Playing the Odds: Antidepressant ‘Withdrawal’ and the Problem of Informed Consent

Stuart Shipko, MD
277
5727

If I thought that it was possible, I would have opened a string of clinics all over the country to help get people off of antidepressants.  Unfortunately, the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe and long-lasting than the medical profession acknowledges, and there is no antidote to these problems.

Outside of using a benzodiazepine, I don’t have a lot of suggestions.  Reinstating the medications often does not help and sometimes there is a negative reaction. In the past I worked with SAM-e, thought to enhance neurotransmitter synthesis, and L-tryptophan, a precursor of serotonin.  It had placebo value, but was not an ‘antidote’ to the problem

The problem starts with nomenclature.  The citizen scientists of the Internet have labeled the problem ‘protracted withdrawal.’  To physicians, withdrawal is a phenomenon that starts when the blood level of a substance drops to near zero and persists for a week or two.  The concept of ‘protracted withdrawal’ is inconsistent with the very definition of withdrawal.  So when a patient tells their doctor that they have ‘protracted withdrawal’ the doctor draws a blank.

Citizen scientists developed a set of corollary beliefs; primarily that the protracted withdrawal is largely due to stopping the drug too fast and that if one waits long enough that the symptoms of protracted withdrawal are going to go away.  My clinical observation is that long lasting symptoms occur even in patients who taper very slowly, not just those who stop quickly, and that there is no guarantee that these symptoms will go away no matter how long the patient waits.

What I have observed is that the ‘withdrawal’ symptoms occur while patients are on a steady dosage of the drug, shortly after stopping the drug and weeks or months after stopping the drugs.  The only precedent for this type of presentation is tardive dyskinesia (TD).  Tardive refers to symptoms that occur later and dyskinesia refers to movement disorder. TD is generally associated with antipsychotic medication, and is also a manufacturer labeled side effect of the SSRIs.  TD occurs while on antipsychotics, primarily occurs shortly after stopping them, and may occur months or even longer after stopping the drugs.  With the SSRIs, it is not so much a tardive movement disorder as a tardive problem with akathisia, a sort of constant restlessness or agitation that is accompanied by an agitated anxious/depressed state.  It is a very  uncomfortable sensation.

It is generally unappreciated that people who stop SSRIs often develop a new onset of severe depression or anxiety months after stopping the drugs.  It took me years before I realized that this is what was occurring, but this seems to be fairly common.  Patients often did well for months, only to develop fairly acute profound states of anxiety and or depression.  The anxiety and/or depression was not a relapse, because the patients never had these symptoms before starting the drugs.  Because people are thinking of the discontinuation problem as withdrawal, they are not considering the later onset symptoms as related to stopping the drugs.  What is somewhat frightening to consider is that patients with tardive dyskinesia sometimes do not manifest symptoms for years after stopping antipsychotics.  Will this be the fate of those who stop SSRIs?  This won’t be known for a long time, particularly if nobody is doing careful research on the topic.

Tapering the drug slowly definitely minimizes the acute symptoms that occur when stopping an SSRI but does not appear (IMHO) to have much bearing on the longer-term and late-onset symptoms that occur when stopping an SSRI.  I have not found a meaningful antidote to the longer-term symptoms.  L-tryptophan boosts serotonin in the central nervous system, but has not benefitted my patients.  Some websites advertise supplements that increase glutathione, a liver detoxifier, as an antidote.  SAM-e increases glutathione, and has not proven to be particularly helpful.  SAM-e also increases neurotransmitter synthesis, and even when taken with L-tryptophan, does not seem to make much difference.  Benzodiazepines seem to offer some relief, but they are dependency-forming and if taken regularly result in another dependency – although this is worth it for some patients.

Not only do some patients stopping SSRIs develop a variant of tardive akathisia,  a percentage of the patients who develop this problem will find that reinstating the SSRI will not alleviate the problem and may actually make the problem worse.

The difficulties that occur when patients stop SSRIs, particularly after 5 or more years on the drug, have not been fully acknowledged by physicians and citizen scientists alike.  In my experience stopping SSRIs after 5 years of cumulative exposure can be risky, and I am not advising anyone who has taken the drugs for 10 years or more to try to stop unless they are willing to risk disabling symptoms.  The documentary movie, “Numb” by Phil Lawrence shows what can happen when a person taking Paxil for a decade tries to stop the drug.  I’m sure that there are some people who can stop SSRIs after taking them for long periods of time, but prior to making such a decision, people are entitled to have a good idea of what can happen to them.

Those who are on self-help websites want to believe that if they wait long enough (however disabled they may be in the meantime) that they will get better.  The people that I have seen, suffering and disabled, waiting years for the ‘withdrawal’ to end are heartbreaking – particularly when they may be waiting for something that is not going to end.  If tardive dyskinesia is any guide, sometimes TD does go away, and sometimes it persists indefinitely.  I expect that the same is true for SSRI withdrawal.  The incidence of the late-onset and longer-term symptoms is not known because there has been no systematic study of the problem.

Absent a meaningful treatment for the withdrawal emergent symptoms, proper informed consent before starting OR stopping the SSRIs is critical.  Nobody should take SSRI antidepressants unless they know exactly what they are getting into. Informed consent for the SSRIs must necessarily include information concerning the difficulties related to stopping the drugs as well as the symptoms that occur when starting the drugs.  Also, patients who are considering stopping the drugs must also have informed consent concerning possible difficulties.

For this reason, I recently published an eBook, “Dr. Shipko’s Informed Consent for SSRI Antidepressants.”  It is the first book that gives warnings for patients who are considering stopping SSRIs as well as those who are considering starting SSRIs.  The book is short and readable and does mention that the drugs can be very helpful for some patients.  Most books on the topic are completely negative about using these drugs, and the bias is off-putting for patients who are trying to make their own decision about taking SSRIs.  I would hope that patients find the eBook palatable and reasonably objective.  Patients in my practice find the book helpful, and when a patient is still interested in an SSRI even after reading the book, I take this as a serious indication of how much they are suffering, and may find that the risk/benefit ratio tilts in favor of trying an SSRI.

If you know of someone who is thinking about starting or stopping a SSRI, please consider sending them a copy of ‘Informed Consent.’

Support MIA

Enjoyed what you just read? Consider a donation to help us continue to produce content, provide up-to-date research news, offer continuing education courses, and continue building a community for exploring alternatives to the current paradigm of mental health. All donations are tax deductible.

$
Select Payment Method
Loading...
Personal Info

Credit Card Info
This is a secure SSL encrypted payment.

Donation Total: $20.00

277 COMMENTS

  1. It makes me so angry that even though I’ve thought I’d heard it all, this article tells me that things are even worse than I thought. Very informative, but I wish this situation didn’t exist.

    Maybe we should be pushing harder for research on getting off these psychiatric poisons. Here we have a doctor who is trying hard to help people get off these drugs, but he himself says he’s come up with little or nothing. How sad and alarming.

      • Just wanted to share that I had a similar situation with a benzodiazepine. Please don’t underestimate the grave consequences stopping a medication can have. I’m glad I stopped, but my protracted withdrawal (ten years now) includes chronic, severe insomnia, which I didn’t have before being prescribed a “low” dose for 8 years. I am not sure I would have stopped if I knew I would NEVER EVER sleep well again. I hate big pharma as much as everyone else, but like the wretched Hotel California, we’re in it.

        I guess I will add that using a benzodiazepine to deal with protracted withdrawal of SSRI’s is probably not a good idea for the majority. I was in tolerance withdrawal (klonopin) for several years and doctors diagnosed it as somatization. I finally figured it out, they didn’t. I was dependent, so the only options were to either increase the dose repeatedly over time or quit and live with the iatrogenic insomnia. I chose the latter.

        • That’s a great thing Laurie. I’m sorry your so uncomfortable. But I think you will fair in the long run. Shrink’s are overly obsessed with the concept of addiction. That’s why clonazepam is the most favored benzo in their arsenal. They speculate this “long half life” BS. And attribute to it magical qualities (“it’s less addictive than Ativan”). And with that, the patient is usually medicated around the clock. So, if you take Klonopin more than once a day you will always have it in your CNS. And if you always have a drug in your brain, your always gonna want/need the drug. Especially when you run out. But if you can find a doc smart enough to bend the rule’s to your advantage then you can just take triazolam 2-3 x daily, and never become physically addicted to your Rx. You may want to keep taking it over and over (like beer racing). But that’s only a reflection of the weakness of character in the user. And not a bad side effect of the pill. You have to remember – Psychiatry is an institution that look’s at the big picture of “social control” of the masses deemed unfit to attend a black tie event. Your personal, idiopathic needs come second. And ego has a lot to do with it as well. The doctors have a mental blueprint of what they think is good social behavior. And they expect you to adhere to their prescriptive treatments. So if your using Xanax, Ativan, Halcion – PRN, then your a drug addict. But if you take Klonopin on a regular schedule – everyday at the same time(s), then your just following a plan set by your doctor. However erroneous/hazardous it may be. So, download Tor/i2p. Get aquainted with BitCoin. And be your own doctor/pharmacist. You don’t need years of worthless medical school. Just the Science portal of Wikipedia. You Go Girl !

      •  STUART SHIPKO, MD is 100% accurate in his assesment and analysis. I speak from experience as one diagnosed and on an SSRI. Im also a RN in Critical Care educated about neurotransmitters/horomones and the like. Withdrawl from SSRIs can be a nightmare. Ive been on Citalopram for 5 years for social anxiety and when you taper down there are definite side effects. Its scary, hard and it takes a lot of determination. This MD is trying to help people, not scare them. Inform them and empower them with knowledge and awareness. Please have some level of compassion towards the patients and not make it a drug company issue. Yes, I agree though, if people are scared to come off these drugs the SSRI companies will definitly benifit. But do you have any insightfull suggestions my friend?

  2. It seems to me hard to believe anyone could recommend these drugs knowing this information, especially in light of Kirsch’s work suggesting that the drugs are generally acting as active placebos and have little to no actual clinical effect, except in the most severe cases. I found this article extremely distressing, as Ted did – I knew it was bad, but I’d assumed and believed that time did allow this kind of brain damage to heal.

    And Stuart is right to distinguish that this is NOT a withdrawal effect. This is the effect of ongoing damage to the brain, which may or may not heal. It goes right back to Peter Breggin’s and Whitaker’s description of the neurological up- and down-regulation in response to enormous, enforced changes in neurotransmitter availability in the brain. There is NO excuse for even considering doing this to a patient, especially to a person suffering from mild to moderate depression, when there are so many other options available.

    Ugh!

    — Steve

  3. Oh man, I should not have read this. I am one of those waiting and hoping for recovery after coming off 20 years worth of anti-depressants, mood stabilizers, anti-psychotics and benzodiazepines, a little over 4 years ago. I have no choice but to keep going. I refuse to swallow anymore of that poison.

    I do want to let Dr. Shipko know that withdrawal from benzodiazepines is every bit as horrendous and damaging as anti-depressants. They will give temporary relief perhaps but introduce a whole other level of hell. All you have to do is go to Benzobuddies.org and read. There is a protracted group on the forum with over a 100 people in it, that is hidden from public view. Those people are off the drug over 18 months and still suffering very badly. Please don’t ever think that benzo’s are an answer to anti-depressant withdrawal. It’s just not true.

    It was at least somewhat hopeful to hear that Dr. Shipko considered opening clinics to help us. I really hope he doesn’t walk away from that possibility. There seems to be nothing that helps this as he has discovered. We do however need validation and the comfort of hope.

    I purchased “Numb – the Documentary” and watch it often to comfort myself that what I am going thru is real as is doubted by the majority of medical professionals that I have seen.

    I hope my fellow psych drug survivors that are living on hope don’t see this article because hope is ALL we’ve got to hang onto.

    • Shipko has no research to back his claims. He is probably seeing the 1 in 10 000 who seeks him out because he specializes in these problems. (see my analysis at the bottom of this post)

      He is also probably writing this to market his 28 page “book” for $ 4.75. Those who really want to help, like Monica, give away the information on their website. It is not difficult to put 28 pages on a website.

      Shipko also serves the pharma industry well by scaring people away from stopping SSRI. He is probably worth millions to the industry!

      • I would not be so harsh. My doc truly believed he helped me, he may have only seen me for 15 minutes, and prescribed so much, but he believed what he was doing was helping. My sister and him together…… that he could fix any emotional ailment with a prescription within 15 minutes of meeting me? And putting me on “what she was on”, she was amazed. We had not grown up together, did not really know each other. So must be “genetic” this non existent illness. Now I see the pattern, the pattern of her life into chaos, I followed her on the same path ten years later. She can not give up due to her suicidal spirals. I have never been suicidal in my life, and apparently that somehow has become the somehow level of deep despair. Suicidal spirals, caused always by WD, or even while on her polydrugs. Please Doctor, be brave, go one any one of these drugs for three weeks, then go CT. You can do it after 3 weeks. Then you will understand, until then you are looking at us from the perspective of someone looking at goldfish in a goldfish bowl. I am glad you realise there is WD, but how many patients have you previously prescribed this stuff too? I am glad you have follwed the progress of these horrific drugs. I was one of the first guinea pigs, I trusted, I was depressed, I trusted, when I never usually trust. I will never, ever trust anyone again, except myself.

  4. I hope Dr Shipko is absolutely certain of his facts, as this article is likely to be read by thousands of people hanging on like Whoopsie and myself, desperate for relief from horrendous withdrawal symptoms that have lasted years – exhausted, in pain, disabled but alive ONLY because of the hope that things will get better and we will recover. This article extinguishes that hope – if we choose to believe what it says.

    Personally, I think it is irresponsible of both Shipko and MIA to deliver such a doom-laden message to so many of us – a message which may be too much for some of us to bear – without providing more caveats and balance. How many patients has he seen in this unending state? Roughly what percentage of those in withdrawal are likely to suffer perpetually? If he doesn’t have the answers, then at least he should acknowledge that his sample may be biased (i.e. long term sufferers seek him out because of his reputation), and that his thoughts and guidance are based on his necessarily limited experience in practice rather than a large study.

    There are other withdrawal experts – some who have worked with significantly more patients than Shipko – who tell me the exact opposite. That everyone does eventually heal (whether from benzos or SSRIs), that it can take many years, that we should never give up hope. I choose to listen to them.

    I also take comfort from the following thought: SSRIs and benzos have been around for more than thirty years and have been taken long term by hundreds of millions of people. If a significant percentage of people never recover then where is this cohort today? I’ve been involved in the withdrawal community for five years now and have only come across maybe ten people who claim not to have recovered fully after a few years, and most of these have made great improvements.

    Shipko may be right that this process takes a very long time for some people, and that for one or two it seems to go on indefinitely. But it appears to me that the odds of that happening are very small indeed, and that this message must also be conveyed. There are a lot of very fragile people out there.

    • I’m sure that Dr. Shipko will respond, but I wanted to convey that I’ve actually been in conversation with him about this for a year. He acknowledges that he may have a select group; people who come to him tend to be in rough shape. We’ve discussed other ways to interpret what he was finding in his practice. He acknowledges that people do get off the drugs, and he is certainly all for it. But what he posted today is consistent with what he’s been saying to me for the past year, that there seem to be some people who really are permanently harmed. If true, it seems responsible of us to publish it in the interest of fully informed consent when one chooses to use a medication.

      • “If true, it seems responsible of us to publish it”

        Yes of course that’s right – but neither you nor Shipko have any hard evidence that it is in fact true. You have his clinical experience, which he acknowledges may contain bias. If he is going to present something as fact then we need more data from him to back it up. How many patients? What percentage? etc etc

        He believes it to be true and it may indeed be true (to some degree). But you haven’t proven it and therefore your point about responsibility doesn’t stack up (unless delivered with caveats). Given the extreme sensitivity of this information MIA ought to be seeking out the many other experts who hold an opposing view and ensuring that those of us affected by this have some vestige of hope to hang onto.

        PS not surprised to have just seen this on one of the online groups: “Dr. Shipko’s post in MIA made me so suicidal again and I haven’t felt that way in months…”

        • heretohelp,
          I find it unnecessarily alarmist too. Getting better can take a very long time but there are a lot of us figuring it out…I hope you’ll take a look at the links I posted in response to Shipko.

          it’s an individual journey and the autonomic nervous system dysregulation plays out differently for everyone, but it’s a puzzle that can be paid attention to and healed. There are a lot of us managing to do it. Please do not lose hope. To accomplish the task we must in part believe we can figure it out…otherwise we give up…it’s no small task to accomplish it.

          hang on…I’ve seen plenty of folks who’ve been sick for years improve and recover and thrive…and I’m in process…always getting better, albeit slowly…but very undeniably always moving in the right direction.

        • I think some of this is unfair. I read Dr. Shipko’s article as his own clinical experience, and by definition that is a small group. Dr. Shipko also clearly stated the need for research. When people start threatening suicide because they are upset by what an individual clinician has written, this puts the entire website at risk. Each of us, no matter how dire our circumstances, has to take responsibility for ourselves. Either we want these conversations to be frank and open, or we’re asking to be paternalized. Hope is something we develop within ourselves, something we hang on to that serves us, and one doctor’s clinical experience or conclusions is not taking mine away. Personally, I did not read Dr. Shipko’s article as recommending hopelessness at all, and I feel that the comments section fills out the picture.

          • Good points, Nancy, but nobody’s threatening suicide here. HERETOHELP reported that somebody on another online group felt suicidal, which is not a threat.

            Thanks to all. John

          • I agree with Nancy and I hope this doesn’t hinder any future discussions about the possibility of permanent damage. If it can be discussed about in relation to crystal meth or antipsychotics or even cocaine I don’t understand the resistance to it being explored with SSRIs.

            And can I just make a parallel with what’s going on with Propecia sufferers because some of them have symptoms which are very very similar to protracted withdrawal and a doctor came out last year in mainstream news to say that he suspects the damage “might be permanent” and the chance of recovery “less likely the longer they have these side effects” and the Propecia community aren’t vilifying him they’re glad to hear someone finally acknowledge it.

            There is obviously a overlap with SSRIs and anti psychotics in relation to symptoms and withdrawal so it isn’t far fetched to assume that some of this damage might be permanent as it is with APs. At least one study I know of showed stunted growth for kids on SSRIs, so for those of us who are dealing with this and took medication from teens up until our twenties who years after the drug are seeing little improvement in our symptoms how can we be assured a recovery? What about all the people battling PSSD years later or who now have drug induced medical conditions? Some are getting better, some are not.

            I am baffled at how much no one wants to approach this issue. When I first decided to taper I also read the horror stories and I was terrified, should the horror of withdrawal have been hidden to spare peoples feelings? Had I know what the result would be in getting off medication I’m not sure I would have done it but by then I was already struggling badly with what I thought were side effects (now I think most of was just medication damage) and was willing to risk it in hope of getting my life back.

            I find the issue of permanent damage has become a dirty ban worthy word in some circles, it’s like no one want to talk about it and are willing to marginalize those that do. As if it isn’t natural to speculate that, as with the use of other drugs/substances, for certain people a point is reached when a lot of damage done isn’t reversible. I find discussing this possibility preferable to just acting like people still having problems after taper don’t exist or just have some kind of “anxiety” issue. I think that for accountability and the purposes of getting of full, accurate picture of exactly what these drugs can do and have done and for those of us still struggling without any recognition of the damage that’s been done to us, this issue of permanent damage needs to be fully explored. I don’t find this article scary, it was scary when I finally tapered off these drugs only to find myself practically disabled and with little improvement month after month year after year.

            And it’s very invalidating for people who’ve already been treated like collateral damage to then have this repeated by a refusal to discuss this issue.

          • Thanks for your interesting comment, Savanna. But, far from resisting discussion of permanent damage from SSRIs, we’ve discussed little else in the 170 or so comments that preceded yours.

            No one wants to approach this issue? We’ve all been confronting it here alone for a week now. EVERYBODY wants to talk about it here and is doing so, and nobody is or can be marginalized. Only the moderator can remove comments, and he’s only done so a couple of times and not to stop discussion of permanent SSRI damage.

            John

    • Thankyou, your comments are very, very appreciated. If it takes years, I dont care, if I last that long. I can then enjoy my grandkids, actually enjoy exercise and walks again. I have my brain back, but not my emotions. I have been spared the heart attack from the drug induced hypertension. My fingers no longer swell, I no longer fall over unexpectedly, I no longer get ear infections…………I will hopefully have spared myself a shortened lifespan of 25 years. Five years isn’t long after 10 years of hell. Took me ten years to lose everything while on these drugs. So if I have a life after ten years? I hope so. SSRIs have not been around 30 years in Australia. I took the first of them 20 years ago. Lucky me 🙂 Not addictive like benzos …. quite safe….. blah, blah, blah… look at me now? Disability Support pension, unemployable, me and my son were homeless six months ago. And someone says stay on the poison? Everyone reaches the stage THEY CAN NO LONGER stay on this stuff, or they die. So choice is, do you think you have enough years left to survive the WD? but I just wish I had found out the nonest truth about WD, before I started my WD journey. Shock horror, years, not months, yes a rude awakening, but to say some never recover, is very cruel to say, as if they stay on AD they have no life either.

    • Irresponsible or not, I am myself relieved to read that I’m not alone in this world having suffered intensely unpleasant physical and mental symptoms for 13 years after taking paroxetine and then sertraline, both low doses. I had to quit rapidly because I developed horrible side effects on sertraline after about a year, called the doctor who advised me to increase the dose which I did taking one tablet only and it all got worse. I had to get off fast. This was thirteen years ago and after two years of crawling on the floor with horrendous and scary withdrawal problems of which some still remain, I now have constant akathisia and can’t do anything for more than two minutes at a time and then I go pacing around the house for hours on end. It has been the same for 13 years with no relief whatsoever. My body is damaged – ataxia, violent shaking and constant shivering, fainting, involuntary movements, pain everywhere and confirmed neurological damage (hyperreflexia, foot drop and nerve damage etc. I was a normal, healthy woman who went to the doctor for sleeping problems caused by too much work at odd hours and was prescribed these rat poisons that have totally ruined my life. I haven’t seen any improvement in 13 years and just as dr Shipco, I suspect problems like this can be permanent. I now and then manage to get a prescription of Ambien and that actually gives me some relief – a few hours of relative but false wellbeing. It does nothing for the physical damage but it makes me able to sit still and watch TV or read a book. I wouldn’t recommend that solution to anyone else though because they are highly addictive and some people get weird reactions from them but for me they give some kind of relief .

  5. I have recently read both of Dr. Shipko’s e-books; the one on anti-depressant withdrawal and the one on benzodiazapine withdrawal. I think they are both very worth having/reading for anyone interested in the topic.

    Like Ted, I am outraged. To me reparations are in order for the lives ruined by these drugs.

    • Jim,

      I’m outraged too.
      And I certainly think there ought to be reparations for people who were not informed, but what about this statement by the blog author?:

      “Patients in my practice find the book helpful, and when a patient is still interested in an SSRI even after reading the book, I take this as a serious indication of how much they are suffering, and may find that the risk/benefit ratio tilts in favor of trying an SSRI.”

      I’m all for adults making their own choices. But there are times when all I can say is that I just don’t get any of this anymore. I really don’t. It makes no sense to me.

      Duane

      • Supply and demand.
        We have people *demanding* immediate relief.
        Do we insist on freedom to choose, and then sue the supplier?

        If there was not informed consent (and there rarely is), then it would seem there is a case. But what happens if we begin to see consent take place (finally, for once), and people continue to demand psychiatric drugs?

        It seems the short term often turns into long-term, polypharma, addiction, lots of fallout….

        Not sure what the answers are in preventing more injury.

        Duane

        • There are two answers I can think of:

          1. People only demand immediate relief when they believe that it is on offer and won’t injure them (e.g. give them brain damage, which is what “protracted withdrawal” is).

          2. Doctors and Pharma like to pretend that this is all about the freedom to choose, but they are actually very selective about the “immediate relief” that patients are allowed to choose: brain-damaging drugs, yes, by all means. Suicide? Self-harm? A big fat NO– and how dare any of us evil survivors suggest that people’s rights should not be taken away to justify preventing suicide or self-harm!

          It all seems very disingenuous to me when people talk about this as an issue of personal freedom.

          If people want immediate relief that IS harmful to their health and they are fully informed of that matter, let them take heroin– at least you can kick that after 10 or 20 years and still have a fully functioning brain or body. I know it sounds hyperbolic, but we have to STOP PRETENDING THAT PSYCH DRUGS ARE ANY DIFFERENT THAN RECREATIONAL DRUGS. There is no difference, moral or chemical.

          The only difference, in fact, is that doctors and pharma have control over the supply of and access to psych drugs. This means that we have to fork over money and power to them to get the “immediate relief” that some of us clamor for… even if just as much relief is available with FAR less devastating side-effects in an illegal drug.

          I do not promote any drug use; I do defend people’s right to alter their minds if they so choose, and without having to justify it with bogus “health” arguments. There is no valid “health” argument for the use of any drug with people who have mental distress. There are other valid arguments, but let’s not lie to ourselves and pretend that they are health arguments just so we can all feel good about people’s “choice.” Sometimes people choose things for reasons that don’t strike others as healthy, hopeful, or whatever. The only thing the recovery/peer/survivors movement is saying is that we should be up front about the facts while also respecting their choices.

          If people, when truly informed, still continue to seek out anti-depressant scripts, then fine. But informed consent should also include the fact that the theory that they have a “mental illness” is an UNFALSIFIABLE theory. That means it isn’t scientific. Many people might be consenting to drugs, even knowing they are potentially damaging, because physicians lie to them and tell them they have a mental illness.

