60 Minutes, The SSRIs, and The Dirty Little Secret

Jonathan Leo, PhD / Jeffrey Lacasse, PhD
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Last night 60 Minutes presented the work of Irving Kirsch. Back in 2004 one of us (Jon) wrote, “It remains to be seen how the mainstream press explains this “dirty little secret” to the American public, but so far it has received little airtime.” It is refreshing that a show like 60 Minutes has covered this.

Overall the show was very good. However, for anyone who has read Kirsch’s work the idea that this is new information was a little surprising, as he first showed that there was a minimal difference between SSRIs and placebos approximately 14 years ago. The other slightly misleading part of the show was how they presented those who “disagreed” with him. At this point even within mainstream psychiatry this is virtually a non-existent debate, and it is now well acknowledged that the difference between placebo and antidepressant drug effect is minimal. If you listen closely to the scientists who 60 Minutes interviewed to get the other side even they didn’t really disagree with Kirsch’s main findings.

The current state of the SSRI debate amongst Prozac’s proponents is as follows: At one end of the spectrum, some, such as Michael Thase, a clinical trial researcher and medication proponent, say that for every ten people taking an antidepressant the drug helps one person. At the other end of the spectrum there are those who argue that it helps three people. Or put another way: Are SSRIs effective for 10% or 33% of the patients that receive them? See: http://www.psychiatrictimes.com/clinical-scales/display/article/10168/48136

Even the pharmaceutical companies acknowledge that the difference between drug and placebo is minimal. In 2001, an advertisement for Wellbutrin had a graph showing that the difference in efficacy between Wellbutrin and placebo is only 10%. This does not come from a critic, but was on wellbutrin.com in the early 2000’s.

If everyone agrees that the true drug effect is minimal then what is the disagreement about? The argument comes down to the significance of these low efficacy numbers. There are some, like Thase, who take the public health argument, which goes as follows: The medication helps one (or 2) out of every ten people which might not sound like much, but if you give the medication to ten million people then you are potentially helping a million people. This brings up the obvious point about potentially giving side-effects to the other nine million people. Or most problematically: Do patients understand their odds when they start taking these medications?

Some Background

In 1998, Kirsch compiled and analyzed data from numerous published studies that had compared anti-depressants to placebo. Kirsch’s meta-analysis found that the standard medications were only slightly better than placebo, and the difference was virtually insignificant. Not surprisingly the critics were harsh as Kirsch’s study called into question the entire rational and justification for the millions of anti-depressant prescriptions written every year. They claimed that Kirsch’s study was biased because of the studies he included in his analysis. So, in a stroke of genius, Kirsch, Scoboria, and Moore used the Freedom of Information of Act to gain access to all the studies that the drug companies had submitted to the FDA for the purpose of getting these drugs approved. They re-ran their analysis with the new data and again found that the placebo response was responsible for the majority of the effect. In the case of Prozac, the placebo response duplicated 89% of the drug response. Keep in mind that this was done with the companies own studies, so it is hard to find a more favorable database for the medications.

Where it got interesting was with the critics. The same issue of Prevention and Treatment that published Kirsch’s analysis of the pharmaceutical company data also published several commentaries-both pro and con. Kirsch’s critics did not argue with his main findings, instead they quibbled about the interpretation of the results. In their reply, Kirsch and his colleagues bluntly stated: “We are very heartened by the thoughtful responses to our article. Unlike some of the responses to a previous meta-analysis of antidepressant drug effects, there is now unanimous agreement among commentators that the mean difference between response to antidepressant drugs and response to inert placebo is very small.” One of the essays by a clinical trial researcher went on to explain that this miniscule difference between placebo and medication is commonly referred to by researchers, FDA reviewers, and a small group of critics as the “dirty little secret.”

In 2002, an interesting study in JAMA examined the effect of St. John’s Wort on depression and also seemed to confirm Kirsch’s results (2002, Vol. 287, p. 1807). The authors found that on most measures St. John’s Wort was no better than a placebo. This was blared out over the radio waves, prominently reported in the papers, and told to all Americans on the nightly news. Yet most of the early press accounts missed the more significant part of the story which was that there were three treatment groups in this study. Zoloft, one of the most common antidepressants, was also included in this study, and Zoloft was no better than placebo either.

It will be interesting to see how patients respond to these latest revelations on 60 Minutes. The facts have been around for a long time and are easily accessible on the Internet. But is this information passed along to patients when they are prescribed antidepressants?

