory loss? isn't that part of the problem? the memories?
BEFORE taking medication , TRY NATURAL ways, like natural medicine, exercising everyday for 1 hour (making sure you sweat), eat healthy-nutrition is very important- B-vitamins, C vitamin, calcium and magnesium, most of ALL understanding your condition 100% by reading about it from books and websites, THERAPY (CBT or Phycotherapy) itself is VERY HELPFUL! always do whats natural first.
ReplyDeleteAfter fifteen years of antidepressant (seroxat, prozac, effexor, mirtazepine, escitalopram), one after the other becoming ineffective, I'm now taking a combination of the last two, which are just keeping me going. It's not quite as hard to get through the day. I hate taking the AD's but the alternative is that I would probably not have survived. Thank you for this excellent source of information, I wish I had come across it before, it brings so much together in one place, thank you.
ReplyDeleteLexapro is a permanent life long cure for any depression if survive treatment. I was told by a marriage counselor to request drugs for my OCD symptoms (checking, intrusive sad thoughts, previous eating disorders as a teen & heavy drinking-probably perpetuated by my father’s suicide in 1981 while he was on imipramine and many other psych med’s) I went to my husband’s pcp who never met me before. He gave me a depression self-test & diagnosed me with depression, then prescribed Lexapro & Rozerem since I had a terrible insomnia problem. He also decided it was a good idea to start kissing me and grabbing me in his office. The Lexapro did such a good job getting me up & doing things but I believe it also may have made me nervous because it raised my blood pressure from it’s usual 120/80 to 145/110. I was really up! I could drink twelve shots of straight liquor & still be walking around for hours. This was the busiest year of my life. I got 2 DUI’s 4 drunk in publics & an involuntary commit for suicide, attended 2 rehab’s, a hypnotherapist, weekly ASAP programs, all while working full time. During medical treatment I was seen by 3 psychiatrists 4 doctors & many counselors. Most of the follow up treatment involved numerous more drugs anti-buse campral Buspar. All of which I had to stop taking due to side effects-full body tremors and falling down. After the second DUI when I was also charged with a felony for pinching a police officers butt, I decided maybe I should stop Lexapro b/c I seemed to have developed some obsession with alcohol & I could see I was also becoming delusional. While in jail I requested no more medication for 1 week and was able to stop although the depression side effects of the withdrawal lasted about three months. I met many other women in jail for DUI’s while on Zoloft, Lexapro and Abilify & others for shoplifting on Zanax. My depression is 100% permanently cured. I no longer ever feel sad about my life. I have never killed anyone driving drunk. I didn’t kill myself. I am no longer in jail, I didn’t get my kid taken away from me. I am not in a mental institution, and I don’t have a lethal diastolic blood pressure of 110. No matter what happens in my life now, I am always hopeful and never depressed.
ReplyDeleteYou have a lot of criticism for the status quo and the scary thing is it all makes sense and much of what you've said matches what I've experienced. So am I lost, destined to get worse and worse because I'm on antidepressants. I'm damned if I do and damned if I don't. Besides the criticisms do you have any answers?
ReplyDeleteHey, Eleanor. There are no easy answers, and I make that very clear. But there are options. The Recovery section has numerous articles on things you can be doing for yourself. Other sections give you insights into moods and behaviors. Plus there are talking therapies in the treatment section. Your antidepressant may have put you in the position for you to implement some of these practices. Again, no guarantees, but where you have choices you have hope.
ReplyDeleteI think this article is very funny because it is true. Bitter sweet and totally real. Psychiatry is using us as guinea pigs in essence. A little statistical evidenced based evidence and then they hand out these drugs as they seem like they only solutions that they can offer.
ReplyDeleteBut, Psychiatry is working in the dark. Drug companies and the love of money does not really help things. However, it has helped me. Medication that is. What didn't help was the years of taster/trial periods. Cognitive thought, stress levels,stress vulnerability, life situation all are real aspects to mental health which are always undermined by the medical model. We are human not lab tests. The latter often feels more fitting some days. In the U.S there is more of a humanistic approach from what I have been taught. This notion seems more fitting. Person centred care, mindfulness, and self empowerment is my mantra. When people have "strive" it can really be rewarding. Depression often takes this away and a stubborn fighting spirit and resilience can help a lot. The mind at war often does have ups and downs but it is that fight that enables us to continue and find for some ability to experience pleasure. I think this is more universal than an anti-depressant. However, sometimes when we are very low we need humanistic help from others, as well as encouragement, understanding and appreciation.
Thanks
PaGe
good information. i am a 25-year guinea pig. also have had ect, which caused long-term memory loss -- not worth the debilitating side effect. whenever i hear of anyone contemplating ect, i try to talk him/her out of it. but i never can, all are so desperate.