          • There is an enormous problem with ignorance and udder lack of ethics in today’s mainstream medical community, I agree. I was lied to, told an antidepressant was a “safe smoking cessation med” by a doctor who was paranoid of a malpractice suit and wanted me defamed and discredited. The withdrawal effects (brain zaps, powerful dreams, and odd sexual side effects – all of which I still have, 14 years later) were misdiagnosed as bipolar. A “disorder” that has no scientific validity. This resulted in coerced, forced, and egregious drug cocktails that made me ungodly sick. And not surprisingly, since the drug cocktails I was forced to take all now have drug interaction warnings stating they cause anticholinergic intoxication. And I’ve been told that the psychiatric industry has been covering up malpractice for the mainstream medical community with their fictitious disorders and toxic drugs for decades. And the psychiatrists have been covering up child abuse for the religions for decades also, and I have proof of this in my family’s medical records also. I dealt with the “dirty little secret of the two original educated professions,” according to an ethical pastor. And it’s starting to seem all of psychiatry is a sick, twisted joke – and the psychiatric practitioners are the unrepentant hypocrites Dante claimed belong in the lowest depths of hell. I agree with Jim, “reparations are in order for the lives ruined by these drugs.”

  6. Thanks for sharing your insights on Mad in America.

    I’d like to share some work I’ve done…if you’re familiar with autonomic nervous system dysregulation perhaps this will resonate…these symptoms can be worked with…it just takes a long time and a deep commitment to paying attention to the whole being. These issues can heal with a broad and holistic approach…I’ve seen it in many others and I’m in process doing it.

    Protracted psychiatric drug withdrawal syndrome, chronic illness, CFS, Fibromyalgia. Yeah, they all have things in common.
    http://beyondmeds.com/2013/07/08/psych-drug-withdrawal-cfs-fibromyalgia/

    Autonomic nervous system dysfunction, protracted psych drug withdrawal, CFS, Fibromyalgia and why I still limit engagement on the internet
    http://beyondmeds.com/2013/07/24/ans-and-interaction/

    there are connections here to PTSD too which is a sort of autonomic nervous system dysregulation as well.

    I’m sorry you’ve perhaps alarmed so many people. This is an awful, terrible, horrifying journey that I would not wish on my worst enemy (I’m opposed to torture) but it is not a hopeless one.

  7. Sadly this message is similar to what many of us heard from the mainstream…instead of “you need to be on these drugs for life” it’s “these drugs have harmed you for life.”

    It doesn’t need to be true. And saying it is, frankly, given the lack of research, if nothing else, is not entirely responsible.

    • I think one of the take-home messages is precisely that there is so much that is unknown. Research into this area is needed, and the funds for it are scarce-to-nonexistant. So we have only the experiences of individuals from which to try to reach decisions.

      One important point, though, is that this is not actually different even if the research exists; it might be presented as definitive, but it likewise does not apply to all cases. As Monica points out; though it may be very hard, nobody knows how things might go for an individual who manages to forge a path that has not been taken before. This is always true. Whether it’s research or anecdotes, we must make our own decisions and find our own way.

    • Brilliant, PaulWoodward!
      And, as a corollary to further highlight the absurdity of it all:
      SSRIs can cause such debilitating brain damage that one may never be able to stop once starting, but the fact that they cause brain damage and can be debilitating should not stop us from keeping them “in the toolbox.”

      I just don’t get this.

  8. I stopped taking psych drugs in 1982, so I never took any second generation anti-psychotics or SSRIs. However, I tried and failed to withdraw many times before I was finally successful in 1982, when I then had the support of an orthomolecular program based on tissue mineral analysis of hair samples.

    I followed the supplement program and the personal diet plan very carefully, and I was retested and had my program adjusted every three months for several years. Without the orthomolecular program, I am certain I would have died still on psych drugs years ago.

  9. I received the link to this article from a member of my site. Wow…a lot of speculation going on here. As one who has helped thousands of ssri users successfully get of these drugs, I have to point out that there are quite a few misleading elements. The first one is using Phil “Numb” as an example. Phil followed his doctors weaning recommendation, which was a very rapid wean for his years of Prozac use. His situation didn’t have to be so dire, and he knew this when he started the filming. He was warned by many,myself included, to not use that weaning schedule, it was destined for failure.

    Another aspect is not recognizing the emotional trauma that withdrawal creates. This is a HUGE part of the process that no supplement is going to help. Non drug therapy is critical for dealing with this trauma. The health anxiety created by having a brain that is sending such mixed, bizarre signals is commonplace in those weaning. It takes considerable time to trust ones brain again after experiencing the life altering symptoms that withdrawal creates. Now add the return of emotions, previously stunted by ssri’s, and this is a whole new learning process for users, especially those put on these drugs in their teens. But it is possible, I see it every day.

    I disagree, vehemently, that long time users should just stay on the drug. We’ve seen many success stories from long term users and the recommendation that long term users should just stay on the drug will not be a realistic situation for most users, since drug tolerance will be reached before most “lives” end, leaving the user in horrendous condition while still swallowing the ssri.

    I’ve dealt with the ramifications of the “doom and gloom” scenarios by Dr. Shipko(who I have the utmost respect for) before. It results in panic and despair in many, as this article is already doing.

    The reality is that extremely slow weaning, for the majority, will result in success. This is not a quick “fix”, for some it takes years and that patience must be supported. Don’t “switch” drugs, don’t add drugs and don’t fall into the trap of swallowing every supplement out there that claims to fix this quickly. We must also never forget that hope should never be taken away from someone who has made the decision to take back their mental health from a drug.

    One thing I can agree with is that the research is dismally inadequate…but until that change, if it ever happens, we must tread lightly on a speculation of permanency, because that takes away every ounce of power and hope that a person has.

    Now I will return to my site to calm the fears of those who now feel helpless in this journey.

  10. “Informed consent for the SSRIs must necessarily include information concerning the difficulties related to stopping the drugs as well as the symptoms that occur when starting the drugs.”

    Wow, that would have been nice! The only information I got was about how very lucky I was that there were these great, effective new “medicines” to help me “manage my chemical imbalance,” and how I would “need to take them my whole life [drum roll… ] just like diabetics take insulin,” and how, “unlike some other drugs, SSRIs have fewer side effects…”

    I wasn’t even depressed in the first place, but SSRIs made me depressed.

    So finally, many foggy, frustrating, agonizing years and horrible side-effects later, I figured out that these “meds” were literally killing me, and – on my own, of course – I tapered off from them. Alas, that almost killed me, too! It didn’t help matters that I could not – despite looking everywhere I could – find a single medical professional who was willing to admit that what was happening to me was real.

    I ended up on Benzodiazepines. I hated taking them, but they allowed me to sleep and to eat, which I hadn’t been able to do for a while. Now, more than a year later, I am tapering off from them and it is quite difficult, to say the least… No, it is downright frightening and excruciating. So far, for me, however, it has been nothing compared to the horrors of coming off of Paxil.

    I was grateful to read this post because people need to know that the harmful effects of SSRIs should not be underestimated. Having said that, I don’t think the contents of this article provide sufficient reason for anyone to give up hope. Mine, at least, is undiminished.

    Informed consent would indeed be an excellent place to start when prescribing neurotoxins to people in distress.

  11. Dr. Shipko,

    You wrote:

    “Most books on the topic are completely negative about using these drugs, and the bias is off-putting for patients who are trying to make their own decision about taking SSRIs.”

    In light of all you’ve had to say in this post, regarding the dangers of these drugs, I don’t understand your reasoning here.

    We all like to make our own decisions, particularly in the area of health. But if the drugs are truly as dangerous as you describe, how can you provide *fully-informed consent* without scaring someone out of trying them and/or trying to withdraw after years of being on them?

    I’ve not read your book? Maybe it’s less vivid?

    Duane

  12. I think one of the problems we have here is when people suffer severe withdrawal from SSRIs they look for answers from doctors and psychiatrists.
    this then gives the mostly over inflated ego of the medical practitioner a feeling that they know best.
    when in truth they are least knowledgeable on the subject.
    I think Dr Shipko is a sensationalist.
    i have witnessed his actions to play up to an audience in a film about an SSRI withdrawal sufferer.
    i think he has quite a high opinion of his own thoughts.like most doctors-psychiatrists.
    i’ve suffered for six years with prolonged antidepressant withdrawal.
    thats what it is in my opinion as well as severe CNS damage after going cold turkey on my doctors very stupid advice that it was ok to do that with prozac because you dont get withdrawal.
    i’ve learned alot about whats wrong with me from people like Alto Strata.
    people who have actually suffered.after a terrible disabling withdrawal that has lasted so long without recognition or help.i would like to say this.
    that there is hope.
    i am recovering.i do feel much better than i did.
    as much as i respect Dr Shipkos opinions.thats all they are.
    he has no experience of SSRIs himself and to call people with the most experience on this problem”citizen scientists” is just like saying they know nothing.
    it seems its used in a sarcastic way.as if he knows more.
    because hes a doctor-psychiatrist.
    but thats how i and all others got into this mess in the first place.by believing doctors and psychiatrists.
    i would like to know what experience he has of taking these drugs?
    a psychiatrist once told me there was no such thing as prozac withdrawal.when i asked he how she knew,because she had never taken them.
    she replied,i’ve read alot about them.i then replied.i have read alot about the moon.but i would’nt tell Neil Armstrong what it was like to go there.

  13. Oh…I agree “withdrawal” symptoms often begin before any formal withdrawal starts…

    it seems to often happen as a result of what appears to be autonomic nervous system damage from drug use in general and coming on and off drugs before actually deciding to discontiue altogether…it’s often associated with folks who have multiple trials of multiple drugs coming on and off of them without titration which is often what is done when trials and drug switching is happening.

    I had multiple episodes of such drug switches.

    this is why I also do not believe that a slow taper will protect everyone. I was destined for hell because of my particular drug history and my particular body. But not everyone has these multiple switches in their histories. and even if they do problems can be mitigated with slow tapers.

    • “…‘withdrawal’ symptoms often begin before any formal withdrawal starts… it seems to often happen as a result of what appears to be autonomic nervous system damage from drug use in general and coming on and off drugs before actually deciding to discontinue altogether…”

      Thank you SO much for mentioning this aspect. I experienced this myself, and tried to explain it to so many doctors, with absolutely no success. One of them, who happened to be a psychiatrist, literally laughed in my face as I sat trembling before him, desperate for help. When I stared at him in disbelief, he said, “Usually when I hear things like that, it means that someone hasn’t been taking their medicine as directed.” He then offered to put me on another SSRI.

      I think it is very important for people to be aware of the phenomenon you have described.

      • I find your article saying withdrawal will for certain never stop scarey and untrue.

        I was on everything in the PDR between 1986-2002 (Neuroleptics, benzos, z drugs, mood stabilizers, anti depressants) and switched multiple times from one to another drug(s) on my psychiatrist’s whims. I tapered off 7 psyche drugs entirely on my own because I was literally dying from them. My pdoc was totally unaware of the horrible side effects I was suffering (so he said later and the list is endless) and when I told him I was having problems he added more drugs. Here I am years later saying I did it (I’m drug free), it was sheer hell but I did it. I have a progressive demyelination disease thanks to Seroquel but its hell is better than being on psych drugs.

        Do I recommend everyone stop their drugs?? No, because they may not be ready to or feel with certainty the drugs are helping. I do try to tell them the long term problems being on these drugs can cause and ask them pointedly if they’d ever tried anything non drug that might help.

        Would knowing the withdrawal might never end had stopped me trying to come off these drugs?? I doubt it. I can only say for me coming off psychotropics gave me my life back maybe not my whole life but enough. The kicker is I was told later I’d never been mentally ill.

        • Congratulation Aria that’s a wonderful achievement. Successfully getting off these drugs can be hard, but worth it. I’m thankful I was able to succeed when I cold turkey stopped all the drugs I was on for a number of years.

          “I can only say for me coming off psychotropics gave me my life back maybe not my whole life but enough.”

          Exactly. And ‘I can only say for me’ too. As we all only can. It is important to include everyone’s drug withdrawal story so I thank you for sharing yours.

          • Thank you. The more our stories are out there the more hope for the rest.

            I’m glad Mad in America offers a forum for us to express what we went through and our continued survival. I use the word “survival” literally.

    • Monica, this is what has been happening to me. I’ve been on the same meds since 9-11 and should not have been on them that long. I fell for the “maintenance dose” speech I was fed by my doc.

      Now I find out that I have ssri and benzo induced malfunctions that no doc is going to believe are the result of _taking_ the drugs. I’m faced with tapering and coping with a huge unknown. When I stopped taking an ssri years ago via that ridiculous take 1 then take 1/2 method AND was told you can “just stop” ssri’s, I didn’t report any negative reactions at the time. In fact, much later (1 year maybe) I had a crying meltdown out of the blue and was told I was “depressed” when in fact I was not depressed! it was a long-term reaction to stopping the ssri and I can see now that there were other w/d issues too that were never mentioned as possible. Rage, anyone?

      Now I’m having negative symptoms on the “maintenance dose” which technically shouldn’t exist, and none of which include depressive feelings/mood. (BTW, the dose has been the same – no change – since inception) My Ph.D wants to double the SSRI now! Laughable, just laughable. I don’t need more harmful meds — I need to mitigate the damage that has already happened, and this time I will not fall for any BS “relapse” talk, nor fear it. I’m not worried about W/D enduring, more that there has been real damage done to my brain and nervous system.

      Thanks!

  14. Dr. Shipko, I’m very disappointed by your approach to this problem.

    First, you are offering “informed consent” for people who wish to go off antidepressants. According to your theory, by then, it’s too late for them. This doesn’t help those millions of patients who are caught in the trap at all.

    You should be putting your efforts into educating doctors of your findings about the perils of withdrawal.

    Second, you dismiss the importance of tapering to protect the nervous system. Clearly, many people can taper off antidepressants and do well afterward, as many, many anecdotes on the Web reveal. We also see people recover from those tardive symptoms to which you refer. It does take time.

    As you are an expert in benzo tapering, I am confused as to why you would not apply the same reasoning to antidepressant tapering.

    Third, you dismiss the efforts of “citizen scientists” and self-help Web sites supporting tapering, which exist only because of the vacuum of knowledge among doctors.

    If these self-help resources did not exist, people who wish to go off the drugs would have no help in tapering, as few doctors even grasp the concept.

    Whether you call the symptoms “prolonged withdrawal syndrome” (symptoms being continuous from discontinuation of the drug) or post-withdrawal syndrome or whatever you want to call it, medicine pays little attention to any long-term effects of psychiatric drugs. “Citizen scientists” do. Nit-picking about nomenclature makes no sense. We both know what we’re talking about. The rest of medicine couldn’t care less.

    Fourth, the impact of your article is:

    – Don’t go on the drugs.
    – Don’t go off the drugs.
    – If you run into a problem, don’t call me.

    Is this really what you want to say?

    With your background in neurology as well as psychiatry, you could help people who have experienced long-term post-withdrawal symptoms by focusing on ways to stabilize the autonomic nervous system.

    (Tardive dyskinesia may not be the only analogy; see parallels to dyautonomia underlying chronic fatigue syndrome and fibromyalgia explored on the Beyond Meds blog http://beyondmeds.com/2013/07/24/ans-and-interaction/ There’s also traumatic brain injury, which takes a cycle of about 7 years for recovery.)

    This is why your experiments with serotonin boosters such as SAM-e and tryptophan went nowhere — you simply tried to replace the antidepressant. How would this stabilize dysautonomia? The problem is downstream of the (most likely desensitized) serotonin receptors.

    Just addressing the sleep issues alone would be of tremendous help to those suffering from withdrawal syndromes.

    I have a great deal of respect for your concern about withdrawal problems and for what you may have observed in your practice. I fear your frustration and anger on behalf of injured patients has caused you to give up on treatment of post-withdrawal symptoms. There is a crying need for someone of your caliber to delve further into this. I beg you to persevere.

    • “Third, you dismiss the efforts of ‘citizen scientists’ and self-help Web sites supporting tapering, which exist only because of the vacuum of knowledge among doctors.”

      “If these self-help resources did not exist, people who wish to go off the drugs would have no help in tapering, as few doctors even grasp the concept.”

      Yes, it was my experience that doctor after doctor, psychiatrists and other generally more respectable varieties alike, could not grasp the concept of tapering at all. It is reckless, irresponsible, and inhumane for anyone with a prescription pad and a Zoloft clock to maintain such willful ignorance at this point.

      Thank you for this, Altostrata, and for all that you do.

      Again: Thank Goodness for citizen scientists.

  15. I was on Effexor XR for a number of years. Then I took three bottles of it to try to kill myself. I am lucky to be alive since the internist who took care of me in the medical hospital didn’t think I’d live and if I did I’d be someone who’d have to be taken care of and watched over for the rest of my life. When he saw that I was going to live he didn’t expect me to walk out of the hospital on my own two feet, but I did. He obviously knew something or thought he knew something about what was going to happen with me because of the Effexor. He didn’t share anything with me and I didn’t ask at the time. Perhaps it is a good thing that he didn’t share anything since that might have destroyed some of my determination to prove him wrong about everything.

    While I was held in the psych hospital the psychiatrists put me back on the damned stuff. Once I got out of the hospital I took myself off the drugs and have been off for about two years now.

    I don’t know anything about Dr. Shipko. What I do know is that I am not the same person that I was before I tried to kill myself with the Effexor. I’m not as bright or as sharp as I was before. I experience an inner anxiety that I never had, an anxiety that gnaws at my insides and makes me feel like I’m literally going to explode like a ballon with too much air in it. I feel that I’ve been affected by the drug but can’t put it all into words. What I do know is that I can’t think fast on my feet anymore, I have absolutely no patience at all. The Effexor had to have some effect on my brain and body, you don’t take over 18,000 mg. and expect to escape scott free.

    I don’t want to lessen anyone else’s positive attitudes about their ability to eventually get their lives back from these toxic drugs. I do believe that we need to give Dr. Shipko’s information some thought and study. To turn a blind eye to it because it’s difficult to think about doesn’t seem honest or intelligent to me.

    • no one is turning a blind eye. Shipko has made some absolute statements that are absolutely not proven.

      it’s not that I don’t think some people don’t completely recover…but Shipko is saying it unequivocally as though it were written in stone and must be…the fact is if everyone were given appropriate supports to learn and apply the things I and a great many of us are learning and applying those who aren’t recovering very well might start improving…

      there are very few people who can address these issues as broadly and holistically as necessary on their own and until there are professionals that can competently help people do that along with holding a space of healing hope, then yeah, we’re gonna have people not making it or taking far longer than necessary…but right now we have no proof that there is necessarily anything inherently permanent about the condition …from my view it’s a massive challenge that may very well be more than some can take…at this moment without meaningful supports

      that said:

      I have not met anyone sicker than I was. I could NOT leave the house for 2 years…this is not hyperbole…I would have collapsed like a caged animal and shielded my eyes and body had I had to be exposed to light/noise/people/stimulation of the outside world. I would have been institutionalized if met by MDs who did not understand what was wrong with me. It’s likely I’d be dead right now if that had happened.

      I have no doubt Shipko would have written me off if he’d seen me at that point. No doubt at all.

      I thank god I could not manage to get out of the house to see a doctor. I also pretty much knew it was a suicide mission to go see one…what a horror…but that is what I lived through.

      I have had to come at these issues from multiple disciplines…tryptophan and SAM-e are not gonna cut it…no way. And I’ve not met a single professional who understood the totality of how we are affected…I do have one who understands the dynamics of the foundation very well so that he’s been a great partner…and I have other great professional partners who help me with bits and pieces…

      I get the bulk of my information from peers…not just psych drug withdrawal peers but peers in the autoimmune disease and chronic illness circles too. Food intolerance circles etc…

      all systems in the body have been affected…my sweep for wellness is very very large and among many disciplines because it needs to be.

  16. During the last 15+ years, I’ve withdrawn from SSRI several times, twice after three or more years of continuous use. I probably won’t have to withdraw no longer since I’m not gonna use them anymore. Anyway, even when on our last meeting with doctor last autumn, where I gave I gave heavy critique about what they had done and psychiatry in general, my psychiatrist, after I had at time withdrawn from neuroleptics, suggested that I could stop SSRIs (I had already done so without telling her) and said I might feel melancholic for a while and then it’d go away. My experience has been entirely different.

    First time I withdrew, I got brain zaps, etc, while going down. Otherwise, I think I felt quite good, as if I got my spirit back. However, similar to what Shipko said, I think I noticed quite early on that after a longer time, such as after three months, I started to get worse and even got effects that were different from what I started with. I think there were many different physiological things at play here, the body adapting to SSRI and the rebound, etc. I don’t know, or think, I would have got much better just by waiting for the effects to go away. I practiced and experienced years with different systems, similar to what Monica has been talking about, and gradually learned more about how my mind was connected to my body, I learned to listen my body and work with it in various means. Last years’s autumn when I quit SSRI after 3-4 years of use in a short time, it was no big deal compared to the times I did that earlier, and I think it’s because of what I had learned during all those years and my application of it. Still, at least in current time, there are no perfect systems which will tell you what will work for you, it often requires plenty of research, self-experimentation, practice, time, etc. I’m just getting grip of what works for *me* but I don’t claim it works for others.

  17. Wow, I’ve been following this article and all the comments about it for the last couple of days. I wrote the MIA Op-Ed in December, “A Call for a National Research and Training Institute for Safe Psych Drug Withdrawal”. Shortly afterward I turned my major efforts toward providing a “Soteria-like” environment for my family member who is withdrawing from a variety of long-term psych drugs. During this time we have received great benefit from reading the Madinamerica.com, Survivingantidepressants.org and Beyondmeds.com websites, from other psych drug withdrawal survivors suggestions, and from one psychiatrist who helped my family member “bridge” over to Prozac from Effexor XR, which had her housebound and immobilized for 4 months. She is now very slowly tapering off of Prozac (5% a month or less, as needed), and next week will have surgery for the gastrointestinal malfunctioning brought on by her years of psych drug use.

    I too would like to see more research and training on withdrawal methods, the types of damage done by various psych drugs as well as the most effective reversal and repair of that damage. As I help my family member through surgery and then the remainder of her taper, I’m thinking about how I can contribute to even some of this. It would be good to find venues for doing the research that is needed. One thought I’ve had is to return to public health grad school and do a dissertation on one of these topics. Another is to just start applying for research grants. It has been suggested that I get together a literature review of the research on psych drug damage to date in order to begin. If anyone can or wants to help with this, or contribute their advice, it would be appreciated. In the meantime, I’d welcome other ideas/brainstorming about specific ways to get this needed research and training accomplished.

  18. psych drugs are GMO’s, no?

    And if genetically modified, then stopping the drug means the “modifications” are permanent and “ssri discontinuation is even more problematic than acknowledged” is exactly correct.

    gastrointestinal malfunctioning. Sure am glad I didn’t swallow the idiot’s PPI drug. Probably would’ve messed me up some more.

    • Are you sure surgery is needed? SSRIs mess up everything, (especially digestion and the gut)…it is not until you are off them that the body recovers naturally. I had many ailments, including failing liver stage 3a kidney disease. High blood pressure, high cholesterol, overweight…… All went arter 18 months off effexor. Effexor is a terrible one for physical illness……… can the surgery wait for a year or two?

  19. How I would love to prove Dr. Shipko wrong! Perhaps even Dr. Shipko would like to prove himself wrong. But he must call it as he sees it. Even ONE patient suffering so would be dreadful.

    I remember feeling similar dismay on first encountering Monica Cassani’s blog just a few years ago. Her withdrawal and very slow recovery is the most dramatic I am aware of thus far. Dr. Shipko gives the impression her symptoms are quite common, but not her recovery. I am encouraged by her comments on this article and suspect she is right in thinking Dr. Shipko might indeed have written her off.

    A few questions occur to me. How do we know that anything that happens years later has anything to do with SSRIs? Do such ‘symptoms’ occur in emotionally distressed people who never or rarely took psych drugs? But where would one find any significant population of ‘drug naive’ people? Likewise ‘symptoms’ which Dr. Shipko has observed in patients on a steady dose of drugs, which are obviously not withdrawal symptoms, but brain damage, long-lasting and possibly permanent.

    Severe depression and anxiety in people off psych drugs after many years on them may not be caused by the drugs, particularly if the person was put on psych drugs at the first sign of distress and never actually allowed to experience severe depression or anxiety, as ISYORKE suggested.

    Interestingly, I know of people who have been on static low doses of benzos for years, and others whose SSRI dosages have increased. More and more it seems to me that the effects of the two classes of drugs are surprisingly similar.

    Some have found antihistamines a better substitute for SSRIs than benzos. SSRIs were first developed from antihistamines and are chemically related, though antihistamines do not seem to have the same problems. People also find antihistamines effective for sleep, too much so on higher doses, where they seem more effective against insomnia than against allergies!

    Also, may I mention in passing that one of my closest friends is a psychotherapist for over thirty years with a wide variety of clients, including some desperate cases, and he has never seen anything like what Dr. Shipko describes. Make of that what one will.

    BTW, if Dr. Shipko specializes in the most severe cases, that is to his credit.

    Thanks to all. John

  20. Dr. Shipko and others:

    I really really wanted to like this blog posting. The title was a very provocative criticism of antidepressants and it was even written by an M.D. After all, I have been a longtime critic of Biological Psychiatry and I am always looking for more ammunition to use in the fight against the medical model and the damaging use of psychiatric drugs.

    However, this topic kept me up late last night stewing about its content, even before I had a chance to read any critical responses. I have decided I am more with Monica, Duane, and Altostrata on this issue, and believe part of this blog posting presents a mixed message and promotes speculation substituting for science.

    Biological Psychiatry first promoted antidepressants based on speculative pseudoscience about “chemical imbalances” and low levels of serotonin in the brain. They had no hard evidence; only serendipitous events and anecdotal experience. How are the following statements fundamentally any different in their lack of scientific substance:

    “…people who stop SSRIs often develop a NEW (my emphasis) onset of severe depression or anxiety months after stopping the drugs.”

    “…the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe than the medical profession acknowledges, and there is NO (my emphasis) ‘antidote’ to these problems.”