35 COMMENTS

  1. I have taken virtually every available antidepressant on the market. The only one that has had any measurable success is Cymbalta. It has been a life saver for me. I have also benefited from Lamictal. I am diagnosed Bipolar 2, and I have severe depression. Antidepressants are highly over prescribed. Folks with mild/moderate depression are wasting their time and money. These meds will only work for people who have serious mental illness. These medications save many lives for people who really need them.

    • The fact is that these drugs, not meds but drugs, are not effective in treating depression at all. In fact, over a long period of time they even induce heavy depression. The psychiatrists and their buddies in the drug companies want people diagnosed as bi-polar to believe that it takes care of the depression but they do not. These drugs cause shrinkage of the frontal lobes, that very part of the brain from which the best of what we are as humans arises. The eventually interfere with cognitive processes. The psychiatrists giving these toxic drugs to people never tell them about the bad side effects so there is no informed consent. In the state hospitals people are forced into taking the toxic drugs whether they want to do so or not. All of these drugs create a chemical lobotomy, taking away peoples’ creativity and emotions. Psychiatrists are nothing more than flim flam artists selling their own brand of “snake oil” to the masses and are the shills for the drug companies producing these toxic drugs.

        • Sorry, I keep thinking about stuff that I forgot to post. These drugs often cause a person to experience mania and then the psychiatrists slap another label on them known as bi-polar. Bi-polar used to be a rare thing fifty years ago but now everyone is bi-polar. This is great for the drug companies because now this person can be made to take neuroleptics on top of the antidepressants so they get more money. It is no wonder that the Disability rolls for Medicare have skyrocketed with 850 adults and 250 children being added to the rolls each and every day! These drugs are useless, except for the drug companies, which make billions of dollars off of them every year. It’s no wonder that they don’t want the dirty little secret known because it is such a lucrative profit making venture for them.

          • Once the SSRI’s make you crazy and are then forced to take the anti-psychotics, you get diabetes. Now you have to take diabetes medication. It is all a big scam. My friend was put on these poisons and became a bloated mess. It is hard to believe.

          • Our adult daughter was prescribed two anti-depressants , out of hospital, while she was reducing lithium and that sent her into a bad mania. Since the last hospital had failed to document her akathisia to Risperdal, it was given to her again, and that triggered a horrible state for an extended time until Risperdal was withdrawn. Why don’t hospitals keep better documentation of patients’ responses to medications? There is no incentive to improve the treatment as we have come to expect in other areas of American medicine.

          • That mania after antidepressants are started could be easily prevented if the prescribing shrink did a decent examination or simply used tests like the Hoffer/Osmond Diagnostic to quantify their clients’ dysperceptions. You don’t give antidepressants to dysperceptive people as a primary treatment, because they’ll trip out if you do so.

          • “Once the SSRI’s make you crazy and you are then forced to take the anti-psychotics, you get diabetes.” True, the antipsychotics do cause extreme weight gain and diabetes, plus many more extreme adverse effects.

            But combining the antidepressants and antipsychotics is also medically known to make a person “mad as a hatter,” via a known adverse drug interaction called anticholinergic toxidrome. These are the central symptoms of anticholinergic intoxication syndrome, from drugs.com:

            “Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

            These symptoms are indistinguishable to the doctors, from the symptoms of “bipolar” and “schizophrenia,” not to mention anticholinergic toxidrome is not a billable DSM disorder, so it’s always misdiagnosed as one of the billable disorders by the psychiatrists.

            And I’d say that the fact that today’s “bipolar” drug cocktail recommendations:

            http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/treatment/con-20027544

            Which recommend combining the antidepressants and antipsychotics, a medically known way to create “psychosis,” via anticholinergic toxidrome, is a much bigger “dirty little secret” than “this miniscule difference between placebo and medication is commonly referred to by researchers, FDA reviewers, and a small group of critics as the ‘dirty little secret.'”

            And this iatrogenic illness creation system, that comprises the psychiatric “gold standard” DSM system of today; and the whole reason for the existence of the scientifically invalid psychiatric industry at all, has even more “dirty little secrets” behind it, according to an ethical pastor of mine.

            My ethical pastor confessed, after reading my medical records and research, that the “dirty little secret of the two original educated professions,” medicine and religion. Was that the true function of the psychiatric industry, historically and now, is to cover up easily recognized iatrogenesis for the mainstream medical community, and child abuse for the religions. By defaming, discrediting, torturing, and murdering people to cover up the easily recognized medical mistakes of the mainstream doctors, and medical evidence of child abuse for the religions.