ReplyDeleteI've taken ssri's snri's antipsychotics, mood stabilizers plus others that i can't even name. my hypomanic periods have been so rare (only two in 15 years) that i was diagnosed with treatment resistant mdd with gad. can't really fault the pdocs for that. (i went to one for 10 years and she never saw a hypomanic episode.)
thanks for the good info -- i feel forearmed. what are these 'robust dopamine agents'? i am guessing cocaine is one. it's the only drug that ever made me feel good. amphetamines don't come close! only make me feel more agitated.
I fully agree with your article on psychiatry treating patients as 'guinea pigs' because they have not done enough research on the functioning of the brain...their remedy being to dish out these antidepressants! However what I would like to know is if after taking these antidepressants for years, is it possible to stop taking them completely without fear of any permanent damage being done to brain functioning!
ReplyDeleteHello, very interesting this site and all the comments. I am the mother of a bipolar ll female who was diagnosed with the condition after going through post-partum depression that was no responsive to Lexapro. It's been a hell of a ride for 6 years. Two grand children later and still having to interveen in her life to keep those kids taken care of and the monetary support, well let's just say OMG! I do appreciate the website, we all need more understanding as I agree with glow20 about research. Let our voices be heard for funding and maybe when my grand-children grow up there will be something to explain why their mother is like she is.
ReplyDeleteI wanted to comment on some of anonymous comments. I too have been learning that the lack of pleasure that people get from doing things that used to give them much pleasure before, may have more to do with dopamine levels then serotonin levels. I also have hypothesized that dreaming at night when one sleeps may have a direct link to depression in the majority of 'clinically depressed' patients such as myself. Like anonymous I too took Zoloft, which was my first anti-depressant drug to try. Wow! Like a fair percentage of people, the switch was finally pulled/pushed...the light finally came on and stayed on. Not only did I have a more pronounced longing for my usual activities that gave me pleasure but I found myself actually intrigued enough to motivate myself into new directions that I hadn't even thought about and old activities that I strangely felt renewed excitement for. I no longer had the anxiety that had crippled my life so much in the past especially during childhood. It became less critical to avoid speaking to a classroom of people...it was harder for me to become embarrassed. I was highly motivated and animated in my verbal discussions. It had become a wonder drug for me...unfortunately the benefits waned after several weeks/months/years of continuous use. To answer your question about things that increase dopamine levels w/o administering drugs, prescription or even street...YES, there are therapies that increase dopamine levels in the brain w/o drugs. One of which most of us know is exercise. Runners high has clearly been documentated..but I fell upon a true and well proven therapy that I have used and continue to use and that is TSD therapy. I do not do it as one study suggested doing three TSD's in one week; I usually muster the courage and strength to keep myself awake for at least one night. The benefits are subtle at first but by the end of the day, I have usually received at least three marketed mood increases. One around sunrise-to a couple hours after, then another one around noon and a third one by the end of the day around 5pm. It works for me like Zoloft did the first time I tried it. SSRI's may limit REM sleep and for some reason, staying awake all night--no catnaps even for a minute, enables the brain's synapses to fire/talk to the pertinent places and go thru the usual channels that increase dopamine levels in the brain. If a person is as clinically depressed as we were/are then it should work. i tend to slip/drop or even slide into a very dark state of being with anxiety levels near max and depression near its worse. I don't want to get out of bed and find it frightening to just get up! I found no level of pleasure in anything that I did and that includes appetite. I get no pleasure out of eating therefore seem to have no appetite. this form of therapy is transient, of course, but can be maintained with the help of a mild stimulant/anti-depressant substance such as welbutrin, caffeine, low doses of paxil perhaps, or a low dose of a weak amphetamine such as Ritalin. For the anxiety part to be maintained a low dose beta blocker can facilitate the continued relief from anxiety, which by themselves does not lift me out of my depression episode. I don't plan but it seems that I need to do at least two TSD's per month. I don't plan them because, who would really want/desire to stay up/awake all night long when you know the only partial, tiny, tiny bit of relief from this hellish depression/anxiety is to check out/go to sleep? It has also been noted and verified from me that some patients get to be in a hypo-manic state...I do especially by 5:00pm. I have hypothesized that doing a TSD or two or three within one week could set a person up for a 'crash'. Well, while that is true, I would still want to experience the joy of just living and doing everyday activities...meaning I would opt for the manic/depressant roller coaster over the roller coaster that was out of service and not going anywhere!
ReplyDeleteTo John M. :
ReplyDelete"As for the long-term, it simply doesn't exist. No one does five-year studies. Studies lasting a year or more are extremely rare and are marred by extremely high drop-out rates and methodological glitches too numerous to mention. "
It does seem like there could be a wealth of long term studies of actual patients like myself on the same theraputic dosages for 5 years plus, like myself nearly 6 years since the last change in dosage. Is there or should there be some type of web site that could sort out all of these experiences realizing would be difficult to separate the valid responses or embellishments etc. When reading through comments on sites like yours I tend to skim through and seek out those who have been dealing with BP on a long term basis and what works for them in relation to their diagnosis. I am not at all discrediting the newly diagnosed as they need the most information, just would like to see the BP community empower themselves to combat the neglect from the medical community. Would like to hear your thoughts.