    Where is there any scientific analysis of who these people are and what conditions in their life that might have led to these new symptoms or a relapse of the old ones? Do they have serious stress in their life? Did they experience new trauma? Do they have unresolved trauma in their past? Are they abusing or misusing mind altering substances such as pot, alcohol etc.? What is their diet? Do they exercise or meditate and, if not, why not?

    How can we evaluate any of these cases or Dr. Shipko’s main arguments without some of this information? Were these questions asked and if so can we trust that the individuals will respond honestly when asked? Without this knowledge how can we say that some type of “protracted withdrawal” or Tardive Dyskinesia from SSRIs is involved?

    I don’t believe I am afraid of the truth about the dangers of antidepressants; I tell people they are overhyped and have serious side effects and many long term negative consequences. But this blog has a major theme prophesizing doom without significant science to back it up.

    Readers of this blog who have been fortunate enough to get off SSRIs or soon want to get off could easily run in a negative direction with this information if they are experiencing some new form of extreme stress in their life. Will some people now think they are permanently damaged due to a return of certain symptoms in response their new (or old) stressors? Or will they give up any dream of being medication free?

    It is irresponsible to seriously write about ALL these SSRI dangers without at the same time mentioning the scientific concept of “NEUROPLASTICITY.”

    I have been doing addictions work for over 20 years in community mental health. I have seen people who had serious addictions for decades. Yes, I have seen relapse, but I have also met people who had decades of permanent abstinence after years of terrible substance abuse, and quite often these addiction problems are related to extremely traumatic childhoods of unimaginable forms of abuse.

    I believe addiction issues involve well traveled neural pathways in the brain that involve impulsivity, compulsivity, and negative thought patterns, and they involve more primitive parts of the brain that make humans attracted to things that produce various forms of pleasure. When permanent abstinence occurs over time, I believe new brain pathways of recovery are formed that overwhelm and dominate the former more dysfunction patterns of thought and behavior. A similar dynamic of transformation of brain pathways may take place when people overcome a serious period of depression.

    Yes, there is some speculation in my above points, but there is more evidence to make these speculations then the so-called theory of some form of permanent damage to the brain’s sertonergic system of homeostasis leading to unrelenting periods of depression and anxiety arising out of the blue.

    Transformation and liberation from these problems involving some form of brain neuroplasticity is possible, and many of the writers at MIA are a testimony to this possibility. Perhaps we need to scientifically evaluate what actually constitutes these qualities of human resilience so as to give more people hope for permanent change.

    And then there is the mixed messages about prescribing Benzos (more than 3 weeks) and SSRIs. If a doctor knows the true dangers of Benzos and SSRIs how can they justify giving out prescriptions? These drugs were developed and promoted and approved under false pretenses(read Peter Breggin on the approval of Xanax and Prozac). If it can be proven that they cause far more harm than good how can any doctor justify prescribing them? Donna made a salient point to Dr. Steingard in a previous dialogue when she said that people often ask or demand antibiotics but responsible doctors refuse to prescribe them.

    Dr. Shipko, given your current knowledge on these drugs could you please explain when it would be appropriate to prescribe a Benzo or an SSRI, and if so, for how long?

    By raising these criticism, Dr. Shipko I am not questioning your intentions here, but I am questioning some of your scientific method and one-sidedness in presenting a very controversial subject.

    Richard

    • ““…the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe than the medical profession acknowledges, and there is NO (my emphasis) ‘antidote’ to these problems.”

      Where is there any scientific analysis of who these people are and what conditions in their life that might have led to these new symptoms or a relapse of the old ones? Do they have serious stress in their life? Did they experience new trauma? Do they have unresolved trauma in their past? Are they abusing or misusing mind altering substances such as pot, alcohol etc.? What is their diet? Do they exercise or meditate and, if not, why not? ”

      I also would like to see some science regarding long-term use (and discontinuation) of psych drugs and it’s relation to gastrointestinal malfunctioning. Sure am glad I didn’t swallow the PPI drugs.

      • “Where is there any scientific analysis of who these people are and what conditions in their life that might have led to these new symptoms or a relapse of the old ones? Do they have serious stress in their life? ”

        MJK, in my case, no alcohol no recreational drugs. I eat good, exercise, meditate, teach breathing to others, work, clean, rear my son, worry about finances occasionally, and I don’t need analyses to tell me life is tough as heck sometimes and a real joy at others. Unresolved trauma?? Pfft!! Respectfully, someone has been drinking the cool-aid.

        Conditions in my life, following 9-11? short term ptsd for which I received Paxil and Lorazepam and then Zoloft later for a phantom “depression.” Took me three years to stop ducking when an airplane flew overhead. Zoloft has ruined my life, flat out, add to that the words of a very savvy new doctor who reluctantly said, “Umm, you are NOT PTSD any longer, haven’t been for many many years. Didn’t ANY of your doctors talk about this??” and yet I was left on extremely harmful meds for over 13 years!?

        Big Pharma is a vampire that must feed and it doesn’t give a hoot where it finds prey.
        Three biggest PR targets are Elderly; children; and (LoL) sports fanatics. However, with depression ADD bipolar etc being lumped into fuzzy grey categories that mean nothing, EVERYone can be a patient. ‘Cuz we’re yer friends…

        Best,
        naturally

    • “Where is there any scientific analysis of who these people are and what conditions in their life that might have led to these new symptoms or a relapse of the old ones? Do they have serious stress in their life? Did they experience new trauma? Do they have unresolved trauma in their past? Are they abusing or misusing mind altering substances such as pot, alcohol etc.? What is their diet? Do they exercise or meditate and, if not, why not?”

      Excellent questions, Richard! John

  21. Thank you for posting this–some good information, and simple recognition of the problem, though I agree with others that this is too pessimistic. I was able successfully to get off SSRIs after fifteen years and have heard of enough other people either having relatively little difficulty or gradually healing over time that I really don’t think the long-term outlook is quite as dire as this suggests. What I do find reassuring here is knowing that other people often do well at the outset and then encounter very bad depression a few months out. That was my experience several times, after both slow and fast tapers. Each time, 2-3 months after the last pills…whomp! After three or for times it became very clear that a) this was not at all the mild depression I’d had earlier and that the pills helped with…for a while, and b) it was not related to vulnerability to particular stresses that might have come along–it was like clockwork each time, regardless of context.

    While my experience also fits with the comments here that supplements don’t do a lot of good, I think the other big piece is support and social context. A really good therapist, friends and family, activity…if you can build and rely on a solid network, that can really make the difference. If not physiologically, certainly in being able to get through the worst of it. And lastly, in my experience, the brain really can heal from these rotten drugs. I can’t say for certain that I have completely (memory is not what it was…but then again there’s this pesky age thing), but no question that, almost 2 years out, everything is much better and all acute side-effects are gone. Oh, really lastly: my experience was that reinstating did clear up the withdrawal symptoms each time I had to do it.

  22. Dr Shipco,
    Do you have any research to support this? It seems overly pessimistic. I have stopped several patients with SSRI, and they are very happy about it. I have actually toyed with the idea of starting a big clinic for withdrawal. Dr. Breggin seems to not support your pessimistic view.

    The big danger is that with this article you may create a big unnecessary of nocebo effect.

  23. In response to Richard D. Lewis, JOHN T SHEA, mjk, researcher, Danny S —

    Dr. Shipko is indeed correct in that some people, perhaps the very end of the bell curve, will have difficulty recovering from antidepressant withdrawal for a very long time. (I am one of them.)

    Often these people have prior history of going on and off psychiatric drugs or being switched from drug to drug without cross-tapering.

    It appears the nervous system is not made of rubber. With repeated jolts, it can be made exceptionally vulnerable to chemical and other stresses.

    As Dr. Shipko observes, under these circumstances, application of other psychiatric drugs backfires. (One might speculate that this iatrogenic damage underlies so-called “treatment-resistant depression.”) An injured nervous system requires much more gentle treatment.

    From my observation, these statements by Dr. Shipko are absolutely correct:

    “…people who stop SSRIs often develop a NEW (my emphasis) onset of severe depression or anxiety months after stopping the drugs.”

    “…the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe than the medical profession acknowledges, and there is NO (my emphasis) ‘antidote’ to these problems.”

    Although the medical profession almost invariably mistakes any withdrawal symptoms as relapse, those tardive post-withdrawal symptom patterns (even “tardive dysphoria”) are distinct from relapse or any mental condition found in nature. They are not merely “depression” or “anxiety.”

    It’s quite common that people who have no personal experience with withdrawal syndrome cannot imagine its sometimes bizarre neurological manifestations. I can assure you, it feels nothing like a normal state of mental distress.

    You may read many case histories here http://bit.ly/jAjLKr

    Dr. Shipko brings up very valid points about the dangers of psychiatric drug withdrawal, which should be factored in to the risk-benefit assessment prior to prescription of any of these drugs but, because of pharma efforts to obscure them, are not.

    Although he’s authored a paper on it, he hasn’t even mentioned Post-SSRI Sexual Dysfunction (PSSD), another post-withdrawal condition where the sufferer does not regain sexual sensation or functioning for a very long time, perhaps indefinitely, after stopping the drug.

    Like withdrawal syndrome and post-withdrawal dysautonomia, PSSD should be recognized as a risk of psychiatric drugs and incorporated into informed consent PRIOR to prescription.

    But that would require medicine to recognize these risks. I hope Dr. Shipko continues to direct his message towards doctors.

    • “Dr. Shipko is indeed correct in that some people, perhaps the very end of the bell curve, will have difficulty recovering from antidepressant withdrawal for a very long time. (I am one of them.)

      Often these people have prior history of going on and off psychiatric drugs or being switched from drug to drug without cross-tapering.

      It appears the nervous system is not made of rubber. With repeated jolts, it can be made exceptionally vulnerable to chemical and other stresses.”

      I’ve tried to read some of your story, but I have not been able to see precisely biologically what you say drugs have done to you. Have you had any tests carried out on your nervous system?

      You keep mentioning this dysautonomia,

      wiki says the symptoms of dysautonomia are the following:

      The primary symptoms present in patients with dysautonomia are:

      Excessive fatigue
      Excessive thirst (polydipsia)
      Lightheadedness, dizziness or vertigo
      Feelings of anxiety or panic (not mentally induced[citation needed])
      Rapid heart rate or slow heart rate
      Orthostatic hypotension, sometimes resulting in syncope[1] (fainting)

      Are you saying that you have these symptoms?

      ” (One might speculate that this iatrogenic damage underlies so-called “treatment-resistant depression.”)”

      That all depends on if you believe ‘depression’ is something caused by the state of the nervous system doesn’t it? Do you believe this, Altostrata?

      I think in all this talk about people having problems in their effort to stop taking psychiatric drugs it is important to remember plenty of people, like me, found cold turkey to be a good option that worked for them too. There are many ways of ending dependence on psychiatric drugs or any substance. People should find what works best for them. Millions of people around the world have immediately ceased taking psychiatric drugs. Just as millions of people have stayed in hotel rooms and not written online complaints about bedbugs. I think it is important to have an even understanding of people’s experiences. Only reading about the horror stories of people who have failed (for whatever reason) to easily overcome reliance on psychiatry and psychiatry’s drugs, can certainly lead to bias in this complicated endeavor we call surviving psychiatry.

    • ‘Although the medical profession almost invariably mistakes any withdrawal symptoms as relapse, those tardive post-withdrawal symptom patterns (even “tardive dysphoria”) are distinct from relapse or any mental condition found in nature. They are not merely “depression” or “anxiety.”

      ‘It’s quite common that people who have no personal experience with withdrawal syndrome cannot imagine its sometimes bizarre neurological manifestations. I can assure you, it feels nothing like a normal state of mental distress.’

      I am not at all sure how one can make the distinction you refer to, Altostrata, and certainly not for anyone other than oneself.

      Such ‘symptoms’ need not be a relapse. As already suggested, they may be things a person has not experienced before because they took psych drugs at the first sign of distress, an increasing pattern with children as young as one year being drugged. And how can you or anyone else possibly be familiar with all mental conditions found in nature?

      I certainly see nothing ‘mere’ about severe depression and anxiety. Profound and bizarre ‘symptoms’ have been recorded since long before SSRIs or any other modern psych drug. Nor can you know what ‘a normal state of mental distress’ is like for anyone other than yourself, apart from what the other person tells you about it.

      Incidentally, the Surviving Antidepressants link is broken.

      Thanks again to all. John

      • John, if you don’t believe what people who are suffering from post-withdrawal syndrome tell you about their condition, who are you going to believe?

        Why don’t you dismiss us the way psychiatrists dismiss all their patients’ complaints about adverse drug effects? We’re very used to that.

        Anyone who has realized he or she is suffering from post-withdrawal syndrome comes to that despite condemnation from their doctors, their families, their spouses, and callously uninformed comments on the Internet.

        Here’s the link to case histories http://tinyurl.com/3o4k3j5 and it is working.

        • Casual drive-bys, Altostrata? That is an insult and quite uncalled for! I questioned nothing you said about your condition except your sweeping assumptions about others. In absolutely no way did I dismiss or condemn anyone. Did you read my other comments here and elsewhere on MIA at all?

          http://tinyurl.com/3o4k3j5 is indeed working, but is a completely different link from http://bit.ly/jAjLKr which remains broken.

          ‘Anyone who has realized he or she is suffering from post-withdrawal syndrome comes to that despite condemnation from their doctors, their families, their spouses, and callously uninformed comments on the Internet.’

          You’ve edited ‘casual drive-bys’ to ‘callously uninformed comments’ but that’s not much better. Again you claim to speak for a large group of people. ‘Anyone’? Do you really know every one of them?

          Where is YOUR sympathy and compassion and respect for fellow psychiatric survivors such as myself?

          John

        • Altostrata if you are truly for informed consent and protecting people from these drugs then I have to ask…

          Are you opposed to forced drugging? I have never seen you come out on record against involuntary medication Altostrata.

          When it comes to problems after a life or years spent in psychiatry, problems people are labeling a ‘syndrome’ (as if everyone’s problems are the same), I maintain it is perfectly reasonable to point out that when these problems or ‘symptoms’ are subjective mental states and feelings and thoughts, outright blaming them on ‘drug damage’ that nobody can prove the biological etiology of, or mechanism of action of, is a controversial thing, and should not, be taken as some proven inarguable fact.

          That is, if someone was sad and anxious, spent years drugging themselves, and now is sad an anxious, just blaming that on the drugs, is merely ONE interpretation.

          I have just read the wikipedia page for this ‘post acute withdrawal syndrome’….

          It says:

          ‘Any of the following may trigger a temporary return or worsening of the symptoms of post acute withdrawal syndrome:[citation needed]

          Stressful and/or frustrating situations
          Multitasking
          Feelings of anxiety, fearfulness or anger
          Social Conflicts
          Unrealistic expectations of oneself

          Clearly, clearly, very clearly, this is some subjective stuff, and I maintain that it is obvious that these subjective problems that people are labeling symptoms, have many other possible explanations.

          The clearly biological symptoms of drug damage and withdrawal, I don’t argue with. I have concern about the subjective mental states and thoughts and feelings that people are without any hard evidence, saying are ‘absolutely’ caused by ‘ hyperexcitability of neuronal pathways’.

          That is just not a proven fact. I’m sorry, I wouldn’t accept psychiatry making such a claim without evidence so why should I accept you making such a claim without evidence.

          I have no problem with someone communicating to the world that they’ve had enormous problems since psychiatric drugs entered their lives. But when they seek to make it into some incontrovertible scientific fact that some subjective mental state is caused by whatever they say its caused by, let’s see the proof.

          And again, if Altostrata could respond and explain if she is in favor of involuntary commitment laws that force these drugs into people’s bodies, that would be the true measure of whether she truly cares about informed consent.

          Thank you.

        • “Anyone who has realized he or she is suffering from post-withdrawal syndrome comes to that despite condemnation from their doctors, their families, their spouses, and callously uninformed comments on the Internet”

          Well said, Alto. Also consider that some of us have become tolerant, in a way, of dealing with potentially dangerous SE’s so that they are not always so noticeable. I.e., you live with a lot of pain, you get used to it. I can still function beyond some of these symptoms, but not anymore. I didn’t realize my degree of zombification until I had a two minute space-out episode a few weeks ago, which at the time I was concerned could have been a TIA.

          The cocktail I’m on is caustic, despite its appearance as mild, low dose, wimpy or minor. For me, today, it’s not. What reef shark Paxil began, Great White Zoloft is going to finish and the benzos are chumming the water.

      • I’m sorry John, I don’t know your story or anything of you or what you have gone thru as a psych drug survivor. In another life, with another brain, I’d be interested but there are so many thousands suffering that those are the ones I try to give my energy to if I happen to have any. It sounds like you survived intact and I’m really happy that you made it out okay.

        I do need to validate what Altostrata stated ‘It’s quite common that people who have no personal experience with withdrawal syndrome cannot imagine its sometimes bizarre neurological manifestations. I can assure you, it feels nothing like a normal state of mental distress.’

        This is why those of us suffering withdrawal syndromes stick together … we have an understanding of the bizarreness that no one can get that hasn’t experienced it. It is not a new level of mental distress, it is a damaged CNS. I’ll try to explain because I think this is what you’re contesting, I could be wrong and don’t understand your comments.

        The first year off, after my year long taper, my entire body felt as if it was being electrocuted 24/7. I hardly slept that first year and yet I survived every torturous moment of it. It’s like putting a coat hanger in an electric socket and you can’t let go. Since then I feel that I have been healing from that damage and it’s taking it’s sweet, precious time. I hope you’ll try to understand and if you don’t that’s okay. Fortunately we have each other that understand and the lucky ones of us have family members and/or friends that believe us. I don’t need you or the world to believe me … I know, other psych drug survivors know and that is enough.

        Each of us still suffering have been affected in different ways. For instance some people have nerve pain in their feet and legs, whilst others have it in their head and neck. Other systems seem to break down also like the GI system, the heart, the thyroid etc. I may be naïve but I choose to believe what people tell me that they are experiencing. I think I’d rather be me, without doubting what others are reporting.

        I have brain damage, meaning, I don’t even know if what I’m saying fits in with what you and Altostrata are saying but I’m putting it out there anyways just in case I’m seeing it correctly. If I’m not please forgive. I have a hard time with reading and have cognitive impairments that I never had before.

        Another example is that some people have tinnitus and dizziness that don’t go away, I was lucky to not have those. Some folks have the GI stuff really bad and can’t eat normally anymore. I do have difficulty breathing as the muscles in my chest are squeezing so tightly. I could go on and on listing various symptoms. When you have been compromised in this way, it’s utterly exhausting trying to explain what you’re going thru. I also can’t take stress or confrontations and am amazed that Altostrata can do what she does running her site. Apparently she is not brain damaged like me for I couldn’t do it but I 100% believe that she suffers with her own unique set of symptoms.

        I wonder if we haven’t been fighting this so long that we just get tired of reporting and explaining to people who haven’t experienced it. People choose to believe it or not. With each other we don’t have to and often don’t want to as we live to distract from our suffering and just work on supporting the other. Understand?

        I hope I haven’t embarrassed myself with these comments. I just am tired of feeling like a dead person and have a need to put myself out there from time to time. Hopefully I don’t draw any arrows as I’m hurt bad enough. We’re all in so much need of empathy and compassion for our lonely plight and daily battle to merely survive. Some have that capacity and some don’t. I hope like hell I make sense.

        • I am neither intact nor okay, Whoopsie, at least not yet, but certainly not as challenged as you are. I do not question either your or Altostrata’s dreadful experiences. I do not consider it naive to believe what people say they are experiencing. All I did question were some of Altostrata’s generalizations about other people. Questions are neither condemnations nor dismissals. And I think you have addressed my questions very well.

          My first comment on this article questioned Dr. Shipko’s near-despair, something both you and Altostrata also questioned. None of us condemned or dismissed Dr. Shipko. Only when Altostrata changed to agreeing with Dr. Shipko did I question some of her generalizations about others.

          I am no neurologist, but what you describe certainly sounds like physical nerve damage to me. Not unlike what Monica Cassani describes on her BEYOND MEDS blog. So the effects of psych drugs on yourself and a significant minority are nothing less than poisonous. I see no need for you to postulate an exact theory of how that happens, much less prove it.

          Many thanks for making the no doubt considerable effort to outline your experiences to me. In no way did you embarrass yourself and you make excellent sense. I wish you and all your comrades success.

          John

          • I agree John when you say “Questions are neither condemnations nor dismissals”.

            I asked a couple of questions. For this, I get an outrageous ad hominem attack from Altostrata as demonstrated below.

            I do not doubt that people experience grave problems. When they make specific sounding biological etiology assertions, I think to look into it further and ask a couple of innocent questions. Never again.

            I found whoopsie’s brief description of these various symptoms/problems useful. That’s the sort of question I was asking Altostrata before she chose to spin it into whatever she claims I was doing in her comment below.

        • Whoopsie

          I have the foot and leg pain, the dizziness and the tinnitis, plus I have this inner anxiety that gnaws at me like I’ve never experienced before. I’m short-tempered and lacking in patience and cannot abide lots of noise or activity. The dog’s claws clicking on the hardwood floor of my apartment sets me off something terrible.

          I was never like this before. It’s been six years since my overdose on Effexor and two years since going cold turkey off of citalopram. I didn’t experience all of these things until about a year ago and it seems like they surfaced overnight.

          I had to go off Effexor twice cold turkey and I experienced the mind zaps and when I sat in a chair it felt like I was flying backwards in the damned thing.

          Every person is different and unique. Many people may not experience these late effects after getting off the drugs but I believe that many of us do.

          • Hi Stephen,

            I’m so sorry that you are experiencing these horrid things in your body. If any psychiatrist tells you it’s your “underlying disorder” or “it seems these drugs have uncovered the previously unmanifested Bipolar Disorder” tell them to go fly a kite. Ha!! Isn’t that a nice visual that they would be out flying kites and being peaceful and joyful instead of labelling and drugging people till they die? The whole world would be so much better off.

            When I read these stories, my reaction is that psychiatry needs to come down like the Berlin wall. This should not happen to ONE MORE PERSON EVER!!!

    • Altostrata

      Thank you for your thoughtful response.

      I don’t dismiss the possibility that there could be some type of more permanent systemic brain disruption caused by SSRIs. My point is there is no scientific proof of this at this time, and it is wrong to promote or imply that there is such proof.

      Anecdotal experience here at MIA and on other websites such as “Surviving Antidepressants” is valuable information and perhaps helpful to this discussion, but it does not represent definitive proof of Tardive Dyskinesia or Dysphoria.

      I still believe some of my questions regarding other factors that could be contributing elements to the start of new or old symptoms are still pertinent to this discussion.

      “Do they have serious stress in their life? Did they experience new trauma? Do they have unresolved trauma in their past? Are they abusing or misusing mind altering substances such as pot, alcohol etc.? What is their diet? Do they exercise or meditate and, if not, why not?”

      It has been repeated often by many survivors that these drugs cause “emotional numbing” as one side (or main) effect of even short term use. One might speculate that as a person in withdrawal or post withdrawal suddenly starts feeling intense emotions or feelings again (due to some of the factors mentioned above in my questions) they might be extremely sensitive due to the prior period of numbing. This may be a condition of heightened “sensitivity” not necessarily permanent brain damage.

      A person’s frustration or pain tolerance threshold could be seriously lowered after stopping SSRIs in a similar way as long term opiate addicts who suddenly stop using. Every one knows that former opiate addicts in early recovery have no tolerance for even low levels of physical or emotional pain; this is one factor in high relapse rates. This threshold level seems to return to a more normal state after some time goes by.

      And when people experience new (or old) symptoms of anxiety and /or depression do they self medicate with other mind altering substances, even if they avoid returning to psychiatric drugs? Alcohol and pot can cause paranoia, anxiety, and depression in certain people and how do these substance react with people who have a heightened state of sensitivity due to a prior state of emotional numbing from SSRIs?

      And what about the use of Benzos with people with post SSRI withdrawal symptoms? Dr. Shipko admitted that people want them and he prescribes them. Do these drugs provide temporary relief in the short run, but actually worsen the symptoms in long term outcomes by disabling normal coping skills and by actually increasing someone’s heightened state of sensitivity?

      I have never experienced a post withdrawal syndrome and do not want to second guess anyone’s decision to relieve terrible symptoms with some type of drug; that is a choice every individual needs to make for themselves. But we do need to thoroughly examine ALL factors in post withdrawal symptomology before we rush to judgment on these important questions.

      My knowledge about Benzos (including from MIA writers) combined with what I have observed in the high rates of their use in community mental health, is that they are emotionally crippling drugs; dependency occurs quickly and it undermines people’s internal coping mechanisms. Anxiety problems tend to increase with their use and when more stress hits a person they are more prone to be in a repeated state of crisis mode.

      I would still ask Dr. Shipko to please respond to some of my questions raised in my above post.

      “… there is the mixed messages about prescribing Benzos (for more than 3 weeks) and SSRIs. If a doctor knows the true dangers of Benzos and SSRIs how can they justify giving out prescriptions? These drugs were developed and promoted and approved under false pretenses(read Peter Breggin on the approval of Xanax and Prozac). If it can be proven that they cause far more harm than good how can any doctor justify prescribing them? Donna made a salient point to Dr. Steingard in a previous dialogue when she said that people often ask or demand antibiotics but responsible doctors refuse to prescribe them.

      “…given your current knowledge on these drugs could you please explain when it would be appropriate to prescribe a Benzo or an SSRI, and if so, for how long?”

      Altostrata, I believe these are fair questions. If you could prescribe, I can’t imagine you ever prescribing an SSRI except to help someone in the withdrawal process. And Benzos are wonderful drugs in a hospital setting, but outside of a hospital they are perhaps the most dangerous and misused drugs in the world.

      Richard

      • I have already commended your questions, Richard, but I find it very hard to explain what Whoopsie describes above as a psychological/emotional reaction. I have heard of such weird ‘electrical’ effects before, and I need no scientific proof to suspect nerve damage.