            The “dirty little secrets” do seem to run quite deep, and are quite disgusting, when it comes to all of those who profiteer off the psychiatric industries current crimes against the innocent, and unjustly misdiagnosed and iatrogenically harmed.

            Especially giving, “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012). Individuals with psychiatric illnesses and a history of trauma also appear to display significantly higher functional impairment than the remainder of the sample (Cotter, Kaess & Yung, 2015).”

            Implying, wrongly misdiagnosing child abuse as one of the made up psychiatric disorders, resulting in inappropriately drugging a person, is doing more harm, than good. But also that the psych drugs may actually help the small percentage suffering from an actual “psychosis.”

            But right now, in the ballpark of 87% of those being forced to take antipsychotics, were misdiagnosed, and are being made worse on the antipsychotics, rather than better. Thus, all those who had dealt with either easily recognized iatrogenesis or possible child abuse cover ups, who were wrongly misdiagnosed and miss-medicated, should be weaned off the drugs. This is in the ballpark of 87% of those currently being miss and forced treated.

            Our courts should be made aware of today’s psychiatric misdiagnosis rate. And, that misdiagnosis, results in symptoms no different than proper diagnosis.

            This means we need drug withdrawal clinics, and seemingly ethics classes for a medical community that had delusions of grandeur their “dirty little secret” way of covering up their malpractice, is no longer unknown.

  2. The entire video and transcript is at http://www.cbsnews.com/8301-18560_162-57380893/treating-depression-is-there-a-placebo-effect/?tag=currentVideoInfo;videoMetaInfo

    Poor Dr. Thase. In front of God and the entire video audience on the planet, the only defense he could come up with amounted to a denial of the importance of statistical significance in clinical trials. 1-3 people helped out of 10? That’s good enough for evidence-based medicine?

    And, yeah, what about the side effects for the rest? Does a benefit for a minority justify the increase in diabetes, stroke, osteoporosis, etc. for the other 70%-90% arbitrarily prescribed these drugs? What’s the public health cost of that?

    I wish I could be a fly in the wall when, having seen 60 Minutes, patients who have been maintained for years on these drugs without any benefit ask their doctors the hard questions.

    I also see a tsunami in withdrawal syndrome, which I dread. Some people are going to find exit isn’t easy.

    • Very true. It takes as long to taper off these damned things as you have been taking them. People try to go off of them too fast and end up with a drug withdrawal reaction which then is interpreted by the psychiatrists as proof that people are “ill” and they smack them with even more drugs. It is the most unbelievable thing I’ve ever seen in my entire life.

    • The drug companies. The drug companies set up these fake scientific studies which are rigged by the way that they choose the people who participate in them. Then, the studies only run for about six weeks. On top of that, drug companies write “scientific papers” about these “scientific studies” and have famous psychiatrists who get paid by the drug companies to sign their names to them. The FDA never sees any of these negative studies. They are kept hidden by the drug companies.

  3. Why did it take so long for people to wake up and see that following the money is all it takes through the twists and turns of biological psychiatry?
    Now that patents are expiring, the truth comes out.
    When people say, “psychiatric drug X saved my life”, I think they are improving because they had a doctor who took time and cared about them, which is rare.
    The placebo effect of a kind and caring doctor is worth a lot. But it is easier and more profitable to prescribe a drug. Read Dr Carlot’s book, where he describes knowing that it’s all b* but caved in because he has to maintain his financial lifestyle.

  4. “It will be interesting to see how patients respond to these latest revelations on 60 Minutes.”

    You can find out by reading the comments on cbs’s website. I read them. It as an avalanche of basically three types:

    1: Of course antidepressants don’t work for people who don’t have [the biological cause of] depression. They posit that mild to moderately depressed people are only diagnosed because of expanded diagnostic criteria and are really just dealing with normal life’s ups and downs.

    2: Some people may get tricked by placebo’s, but not me. I know my medication works for me, I’m one of the 10% that needs them like insulin for diabetes (I think probably 90% of them will say this)

    and my favorite:

    3: Nobody whose ever had depression would ever question antidepressants or psychiatry at all. These people [kirsch, whitaker, breggin, ect] have no right to talk on the matter. (What an arrogant assumption that everybody whose ever had psychiatric symptoms loves psychiatry and it’s drugs, that there’s no such thing as antipsychiatry mental health consumers or psychiatric survivors, and that only perfectly well people would ever criticize psychiatry.)