        Delayed depression may sometimes be an emotional relapse and maybe SSRIs do not cause delayed movement disorders, but what about the organ damage Whoopsie and others outline? All experience and evidence is anecdotal in its raw form and the fact that something cannot be proved ‘scientifically’ or ‘definitively’ does not make it go away.

        I would also be careful about making inferences about psychiatric survivors from the behavior of drug abusers. No doubt the two groups overlap, but how much? My guess is that far more people are abused by drugs than abuse drugs.

        Thanks, Richard. John

      • Richard: “And Benzos are wonderful drugs in a hospital setting, but outside of a hospital they are perhaps the most dangerous and misused drugs in the world.”

        Yeah, I pretty much agree. In one sense, when used in a right manner, benzos are perhaps the most efficient and safe psych-medications out there. They hit the right button in brain to reduce anxiety and they’re not very toxic to the body. I’m not totally anti all drugs, I think there’s nothing a priori bad about ingesting chemicals which affect your nervous system. While I agree that they often cause severe problems when used chronically, at least I would like to write some statement that if I ever get hospitalised because of full-blown psychosis of any kind, I will not accept neuroleptics in any situation, but it may be OK to use benzodiazepines in the acute phase.

        Currently they claim that people in psychosis have anosognosia, etc, so they don’t understand what’s best for them. Why can’t I make a statement when I’m not considered psychotic that because of my understanding of the functioning of brain, mind, my own mind, and so on, if in future I get closed to a hospital because I’m considered psychotic, I still do not want to take neuroleptics. That way they couldn’t claim the choice is because of anosognosia or whatever, the decision was made in a “normal” state of mind. I read that in Finland, there’s some national program trying to improve the treatment of mental illness, and one part of it is that a person can fill some official sheet about his will if he gets hospitalised because of mental illness. When I looked at the sheet they proposed, it seemed totally useless for actually affecting your treatment. It had a checkbox “If you get hospitalised because of mental illness, do you want to get treatment according to the best known scientific information about mental illness? yes/no”. Ridiculous. If a person says yes to that, it means that they’ll still get treated with neuroleptics because those people claim it’s the best scientific information. If they don’t check that part, it doesn’t make any difference. Sheets like that only give people feel they are in control, they don’t change the treatment at all.

        • Hermes

          You make some excellent points. Others have written about short term Benzo use in a hospital to help with acute psychosis instead of neuroleptics. This would be much more humane.

          What did you think of my two part response below on informed consent and the possibility that Benzo prescriptions may actually be a causative factor in SSRI post withdrawal problems?

          Richard

          • “What did you think of my two part response below on informed consent and the possibility that Benzo prescriptions may actually be a causative factor in SSRI post withdrawal problems?”

            I read through those posts with great interest, but I feel it’s somehow out of my scope of understanding. I know things about mechanisms of some of these drugs on brain and mind, in part because studying the functioning of brain has been my hobby and interest for many years, in part because because I have direct experience of dopamine agonism and antagonism, etc, and their effects. For instance, I’m not saying much about lithium because I’ve never taken or researched it. In a similar way, I don’t have strong opinions about causal factors of SSRI/benzos in this case because I feel I just don’t have enough understanding or experience on this issue.

  24. Oddly, although the Mad in America community has sympathy for all kinds of damage from psychiatric treatment, this conversation again demonstrates that somehow there is a great deal of resistance to the idea some people continue to suffer even when they are off the drugs — despite personal testimony from the sufferers. For example, would anyone state on MIA that people who claim they damaged from ECT did not in fact suffer such damage? Why are those who claim to have post-withdrawal syndrome subjected to suggestions they are perhaps deluded, mistaken, stupid, or merely experiencing some kind of relapse? In a community of psychiatric survivors, why are not those with post-withdrawal syndrome afforded the same respect and compassion as other psychiatric survivors? Why are they subjected to attacks on their personal credibility? If you didn’t like the way your doctor dismissed your understanding of yourself and your problems with psychiatric treatment, why are you doing that to other people? When it comes to post-withdrawal syndrome and the testimony of people who are suffering from it, where is the sympathy and compassion and RESPECT for fellow psychiatric survivors? Although unwitting (except for one person), the hypocrisy and meanness here hurts all the same. And it speaks poorly for the MIA community.

    • If you think asking you this:

      “I’ve tried to read some of your story, but I have not been able to see precisely biologically what you say drugs have done to you. Have you had any tests carried out on your nervous system?”

      …constitutes mean-spirited disrespect, is an ‘odd’ question to ask, ‘reflects poorly on the MIA community’, then I disagree.

      It was a reasonable question.

      Another commenter even concurred that it was a reasonable question.

      “You ask some very good questions, Anonymous 12:39 pm”

      Someone who is ‘dismissing your understanding of your problem’ wouldn’t probe you further to try and find out exactly what your understanding of your problems is. I’m still not clear on what you believe Altostrata. Of course, refusing to respond to me, and instead making some strident denunciation of my human decency, isn’t going to clear up those initial questions I asked of you.

      I didn’t mount a character attack on you. You did on me. It is probably against the commenting guidelines what you’ve insinuated. I’m interested in examining and understanding why you make claims about your autonomic nervous system. It seems a very specific part of your body to testify is damaged. I just wanted to inquire further about your story with you. You only seem interested in haranguing and shaming anyone who even dares not immediately walk in lock-step with your interpretation of these problems. I was open to hearing your answers to my initial questions. It’s a shame you responded in the manner in which you did really.

      There can be no doubt that many people have been damaged by psychiatric drugs and all sorts of drugs. There are many ways to end one’s dependency on drugs. All voices are important. When people make specific claims about specific parts of their biology being damaged and I ask some reasonable questions about what symptoms and tests they may have had, that is not a hate crime against you Altostrata. It’s not some act of disrespect, some blight on this community, some shameful act of line-crossing Altostrata, it’s just a couple of questions I asked.

    • I’m sorry, but when there is the abundance of evidence that SSRI’s cause severe withdrawal symptoms; where does this not end up being brain damage? All that they have been proven to do is to interfere with natural biological functioning in the brain. There are enough other substances that do this (prior psychiatric drugs that now are street drugs, sugar, alcohol, nicotine etc.) and which people associate with relief. Are these going to be prescribed by a doctor and then end up being paid for by medical insurance? Is this necessary to give a bunch of innocent animals SSRI’s? Or maybe try Torey’s collection of brains, only you’d have to get a subpoena. http://www.youtube.com/watch?v=VvMd1VDx5N8

      Bust just think, if they find brain damage is caused by anti-depressants; they’ll be inspired to make another drug to fix it…

      The body itself can repair damage, I think it’s designed better than the drug companies policy; as is nature with it’s modes of healing….

    • I’ve decided not to remove this comment because there’s some extremely valuable conversation happening around the ad hominems. Altostrata’s final remarks do appear to be a personal attack against Anonymous. I want to ask that everyone make an effort to give the benefit of the doubt and remain civil as this conversation continues. Any further personal attacks will be removed.
      • This is the best community on the Planet. I participate in a few other places, here and there, over the years. MIA is really the best, in my eyes.

        (p.s. – The red of Matthew’s comment is the sort of red I meant. You know, for the page views. It is less harsh than the vibrant red that was there a while ago. lol)

      • Anonymous,

        I have reread this thread several times as an FYI to make sure I wasn’t overreacting before I posted this comment so here goes. With all due respect, your comments do feel like an attack to me and not an attempt to understand a person’s situation.

        First of all, I am stunned that you are even asking someone if they are in favor of forced drugging/involuntary medication who has suffered greatly. What kind of a question is that?
        I know this sounds very blunt but in my opinion, that would be like asking a rape victim if they are in favor of rape.

        The first paragraph sounds similar to psychiatrists who don’t believe that someone has suffered adverse affects from drugs and wants to tie everything to someone’s mental state. I do agree you can’t blame everything on the drug. But when you have symptoms that are totally out of the blue as some people have reported like Stephen Gilbert, it is certainly reasonable to wonder what long term effects meds have had.

        You keep coming across as demanding scientific proof but it is not like the side effects of these drugs have been studied long term. And I doubt they seriously ever will be for obvious reasons.

  25. The reason that this thread has become somewhat heated is to do with the tremendous harm that many of us have suffered and the ongoing denial of our issues that we receive at the hands of doctors, friends and often family. It is one thing to suffer as terribly and for as long as we have, it is yet another to have those who should be supporting us cast doubt upon its causes.

    We therefore react vehemently to any line of questioning which appears undermine our experience – whether this is the intention or not. So while it may seem innocuous and even sensible to promote investigation into other causes, or to propose alternative theories, the effect is to invalidate what we know is going on in our bodies, and the reasons for that.

    Remember that we have been going through something unspeakably horrible for a very long time, and have already suffered denial from many of those closest to us. My brother, for example, decided two weeks ago to tell me that ‘my problems’ are all my fault, and that he does not really believe that I am physically ill after 4.5 years off the drugs. He was astonishingly brutal; my relationship with him will never be the same. However I’m sure all fellow withdrawal sufferers have stories like this.

    So I’m afraid the some of the commenters here touched some very raw nerves – and yes these nerves are undoubtedly physically damaged, though unlike Shipko I believe – based on all the good stories out there – that they have the capacity to heal with time.

    • heretohelp I appreciate your comments and have been following the exchanges on this post over the past few days. I agree about the painful reactions from people regarding the damage done by psychiatry which I describe as like tackling a sliver of wood in your finger with a sledgehammer.

      I take part in a number of national mental health groups in Scotland from the survivor perspective, saying that I have survived mental illness and psychiatry. The groups consist of psychiatrists, nurses, government staff, clinical psychologists and service users. When I describe the coercion in my experience, at most meetings, there are pained looks all round from the professionals. And, interestingly, sometimes from the service users. They’d prefer I spoke of ‘positive’ outcomes. But that’s not why I’m there. I don’t get paid to play their tune.

      I have had every close family member go through the psychiatric system, parents, siblings and sons, which means that there’s not one of us who doesn’t know what it felt like. Although some of us might wish to forget and leave it in the past. Maybe it’s a blessing or good thing for my family, although some or most folk, of course psychiatry, would see it as the opposite. Blaming mothers, genetics, brain chemicals, mental illness, Uncle Tom Cobley and all. When in fact it’s all about the challenges of living. And the interference of government, society and psychiatry. The terrible trio.

      • Chrys,

        Not to minimize your experiences but in my opinion, the issue of people not wanting to hear anything but “positive outcomes” exists in all of society. For example, someone who rants about a situation is seen as having a negative attitude and not trying hard enough even though that person may have tried everything they can think of to make the situation work. It is like they are guilty until proven innocent.

        Thank you for not giving into the “positive outcomes” tune. It sounds like you are doing great work.

        • Yes you’re right AA.

          However I do think that in mental health meetings there is an even more concentrated effort on behalf of the people in power to silence the critical voices. I sometimes describe it as ‘straitjackets appearing’.

          It just means those of us called to speak out and resist have to gird up our loins and go for it. Regardless of the opposition. It gets easier the more you do it. Or that’s what I’ve found.

          • Excellent points. Heretohelp, and your brother’s comment appalls me too.

            Interesting, Chrys and AA, particularly given that psychiatry’s basic philosophy has itself long been so pessimistic with it’s dogmas about ‘life-long illnesses’ and ‘treatments’ rather than healing and recovery. They expect you to be more optimistic than they are!

            Thanks to all. John

  26. Apart from the clear advertising for his overpriced “book”, I think Shipko probably is a well meaning, enthusiastic and compassionate man, but this post is negative and hope-destroying, full of opinions and totally lacking any scientific basis.

    I started analyzing it for myself because it affected me. And I am a very optimistic clinical psychologist, I should not be influenced by such baseless opinions. But Shipko’s communication style is so overpowering that I was affected. So I will publish this analysis here to help others not lose hope because of things that may happen to only 1 in 10 000 patients. Shipko has no research to refer to, so he should have stayed quiet. My comments are in bold. I publish in seeral parts to avoid the 2000 characters “read more”limit.

    If I thought that it was possible, I would have opened a string of clinics all over the country to help get people off of antidepressants.

    Here starts the pessimism. Why shouldn’t this be possible? We have hospitals that have patients actually dying, but we don’t stop having hospitals because a few cannot be helped. By starting with this statement, Dr S builds a case for not having hope.

    Unfortunately, the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe and long-lasting than the medical profession acknowledges, and there is no antidote to these problems.

    Even if he uses the word “sometimes occur” they are drowned out by the absolutist (and with no scientific backing) words “no antidote to these problems”.

      • Yeah, the point of ‘more’ button kind of was that if you’re not interested in that topic or post, it doesn’t distract so much from what you’re trying to do. Circumventing ‘more’ button by breaking one long post in 12 or so different posts is worse than posting a long post with or without a ‘more’ button. Note that I’m not saying anything about claims made here, just the posting style. If other people posted their long posts like that, this would be a mess. “My argument is so important that every person needs to see every single word of it, if there’s a more button some of them see only part of it and that’s unacceptable.”

        • Indeed. Hermes, you hit the nail on the head. I put the feature in place specifically so that very long posts do not dominate the screen real-estate for people who may want to scroll through the comments without the inconvenience of very long chunks of text. Intentionally circumventing this feature is an abuse of the way the site is setup. I hope nobody else gets the sense that this is a good idea from researcher’s example.
        • I strongly disagree and commend Researcher for saving me the bother of clicking the ‘more’ button, which I loathe on this and other websites. Researcher clearly indicated what he was doing at the start, so anyone who disliked his critique could simply scroll through his later comments. This section is supposed to be for such comments on the article, even though many of us, myself included, use it for debating, something Ted has suggested might be better done on the little-used MIA Forums.

          John

          • Hi John,

            If I recall correctly, Ted was making that recommendation based on the fact that the comment threads on that particular post had veered wildly from the topic of the article.

            I think he also mentioned that he had some points to make himself, but didn’t want to go further off topic. Then he stated – I think – that he would like to post those thoughts in the forums, but was concerned that they would never be read there.

            Personally, I think it’s a shame that the forums are not used more, because we don’t, for instance, get to know whatever Ted had been thinking about! It’s circular and funny, in a way, that people never use the forums “because no one ever uses the forums.” I think they have potential. Commenting here is great, too, of course.

            Cheers.

          • Good points, Up-Rising. On-topic vs off-topic is a judgment call hard to make at times. I come here from links posted on the ISEPP Listserv, so I’ve barely checked out the MIA forums yet, but they do look interesting.

            Thanks, Up-Rising. John

  27. Analysis of Shipko’s pessimism part 2
    Outside of using a benzodiazepine, I don’t have a lot of suggestions.

    This also seems quite pessimistic and unimaginative. Go to Monica’s site to find hundreds of suggestions and encouragements to what can be done. Mentioning benzos as a solution gives a strange effect since most users of mia would think benzos are worse than ssri. So mentioning this as the only hope, creates a double hopelessness.

    Reinstating the medications often does not help and sometimes there is a negative reaction.

    According to Breggin, this is absolutely not the case. For the vast majority reinstating the dose works wonders. But shipco may create much fear and nocebo (negative placebo) effect with this statement. Such unfounded absulutist negative statements are very dangerous.

    In the past I worked with SAM-e, thought to enhance neurotransmitter synthesis, and L-tryptophan, a precursor of serotonin. It had placebo value, but was not an ‘antidote’ to the problem.

    Some MD jargon to give the impression that Dr S. is an expert and has tried everything. It is not very inventive and persistent to try just two things.

    Citizen scientists developed a set of corollary beliefs; primarily that the protracted withdrawal is largely due to stopping the drug too fast and that if one waits long enough that the symptoms of protracted withdrawal are going to go away.

    Shipko claims to not use Citizen scientists in a negative way, but here he claims that they have “corollary beliefs,” (in many ways worse than “beliefs”, because they are just results of other beliefs) while he has “observations”. Subtle power language.

  28. Analysis part 3
    My clinical observation is that long lasting symptoms occur even in patients who taper very slowly, not just those who stop quickly, and that there is no guarantee that these symptoms will go away no matter how long the patient waits.

    Clinical experience with a very select population, but presenting it as general truths without having a shred of statistics to back it up. Monica and alto have thousands of successful cases.

    What I have observed is that the ‘withdrawal’ symptoms occur while patients are on a steady dosage of the drug, shortly after stopping the drug and weeks or months after stopping the drugs.
    Personal observations of one man, no studies, no references.

    The only precedent for this type of presentation is tardive dyskinesia (TD). Tardive refers to symptoms that occur later and dyskinesia refers to movement disorder.

    There is no reason to link these observed symptoms to td. Td is very well documented as an effect of antipsychotics use, and therefore it may seem that the shipko effect is well researched and established as well. It is still just his observations of some patients i a very select group of the sickest patient. We may easily be talking about 1 in 1000 patients or 1 in 100 000. In a big city he could have his whole practice filled with such patients even if only 1 in 100 000 get it.

    TD is generally associated with antipsychotic medication, and is also a manufacturer labeled side effect of the SSRIs. TD occurs while on antipsychotics, primarily occurs shortly after stopping them, and may occur months or even longer after stopping the drugs. With the SSRIs, it is not so much a tardive movement disorder as a tardive problem with akathisia, a sort of constant restlessness or agitation that is accompanied by an agitated anxious/depressed state. It is a very uncomfortable sensation.

    Again; no research, no references. Just words associated with suffering and claimed to be chronic

  29. Analysis part 4
    It is generally unappreciated that people who stop SSRIs often develop a new onset of severe depression or anxiety months after stopping the drugs.

    Often? How often. It is “unappreciated”, which must mean that it is maybe only Shipko who “appreciates this.

    It took me years before I realized that this is what was occurring, but this seems to be fairly common. Patients often did well for months, only to develop fairly acute profound states of anxiety and or depression.
    “seems to be”, no numbers, no references.
    “before I realized that this is what was occurring”. The presupposition (what needs to be true for the sentence to make sense) is that this is happening. Dr S just realized a fact.
    “Fairly common” can mean anything. If Dr S. gets sought out because of his e-book, most of his patients will have this problem, even if the rate is 1 in 10 000.

    The anxiety and/or depression was not a relapse, because the patients never had these symptoms before starting the drugs.
    Dr S. confidently states: “was not a relapse”. How can he know? Just because patients did not remember that they had these symptoms, or because they said so to be sure to capture the interest of dr S? The point is that there are so many subjective factors, including Dr. S remembering more easily things that fit his theory, that we have to do research, and cannot say anything definitive based on one man’s clinical subjective experiences.

  30. Analysis part 5
    They developed “fairly acute profound states of anxiety and or depression”. Can some (probably 1 in 10 000) people spontaneously develop these states and contact a doctor for it? Of course, that is what brought them to treatment in the first place. They have plenty of cues in the environment from earlier episodes that can trigger such reactions.

    Dr S. creates a strong and dangerous nocebo effect by implying that when things go well for many months, you can expect the worst. Many of us already have this too good to be true thinking pattern unnecessarily in our head and may destroy our best moments with it.

    Is there anything to link these strong reactions with the SSRI? Not really, unless you have a strong biological explanatory model for psychological suffering. This is the danger with Shiopko’s reasoning. It is as much biomedical model as the worst chemical imbalance theories. And he has absolutely no research, just a hunch that it must be the biological imbalance created by the SSRI.

    Because people are thinking of the discontinuation problem as withdrawal, they are not considering the later onset symptoms as related to stopping the drugs. What is somewhat frightening to consider is that patients with tardive dyskinesia sometimes do not manifest symptoms for years after stopping antipsychotics. Will this be the fate of those who stop SSRIs? This won’t be known for a long time, particularly if nobody is doing careful research on the topic.

    So, it is not known, these are just opinions!

  31. Analysis part 6
    Tapering the drug slowly definitely minimizes the acute symptoms that occur when stopping an SSRI but does not appear (IMHO) to have much bearing on the longer-term and late-onset symptoms that occur when stopping an SSRI.

    At least he states “in my humble/honest opinion (IMHO)”. But the statement seems very absolutist, even if it is presented as just an opinion, as something that “appears to”. To someone who is afraid of reading just this, the cautionary words are going to drown and the hopeless message is remembered. A psychiatrist should know that this kind of communication style is dangerous especially for people who have problems with anxiety and depression.

    I have not found a meaningful antidote to the longer-term symptoms.
    “antidote” : biomedical model again. I cure sever anxiety every day without any form of biological antidote, and I don’t expect to find one either. Then I would have to subscribe to the biomedical model.

    In the search for antidotes, he then comes up with only 2(!!) chemicals, and that’s it. There are so many things that could be tried, it is ridiculous to give up after trying actually only L-tryptophan and SAM-e, before resorting to benzos. Look at all of Monica’s posts on Beyondmeds.com to get hundreds of ideas.

  32. Analysis part 7
    L-tryptophan boosts serotonin in the central nervous system, but has not benefitted my patients. Some websites advertise supplements that increase glutathione, a liver detoxifier, as an antidote. SAM-e increases glutathione, and has not proven to be particularly helpful. SAM-e also increases neurotransmitter synthesis, and even when taken with L-tryptophan, does not seem to make much difference. Benzodiazepines seem to offer some relief, but they are dependency-forming and if taken regularly result in another dependency – although this is worth it for some patients.

    A lot of medical jargon, straight down biomedical model thinking, culminating in suggestion of benzos. He might as well have included cannabis, alcohol, cocaine and heroine. They have all been used as legal antidotes in earlier times.

    Not only do some patients stopping SSRIs develop a variant of tardive akathisia, a percentage of the patients who develop this problem will find that reinstating the SSRI will not alleviate the problem and may actually make the problem worse.

    Dr Breggin who has probably seen more hopeless cases than Shipko, but has a more positive non-biological attitude, states the exact opposite.
    Still Shipko is operating with “some” and “a percentage” with absolutely no reference to research or even concrete numbers from his own selective practice. There is absolutely no reason to believe the this is relevant for more than maybe 1 in 10 000.

  33. Analysis part 8
    The difficulties that occur when patients stop SSRIs, particularly after 5 or more years on the drug, have not been fully acknowledged by physicians and citizen scientists alike. In my experience stopping SSRIs after 5 years of cumulative exposure can be risky, and I am not advising anyone who has taken the drugs for 10 years or more to try to stop unless they are willing to risk disabling symptoms

    No references, no research, arbitrary cutoffs and power language of “I am not advising anyone”. Even with Tardive dyskinesia with a 3% risk (well researched) per year, the majority will not get it even after 10 years of treatment. So would that merit taking the hope away from the 70% who will not have the problem? Breggin does not hesitate: he gives hope!

    The documentary movie, “Numb” by Phil Lawrence shows what can happen when a person taking Paxil for a decade tries to stop the drug. I’m sure that there are some people who can stop SSRIs after taking them for long periods of time, but prior to making such a decision, people are entitled to have a good idea of what can happen to them.

  34. Analysis part 9
    A quote from another post here: “Phil followed his doctors weaning recommendation, which was a very rapid wean for his years of Prozac use. His situation didn’t have to be so dire, and he knew this when he started the filming. He was warned by many,myself included, to not use that weaning schedule, it was destined for failure.” The trailer shows him optimistically cutting down with 50%. This is destined for failure for most, but sadly typical for being “assisted by a medical professional”. So if this is what Shipko uses as his guide/knowledge base, we have to doubt most of what he is stating in this post.

    Quick taper is very dangerous for most, including risk for suicide!!!, and many may have had this through rapid medication changes in the typical trial and error methods of psychiatry.

    Those who are on self-help websites want to believe that if they wait long enough (however disabled they may be in the meantime) that they will get better. The people that I have seen, suffering and disabled, waiting years for the ‘withdrawal’ to end are heartbreaking – particularly when they may be waiting for something that is not going to end.
    “Those who are on self-help websites want to believe”. This is tarring a lot of people with a very negative brush:. Gullible people with unrealistic hope. The human experience is so multidimensional that there is guaranteed to be a positive change in some areas (see Monica’s story) and others that stay relatively unchanged. Life is like that. It is not static. There are ups and downs in thousands of domains of experience.

    I don’t think Shipko wants to take away people’s hope, but he does this very powerfully here with an overconfident language , based on nothing but his very selective practice.

    And hope is the main ingredient I healing, so he is very wrong in messing with our hope on the basis of no research whatsoever.

  35. Analysis part 10
    If tardive dyskinesia is any guide, sometimes TD does go away, and sometimes it persists indefinitely. I expect that the same is true for SSRI withdrawal. The incidence of the late-onset and longer-term symptoms is not known because there has been no systematic study of the problem.

    Again, a totally spurious link to TD, no research. If you don’t know, don’t scare people and take away their hope because a few seem to not get better.

    Absent a meaningful treatment for the withdrawal emergent symptoms, proper informed consent before starting OR stopping the SSRIs is critical.

    Who says there is no meaningful treatment! Thousands have got a new life by stopping. Have a look at Monica’s and Altodtrada’s sites!

    Nobody should take SSRI antidepressants unless they know exactly what they are getting into. Informed consent for the SSRIs must necessarily include information concerning the difficulties related to stopping the drugs as well as the symptoms that occur when starting the drugs.

    Agree 100%, but difficulty does not mean impossibility.

    Also, patients who are considering stopping the drugs must also have informed consent concerning possible difficulties.

    Yes, but there is a big risk for nocebo effects.

  36. Analysis part 11
    For this reason, I recently published an eBook, “Dr. Shipko’s Informed Consent for SSRI Antidepressants.”

    Ah, so Shipco actually has a product to sell e.g. at Amazon.com at 4.75 for only 28 pages. Is that the motivation? I actually thought he was so motivated for helping people that this info would be on a website, for free. But this is the highest price per page I have seen in a long time on Amazon.

    It is the first book that gives warnings for patients who are considering stopping SSRIs as well as those who are considering starting SSRIs. The book is short and readable and does mention that the drugs can be very helpful for some patients. Most books on the topic are completely negative about using these drugs, and the bias is off-putting for patients who are trying to make their own decision about taking SSRIs.

    I would hope that patients find the eBook palatable and reasonably objective. Patients in my practice find the book helpful, and when a patient is still interested in an SSRI even after reading the book, I take this as a serious indication of how much they are suffering, and may find that the risk/benefit ratio tilts in favor of trying an SSRI.

    Risk/benefit? Even according to Pharma sponsored research the placebo reaches the same level as the drug only 3 days later. Star* D found that only 3% were helped after one year, and Kirsch found them no better than active placebo, with no clinical benefit over inactive placebo.

  37. One could suspect Shipko for being funded by the pharma industry, and actually be more useful for them than many others. He can scare people from stopping SSRIs and this will benefit the drug industry enormously, especially now that people may think twice about starting SSRIs. After all there are millions that may continue indefinitely with their SSRI because Shipko has scared them so thoroughly with an article based only on his opinions and very selective observation.

    If you know of someone who is thinking about starting or stopping a SSRI, please consider sending them a copy of ‘Informed Consent.’

    Free advertising for his overpriced “book” that was published 16 July 2013 and is already ranked as nr 19 in psychopharmacology, higher than “The Emperor’s new drugs” by Kirsch.

    And again: Not a single reference!!!!!

    • Many thanks, Researcher, for your detailed and succinct critique.

      ‘Is there anything to link these strong reactions with the SSRI? Not really, unless you have a strong biological explanatory model for psychological suffering. This is the danger with Shiopko’s reasoning. It is as much biomedical model as the worst chemical imbalance theories. And he has absolutely no research, just a hunch that it must be the biological imbalance created by the SSRI.’

      You here express well an ongoing paradox and problem with some critiques of Biopsychiatry, that they are themselves quite physical/biochemical regarding anxiety and exhaustion and ‘depression’ etc. That said, I still find it hard to find a purely emotional/cognitive cause for the brain zaps and organ damage and severe pain survivors report.

      I would be curious to hear from any of Dr. Shipko’s patients, some of whom are probably reading this.

      Your references to Peter Breggin are interesting, given Dr. Shipko belongs to Dr. Breggin’s Empathic Therapy group and has a page on its website. Breggin memorably declared that the alternative to drugs was everything else, life itself.

      Thanks again to all. John

    • Researcher and others

      Researcher, your critique of Dr. Shipko’s analysis has taken some of my own concerns to a much deeper level and I appreciate your contribution to this discussion.

      At the same time I would say that your cynical speculation about the doctor’s personal profit motives regarding the promotion of his book and also helping Big Pharma sell more SSRI drugs is not part of civil discourse. It actually misdirects and undermines the importance of this discussion and takes away from the power of the position you are fighting for.

      This discussion vitally needs Dr. Shipko (and others) to reengage and I hope the tenor of some of the responses has not discouraged him (or others) from responding. At the same time I will say he should have been prepared for a contentious discussion because of the controversial and emotionally charged nature of his position.

      Let’s get back into it. I cannot believe that more MIA readers are not bothered (enough to write about it) by the mixed message in Dr. Shipko’s posting regarding his prescribing of both SSRIs and Benzos.

      He has presented one of the most devastating analyses of the long term negative effects of SSRI use on the internet. He promotes a view (based more on speculation, than actual science) that SSRIs, especially after 5 or more years of use, may cause a more permanent condition of Tardive Dyskinesia or Akathisia. “…accompanied by an agitated anxious/depressed state.” He describes them as new symptoms not a relapse of the old.

      Yet, after prophesizing and detailing such a dismal outcome of prolonged SSRI use combined with a statement that there is “…no antidote to these problems” he then states the following:

      “The book (Dr.Shipco’s book on informed consent related to SSRI’s use) is short and readable and does mention the drugs can be very helpful to people. …and when a patient is still interested in an SSRI even after reading the book, I take this as a serious indication of how much they are suffering and may find that the risk/benefit ratio tilts in favor of trying an SSRI.”

      There is a major contradiction of ethics in these statements. If a doctor has evidence that a drug causes far more harm than good, and in this case, short term benefits that precede excessive long term damage, how then can they justify prescribing the drugs to any person, no matter how much they request or even beg for a prescription? “Inform Consent” has no real meaning in this scenario.

      These drugs were created and promoted world wide under false pretenses and corrupt science. The scientific evidence is strong that they don’t do what they are advertised and promoted to do, and that there are terrible side (or main) effects. This is the commonly accepted view of most critics of Biological Psychiatry. And I assume Dr.Shipco would call himself such a critic. So therefore, just because these drugs exist in the market place this does not mean a doctor is somehow obligated to prescribe them. On the contrary, in my view, they should be ethically obligated NOT to write new prescriptions for them.

      Antibiotics exist in the market place. People ask for or beg doctors to prescribe them all the time. Responsible doctors refuse to prescribe them when they are not appropriate due to the potential long term dangers.

      This raises the question: can these drugs (SSRIs) “…be really helpful to people.” as Dr. Shipko states, and is this his justification for why he continues to prescribe them despite the dangers (thus creating this major ethical contradiction). My answer would be, maybe. Maybe SSRIs CAN be symptom reducing in the short term.

      (Warning) Now,I am forced to delve into some speculation to explain why I said maybe. I believe that SSRIs may actually be more effective in dealing with anxiety symptoms than with depression symptoms. Even though I believe the two sets of symptoms are dialectically related, they do have distinct and separate characteristics. One connected aspect of both depression and anxiety is the failure (or lack of confidence) in being able to predict the future within one’s environment.

      Many people on SSRIs have described to me that these drugs seem to take the edge off of their anger and anxiety in dealing with major stressors in their life. For some people this may (in the short run) make their life more predictable and tolerable, and appear to lessen their depression or sense of despair and hopelessness functioning in a difficult environment.

      The truth in all this could be related to the frequently reported SSRI effect of “emotional numbing.” Anxiety and/or anger could be temporarily suppressed or numbed out for some people. Of course “emotional numbing” comes with a price and has major downsides because many of these same people who like the “edge” being taken off in their life also bitterly complain about not feeling emotions matching the actual conditions they are facing in life, such as, not crying or grieving appropriately when some one dies or something very sad happens. Or feeling no desire to connect with people in an emotional or physically intimate way. This emotional state of being is very uncomfortable and alienating to people, and rightfully so because it runs counter to the essence of human beings as social and compassionate creatures. This is one major reason why people decide they want to stop these drugs.

      So what these drugs (SSRIs) giveth they also taketh away. Many people do not discover this terrible tradeoff of symptoms until after they have become dependent on them. And then they will have to face possible major withdrawal problems when they try to get off the drugs, some that could last for years.

      Furthermore, what these drugs giveth (to the small number of people who report benefits) is usually short lived. Uncomfortable symptoms (both old and new) seem to break through even while on the drugs, and certainly continue in the post period of withdrawal. Life is difficult (including the reality surrounding the use of SSRIs) as Monica so eloquently wrote about in her blog. So now the same people (understandably so) desperately ask their doctors for more help. Now comes a new round of pill prescriptions including the infamous, Benzos.

      Now before I start writing about the closely related Benzo ethical contradiction in Part 2 of this posting, I have to ask once again: If a doctor is aware of the risk/benefit ratio discussed above, especially if they claim there is little or no hope for some of these patients to fully recover from post SSRI use, how on earth can they ethically justify prescribing SSRIs to anyone. Am I the only person aroused by this ethical contradiction of supposed “Informed Consent?”

      Richard

      • Now on to Part 2, addressing the ethical contradiction and mixed message in Dr. Shipko’s posting regarding the prescribing of Benzos, and how this may, in some ways, be connected to the actual problem of prolonged symptoms in post SSRI use.

        Dr. Shipko states the following in reference to helping people deal with SSRI post withdrawal symptoms:

        “Outside of using a benzodiazepine. I don’t have a lot of suggestions …Benzodiazepines seem to offer some relief, but they are dependency-forming and if taken regularly result in another dependency.”

        So there you have it, Benzo prescriptions may actually be a PRECIPITATING FACTOR in the unrelenting nature of post SSRI withdrawal problems.

        Dr. Shipko does not specifically say if he prescribes Benzos in this situation (I have asked him twice before and received no response) but he implies that he does by stating “outside of using benzodiazepines…” and “Benzodiazepines seem to offer some relief….”

        So it may be true that many of his patients with persistent symptomology are receiving Benzos for some
        period of time. Now this becomes a whole new factor to be considered in understanding the phenomena of post SSRI withdrawal and must be ruled out as perhaps an additional causative element in this whole process.

        Whether or not Dr. Shipco prescribes Benzos is not critical to my argument here. I am sure many psychiatrists (or even most) do prescribe Benzos when a patient complains about the intense nature of anxiety experienced in post SSRI withdrawal. I believe most psychiatrists do not understand the emotionally crippling nature of these drugs or the serious problems with Benzo withdrawal that could even exceed that of SSRIs. However, Benzos are more than just addictive with withdrawal symptoms.

        As a counselor and a non prescriber of drugs, I must admit that I have not been faced with the difficult ethical decision of whether or not to prescribe a drug (like a Benzo) that I know will provide short term relief to a human being in a desperate state of emotional discomfort. For example, I am sure I would absolutely consider short term prescriptions to a distraught parent whose child just died or some other similar scenarios. But clearly I would rarely (if ever) exceed a 3-4 week prescription.

        However, as a counselor I have had several people literally beg me to convince their doctor to prescribe Benzos to help them manage their anxiety. All of them had prior experience with a Benzo (got them from a friend or bought them in the street) and found them very effective. I did my best in those situations to educate them about short term vs. long term consequences (including the truth about how Xanax received FDA approval). But my attempts at education (no matter how deep I go) usually does not stop repeated pleading requests.

        Here in lies the problem, Benzos ARE extremely effective in most cases in lessening severe anxiety in the SHORT RUN (perhaps no drug is better at this). After 3-4 weeks this effectiveness starts to reverse itself unless higher doses of the drug are used.

        My experience in working with people and reading about other people’s experiences tells me the following: Benzos, overall, undermine a person’s own natural coping skills/mechanisms by causing a kind of atrophy as the person relies more and more on an external pill to manage strong internal discomfort. Confidence in their ability to manage strong emotions or other stressors in their environment are eroded; they feel weak and vulnerable and are susceptible to major anxiety symptoms. And in Part 1 of this posting I made reference to the dialectical connection of these feelings to depression.

        One psychiatrist Dr. Andre Drummond, who has written extensively on anxiety problems, states (counter intuitively), that people with “anxiety disorders” are the LAST people who should be prescribed Benzos. It tends to make their problems worse. He further devoted an entire chapter in one of his books describing a phenomena he calls “The Benzo Blues,” which is a condition of depression developing out of prolonged Benzo use. And I stated in a previous posting that Benzos set people up for having on going periods of crisis interrupted by occasional periods of relative stability.

        Does any of this sound familiar to what people describe about post SSRI withdrawal symptoms? And are Benzos part of the solution, or in fact, part of the problem with this drug withdrawal phenomena. Of course there is no one answer to this problem. These symptoms are most certainly multifactorial and individual and unique to each person’s life circumstance and personal history.

        And in a previous posting I raised the other concern about alcohol and pot being used by some people as a form of self-medication with these uncomfortable SSRI withdrawal symptoms; BTW ethyl-alcohol is also in the same family of sedative-hypnotics as is Benzos and may have similar results.

        (Warning) So we might speculate that after a period of prolonged “emotional numbing” caused by SSRI use that when they are removed from someone’s system or reduced in dose, and as real human feelings and emotions start returning, there is a period of “supersensitivity” or “emotional overwhelm” (as Breggin calls it) as raw receptors are slowly (or suddenly) flooded with new sensations. This most likely feels extremely uncomfortable or intolerable as people negotiate a difficult life (including the problems their depression brought on) and now gets expressed in depressed moods and perhaps even higher forms of anxiety.

        Now in desperation a person asks for help and doctors not understanding or knowing what to do (many should know better) they start prescribing Benzos as a last resort. Perhaps, if other supports and forms of healing were accessed and somehow people could hold on through this difficult withdrawal process then improvement or transformation could be at the end of this journey. But, when and if, Benzos are prescribed to such a person in this journey this could actually create the conditions for “snatching defeat from the jaws of victory.”

        So once again I have to ask: If a doctor is aware of the risk/benefit ratio discussed above, as it relates to Benzos (including Benzos used to treat SSRI withdrawal problems), how on earth can a doctor ethically prescribe these drugs for more than 3-4 weeks, if at all? And is there a direct connection between Benzo use and the nature of SSRI withdrawal that needs further exploration? And where is the real “Informed Consent” as it pertains to Benzos?

        And finally, when Dr. Shipko states in his opening paragraph:

        “If I thought that it was possible, I would have opened a string of clinics all over the country to help get people off of antidepressants. Unfortunately, the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe and long-lasting than the medical profession acknowledges, and there is no antidote to these problems.”

        Researcher was insightful in analyzing the negativity and hopeless in this opening statement, especially when Benzos are proposed as the only hope. Other things came to my mind that do not bode well for people seeking help for these problems.

        I have often thought, and even foolishly suggested to some psychiatrists, that there is a huge “market” out there for treating people trying to come off of Psych drugs. Perhaps I thought, even though I’m a critic of capitalism, that this financial incentive might somehow convince psychiatrists to take a different road away from Biological Psychiatry. It was foolish and it’s not going to happen! At this time only a few knowledgeable and courageous psychiatrists will be willing to do this work and Dr. Shipco’s posting hints at why.

        Most Biological Psychiatrists are obsessed with liability issues and they currently believe that drugging and sedating people limits their risk of suicide and self-harm. We at MIA know this is wrong, but this is how THEY think. Most psychiatrists when faced with what they might describe as unrelenting SSRI withdrawal problems, are going to believe there is too much liability to risk taking on these patients. They will say that these patients are “too high maintenance” and “too risky.”

        And my fear is that people seeking help for these long term withdrawal problems will be viewed like “chronic pain patients” or perhaps people labeled “Borderline Personality Disorder”; people viewed as difficult to work with and to be avoided in one’s practice. We need to fight this form of discrimination.

        Monica, Vanessa, Altostrata and others do important and heroic work in this area. We need to advocate and fight for more attention and research on this important issue. We need to be more scientific while listening carefully to survivors experience. We need to avoid being alarmist or jumping to conclusions without science to back it up. At times, speculation is needed to begin to expand our theories, but let’s make sure we call it that. Perhaps this overall discussion will become a part of that process.

        Richard

        • Interesting points, Richard. Just a couple of quibbles occur to me:-

          $4.75 for 28 pages is pretty cynical in my book, though I do not suspect Dr. Shipko of working secretly for the psych drug makers.

          Ethyl-alcohol in the same family of sedative-hypnotics as is Benzos and may have similar results!? Only if you define that family very broadly. Most people drink alcohol and only a very small minority suffer anything remotely resembling the ill-effects claimed for Benzos. I would recommend alcohol to most people in preference to Benzos and other psych drugs.

          Thanks, Richard. John

          • Part of effects of alcohol are because of their effects on GABA receptors, just like with benzos. In addition to this, alcohol is also for example NMDA antagonist. In a way, you could try to simulate being drunk by taking ketamine and benzodiazepine together. The ill effects of alcohol are well known. If you took a low dose of benzo, roughly equivalent of one or two cups of wine with dinner, you’d probably have no big problems.

          • John

            Thanks for your support. I hope more people will get in on this discussion.

            My intension was not to equate alcohol and Benzos, but only to point out that this type of substance use must also be evaluated as a potential factor in all this.

            Richard

      • Well, yeah! That’s what I was saying – given the very weak evidence of anything positive happening, and the strong likelihood of something negative happening, I’d say we’ve got a great argument for banning this drug for ANY indication.

        I have talked to any number of SSRI users who describe almost a depersonalization experience, an emotional disconnection not only from their own emotions, but from how anyone else feels as well. I believe this is part of what lies behind the less common but sometimes severe violence that occurs with some SSRI users – they would normally be restrained from killing themselves or someone else by empathy for the impact on others, or at least fear of the consequences, but these barriers are kindly removed by the SSRI experience, and killing oneself or someone else suddenly seems like a reasonable solution.

        It is amazing to me that anyone who knows that we could be causing permanent damage to someone’s brain with a very small chance of any positive impact, and when any such impact is at best temporary, would ever feel OK about prescribing such a drug.

        I’d be interesting to hear Dr. Shipko’s rationale for continuing to prescribe them.

        —- Steve

  38. My position is this.

    When talking about psychiatric drug damage, things like autonomic distrubances such as blood pressure lowering upon getting out of a chair, or the movement disorder Tardive Dyskinesia, are things I believe to be well evidenced to have a biology etiology. These are accomplished facts.

    When talking about more subjective mental and emotional states, thoughts and feelings, and even complex behaviors like suicide, I don’t believe the evidence is there to act as if this is some accomplished scientific fact that they are ’caused by’ the drugs.

    Here, we are being asked to believe that permanently, years after taking drugs, stopping drugs, that someone has the scientific evidence to blame some subjective mental state on a drug they took years ago. Nobody has that evidence, as far as I can see.

    I accept that in the days, months, years after chronic psychiatric drugging many functions of the body will come back into place and it can be a very rough road. This is why it is all the more important for people who understand these drugs are dangerous, to oppose involuntary commitment laws that allow forced administration of drugs. I have compassion for anybody who gets caught up in psychiatry, whether that be voluntarily or involuntarily.

    I believe that two things need to exist to produce an unhappy or anxious person:

    1. The human body, in whatever physiological state we find it in at the moment in question.

    2. The human being’s environment, civilization, society, family, others’ opinions of them, etc.

    Those that blame solely the human body, or drugs put into the human body for extremely subjective and complex mental and emotional states, I asked for evidence.

    Asking them for evidence doesn’t make me the worst person in the world, doesn’t mean I am accusing them of being a liar, doesn’t mean anything except they’ve been asked for evidence.

    I’m always willing to hear their evidence.

    Thank you.

  39. Does this fit here at all? No? Yes?

    https://www.madinamerica.com/2012/05/does-anyone-want-a-genetically-modified-brain-anti-psychotic-medications-may-have-been-causing-it-to-happen-all-along

    Edit:

    “RW: You’re right, it creates customers for the drugs, and hopefully lifelong customers. That’s what they’re told, aren’t they? They’re told they are going to be on these drugs for life. And next thing they know, they’re on two or three or four drugs. It’s brilliant from the capitalist point of view. It does serve some social-control function. But you take a kid, and you turn them into a customer, and hopefully a lifelong customer. It’s brilliant.”

    http://www.naturalnews.com/011353_bad_medicine_psychiatric_drug.html

    GMO’s!

  40. Mjk wrote a comment in response to my comment above, mjk linked to a video of a Chantix ad, and asked me:

    http://youtu.be/3hp_y0wDFz0
    Adverse warnings are part of the commercial for chantix. I don’t think it’s a joke.

    I suppose the makers of chantix have the scientific information you’re looking for, since the warnings are known. What are they basing those warnings on?’

    In this very long comment, I speak to the complexity of drug taking and their relation to the complexity of human life. Click ‘read more’ to see this entire long comment.

    I don’t consider an FDA black box warning that posits complex behavior as a side effect to constitute evidence that this is some established scientific fact. And even if it isn’t the FDA forcing them to say this, drug companies have self interested legal reasons to have these disclaimers.

    A lot of people have tried to make this argument to me before.

    As I see it, drug companies and the government first and foremost seek to ‘cover their ass’, legally. The fact remains that people have successfully sued drug companies after convincing a judge or a jury that the drug ’caused’ the thought or behavior in question. This is not the same as proving a scientific theory, it is just the simple act of convincing a government decider, a judge, or a jury, of someone’s take on the matter.

    Governments and judges can say that OJ Simpson didn’t kill anybody, or that Iraq has weapons of mass destruction, or that Adam Lanza’s brain chemistry decided to kill all those kids, and this doesn’t make it proven.

    It seems to me that any legal drug on the market that is a psychopharmaceutical, is going to be given to millions of people, and out of these millions of people, some are going to allege that the drug ’caused’ suicide or whatever human action under the sun.

    Drugs are taken over weeks, months and years, and it seems to me people are apt to fall into this trap that the drug is the only variable. Common sense tells us that something else also happens concurrently over the course of weeks, months and years, it’s that most complex of variables, it’s called life. Life goes on, through the drugged period, after the drugged period, and it seems any and all thoughts and behaviors can be ‘blamed on’ the drug. It is telling that only the dramatic and ‘bad’ thoughts and behaviors get blamed on the drugs. The good or neutral behaviors or thoughts, get cherry picked out of the equation.

    When there is an ad on TV with a voice-over saying that ‘consumers have reported various thoughts’ while on this drug, one must look at why that ad exists. It exists because it’s possible to sue, and it exists for the same reason that all disclaimers across society exist, the legal environment around this commerce. Convincing a judge that an SSRI ’caused suicide’ is not how science is decided.

    Charles Darwin didn’t just hire Peter Breggin to testify to a judge that evolution had lots of evidence behind it.

    Throughout all of this, the mechanism of action, from molecule to rigged up noose in the closet, is never explained.

    It’s interesting you chose Chantix, an alleged quit smoking aid, for your example ad. It is obvious to me that the time immediately following a decision to try and master a cigarette smoking habit, is going to be a fraught time in someone’s life, well known for ‘agitation, hostility and so on’ generations before Chantix was even a glint in Big Pharma’s eye. How the FDA, how the drug company, how the viewers of that commercial, have decided a correlation is causation, how they’ve eliminated the complexity of ‘what life is like for the recent quitter’, is something that is never elucidated.

    To show how hard it can be to part with a ‘bad’ habit, smoking, take a look at this guy:

    http://www.dailymail.co.uk/news/article-1189559/To-ends-earth-British-Isles-stop-smoking–man-exile-island.html

    He had himself marooned on an uninhabited Scottish island, far away from anyone, to help him quit. People go to all sorts of lengths. There are parallels here with someone ‘hiding the knives from the kitchen’ from someone who is in despair or ‘depressed’, or even something like choosing not to own a gun. Life is much more complex than drug in/behavior out. Chantix ads claiming suicide, seem to exist in some fantasy world where people who are quitting smoking never have a rough time mentally and behaviorally while doing so. And to say quitting smoking and the rough ride associated with it is ’caused by’ the ‘nicotine withdrawal’ is not something I entirely by either. It is but a factor. Making a big change in your life, adjusting to it, putting oneself through discomfort for the greater good of a future years or decades in the future, making a time horizon tradeoff, is part of what makes quitting smoking difficult too, among many other factors.

    People who’ve been led to believe that their problems are a disease, are placed in a helpless position, as Rufus May says, they are seeing themselves as ‘passive victims of an active disease’. Then, they place their fate in the hands of what they believe to be a bona fide ‘medical science’, and expect to be ‘worked on’ by the drug, the expertise of the ‘therapist’ or whatever technological fix. When things go wrong, they blame the drug or the doctor. I accept an incontrovertibly biological drug damage symptom like TD or an autonomic thing like blood pressure problems when getting up from a chair, but I don’t accept it as a proven fact that subjective mental states can be wholly blamed on a drug. I accept that drugs in such a situation ‘may’ be a factor, and that a lot of people have decided their ‘best guess’ is that the drugs did this, the drugs did that. This isn’t incontrovertible evidence. This is not to say that drugs aren’t a factor in people’s problems in life.

    Nor do I believe we can prove that in the case of brain damage it is brain damage in = unwanted behavior out. Especially when the speculated upon damage to the nervous system, hasn’t even got objective biomarkers behind it.

    http://www.apa.org/gradpsych/2012/09/tall-tales.aspx

    The above link, references the most famous neuroscience story in the history of the world, that of 19th century man Phineas Gage, who survived an iron bar through both frontal lobes, the stories of his post accident personality and function have been significantly mythologized. Popularly, his brain injury is said to have ‘ turned the popular, temperate Gage into an angry, unstable drunk.’ The truth is, he went on to hold several jobs, travel to foreign countries, and interact with wide varieties of people with no problem after his accident. He was grossly facially disfigured by his accident, and if he turned to the bottle for a time, there are many social explanations to explain his difficulty adjusting to life as a physical ‘freak’ (as was the language of the 19th century).

    Today, we see NFL players who are unhappy people, plan their suicides, write suicide notes donating their brain to science, before they pull out a revolver, and swallow it. We are supposed to believe it’s a proven fact that the many concussions ’caused’ this action, as though washed up sports stars, and their complex social environments don’t exist. To see how hard it is to go from being paid millions, adored by millions of people, to adjusting to ‘post celebrity’ life, just look at any Hollywood child star. Amanda Bynes for instance.

    As always with brain blaming, and with drug blaming, it’s the bad/unwanted actions that get blamed on the biology, the myriad other actions and feelings get ignored. A retired NFL player with ten concussions might play golf on Tuesday, get up and feel like a hot shower before breakfast on Wednesday, put his pants on one leg at a time, look out the window, reflect on his life, feel bad for himself, write the suicide note, pull out the gun, remember what a gun is, how to load it, what its purpose is, and pull the trigger. It’s the trigger pulling that gets blamed on the brain, the myriad other actions in his life, the golf game, the putting the pants on, the eating breakfast, get blamed on ‘just life’, or ‘the person’.

    I’ve seen lawyers say ‘but for’ the drug, a suicide wouldn’t have happened. We could just as easily say ‘but for’ the rough childhood, ‘but for’ the ready availability of a gun, ‘but for’ a Hollywood child star’s career going south when they were not a cute kid anymore, ‘but for’ the ten shots of whiskey. I only seek to say to people that when something is ‘a factor’ let’s call it a factor, not act as if we’ve proven it is a ’cause’.

    Pouring drugs into one’s brain is always a risky game.
    All I’ve ever seen produced in relation to these complex of states of mind and behaviors being wholly blamed on drugs, are statistics, anecdotes, and government claims. And if anyone’s in the business of saying just because the government and big business have decided to put an ad stating assertions on tv, it must be true, then I could paste the link here to the youtube video of the OJ Simpson decision, the Zimmerman decision, the Iraq war announcement and rationale, etc.