    Hope that wasn’t word salad.

    • EAC: Beautifully stated.
      I had a psychiatrist who was pretty much anti-drug, and talk therapy oriented.

      He had gotten a sample of an early tricyclic years before and decided to take it, even though he wasn’t clinically depressed.

      He told me, “Even if I had been depressed, the side effects are intolerable.” To my knowledge, no doctor has ever “understood” it better.

      In their arrogance, they are not mentally ill or delusional in any way. (Except for the “I’m God” delusion.)

      This doctor removed my diagnosis before the insurance ran out, however, it followed me into my regular medical file where it remains.

      The people you described above are, as Dr Breggin calls it, “spellbound.”

      Drugging is easier, faster, gets the patient out of your office within the allotted ten minute time frame, and you make lots of money, even though you only got C’s in medical school.

      I am so thankful to Peter Breggin, and Robert Whitaker.

      I actually took Mad in America to my appointment (several years ago, and after above doctor had died) and with naive wonder said, “You have to read this!” He said he had studied the history of psychiatry in medical school and if I remember correctly, increased my “meds.”

      Correction: I misspelled Dr Daniel Carlat’s name in prior post.

        • Forgive me, Stephen, but this is the second time you’ve called psychiatrists “artists.” Please do not defame all artists, by calling psychiatrists “artists,” as they are the antithesis. You may call them psychopaths, if you like, but please don’t call them “artists” again. They are not.

          • And please let me explain why I say this. I agree, mainstream scientifically provable medicine is an art, of sorts. But, psychiatry is not. It is cut and dry.

            The antidepressants and ADHD drugs have been known for decades to CAUSE the bipolar symptoms (and now violence and suicide). And the antipsychotics / neuroleptics have been known to CAUSE the schizophrenia symptoms (and now they’re known to cause them in the long run.)

            Psychiatry is not an art, it’s nothing other than defaming and harming others for “social control.” That’s the opposite of what artists believe in, we want to make things beautiful. Psychiatry is the antithesis of art. Please don’t defame the artists.

      • “I actually took Mad in America to my appointment (several years ago, and after above doctor had died) and with naive wonder said, “You have to read this!” He said he had studied the history of psychiatry in medical school and if I remember correctly, increased my “meds.””

        And here is what goes on in the back of their minds when they respond like that:

        “pfft, I learned everything I need to know in medical school. I better have, I pulled out 100 grand in student loans to go there. Ya see, I paid for the QUALITY education that only 6 figures can buy, and now here you are referring me to some 10 dollar book and telling me I should read it? How dare you insult my ten years of schooling that way. I’d rather take the possibility of being ignorant and harming thousands of my patients for 40 years than to even consider anything that would devalue my formal education.”

  5. Gentlemen, thank you for another thoughtful post on this topic. I enjoyed the 60 Minutes segment and thought it portrayed well what we scientists have long known to be true: the therapeutic benefit of antidepressants over placebo is small to non-existent for people with mild to moderate depression. The show could have made more of the substantial costs incurred to people who take antidepressants in the form of adverse effects (see Robert Whitaker’s post from today for more on this topic), but only so much information can fit into a 13-minute news report. I am hopeful that this kind of national media attention will contribute to an increasingly honest discussion about the strengths and weaknesses of the dominant biomedical paradigm in the American mental health system.

    I can’t resist sharing a little story regarding Kirsch’s 2002 Emperor’s New Drugs paper. Kirsch and his colleagues initially submitted their manuscript to two top psychiatry journals (I’m assuming Archives of General Psychiatry and American Journal of Psychiatry but cannot say for sure). Both journals declined to send the paper out for review. The paper was then submitted it to Science, where it received glowing peer reviews and was accepted virtually without revision. The paper got far along enough in the publication pipeline for Kirsch to receive the page proofs. Then, it was rejected! The apologetic editor cited concerns about losing drug advertising revenue. Kirsch then sent the paper to Prevention and Treatment, which was an excellent but relatively new journal. The 2002 Emperor’s New Drugs was almost entirely ignored by the media. It wasn’t until Kirsch and colleagues 2008 study that the antidepressant-placebo topic really gained some traction in the popular media, ultimately culminating in last night’s 60 Minutes spot.