    My position is that drugs can disinhibit mood or inhibit mood, but are never the whole story when it comes to complex human behavior and thoughts.

    Science isn’t decided from the judicial bench, or by the legal regulations around TV drug marketing. The epidemiology of the problem of bed bugs in New York City hotels isn’t decided by surveying the reviews of hotel room beds on TripAdvisor.com, and the extent of evidence for ‘syndromes’ around the problems in people’s life during or after psychiatric drugging isn’t decided by Dr. Healy’s ‘adverse events’ internet drug review site rxisk.org, or Altostrata’s forum.

    If Jim Beam was putting ads on TV for whiskey, and the government, and the lawsuit environment dictated that they should have a 10 second warning about bar fights, embarrassing dancing, and not thinking through the decision to get in your car and drive home from the bar, then this wouldn’t mean that science has proven that alcohol turns people into robots with no free will, devoid of a social environment, culture, morals, disco music making you want to dance, your car being parked outside making it tempting to not shell cash out for a taxicab, or guys hitting on some guy’s girlfriend making him want to punch them in the face, and the face puncher’s entire life history and decisions up to that fateful moment in the bar.

    There’s a first for everything. There’s a first time to punch someone in the face in a bar fight, there’s a first time to drive drunk, there’s a first time to become a millionaire, there’s a fist time to try and slit your wrists, there’s a first time to visit the Sears Tower.

    On the day a ‘first’ happens, it is ‘out of the ordinary’, or even perhaps ‘out of character’. Correlation isn’t causation, hundreds of millions of people take various drugs, and some of them convert to Judaism, some of them will start dating today after a long break of not dating, some will take up the Violin, some them hang themselves in a closet with a leather belt. The leap from drug to decision, is something that we can only speculate on. ‘Out of the blue’ someone feels a certain way, is it out of the blue to fall in love? to suddenly take an interest in golf? Life is a dynamic, ongoing process, and I certainly agree that taking drugs that affect mood, drugs than can disinhibit or whatever, can make people feel different in a short period of time. Wondering, keyword WONDERING, what the effects of a drug are, is all we are doing. Nobody should claim they have the Nobel Prize winning proof based on their own personal story. To talk about these complex phenomena in the aggregate, society wide, human condition-wide, as I try and do, is not to diminish, devalue, or demean anyone’s interpretation of their own experiences. This is just my interpretation, you can have your interpretation, I don’t think you’re a bad person if you have a differing interpretation, I believe in freedom of interpretation as much as I believe in freedom of religion. Evidently some people think I’m a bad person for having a different take on things to them. Asking questions, interrogating the issue more broadly, is not something I want anyone to take as a personal attack. I understand a lot of people have a lot of very important messages they want the world to listen to, people are desperate for solutions, and answers, and validation. Urging better scientific validation, is not an act of interpersonal invalidation. And text based communication, in an internet comments section, is not the best format for gauging compassion or sentiment. Ask anyone who has ever tried to ‘sort out’ interpersonal problems via mobile phone text message.

    A world where someone sees an ad for a drug on TV, takes the drug, was led to believe it could cause ‘something’, then lives their life for a while on that drug, and something happens, and then they trot off to court after giving Peter Breggin a suitcase full of cash, and some judge agrees with Peter Breggin’s interpretation of the situation, in no way makes this controversy settled. An FDA black box warning about Tardive Dyskinesia, is a completely different kettle of fish to an FDA black box warning about the decision to rig up a noose in your garage and kick the stool from under you.

    Life is complex, so is the issue of drugs and behavior. A Chantix ad’s myriad warnings aren’t ‘proof’ that within that pill bottle, is a ‘suicide pill’. Plenty of people have driven their car at 70 miles an hour on purpose into a wall during a divorce while liquored up too. I say drugs are a FACTOR in human events, not THE factor.

    All drugs from Heroin to Haldol, are risky things to take, and the problems you can run into taking them, can be very difficult to overcome. Simplistic, pat, statements of ‘causing’ things, are something I don’t buy. I don’t buy it from psychiatry, and I don’t buy it from laypeople either. Life is complex, its complexity should be honored. If I have one message to give this community, it is that the complexity of human life should be honored.

    I don’t believe that when the original author of this piece writes ‘neuropsychiatric’ before a complex behavior or thought he labels a ‘symptom’ can prove all that much about the ‘neuro’ side of things.

    If this is so, then a guy getting punched in the face at a bar, is a ‘neuropsychiatric’ event, and a bartender is ‘practicing medicine’ when he dispenses a mood altering drug, ethanol, over the bar, for tips. And a Friday night ‘on the sauce’ is a ‘treatment’ for a hard week at work.

    If our movement, if anyone critical of psychiatry’s ‘medical model’ demands more from psychiatry than pat blanket statements like ‘he gunned down 20 kids because he is mentally ill, and we know he is mentally ill because he gunned down 20 kids’, then we should hold ourselves to the same standards and not just expect everyone to believe ‘this drug causes suicide because he committed suicide while on the drug or coming off the drug’.

    I don’t take any pleasure in the fact that life is more complex than these ‘creation stories’ of horrible events and difficult times would have us believe. If only the world and human life were so simple. We could ‘treat everyone’s behavior’ and ‘make the drugs safe’ and live happily ever after. Never gonna happen.

    I don’t believe that navigating one’s way from age 0 to 80 is a medical procedure. I don’t look to medical authority to assist me to live my life, tens of millions of people around the world, even hundreds of millions, evidently do, that is their right. Whatever gets you though. Life is complicated and the bad parts of it, can only be ‘seen as’ a ‘neuropsychiatric’ event. Just as certain things are seen by religious people as a ‘sin’. It all depends on whether you place a heap of stock in the explanations around biology. I don’t see any real explanations around biology, I see speculations.

    Here is a quote from Dr. Shipko’s above article:

    ‘ Patients often did well for months, only to develop fairly acute profound states of anxiety and or depression. The anxiety and/or depression was not a relapse, because the patients never had these symptoms before starting the drugs. Because people are thinking of the discontinuation problem as withdrawal, they are not considering the later onset symptoms as related to stopping the drugs. What is somewhat frightening to consider is that patients with tardive dyskinesia sometimes do not manifest symptoms for years after stopping antipsychotics. Will this be the fate of those who stop SSRIs? This won’t be known for a long time, particularly if nobody is doing careful research on the topic.’

    Comparing a movement disorder, TD, with a subjective state of mind, like despair or anxiousness, months, years after someone stopped taking a drug, is a comparison the doesn’t hold water in my opinion. Can someone who ran 2 million drags of smoke, from 300,000 cigarettes through their brain over a 25 year cigarette smoking career, who gave up at age 40, blame their despair age 45 on their drug of choice, tobacco?

    When one thinks in terms of ‘onset of symptoms’ instead of problems in living, as Szasz used to say, ‘we are off to the races’.

    To offer my views on the complexity of life and the complexity of drug taking and the complexity of moving on from drug taking, is not to ‘morally judge’ anyone. It’s to point out what my view of the world and human life is. When I believe what I believe, I don’t expect you to ‘validate my feelings’, and step in line and adopt my beliefs. I have compassion and sympathy for humankind, and I respect people’s beliefs and stories. It is not incumbent on me to ADOPT their take on events and adopt their beliefs. I once believed I was the reincarnation of Jesus Christ. Expecting everyone to adopt this view, would be unreasonable. Even expecting everyone to respect my right to hold this view turned out to be quite unreasonable, in fact these thoughts were seen as something to be exterminated by forced drugging. If someone’s take on their drug taking experience is that they’ve ran into all sorts of problems in the way they feel, in myriad ways, as they go about living their life, living in their body, I understand and respect that they have been through an enormously rough time, catastrophic times in their lives. Speaking broadly about where science is at, where evidence is at, and my views on the complexity of human life, is not meant to be some kind of moral judgment of them.

    I am all for more research, although I highly doubt that researchers who view the whole of humanity as a ‘patient’ with the ‘onset of symptoms’ are the people to do it. Living through periods in your life with dependencies psychological or physical on various drugs, and making the decision to change this situation and stop taking drugs is not easy. I don’t have all the answers, I freely admit this. I wish everyone good fortune in their journey and I offer my thoughts in solidarity with everyone trying to extricate themselves from this mess that is psychiatry’s fraudulent pseudoscience and toxic drugs.

    • You end by saying “toxic drugs”.

      “It’s interesting you chose Chantix, an alleged quit smoking aid, for your example ad.”

      I chose it because I happened to watch a chantix video yesterday, via a research company that pays me to review all sorts of information and provide my feedback.

      Here’s some brainy brain information on chantix
      http://en.wikipedia.org/wiki/Acetylcholine

      Then here’s some more
      http://en.wikipedia.org/wiki/Varenicline
      (From the references: “Leung, LK; Patafio, FM, Rosser, WW (2011 Sep 28). Gastrointestinal adverse effects of varenicline at maintenance dose: a meta-analysis.” and ^ Prochaska JJ, Hilton JF (2012). “Risk of cardiovascular serious adverse events associated with varenicline use for tobacco cessation: systematic review and meta-analysis”)

      Gastrointestinal and cardiovascular. Because those are a demonstrable physical injury, and homicide is a behavior … you think there is no causality of THE DRUG to induce nightmares, bizarre thinking, etc. – unless somebody can give you brainy brain science information to prove it?

      I used the nicotine patch forever ago. It gave me INTENSE nightmares (but then, so did playing and beating DOOM on Nintendo).

      WHY do manufacturers of movies, music and video gaming have WARNINGS and age-limit purchasing restrictions? Show me the brain science that PROVES, in brainy brain science language, that movies, music and video gaming do not deserve to have their warnings and restrictions.

      I believe people CAN have seizures from electromagnetic exposure!! I really, really DO!

      http://www.nintendo.com/consumer/manuals/precautions_console_pak_english.jsp

      And look, you can even have motion sickness from playing video games! Explain to me how riding the bus can impact my body and give me immediate nausea and subsequent diarrhea? It’s a friggen bus ride. How can a bus ride WRECK me so easily – but a PSYCH DRUG (BRAIN ALTERING) is presumed to be innocent in producing severe, extreme MENTAL, emotional and behavioral states in human beings – simply because the brainy brain science information is seemingly lacking?

      “whiskey”

      Please Drink Responsibly!
      (duh, why? because of KNOWN behaviors, maybe?)

      M.A.D.D.

      (did you know that driving while sleep deprived is seen as the equivalent of driving while intoxicated?)

      Where’s the science for the impact of nightmares on human behavior? Can you concede that chantix causes nightmares (in some people) or do you require the BS (brain science)?

      Jesus Christ.

      The power of a WORD is SO powerful that to say JESUS CHRIST can throw some people into a violent fit.

      That’s just a WORD.

      I love you anonymous. You amaze me and make me cry. But let me tell you something. I, for one, DO NOT NEED brainy brain science for ME to know what I know about toxic drugs.

    • “Especially when the speculated upon damage to the nervous system, hasn’t even got objective biomarkers behind it.”

      Neureglin1, a protein that in humans is encoded by the NRG1 gene, is indicated in fetal brain damage – resulting in schizophrenia. Do you believe that is correct scientific informtation?

      I still want to know how society would think and feel if “science” announced to the world that schizophrenia is brain damage. Just brain damage, instead of “mental illness”.

    • Anonymous, I assume you are the only Anonymous commenting on this article. Please feel free to correct me if you’re not. Your long comment is very interesting.

      Quibbles first:-

      You have several times accepted that psych drugs can cause severe physical damage, but questioned their role in emotional suffering. Surely the severe organ and/or neurological damage alone would be more than enough to frighten and depress anyone suffering it, thereby making the drugs just as responsible for their emotional/cognitive suffering as for the physical damage, though less directly?

      Perhaps you favor what some call the ‘Mentalist’ view, stressing the mind over the brain, the view of Freud and many others. That is my preference too. But it is hard to really separate the two, not to mention the spirit or soul. Dualism has limits.

      End of quibbles!

      ‘My position is that drugs can disinhibit mood or inhibit mood, but are never the whole story when it comes to complex human behavior and thoughts.’

      Amen!

      I also agree the legal ‘but for’ criterion is limited in authority and validity outside the courts.

      I still admire Peter Breggin, but I have said on the ISEPP Listserv that his and others’ arguments, in court and outside, that drugs directly cause violence are paradoxically similar to Biopsychiatry’s argument that ‘mental illness’ causes violence. Both are forms of the Robot or ‘Clockwork Orange’ Theory.

      As for whiskey ads, don’t be giving the damned government more ideas!

      Thanks, Anonymous. John

  41. “It is telling that only the dramatic and ‘bad’ thoughts and behaviors get blamed on the drugs.”

    .please
    .remember

    .do
    .not
    .forget

    .these
    .drugs
    .are

    .INTENDED

    .to
    .alter
    .your
    .mood

    Personally, I don’t need too much BS (brain science).

  42. I would like to excuse myself for having made so many posts instead of just one long. However, we might discuss how difficult it is to scroll to the next post vs the effort required to press Read more. The read more may seem offensive to the author, signaling, “now you have become too expansive” when the author just wants to make a thorough argument.

    Personally I just copy the whole thread and have a text to speech program read it to me e.g. while I drive or do chores, and now I manually have to expand all posts to get the full discussion. Would it be possible to have one button at the top choosing expanded or reduced view for the whole thread?

    There is a justification for splitting up posts if there are many themes: The splitting allows for direct relies on topic, instead of people replying to 4 or 5 different topics with the same reply button. So if I have diverse themes in the future, I hope you will not be irritated with multiple posts.

    Another advantage with split posts is that some of the content may be moderated while 90% is ok. Then we would miss the 90% because of maybe one offensive sentence.

    • Yes, if you are responding to specific comments or posting on different topics then it makes sense to submit them separately. When you have one very long response/essay to submit then I ask that you keep it to one post.

      I think of it like our front page. We don’t just post everything in full on the front page, we offer a headline and a teaser so you can then decide what you want to read more about. The idea here is that it’s fine for comments to take up to a page or so of text, but any longer than can dishearten people who are just trying to skim through and get a general sense of the tone of the comments. I understand that this may be an inconvenience for our most engaged readers who want to read everything. It’s here more for the benefit of our many casual readers and lurkers who want to skim, rather than read every word.

      I will add figuring out an “expand all” button to my to-do list. I think that’s a great idea.

      The moderation question seems like a non-issue to me. Here’s why: If something is removed, we save a copy. If it was just for on sentence then you resubmit a revised version without the one sentence. The whole thing can be removed for review and then returned in a very short time. This is, again, much like the way we work with front page authors. We don’t just remove the parts that don’t meet our editorial guidelines. We work on the whole piece until it meets the standards of the site.

  43. Can medication be responsible for complex behavior? It seems like _anonymous is against the thought that medication can be responsible for any kind of complex behavior including suicide and violence.

    Maybe we should let the scientific method help us. If a double blind placebo controlled study shows that patients who don’t know if they are taking placebo or not suddenly report suicidal thoughts and actions, we could use this as an indication that the drug induces the thoughts and behaviors if the medicated group reports 6 times as many incidents as the placebo group.

    What else could be causing the thoughts or behaviors if the research is done according to protocol? The pharmaceutical companies would like to see the opposite effect and they are running the study.

    I have had patiennts who have acted completely out of character the moment the medication has been changed. Some have told about aggressive impulses they never have had before. Should we disregard their experiences? Sholuld we disregard the scientific method?

    • “Can medication be responsible for complex behavior?”

      I think some answers may be found in the differences between why somebody would rob a bank and why another would outright die and why another would murder and why another would suicide and why another would take a hostage and why another would set a fire and why another would torture an animal and why another, etc..

      Why did the one who set a fire NOT torture an animal instead?

      Why did the one who robbed a bank NOT set a fire instead?

      Why did the one who killed somebody else NOT kill themselves?

      Why did the one who killed themselves NOT kill somebody else?

      Why does effexor XR cause brain zaps?
      Is that a simple or complex question?
      I’d really like an answer.
      No, in FACT – I’m demanding an answer.
      And if there is no TRUTHFUL answer, is it because you CAN’T or WON’T.

      Try HONESTY, “science”.

          • My comment was in reply to the focus of “complex behavior”. Researcher didn’t mention effexor XR. I did. That part of my comment was made in general, and has nothing to do with Researcher’s or anyone else’s comments. Researcher (and everyone else here) is not the manufacturer of these drugs. THOSE are the people I’m shouting out to. THOSE are the people I’m demanding answers from.

            I HAD those brain zaps AND many other severe DAMAGES from that loathsome drug.

          • Indeed MJK. I’ve several times suggested in my comments here that such serious ‘electrical’ damage cannot be easily explained except as drug damage. To my knowledge, nothing like them is recorded in accounts of psychological ‘symptoms’ before the modern psych drugs.

            John

      • http://en.wikipedia.org/wiki/SSRI_discontinuation_syndrome#Neurological

        While everybody else is digging into brains, I only care about this:

        “brain zaps,” “brain shocks,” “brain shivers,” “brain pulse-waves,” “head shocks,” “pulses,” “flickers,” or “cranial zings”

        and this:

        dizziness, electric shock-like sensations, sweating, nausea, insomnia, tremor, confusion, nightmares, and vertigo.

        and this:

        According to one source, post-SSRI sexual dysfunction (PSSD) is an iatrogenic type of sexual dysfunction caused directly by the previous use of SSRI antidepressants.

        and this:

        decreased libido, impotence or reduced vaginal lubrication, difficulty initiating or maintaining an erection or becoming aroused, persistent sexual arousal syndrome despite absence of desire, muted, delayed or absent orgasm (anorgasmia), reduced or no experience of pleasure during orgasm (ejaculatory anhedonia), premature ejaculation, weakened penile, vaginal or clitoral sensitivity, genital anesthesia, loss or decreased response to sexual stimuli[26]) that persists for years or forever after the fact.

        and this:

        agitation, anxiety, akathisia, panic attacks, irritability, hostility, aggressiveness, worsening of mood, dysphoria, crying spells or mood lability, overactivity or hyperactivity, depersonalization, decreased concentration, slowed thinking, confusion, and memory/concentration difficulties.

        and this:

        dysphoric mood, irritability, agitation, aggressiveness, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.[citation needed]

        dear brain diggers,

        STOP IT!!!

        It has been suggested the sensations may represent an alteration of neuronal activity in the central nervous system.[38]

        (alteration – maybe you mean MODIFICATION)

        That sounds DEADLY serious. I think you’re vile evil people and need to be S T O P P E D.

        • And another thing – why is it that plenty of people easily accept that these drugs can turn some people into drooling, lethargic vegetables and “zombies” but it’s unacceptable for some people to think or believe that these drugs can turn some other people into killers (of themselves or somebody else).

          Believable to think they’re toxic drugs if they render you IMMOBILE but if they drive you to do something whacky crazy, it’s not the drug – it’s just the person.

          Whatever.

          • Many of us have discussed the question of causation from many angles, MJK. I’ve already expressed my skepticism about the Robot or ‘Clockwork Orange’ theory. Drooling and other symptoms are not in the same category as complex purposeful decisions like murder.

            Nonetheless, if you still believe a drug can absolutely remove all a person’s will and conclusively compel them to kill someone, to the exclusion of all other factors, I cannot prove you wrong. Neither can I disprove the similar theory of demonic possession, which is much older and attested to by better authorities. I wish I could. Both theories frighten me, and I make no secret of or apology for that fear.

            John

          • “complex purposeful decisions like murder.”

            Right, because the drugs are just “unmasking” the natural born killer inside.

            smh

            Oh. “if you still believe a drug can absolutely remove all a person’s will”

            Yep. I do. And many mothers in this world lose their will to keep their babies when pressure to have an abortion is over-powering. I believe people’s will CAN be over-powered, influenced, manipulated, lost, removed, altered … and drug induced.

            Yep.

            lol. One more thing: Personally, *I* don’t need the BS (brain science). Others do. I don’t.

          • @John

            Hi. While I love the rhetorical punch of your comment regarding demonic possession, I’m not sure it is a fair comparison. After all, one would first have to prove the existence of demons, and then that they possessed someone. In the case of the drugs, their neurotoxic existence seems to be a given, doesn’t it?

            On a separate note, I appreciate the imagery of demonic possession, because it is very frightening indeed, and I think it is an appropriate metaphor for being on psychotropic drugs. One feels that one’s mind has been invaded – that it is not one’s own.

            @mjk

            “…’unmasking’ the natural born killer inside”! That is some hilarious use of the word “unmasking.” 🙂

          • MJK, I never said drugs unmasked any natural killer inside anyone, or anything even remotely resembling that absurd statement, which is contrary to the whole tone of my comments. And many mothers successfully RESIST the pressure to have an abortion (or not have an abortion as the case may be). I believe responsibility can be diminished by drugs or pressure or influence or manipulation, but not removed entirely. The person still has a choice, however constrained.

            By the way, is ‘smh’ a typo or is it supposed to mean something?

            John

          • No, Up-Rising. nobody has to prove the existence of either demons or demonic possession for either or both to exist. Likewise everything else that exists. Any philosopher will tell you it’s hard, if not impossible, to prove ANYTHING exists, ourselves included!

            And my comment was intended as more than rhetoric. Like tens if not hundreds of millions of people worldwide I believe the evidence for demons is rather better than that for the ‘Robot’ theory of human behavior.

            But yes, possession is also a good metaphor, though the feeling that one’s mind is being invaded has been described for centuries, if not millennia. Likewise ‘voices’ and other forms of ‘dissociation’. Such things long predate all psych drugs, unlike ‘brain zaps’ and other ‘electrical’ damage. Hence my distinction.

            John

          • ” I never said drugs unmasked any natural killer inside anyone”

            Correct. You didn’t say that. I did.

            smh means shaking my head, as in – disappointed.

            (p.s. What makes a killer? Let’s ask psychiatry & big pharma. I’m certain they know. HOW many deaths are attributed to those murderers?).

          • Ran out of edit time. Had another thought.

            re: (p.s. What makes a killer? Let’s ask psychiatry & big pharma. I’m certain they know. HOW many deaths are attributed to those murderers?).

            It is terror to think they’re doing it intentionally.
            It is horror to think they’re doing it accidentally.
            It is maddening ignorance to think they’re innocent and entirely well intentioned.$

          • @John, 10:11pm,

            Apologies, John. It seems I did misread you. Though my “rhetorical punch” comment was intended as a compliment, I did not understand that you were serious about demons.

            And you are obviously quite right that no one needs to prove the existence of a thing for that thing to exist.

            By the way, I hope I didn’t confuse matters by addressing you and mjk in the same comment, while the two of you were having a conversation. It was clear to me then that the “unmasking” remark was not intended to be quoting you.

            I will say that I thought it was so funny precisely because it WAS “an absurd statement,” and I took it as a parody of that word’s use in trite statements such as: “The benzodiazepines seem to have unmasked your underlying depression” or “The anti-depressants have unmasked your true bi-polar disorder” or “The drug cocktail for bi-polar seems to have unmasked your previously hidden schizophrenia.” (I believe these sentences typically occur in that order.)

          • “Because mjk didn’t explain her “unmasking” comment”

            Psychiatry uses that word – “unmasking” (which is why I used quotations). I was mocking them. Would psychiatry go so far as to say it? IS IT “unmasking” a natural born killer within? ‘kay. Whatever.

            Demons? I’ll respond to that.

            One of my favorite things to say is that Jesus Christ didn’t walk around in Hell telling people to take their meds. Christ *cast out* demons. Demons are *within human beings*. I could say a lot more but I’m not going to.

            p.s. – always feel free to ask me to clarify something and I’ll be glad to respond.

          • “Psychiatry uses that word – ‘unmasking’ (which is why I used quotations). I was mocking them.”

            Exactly, mjk! That’s why it was so very satisfying to read! 🙂

          • No apology needed, Up-Rising. While indeed serious about demons, I am not certain of their existence, and quite skeptical about possession. The late Scott Peck was to my knowledge the only well-know psychotherapist who explored possession and exorcism in detail, though I am wary of some of his ideas. It has been suggested that the Devil’s greatest trick is to persuade people he doesn’t exist, but that’s another day’s work!

            No confusion either. Indeed you distinguished your comment to myself from that to MJK quite clearly. And the unmasking qualities claimed for psych drug by psychiatrists are indeed ironic, given the drugs can actually mask so much!

            Thanks, Up-Rising. John

    • There is much more to life than Science and much more to Science than statistical trials, Researcher. I won’t elaborate on the many problems with RCTs except to say I’m very skeptical of them, even when they support my opinions. Correlation is not necessarily causation.

      Your patients’ reports to you are a different matter, and you are right to pay close heed to them. In short, I value anecdotal evidence over statistical evidence, reversing the modern fashion

      John

  44. Let us take a more down to earth example that many can testify to: alcohol intoxication. Can alcohol change the complex behavior of talking to persons of the opposite sex? Can it make a shy person suddenly talk easily with others? Can alcohol make a person suicidal just like SSRIs. Of course!
    Here is a typical quote
    “Dr. Philip A. May, professor of sociology at the University of New Mexico in Albuquerque, said alcohol plays a role in about 40 percent of suicides in New Mexico. “The younger the individual, no matter what ethnic group, the more impulsive the suicide is, and the more impulsive the suicide is, the more likely alcohol is a major factor or trigger,” Dr. May said.
    http://www.nytimes.com/2009/06/19/health/19suicide.html?_r=0
    How can a drug influence a complex behavior. Probably not by starting up a complex chain of thoughts, but by lowering inhibitions to already occurring thought patterns. Almost all depressed persons have thought about suicide as a remote possibility at some time. Most have decided against it e.g. because of concern for the family. Many of my patients say” If it wasn’t for my children, I would have killed myself”. I believe them and feel safe that they will not do it unless they start with SSRI or drastically alter their dosage.
    If SSRI is started or abruptly changed, many patients report an emotional blunting, including caring much less about other’s feelings. This may be the most important factor in causing suicide or violence: not caring how it affects others. The mother above would no longer have the brake on her already existing urges to end her life, she would care less for the children’s feelings and be able to take action.
    Would we be able to measure this in the woman’s brain? Probably not, but she has ingested a chemical just like alcohol, and we could measure the blood concentration. we have a biomarker for suicidal risk: alcohol or SSRI in the bloodstream. Combinations of several SSRIs and alcohol is probably worse.