  6. was on prozac for over 2 years, been off now 22 months, still no emotions, never feel tired, smell, taste, ability to feel touch/pain impaired, pssd, hearing loss, memory, concentration problems, never feel hungry/thirsty, loss of muscle tone/body shape changed?

    How can I fix this? Psychiatrist wants to put me on Mirtrazapine or Gabapentin, Doctor wants me on Amatryptaline? They’ve been trying since I came off the stuff. Suffered horrendous withdrawals. I knew it was the drug and I know i’m damaged, but will I ever return to normal without another poison pill.

    • I’ve got all sorts of permanent problems from childhood psychiatric drug exposure. Some of them are so bad that I’ve been on disability since I was 18 because of them.

      I, however, fight my ass off to stay off of the drugs no matter what. Even if one of them might help me in the form of causing apathy so I’m no longer as upset about my life as I am, I still wouldn’t take it just by principle.

      Why would you say:
      “but will I ever return to normal without another poison pill.”

      You will never return to normal WITH another poison pill. You may likely be permanently damaged, and that should make you angry. Nobody with the tiniest bit of respect for themselves would go and abuse themselves with the very same substances that damaged them in the first place. Be angry, stay angry and work to try and find justice.

    • Oh and there’s one more thing I just thought of. I do believe that most everybody ever taking antidepressants are just like you except for one thing and that is they don’t realize that the drugs caused this or that problem. Most people suffering a lack of emotions after coming off of AD’s would just attribute that to their illness and continue taking drugs again.

      You had/have a level of insight that is obviously much better than most people. You have the opportunity to evade the traps and scams and I really hope that you do.

    • I have often wondered the same thing, chrissy. Gabapentin will probably not help, however, it is one of a few drugs that can be stopped cold turkey after you find out it makes you feel worse.

      I took it for sleep but would wake in the middle of the night and feet “lost”. I don’t know any other word to describe the feeling.

      I saw a new therapist twice. She typed in a laptop the entire time, but she gave me some valuable advice when I asked her “how do most of your patients improve?” She said, “They decide they don’t want to live like this anymore.”

      I was miserable while going off of anti-psychotics, and made others miserable, too. I had made a decision that I didn’t want to live like this (meaning at the mercy of doctors and drugs) anymore. I will never again have a psych hospitalization!

      A funny thing happened when my insurance was gone: No more “mental health ” coverage, therefore, no more doctors. They had been giving me samples of Seroquel and it was oh so important to stay on those meds! Well, when they kicked me out for not paying the therapy bill, the samples were gone, too.

      It wasn’t pleasant, but I am so glad to be off of it.

      If they are only offering you more drugs, more trial and error to your brain, “just say no” It doesn’t mean you are crazy to go out on your own and be yourself.

      It will not be pleasant, it will be painful, but it is worth it. Don’t give up, and don’t give in.

    • Chrissy, I can’t offer you a quick cure, but click on my name to visit my site — we offer peer support for prolonged antidepressant withdrawal syndrome. People can and do recover without taking additional psychiatric medications, which frequently cause additional harm to the destabilized nervous system.

  7. Over the last 24 years, I’ve been tried on over 30 different psych meds for depression, anxiety, agitation. Maybe 3 or 4 of them worked for a few months before pooping out. I’ve been in the hospital once or twice when on few meds, and the doctors felt convinced that the lack of medications was a contributor, so they increased them. But I’ve had to go to the psych hospital lots of times when compliant on multiple meds, and the doctors sometimes didn’t change anything (not much left to try). So how do the medications help again?

    Whitaker’s book raises the possibility that the medications have made my difficulties more chronic. All of the medication-tapering advice I’ve read says (1) to go very slow, and (2) that tons of social support is absolutely critical. I have little social support available to me (and a nervous system that severely gets in the way of that), so basically I’m screwed: I don’t have the resources needed to be successful at this. I can see the possibility (even plausibility?) that over the long run, maybe I would do better off of medications, as many other people have. But in the short run, it’s likely I would do worse, or at least still poorly enough to end up in the hospital yet again. I can’t handle that process, cope with it alone, and no one wants to really put up with me while my emotions and agitated behaviors are bouncing off the wall for a few months, so I’m stuck staying on medications that don’t really help and that possibly contribute to the chronicity. It’s a trap.

    Bob, congratulations on the new and improved website, and all the good additional bloggers.