    • Researcher

      You make some good points supporting the fact that mind altering drugs can be a significant factor in out of the norm behavior.

      Do you have any reaction to my two part response to Dr. Shipko above on “Informed Consent and the possible role that Benzos might play in the phenomena of prolonged SSRI withdrwal?

      Richard

    • Alcohol has probably lowered more inhibitions against good things like friendship and pleasure and humor, than bad things like violence. Similar suggestions have been made for other drugs, though I am skeptical of them.

      This seems more nuanced than your earlier comment, Researcher. You now have more than a correlation, but still less than causation, except in the rather limited legal sense of ‘but for’. But that’s enough for caution regarding drugs.

      John

  45. Dear Dr. Shipko,
    I will be upfront about barely skimming comments on this post of yours – so you may have already received comparable responses.
    After reading this post about playing the odds I feel compelled to share with you that I think I appreciate what I think you are trying to convey and borderline resent the way in which you are conveying it. I commend you for arguing for informed consent that includes discussion about the effects of coming off of psych drugs and for your message that we need more transparent research and information about the harmful effects of psych – drugs. On the other hand I want to candidly and hopefully respectfully express to you that in my eyes your clinical observation or opinion means very little. I don’t appreciate what I perceived to be a belittling and didactic lesson in clinical semantics. I perceived the usage of the term “citizen scientists of the Internet” as patronizing and particularly weird given the rudimentary, deductive, and confused understanding the discipline psychiatry has with regards to what these drugs are doing and what they are treating. I don’t think that your understanding of what psycho-active chemicals do when someone puts them in their body is more authoritative than the opinions of those putting said chemicals in their bodies. I didn’t appreciate your assertion “It is a very uncomfortable sensation.” Are you speaking from first-hand experience? What the definition of withdrawal is and isn’t may be important for you to educate people about but I encourage you to be prudent when assessing the suffering others experience coming off of these drugs if you haven’t had that experience yourself or are unwilling to disclose said first-hand experience. You wrote, “Because people are thinking of the discontinuation problem as withdrawal, they are not considering the later onset symptoms as related to stopping the drugs.” Whether protracted problems are correctly or incorrectly attributed to withdrawal from a drug – I don’t understand how attributing protracted problems to withdrawal from a drug is anything but considering the problems as related to stopping the drug. On the one hand I think it is important that you share observations about how bad you think it is when people come off of these drugs – in an effort to inform the conversation about whether or not individuals should go on these drugs in the first place. On the other hand – as someone who had over five years of cumulative exposure to various “anti-depressants”, over five years of cumulative exposure to various “anti-psychotics”, and at least 4 years of taking benzos every single day – and now takes none of those drugs – I don’t like articles about improving societal understanding of psych-drugs that in my opinion imply in the first paragraph that it may be impossible to support a lot of people who choose to come off of psych-drugs. I don’t search for antidotes to pain in my existence. For me improving our communal and individual response to dissatisfaction with one’s experience of living – requires us to do a 180 in terms of our willingness to numb experiences away with drugs. So to start an argument about making things better by in my opinion implying that it may be impossible to adequately support people who want to come off nationwide – in my opinion is not constructive. Coming off can involve disabling experiences but in my journey the disabling experience of being on psych drugs was far more damaging than the experience of coming off. I came off of years of daily benzos in a matter of days and went through months of soul shaking harrowing hell. I then went through a relatively fast taper off of “anti-psychotics” and experienced a moderate headache and fatigue for about a month. I then went through a relatively slow taper off of “anti-depressants” and maybe experienced some sleeplessness as a result. Oh yeah and while on psych-drug cocktails I experienced what the experts called dystonia and or Tardive dyskinesia and said may or may not be permanent (for the past three years I have not experienced what the “experts” called TD and dystonia), gaining fifty pounds, sexual dysfunction, and lost three years of my early twenties sleeping and tortured by a perpetually losing and demoralizing battle to stay awake. Loving family and the fight in me – saved me – not “experts.” The “experts” only acknowledged that the psych-drugs had probably done more harm than good in the risk/benefit ratio analysis and then repeatedly demonstrated in the various tapering processes that they had no clear intelligible understanding of what the hell these drugs do and hardly any peer reviewed references about how to effectively come off. And in the process of coming off I grew and cultivated profound inner-fortitude and incredible eagerness to pursue joys of living. Psychiatrists might be biased by the fact that people who come off successfully don’t come see them anymore. I don’t talk to psychiatrists and depend on them and present as disabled by coming off to them because I’m busy living instead of asking them how I should go about living better. The growth and pain I went through coming off might have been something I needed to take self-responsibility for and be encouraged to persevere through when I initially reached out to psychiatry – instead of being offered drugs first, drugs second, and drugs third. Might I experience tardive dyskinesia and or akathisia or what you call depression and anxiety “symptoms” months or years from now – yeah I might – but if I do I don’t think an antidote will be what I need. I encourage you to go forward presenting your observations about scary and harmful long-term effects of coming off of psych-drugs and how you think the harm may be far worse than is generally acknowledged – but I discourage you from framing it in a way that in my opinion implies that you have scientific understanding of said effects. Your observations about such an experiential trial and error process are certainly not more scientific than those who have gone through it. I also encourage you to contemplate that the number of people who have had coming off experiences that were more good than bad might be grossly underreported because they don’t “receive mental health services” anymore. IDK maybe I am misinterpreting your post. Maybe you are open to the need to explore ways for those who want to come off and are suggesting those ways will be things other than antidotes and clinics which fail to address what you percieve to be severe and long lastings effects of coming off. I hope you aren’t arguing that since clinics have no antidote for the effects of coming off psych-drugs – it is impossible for people who chose to come off to come off nationwide.

  46. Below are Dr David Healy’s recent thoughts and advice on SSRI withdrawal / long term damage (as posted on another forum)

    Background: It is now generally accepted that antidepressants can cause physical dependence and a withdrawal syndrome, so that stopping antidepressants can commonly lead to withdrawal problems, that these problems may be severe in some instances but are generally less severe, and that these problems may last for months but are more often over within weeks. This piece outlines what is known about states of persisting difficulty and what can be done to remedy them.

    First, it has been known since the 1960s when dependence on and withdrawal from antipsychotics was first outlined that in addition to classic states such as tardive dyskinesia that might be revealed by withdrawal, a variety of stress syndromes and persisting affective disturbances that have been termed tardive dysthymia, tardive akathisia and other tardive syndromes might also emerge.

    Second, by the time enduring problems emerge after antidepressant discontinuation, the character of the initial problem has commonly changed. The initial problems often centre on phenomena that have been termed electric zaps, and electric head, but later these recede into the background and are replaced by a restless or dysphoric state consistent with a tardive dysthymia or tardive akathisia.

    It should be noted that in addition to the abnormalities of sensation common in the initial phases, many of those affected complain of anxiety and depressive symptoms also. It may not be clear to patients or their doctors that these later onset depressive states are new developments, as they may often appear continuous with early onset withdrawal states and may even harder to distinguish from an original depression than the initial withdrawal state was.

    Enduring states of this type can follow discontinuation from almost all antidepressants active on the serotonin system. The problem has not been as apparent on other antidepressants but this may reflect frequency of usage of SSRIs rather than anything else.

    The problems appear more common in women than in men but this again may reflect frequency of usage.

    The characteristic symptoms include “depression”, depersonalisation, agitation/akathisia, a generally labile state and stress intolerance.

    Enduring problems can follow either abrupt or tapered discontinuation of treatment. One difficulty lies in knowing how common such states are.

    A great number of individuals presenting to their doctors with these disorders are in all likelihood being told they have a recurrent affective disorder and are probably commonly being put back on an antidepressant.

    This will happen for three reasons. First the problems will often look “depressive”. Second, most physicians simply do not think that higher order neurological problems of this sort could persist this long. Third, the problems at this point may seem to physicians to be different to the original problems on withdrawal and those affected may be persuaded of this. This interpretation is made more likely by the fact that most people will have had slightly better periods before a bad period leads them to seek help. But even tardive dyskinesia goes through good and bad phases.

    Finally, this scenario overlaps with problems that can appear after stopping benzodiazepines, where the acute phases of withdrawal, which overlap with acute SSRI withdrawal, differed in profile from more chronic syndromes. The profile of chronic post-benzodiazepine difficulties is similar to that of chronic post-SSRI problems, with the chronic syndromes being more apparent in women.

    Treating Severe Discontinuation DifficultiesIn terms of the initial treatment of severe discontinuation difficulties, there are serotonergic and non-serotonergic options.

    The serotonergic options as outlined in a number of withdrawal protocols involve going on a serotonin reuptake inhibitor such as fluoxetine or imipramine, often in liquid form and tapering extremely gradually.

    A second option involves moving to a tricyclic antidepressant or an antihistamine or St John’s Wort on the basis that these share antihistaminic and serotonin reuptake inhibiting properties in common but are less potent (“gentler”) than SSRIs.

    A third option involves treating with agents acting on different systems. Apparent success has been reported with choline-esterase inhibitors or lamotrigine. These have appeared in some instances to ease withdrawal problems in individuals who have found it very difficult to get off treatment.

    Managing Tardive DysthymiaThe management of tardive dysthymia is a different problem to managing severe withdrawal. At present it is not clear what if anything might help the difficulties some people seem faced with 6 months or more into the discontinuation period.

    Faced with ongoing problems, people commonly ask whether it might be worth going back on the original antidepressant and starting a new and even more gradual taper.

    This seems problematic for two reasons. First going back on something that has caused such difficulties, perhaps through some vulnerability of the taker’s serotonergic or a related system, seems risky.

    Second at least some of those who have gone back on treatment have needed to go back on a higher dose than previously in order to alleviate problems and in some instances a return to the original medication has not alleviated the problem.

    Generally the longer the interval off the drug, the less likely it has been that reinstituting the treatment will lead to a resolution of the symptoms.

    If an individual does return successfully to treatment, the question is what next.

    Based on experience with the management of withdrawal from antipsychotics, one option might be to remain on treatment indefinitely. There are several drawbacks to this.

    In the case of the antidepressants it is not at present known if ongoing treatment increases the risk of premature mortality or other disorder. The risks of fractures or haemorrhages seem slightly increased, and perhaps more substantially increased if combined with other treatments like aspirin.

    If the taker has found the SSRI helpful but also emotionally blunting, this would be a significant impairment to quality of life to have to live with.

    A second option is to turn to an antihistamine, such as chlorpheniramine, or to a tricyclic antidepressant, such as dosulepin or imipramine, or to St John’s Wort. The rationale here that a small amount of serotonin reuptake inhibition is all that is needed to produce a helpful anxiolytic effect in those suited to drugs of this type. SSRIs are in fact almost grotesquely overpowered for the purpose – using one is rather like having a sports car in a 30 mph zone.

    Third turn to a completely different therapeutic principle. Among the options are drugs active on the cholinergic system, calcium channel blockers or dopamine agonists.

    Choline-esterase inhibitors may help tardive dysthymic states, in that they have been reported to offer a benefit in tardive dyskinesia, and have been helpful in some cases of SSRI withdrawal.

    Calcium channel blockers have been reported to benefit some individuals with enduring problems after antipsychotic withdrawal.

    Dopamine agonists or stimulants are used in restless legs and related syndromes, and restlessness is often a component of the problems facing individuals after stopping antidepressants.

    The final point concerns the likely duration of a tardive dysthymic episode. Based on the precedent of tardive dyskinesia, and of the difficulties some patients faced on discontinuation from benzodiazepines such states may last for 1-4 years. In older individuals there is a possibility they may last indefinitely. In younger individuals, they are more likely to clear up in a 12-36 month timeframe.

    The resolution of difficulties may require something like a synthesis of new receptors to replace receptors that have been jettisoned in the face of physiological stressor of the SSRI. Whatever the mechanism recovery does happen but may take years and seems likely to be facilitated by activity of various sorts and most probably an avoidance of psychotropic medication – including antihistamines and other compounds.

    Pregnancy – a Special ConsiderationThe issues above are particularly complex for women considering pregnancy, given evidence that serotonin reuptake inhibitors increase the risk of birth defects, spontaneous abortions, primary pulmonary hypertension and neonatal withdrawal syndromes.

    Although more women on antidepressants have perfectly normal babies than have babies with one of the above problems, there is also the issue of the toll that 9 months of worrying might take on a mother and the effect of this on the relationship between mother and child.

    Women contemplating pregnancy or suspecting or finding themselves pregnant and anxious to withdraw may have very real problems in the event of a significant withdrawal. A cross taper to fluoxetine liquid is problematic in that fluoxetine is also linked to an excess of birth defects and the other problems found with Seroxat.

    MANAGEMENT STRATEGIES

    Managing New Affective EpisodesAnother issue that needs to be addressed is the emergence of what is in fact a new affective episode rather than a flare-up of tardive dysthymia.

    In this case, it seems likely that if someone got well on a serotonergic agent in the first instance, they are more likely to show a better initial response to another such agent than they are to respond to an agent from a different class.

    This raises the question of whether the short term benefit is worth taking given the likely longer term problems. To some extent this issue depends on what the alternatives are.

    First if this is a depressive disorder that has responded to a serotonergic agent in the first instance, it is less likely to be severe and as such the risks of attempting to bring about a quick response with drugs – such as the risk of suicide – are not high.

    It would seem best however to take a drug that has less potent serotonin reuptake inhibiting properties – such as imipramine.

    Second, not intervening pharmacologically is a reasonable option for two reasons. One is that the natural history of such disorders is that they will resolve on average within 12-16 weeks. Another is that there is considerable evidence to suggest that those who respond without pharmacological or other interventions are less likely to relapse in future.

    Third, related to not-intervening there are a number of things affected individuals can do for themselves. Exercising, particularly in a routine, is likely to be helpful, as is physical work generally. Diet, especially avoiding alcohol, is likely to be of some importance.

    There are other more esoteric steps a person can take. One is sleep deprivation, which is undertaken regularly as an antidepressant treatment in many European countries.

    Finally, CBT or other psychotherapeutic procedures may be of benefit, where they would seem to be less likely to be helpful in tardive dysthymic states.

    Managing Withdrawal

    A large number of doctors still halt antidepressants abruptly, possibly for 2 reasons. One, they are not aware they should taper the treatment. Second, it is not possible to taper the treatment as only a few drugs come in liquid form – fluoxetine, paroxetine and imipramine. Given that a transfer to fluoxetine liquid can cause its own problems, making liquid forms of all SSRIs available or disseminating information on how such formulations may be prepared is important.

    Patients undergoing a marked withdrawal from antidepressants need an account of what is known about what is happening to them. Something on these lines:Your brain has adjusted to the presence of an antidepressant and the removal of this stimulus now requires the brain to readjust. In some cases, some people readjust in the way a spring does when a weight is removed – it springs back into shape. For others the spring will get back to normal provided the weight is removed gradually. For some others, the spring will not readjust.

    Some antidepressants appear to cause more problems than others but we do not know why this is. Fluoxetine may be helpful for some people as it makes the readjustment process more gradual but it is not helpful for all and comes with its own problems.

    There are a number other possibilities, one of which is that problems are more likely with potent serotonin reuptake inhibitors such as paroxetine and venlafaxine, in which case the best strategy is to move to low potency serotonin reuptake inhibitor.

    Managing Tardive Dysthymia

    It is particularly important for patients suffering from this condition to have a name for the state and an explanation for what is happening.

    For this reason it is proposed to name the enduring condition that can happen after discontinuation of an antidepressant tardive dysthymia. It is not clear how great the overlap might be between the tardive dysthymia linked to antidepressant, antipsychotic or benzodiazepine withdrawals.

    That a number of people exposed to antipsychotics, benzodiazepines or antidepressants may have an enduring problem has been recognized for some decades. The risks of having an enduring problem appear slightly greater for women, and may increase with age.

    There is no clear understanding of what happens in the brain to trigger such problems but it may be that with extended exposure to an antidepressant, some sensitive individuals lose receptors from the ends of their nerve terminals as part of an adaptive mechanism and when the drug is removed these receptors do not simply return to normal.

    If the explanation offered above is even partly correct, it implies that with time the condition should resolve but this resolution may take months or years. It would seem intuitively sensible to suggest that activity, which helps to refashion nerve endings, would help and those affected should therefore be encouraged to be physically active and in general to live life as fully as possible and avoid shutting down or withdrawing from activities.

    • Thank you for posting this. I find it helful for myself. I’ve been off antidepressants for about two years and am still having some real problems that are not going away.

      I suspect that Dr. Shipko is in the position of the “messenger” who is going to get killed simply for bringing the message for people to hear. He may not have expressed everything in the best of terms but I think it’s important to discuss the possibility that some people are going to be affected by these toxic drugs for the rest of their lives, even after they go off of them. We must entertain all possibilities when looking at these drugs and what they do to people. It is not going to be a popular topic since we all want to believe that things are going to be all right eventually. They may not be all right eventually for some of us. But this is not a popular message.

    • Thanks, Heretohelp. It seems David Healy, like many clinicians, swallowed a very large dictionary a very long time ago.

      Dysthymia and dystonia and dysphoria all seem to be fancy names for depression or despair, or aspects thereof. Likewise akathisia seems to be just an extreme restless aspect of anxiety, or fear. Both could be cognitive/emotional responses and not directly neurological. I am somewhat suspicious when people invent and use clinical terms for such age-old thoughts and feelings.

      But the Parkinsonian tremors (dyskinesia) and brain zaps seem new and different and neurological symptoms, as I’ve suggested before.

      I note that Dr. Healy’s suggestions are all drugs, with the exception of his passing mentions of exercise and diet. No mention of talk therapy, which Healy has condemned elsewhere.

      Stephen, nobody’s threatened Dr, Shipko, much less killed him, just commented on and sometimes critiqued his strident claims in a generally polite way in over 200 comments. We’ve all discussed and entertained the possibilities Dr. Shipko and you suggest. You and he might in turn discuss and entertain the possibility that both of you are wrong.

      Thanks to all. John

        • Stephen

          You are one of my favorite writers at MIA and I usually connect with and agree with most of your positions.

          While I am not a survivor, we both share a common experience of working within the system (I am a counselor in community mental health) and have to deal with (on almost a daily basis) the moral dilemmas related to the harm being done by Biological Psychiatry. You have great courage putting your job at risk in your role speaking out so forcefully at MIA and among your co-workers.

          I am one of the people who has been critical of parts of Dr. Shipko’s analysis in his blog. I don’t believe my criticisms were based on fear or some type of “denial” of the essence of his message. Nor do I think I was discounting or rejecting the experiences of survivors who have first hand experience with SSRIs.

          Do you have any reaction to my two part response earlier that questions his position on “Informed Consent” (prescribing SSRIs and Benzos) and the possible role that Benzos may play in protracted SSRI withdrawal?

          Respectfully, Richard

          • Richard

            I also appreciate your posts and comments.

            I don’t have any problems with anything in your two part response concerning informed consent and the benzos. I think that the problems concerning informed consent, or lack of it, and the indiscriminate use of benzos and SSRI’s are issues that need to be addressed now. Too many people are put on both indefinitely, with no information about how habit forming and truly dangerous they are, which points out the big problem with no real informed consent.

            I was sent out of the hospital with an SSRI that causes heart attacks and a benzo and I was given both with the expectation that I would stay on them! There was no discussion about any of the affects that both the drugs cause. Dr. Shipko doesn’t seem to do a very good job of dealing with these points.

            It’s not so much that I support Dr. Shipko in everything that he says. But I do believe that we need to entertain the possibility that, for some people, the effects of these toxic drugs may not go away. Perhaps Dr. Shipko is not the best person to introduce this topic but at least it’s been brought to the table.

            I believe in neuroplasticity and I believe that most people will probably find their way out of the horrible mess that the drugs wrecked on their lives. They need a lot of help and support in doing this.

            My big question is that, if some people don’t recover from the drugs, what do we do to help them cope with that reality?

          • Stephen

            Thanks for your thoughtful and clarifying comment. I am sure there will be a lot more discussion on this topic in the near future and plenty of opportunities to continue our dialogue.

            BTW, in what part of the country do you reside?

            Richard

            P.S. I had to respond here due to no reply under your posting.

      • John

        I agree with your main points in this particular posting and we share similar views on the entirety of this topic so far.

        However, I think that the phenomena of akathisia as a side effect of psychiatric drugs is more than just extreme anxiety. The feeling of wanting to “crawl out of your own skin” combined with a level of discomfort leading to continuous pacing or inability to sit for even short periods of time, must most likely have some type of neurological component related to a drug effect. I have seen people behave this way and also had the symptoms described to me many times. I am not saying it represents permanent damage or will not subside over time.

        Richard

        • Yeah, I think I got quite severe akathisia when I was started on Abilify. I remember being at my parents’ place. I tried to lay in one way in bed and use computer, then I just had to switch to another position. No position made me comfortable. It was totally annoying, but it didn’t very directly resemble anxiety, at least on subjective level.

        • I’m having to answer your response here since I had not way to do so under your post that concerns me.

          I live in the Buckle of the Bible Belt in the South. I am hesitant to give the name of the state itself because, even though I doubt that anyone that I work with ever comes to MIA, you never know for sure.

          None of the people that I work with have any idea that there’s even a survivor movement. The CEO of the hospital where I work never even knew of Robert and his books and research until I shared them with him. I gave him Anatomy of an Epidemic, plus the Courtney Harding studies (which are old data now), the WHO studies, and the two studies done by Dr. Harrow. When he returned the book and studies he stated that the information was “distressing” but things have been business as usual since then.

          I’m not too hard on him since I know that one person can’t change the system and in our state everyone believes the smoke and mirrors and snake oil peddling that the system carries out. I’ve not met every staff person who works in the hospital but I’ve met a lot and out of a staff of 500 only two people in the entire place are willing to admit to and discuss the harmful effects of the toxic drugs. And they aren’t psychiatrists! These are the only two brave enough and trusting enough to talk with me. Perhaps there are more who are afraid for their jobs. They certainly have reason to be fearful for their jobs.

        • More good points, Richard. Though I might not have put the word ‘just’ before ‘extreme anxiety’.

          Anxiety can be very extreme indeed, including in my experience something at least akin to akathisia as you describe it, decades after my last psych drug. And pacing the floor with fear and worry has been described since time immemorial. Nonetheless no one can inhabit the skin of another, so I accept that akathisia may approach dyskinesia in its effects.

          I still sometimes experience what Hermes describes, in so far as anyone can compare, but I do consider it a form of anxiety, probably just because my definition of anxiety is broad.

          As I’ve suggested earlier, it can be difficult to distinguish direct neurological damage from the understandably dramatic distress it can produce. Which is chicken and which is egg? But, as I also said, psych drugs do seem to cause both, whether directly or indirectly. And the damage can last for years.

          Given so many of our comments rightly focus on the danger of permanent drug damage, one may ask what we mean by ‘permanent’. I wonder what is the longest time a victim has lived with such damage. To my knowledge Tardive Dyskinesia, for example, was warned about fifty years ago. Has anyone survived with it since then?

          Thanks. John

  47. With respect, there is little I can take away from this article apart from the wise advice that no one start and SSRI lightly and avoid them if at all possible.

    Because the opinion about implications of long term outcomes after discontinuing SSRIs is just that, and because the opinion given is so grim, the best thing to do in response is to strengthen the calls for more intellectual honest research.

    The author’s experience may be that he’s seen a lot of people suffer years after they stop taking SSRIs. I can except that possibility. In contrast, I have seen people rediscover a fullness and vitality to their lives once they get off the SSRIs they were told they had to take to feel “normal.” /This is why personal experience has limited usefulness, and why intellectually rigorous research is so important. We need more of that.

    I wouldn’t go as far as some of the earlier comments I read in questioning the author’s intentions. I don’t want MIA to become a dogmatic place, and I appreciate room for people to share both their experiences and impressions as well as their personal opinions so long as those do not directly contradict clear, credible and reproducible data.

    That said, people struggling to make a decision about whether to continue or discontinue SSRIs really shouldn’t looking to this article to help them with that choice. Right now we don’t know enough to predict for anyone what their experience will be with discontinuation after use of 5 years or more. It’s good to be prepared that the experience may be difficult, but not good to have people walk away with the impression that if they have taken SSRIs for 5 years or more, they will be miserable if they stop the drugs. That simply goes beyond what we know, and contradicts the lived experiences of many people who right so eloquently on this forums.

    That means for right now, the best advice I could give to anyone considering stopping SSRIs (and by the way, I am personally in that process for myself right now) is to know all possible difficulties in that path, but then follow your own best wisdom and instincts as to what is the right course for you, and don’t let anyone convince you that you are “doomed” to a miserable experience if you’ve taken SSRIs for too long. Know one knows that with any concrete evidence, though we all have our different opinions and impressions.

  48. stan,french, 62 years, 12 years of paxil 20/10 mg, withdrawal of 11 months;
    no help from anyone,

    I found a U.S. forum and I understood what was happening to me on this forum
    it was explained that after two or three years we were healed, and we will had only our original problem, small occasional panic in my case,

    Today, after a slow weaning, I find myself in the theories of Dr. Shipko;
    After almost four and a half years out of any medication:
    I suffer from akathisia which broke late after stopping, as well as
    musculoskeletal problems, motorcoordination, unable to exercise, everything came and /or exacerbates the second year;
    I recognize myself in the damages mentioned by mr Shipko,
    I understand when he speaks of the danger of stopping these meds, even with a slow taper of the paxil.
    I was not very good, but since I stopped, I am disabled as Dr Shipko explains;
    if I had not stopped, I think I would be better than i am today;
    I think those who have taken 3 or 4 years are doing more easily, but for long periods, it is a different story;
    I know many cases like mine who go away from forums because they are not understood;

    I thank Dr. Shipko to talk as do a handful of psychiatrists and reporters;
    thanks to this people

    http://toxicantidepressants.fr/

    • I’m very sorry for your suffering Stan, both from the withdrawal and from the isolation caused by the lack of understanding by others. I guess this is why people get told they have to stay on the drugs for life because actually taking these drugs cause such changes in the brain and body that if you stop you will feel the damage of those changes. Perhaps we feel the damage for life? That’s a scary thought.