  8. Most of the comments here are of the same view but none of them explain what the problem actually is.

    Forty years ago designers and engineers accidentally discovered a problem with human physiology and crowded knowledge work conditions when it caused mental breaks for office workers. The cubicle was designed to block peripheral vision for a concentrating worker to deal with the vision startle reflex. Thus stopping it in offices by 1968.

    Today the “special circumstances” for Subliminal Distraction exposure can be created by almost anyone, anywhere. Explained in first semester psychology the brain deals with the vision startle reflex subliminally making SD exposure impossible to consciously experience.

    When it happened to my wife, I was stunned to find that this problem I had learned about as a 22 year old engineering student in 1966 is unknown in mental health services.

    Connie had severe reactions to drugs I was assured harmless, began to decline, and died in January 13, 2010. There is a recent story about another death from these drugs.

    In nine years of my investigation I found only one doctor who said he had seen and correctly diagnosed the psychotic-like believed to be harmless, temporary episodes when in residency.

    No one has looked for other outcomes for this phenomenon. But chronic exposure would keep the psychotic episode ongoing. Intermittent repeating exposure sessions would create repeating manic episodes that would be diagnosed as Bipolar disorder.

    People who respond to placebos have enough Subliminal Distraction exposure to make them hyper-suggestible,but not enough for the full mental break. This suggestibility first appeared as Jumping Frenchmen of Maine in 1880. The conditions of the bunkhouses for French Canadian lumber jacks allowed SD exposure.

    An incident in Ontario, Canada elementary schools last year shows a wide range of psychosomatic symptoms from SD exposure when industrial Wi-Fi was installed so laptop computers could be used anywhere in classrooms. Parents blamed Wi-Fi transmitter EMR. See the links at the top of my Home page for pictures.

    If you know some one to explain what happens in the brain from a massive number of subliminal failed attempts to execute the vision startle reflex to cause a manic episode, period of psychosis,and potentially a short coma, send them to my site. I put a ‘guess’ on the Background section of the “Letters” page. My email is coded on the “Contact Researcher” page. Connie’s case is on the “Personal Experiences” page.

  9. Since they worked for me a couple of facts.
    1) Drug studies – the people in them know the outcome.
    a- I did a few for gout and one drug that worked was pulled for another reason, I checked the company info online and it was stated there. also very few people in those studies.
    2) Did they take the med as directed most people do not.
    3) true coming off SSRI is like heroin with drawl, flu,etc.
    so the trick is this if on 100 cut down to 75 for a week
    50 a week, 25 etc till off. Some times the drug stops working. so taper off then come back with 200 and then start the normal dose.
    4) you can’t really measure the 53 chems in the brain. so the measurement metric is what? In the case of gout we could pull a value of uric acid.
    5) not all drugs work the same each of us is slightly different.
    6)depression is chemical for some of us, and if a sugar pill works then so be it (maybe it the sugar). I say if it works for you then stay on it. Each one of us needs to manage our health, not just leave it up to a doctor. Then there is my mom who at 80 only has a script for glaucoma eye drops.

  10. Oops since the article mentioned cost. way back before the 70’s people were put away , with meds more are out. wonder what the cost would be to rehouse the same percentage of population today. BTW 8 out of 10 drugs never make it to market.

    And not just with the meds sometimes you have to add exercise and hobbies.

  11. I took myself off of Paxil after a year of use. I saw no benefit other than I really didn’t care to think about what was causing my anxiety (I lost my son to a drug overdose a year ago). I could not cope, i.e. angry, no desire to do anything, see anyone or go anywhere, and panic when I did. So my MD stuck me on Paxil, no more anxiety…off to the sunny, happy place!! However, I simply didn’t “deal” with any of the thoughts. Well, guess what, in three weeks I gained 31 lbs!!! I had no apetite or desire to eat, but that makes no difference. But I stuck with it for a year just to see if there was a benefit. Finally I simply got tired of going to the MD every month for a new scrip so I quit cold turkey! Other than a day of the jitters, and a couple weeks of a whooshy head, nothing, no side effects for me. Wonder if it was really helping to begin with? However, now I have this weight issue, bloating and loss of muscle tone (very flabby), which I can’t seem to get under control. Where in the hell does it list that in the side effects? Now I have forced myself to deal with the issue. Whether I feel better or not mentally remains to be seen. Physically, I feel fat, flabby and miserable. Should have taken my chances without drugs. Damn drugs!! Damn pill pushing MDs. Damn TV for pushing the drug commercials!! Damn, damn, damn!!