      Anti-depressants maim and sometimes kill. That much is clear. The same can be said for benzodiazepines which Dr. Shipko is all too willing to prescribe. Wish he would educate himself further on psych drug damage.

      All the best Stan, I too am over 4 years off and still hurting badly and disabled. At this point we have no choice but to keep going forward with our decision to come off the drugs because going back on is not a solution nor is going onto a different psych drug. May you find peace and joy anyways.

  49. When i read Dr. Shipko’s article, my heart sank. “there is no guarantee that these symptoms will go away no matter how long the patient waits” Stuck to me.

    I am a 24 years old female from South Africa still suffering from Protracted Withdrawal 13 months later.

    I was on antidepessants (20mg) for 4 years for anxiety and situational depression. I was 18 when placed on these drugs and from the moment i started taking them, i noticed horrible side effects and became even more depressed. The more i wanted off, the more each and every doctor told me i needed to be on medication for life! After 4 years i finally took the courage and got off the medication. I tappered within 6 weeks. A cold turkey. I was very very sick. I went to see a Psychiatrist because i was experiencing some strange symptoms known as Derealization, brain fog and anhedonia. He assured me withdrawal from paxil cant last more than 6 weeks max and that i have developed a severe Anxiety disorder (Yeah right, just like that, overnight, coincidentally the same time as stopping my paxil) He said its definately a return of my symptoms and Prescribed Cymbalta. Little did i know the horror that awaited me! Upon starting the cymbalta, i had an extremely severe adverse reaction on the second day. It felt like the blow flow in my brain was constricted. I was sick as a dog, vomitting, my vision went extremely blury and i developed massive DR/DP. I called the doctor immedaitely and he said laughingly ” Oh thats strange, ive never heard of something like that happening, just stop for now and maybe try something else” I was in a terrible state. I luckily found a support group who advised i should reinstate the paxil. After 14 days of reinstatement i quit again, because it was making me feel worse.

    So here i am, 13 months later, no improvements and suffering. I am 24 years of age and it feels like my life is over. Then i read the above article and it makes me give up hope.

    If there is anyone willing to talk to me or give me some reassurance that i will indeed recover, please. I suffer from Severe DR/DP, Brain fog, anhedonia, visual distortions, dizziness, extreme fatigue, head pressure, pain behind my eyes, headaches, and the list goes on and on.

  50. Protracted Withdrawal Syndrome from antidepressants is a horrendous experience, hardly comparable to anything else there is and ever will be.

    I am a poly cold turkey, long-termer (8 years) survivor (high doses of SSRIs, benzo, antipsychotics) switched between the drugs, the doses going up and down. The worst imaginable combo. I am about 5 years off now. Most of the WD was pure hell that no words will ever be able to describe. Yet, since about 3-4 months now, I have started to feel quite considerable improvement (it did keep improving earlier on in WD), but only now am I rationally and instinctively certain that, at some point, I will be able to fully heal. There is still some way to go, but my faith in the final recovery grows with every passing month.

    For those reading it, please, do NOT ever give up. It is possible to keep healing, even in the worst possible circumstances. Our bodies are incredible resilient, and designed to self-repair. Granted, in some cases it may take time, lots of time, but “lots of time” is nowhere near “forever”.

    I hope this video I made about a month or two ago will bring you hope and help you keep faith:

    http://www.youtube.com/watch?v=mea-NdKBpUQ

    If anyone was also interested in learning more about all aspects of antdepressants, there is also this full-length movie called
    “Overpill”:

    http://www.youtube.com/watch?v=ZmXIUnjztvI

    Greetings from Poland

    Keep healing

    Luc

  51. “Outside of using a benzodiazepine…” is quite off putting considering that they are equally as dangerous or more so. It shows how reckless you are and that your words should be taken with a grain of salt. Adding any benzodiazepine to the situation would be the worst thing you could do to ANY person. That you are wholly unaware of this is disturbing. Yet, I’m not surprised by it because that’s the patent solution and why so many people are suffering the consequences of ignorant doctors who blindly prescribe one pill after another to fix problems only to make them much worse. Perhaps psychiatry should stop the assembly line pill pushing and spend some actual time teaching patients some of the myriad of coping skills that would benefit them and don’t involve dangerous drugs. Things like meditation, relaxation, cognitive therapy techniques, deep breathing, etc.

  52. While Dr Shipko’s comments may have SOME truth to it, the part that its for life IS NOT. I was on Effexor for 10 years for a reason i’m not sure of. I did have mild GAD, but I was given samples of Effexor because my heartrate was fast because I was nervous when I went to the Dr for a physical! 10 years later, my cholesterol was always high, so stupidly I stopped taking the 75mgs that i’ve been taking for 10 years. I experienced zaps, the usual, not too bad, then it all went away after a few weeks. 3 months later all at once while I was looking in the mirror I began getting horrible fear, dread, and GAD. Never in my life had I experienced this. I was afraid to go out, paced constantly, and was always horrified for no reason. Of course Pdocs try to give u more meds, and no one recognized any withdrawal effects since it was a few months later. I gave in and began taking the same dosage of Effexor 2 months later after there was no relief at all, and experienced no relief. I went through this living hell for about 7 months, and began to get better. My appetite came back, the sweating stopped, and my fear and feelings of dread were slowly disappearing. As the months went on, I continued to get better and better, until the 2nd year. By then I was 98% recovered. Now i’m left with this 75mgs of Effexor I was taking when I reinstated it 2 months after the hell began, so I started doing it the right way instead of cold turkey. I was doing a 10% drop per month. I noticed that after anywhere from 4 days to 2 weeks i’d feel symptoms, but nothing too bad. I did this for a few months, then decided to do a 5% drop every month instead. Same issues here and there, so I started doing a 3% drop per month last year. I did fairly well on this pattern and got down to about 41mgs until last September, when I woke up with adrenalin rushes in my legs, and felt the same horror I felt 3 years prior. It went away the next day, but I was afraid of the old symptoms returning. I decided to hold the taper for awhile until I completely stabilized, and then I would continue. As November rolled around, I began getting limited symptom panic attacks at times, then headaches, other times head zaps. The limited panic attack seems to be the most predominant. I was able to function and live life, since no phychological effects happened. Finally in mid January, I returned to the state I was 3 years ago. I tried upping the dose a few milligrams, but there’s no difference. I’m now up to 46mgs, and guess I will have to wait this out again until it subsides like it did in the past. To be clear, I never had this in my life before meds, or until I first went cold turkey 3 years ago. But the point of this story is that, no a permanent akathisia is not definate. I healed, and I think if I didnt reinstate the Effexor, I still would of been fine.

  53. I have myself never used psychiatric drugs; however, I have a close friend who used them for a long time and has successfully gotten off them in a fairly short period of time–about two years including a strong pain killer. It was not easy but she persisted. Supplements and a careful diet were part of this; and having people to talk to when things were difficult. That these drugs are addictive should be obvious. Unfortunately what I believe we have here is the situation where the attempt to avoid negative feelings and emotions led to a very poor solution–the drugs. And now the demons have gotten stronger. There is an interesting book which some might find useful–Healing Through The Dark Emotions. I believe from my own experience of going through a seven year depression in my 20’s that even the worst dark condition can be faced and overcome. But one will need some support. Consider the persons who survived the Soviet Gulags or the Chinese Gulags. Consider the many persons down through history who have gone through unmentionable horrors and come through better persons. It can be done. It is unfortunate the psychiatric profession in conjunction with the pharmaceuticals have in effect created a criminal enterprise that is highly lucrative and in many points not different from the British opium trade. But having in a certain sense been taken hostage by these unethical persons one now needs to make a clean escape. All the pain, suffering, misery can be used as fuel to create yourself anew!

  54. ” the drugs can be very helpful for some patients” –can they really? And for how long? What will eventually happen? I consider this a very dangerous statement. An unscientific statement. Generally the drugs rob persons of the very capacity to even know if they are better. I wonder if the doctor has considered that feeling depressed might be a statement about how the person is living his or her life. In which case maybe a change is needed. But if taking a drug makes it okay then the message is ignored; and at what peril? No, these drugs are poison. The very idea that negative emotions and thoughts are merely a screwed up physiology that needs a drug adjustment is a theory which just happens to make psychiatrists and drug companies a lot of money! There is no scientific proof this idea holds water. And I am certain there never will be. For a doctor to give a drug of this nature to anyone is unethical. Remember, do no harm.

  55. Same issues. Trying to get off Prozac due to SSRI sexual issues. Thankfully Buspar has helped. All the therapy in the world cannot help unexplainable depression. That is what I get stuck on. It wasn’t there before the drug. I started it for PMDD and anxiety. Now when the dose gets under 5 mg after about 3 weeks I am a crying basket case. I have trouble knowing what issues are real and what is drug related. Logic goes out the window. Then I up the dose to 10 for a few days and I become serene again. It is so tempting just to stay there but I work for hospice and I know it is not normal to go through my days and not feel. At least I have that emotional compass. This crap sucks.

  56. I see I’m very late to this discussion, but I’d like to add my two cents:

    I, like many who have posted, find it very alarming that mainstream medicine and pharma do not recognize these problems, as significant as they are.

    As a someone who was essentially a kid, 18 years old, first year in college, when I was given Zoloft and klonopin to start…which cascaded into most everyknown SSRI, SNRI, AAP, etc. known to man, leading to a staggering 47 individual medication (of course a lot of these were taken in combination) as well…that I am now 27 years old and essentially off most of the medicines (yeah, I don’t feel great. yeah things aren’t going well), that the message is you’re likely worse off the meds if they aren’t helping you and if you want to go back you might be up a creek anyway.

    Why aren’t doctor’s advocating for their patients’ from the start? I’m sure I could have worked through my initial issues with intense psychotherapy, or at the most stay on an AD for a short time. I didn’t get an “Informed Consent” that the rest of my life was going to revolve around multiple pills a day that don’t even help me to function or go about day to day activities and life.

    My message is that I understand you have your profession and need to stay in business, but maybe if you and your psychiatric ilk didn’t put essentially anyone that walks through the door on antidepressants to begin with, we wouldn’t have to have the discussion, to the effect that we are having it, now. Please don’t tell me that patients are fully evaluated. I don’t believe that a person can diagnose an invisible illness that only comes from really knowing someone’s behavior by sitting with them for 15-20 minutes.

    Matt

    • The part that really bothers me is this “Informed Consent” you write about.

      I would really like to know how many psychiatrists, from the start of therapy, tell their patients that there is a significant chance the first antidepressant I give you will not be effective, and while the second one I prescribe will likely do the trick (or at least it does for some people). How many practitioners go even further to say that many people feel their medicine stops working, and have to start a new class of meds with debilitating side effects that the first class didn’t have.

      I saw several psychiatrists since I was 17 and they only had these conversations with me once I presented the symptoms of this so called “refractory depression.”

      People are saying here that the author’s post is doom and gloom, which is it, but I think doctor’s should be just as candid about the antidepressant from day 1 of giving the nice samples from the pharmaceutical company.

      But, I guess, if everyone got better, or patients weren’t given AD the minute they walked through a door you wouldn’t be able to secure new patients and make money and get spiffs or incentives for prescribing medication that the pharma rep gives to you. If you lost all the AD patients who didn’t really need them, you probably wouldn’t have a business.

  57. I would have liked to have had the option of therapy.

    My doctor diagnosed my stress induced anxiety without any questions and within five minutes prescribed an antidepressant which he could see I was very worried about taking. He assured me that this drug would help me and even told me not to read side effects.

    I developed what I know now to be Akathisia and was back in his office everyday thereafter for a week, progressively getting worse. He was obviously not aware of this serious side effect and went on to prescribe another antidepressant. I became suicidal and developed many side effects, bit still, was dismissed by all health care professionals. This drug was impossible for me to withdraw and believed I would never be free and would have to live my life chained to this drug.

    I have now hit poop-out (something else we never here about) and have lost every single human emotion and have the harrowing withdrawal to do on top, including the terrible condition Akathisia.

    I feel well and truly let down by health professionals. I went to the doctors with an anxiety disorder. I am now unable to care for myself or my family and am 24 hour suicidal.

    We all had a right to know about the possible outcome of these drugs. I, for one, and I’m sure many others would seek alternative therapy and never touched a single pill.

  58. I registered just to comment. I discontinued Cymbalta about ten days ago, and my life has become a living hell. It was prescribed for me in 2004 by my rheumatologist for fibromyalgia.

    A bit of background…over the past 18 months, I’ve been experiencing hypnogogic hallucinations with accompanying sleep paralysis. I recently realized that these incidents were occurring only on the days when I failed to take the Cymbalta on time. Since it has a half-life of only 10-12 hours, the hallucinations were not hypnogogic, but actually mini-withdrawals.

    Fast forward to ten days ago…the hallucinations returned without sleep paralysis. I don’t believe I can describe how frightening it is to close your eyes and still be able to see your surroundings. It was as if my eyelids were transparent. I could even turn my head and look around to view my bedroom. The only way I could tell whether my eyes were opened or closed was this: when my eyes were closed, a threatening figure would appear in close proximity to me.

    Being a rational person, I knew they were hypnogogic hallucinations…until ten days ago when I realized I could move during them. That’s when my research uncovered “SSRI Withdrawal Syndrome” and I heaved a sigh of relief that a straitjacket was unnecessary. (No, I didn’t entertain the thought that my house was haunted. Don’t be ridiculous.)

    That’s the worst symptom, the one that made me think I was losing my mind. I also have the “brain zaps,” horrible vertigo, nausea, cramps, diarrhea, headache, tremor, myalgia, paresthesia, and cognitive difficulties. And many of the fibromyalgia symptoms have increased in quantity and intensity.

    Had I known, I never would have begun taking Cymbalta. Nor is there a protocol in place for discontinuing the drug. The prescribing information merely says, “A
    gradual reduction in the dose rather than abrupt cessation is recommended whenever possible.” However, I took 60mg per day for ten years and the lowest dose available is 30mg. With a half-life of 10-12 hours, there is no possible way to gradually reduce one’s dose since Cymbalta is a capsule.

    In the meantime, I have no idea how long these symptoms will last or if they will worsen.

    • I am so sorry to hear the difficulties you are having! It sucks to have to go to an internet chat room or message board to get information you should have known before you even started taking that stuff. It infuriates me that we are lied to, including many lies of omission, and that when we do bring forward such concerns, the docs are more likely to diagnose something new than to conclude the obvious: the drugs are the cause.

      Wish I had something more helpful to say, but it sounds like you’ve connected to others who have made it through, and they are most likely your best resource. Good luck, and I hope you keep posting!

      —- Steve

  59. for those who need hope about the possibility of healing:

    Today on Beyond Meds is the first of the IT GETS BETTER series:

    SEE: It gets better: A Portrait of Poly Psychopharmacology
    http://beyondmeds.com/2014/08/11/it-gets-better/

    The “It gets better” collection will be a series of republished posts from when I was gravely ill from the psych drug withdrawal process and the following protracted psychiatric drug withdrawal syndrome. So many folks out there are now going through the heinous process of finding their way through psychiatric drug withdrawal syndrome and other iatrogenic injuries from psychiatric drugging.

    While many find their way through after weeks or months, for others it can take years to really get out of the deep disability and darkness it creates. I’m going to start reposting my personal pieces from those difficult days, so that people can see how far I’ve come and find hope that they too might come out of that darkness and find some peace and joy again. I know it’s possible from my own experience and from the many who have found healing and wellness again on this journey ahead of me and with me.

    During these times I was unable to sit upright in bed. I was only able to walk to the bathroom and rarely to the kitchen. My muscles became totally atrophied. I was too weak to hold a toothbrush up to my mouth and therefore went a couple of years without doing what most people consider simple acts of hygiene. I wrote with the laptop propped on my knees and my head propped up a bit with a pillow. Writing was a lifeline that helped me continue. It’s been a source of great joy to find out that my keeping this blog has helped so many others.

    This is not my reality anymore. I am up and out of bed. I practice yoga daily. I dance, I walk and I cook and run errands and do chores. I have not achieved perfect functioning. I still can’t make firm commitments or travel. Still I can enjoy many things in life and I’ve developed a deep appreciation for what I’ve been through and how much it has taught me. Life is a wondrous thing and simply being alive is a reason to be grateful as far as I’m concerned.

    I’ll post one a week for a while and see how it goes. Most of these were written from within a dark fog of various sorts of pain and hellish sensations. I will be leaving them largely unedited, so consider that when perhaps something is not clear.

    SEE: It gets better: A Portrait of Poly Psychopharmacology
    http://beyondmeds.com/2014/08/11/it-gets-better/

    • Thanks Monica for lightening the thread. The article is dangerous in it’s hopeless prognosis for us.
      Wish me luck. After 16 plus years on SSRIs & SSNRIs I’ve finally had enough.
      I wish to God I’d never touched this muck.
      X

  60. I’m glad I stumbled on this article. Although it isn’t the most hopeful thing I’ve read, I’m glad to find something that acknowledges that this problem exists. I haven’t found much information to go on. I’m tired of being told I should be better by now, and that panic attacks only last a few minutes, when my experience demonstrates they can last much longer.
    I was started on Prozac when I was around 11, I am now 31. I’ve tried different medications and have only been able to get off them twice. The first time, I tapered off Effexor in two weeks with the help of my doctor. Four months later, I had completely debilitating anxiety. I couldn’t eat or sleep. I constantly rocked, day and night. I couldn’t leave the house. This went on for weeks, until I hardly had the strength to walk down the hall. I went back on the Effexor.
    Fast forward about five years. I tapered off from Wellbutrin over the period of a year. Again, I crashed a few months later. This time, it was far more severe. I didn’t want to go back on an antidepressant, but my doctor gave me Imipramine, stating it was something given kids that wet the bed and would help me sleep. I didn’t know it was an antidepressant, and was too scared to read about it. I was terrified to take anything and I had already scared myself after reading about Ativan. I did take the Ativan, as the constant terror and not sleeping was too much to handle.
    It is now three years later, and I am still unable to work full time. My marriage is ruined, due to my husband not believing I could still be having symptoms. Added on to the anxiety, I recently started a tongue/ throat click that I hope is just a temporary thing related to anxiety.
    Every day is a struggle, but I know it could be worse. As long as I keep up with exercising and eating the best I can, I can usually stay out of the deeper depression states. I’m living as if it is possible to heal, and trying to accept that this may be as good as it gets.
    Thank you.

    • Good luck and best wishes for healing. How terrible being on these posions at age 11…. for help go to the website surviving antidepressants. I gave up too late, I lost my marriage, my home, my finaces, my employability (my career), and have been on disability now for 5 years… No one warned me…… The illusion that these drugs help is a blatant lie. They cause trauma and distress, what both of us are experiencing, and it doesnt go away like normal depression.

  61. WoW ~Hot Topic~
    I agree with the ideas and thoughts and feelings presented by everyone on this topic. ~Almost all.
    I took 900mg of Wellbutrin for nearly 16 years.
    2 ½ years ago I quit Cold Turkey
    Wellbutrin XLR 450mg ~Still on 200mg ~Don’t even want to “think” about tapering off again
    Seroquel XL 900mg ~I went Down to 400mg of Wellbutrin first
    Topamax 100mg ~Then I went Down to 200mg of Wellbutrin
    Depakote 750mg
    Klonopin 2mg ~Still on 1 and 2mg per day ~Depending on the day
    Abilify 40mg
    Levothyroxine 125mcg
    Metformen 500mg
    Prilosec 40mg
    Flexarill 30mg
    Baby Asprin
    I can’t remember what The Others because~obviously~I have brain farts.

    What is BuPROPion Hydrochloride. Ask Alex Jones and Dr Brownstien what Hydrochloride does to The Human Body and Mind? Don’t Ask If You’re Not Sitting Down. Hydrochloride is POISON.

    http://en.wikipedia.org/wiki/Hydrochloric_acid

    ***https://www.youtube.com/watch?v=dn2YgaosT_E

    Thank You Stuart for shedding light on the truths you’ve presented.

    Thank You Monica you are so very helpful, and I will definitely read your articles {when I feel better}

    I’m new at writing and this site, however, my soulmate, Casper, brought it to my attention 2 ½ yrs ago when he saved my life and my vision and my SOUL.
    I wasn’t going to start posting because I didn’t feel I have anything left to share.

    But I See The POWER of this Site and THE MOVEMENT. This Is Working.

    Also, ~KUDOS, AUBREY for your Spirit To Stand Up For The Truth ~It’s Not Easy

    https://www.youtube.com/watch?v=kqXek853SDE&list=RDkqXek853SDE#t=9

    ~Sarah Blair

  62. I can truly relate to this topic. My life was destroyed by Pfizer’s Zoloft.

    After taking Zoloft for 11 years prescribed for my first major depression episode, I suddenly experienced a worsening of all symptoms overnight, to the point I thought I had stroke. Went to the hospital, made CAT and MRI scans and it all came out normal.

    I always thought Pfizer and my doctor were my guardian angels, but now I know in hindsight that they were my undertakers in disguise. The truth about long-term anti-depressant has been swept under the rug all these years to the point that it is now becoming the pink elephant in the room. `

    I only wish I had a way to make Pfizer held accountable for the damage I know Zoloft has made me. I feel I have been silently lobotomized. It was the perfect crime, as days before that fateful day last year, I would have swear on the bible that Zoloft was my life-saver. I feel I simply have overclocked my brain over the years until one day, without any warning sign not only it stopped working, as became burning gasoline in my brain, and I wasn’t able to stop the fire ever since.

    When I told it to my doctor he just didn’t believed that Zoloft could have changed its effects so dramatically and ordered me to double or even triple the dosage until it worked again. That only added fuel to the fire. I made this diagram depicting my pharmacological path:

    https://drive.google.com/file/d/0B_pa-g27qiWIQk9JaGxCSWZGT28/view

    Once I upped the Zoloft dosage I got into a permanent anxiety and agitated state of despair, near to psychosis but without hallucinations.

    Since the day that Zoloft has failed on me I have been experiencing a permanent burning sensation in the left frontal side of my brain, accompanied with constant painful and despairing sensations of “pins and needles” in that part of the brain.

    I feel hopeless that no doctor could take these symptoms seriously, quickly labeling them as anxiety effects or “sensory hallucinations”. I’m aware that the brain doesn’t have sensory abilities but I also know my body and this is just not normal and it’s simply impossible for me to believe that it is of psychosomatic or somatic origins. It feels too painful and constant and there’s nothing I’ve found that is able to sooth it.

    I know that I was taking Zoloft for 11 years when this first appeared rendering useless all further medications, so there’s absolutely no doubt for me that Zoloft was the single responsible. Even if I try a single pill of Zoloft today I get a psychotic attack in a matter of hours, completely loosing my mind and ability to control myself, as if my skull contents were replaced by a gallon of burning acid, rendering impossible any controlling thought attempts.

    I’m just so sorry and feel so frustrated and helpless that I haven’t found Robert Whitaker’s books years ago, as it would probably had saved me my life. Now I feel it is too late. Pfizer has lobotomized me. And I feel ridiculous for being Portuguese, thinking that our Egas Moniz was a shameful example of medicine practice, only to find out that 65 years after his ridiculous Nobel prize, untrue science and dishonest clinical practice would still have a way of performing the same brutal surgery, now chemically through a psychiatrist with warm and harmless manners, silently through the years, one pill at a time.

    I always thought we lived in an age of science. When I attended university and back when I had an engineering job, I knew that the wrong bytecode in a critical piece of software could make airplanes crash, and make vital signs machines fail in hospitals, leading to the loss of innocent lives.

    Never did I suspected that there could be any science where the principles of forward validation where not met. How is it possible that drugs tested only for 6 weeks, become the long term treatment of patients over decades? How is it conceivable and acceptable in our age that such a science crude and primitive easiness is allowed? How can it be possible that these principles of the scientific method are not the de-facto measure used for new therapies’ approval? This is shameful, uneatable, unpalatable, unqualifiable.

    How can man conduct such a global scale experiment with genocidal contours, replacing the required medical engineering-validation by the nature validation using human guinea-pigs?

    Psychiatry should be in deep mourning mandated by regulators to re-invent itself. Regulators should be held criminally liable for the consequences of these drugs being spread and approved across all continents without consumers being warned of the TRUE potential risks of being chemically lobotomized.

    I was certainly unaware of the long-term risks of taking Zoloft. I was told by my doctor to think of it as insulin for diabetes. And now that I look in hindsight to what has happened and see it validated in Whitaker’s revelations, I am simply ashamed of living in this “modern age”. What psychiatry is making is not honorable and does not reflect the high standards of scientific validation in our times. What psychiatry profession is making is a medieval experiment fueled by Big-Pharma stockholders interests, banking at the cost of an ongoing genocide machine.

    I never believed in conspiracy theories but this is certainly one.

    My life is divided between my unrelenting agony and the admiration of Whitaker’s astonishing work. I couldn’t admire anyone more than I admire him. If I still have any willingness to live left, that is solely to honor his contribute to our age. He should have won the pulitzer prize. At least the CCHR award.

    Part 1: The Roots – Robert Whitaker – Psychiatric Epidemic – PsykoVision CPH – May 14, 2014
    https://www.youtube.com/watch?v=4R6MXO2j0V0

    Part 2: The Scope of the Epidemic – Whitaker – Psychiatric Epidemic – May 14, 2014
    https://www.youtube.com/watch?v=NNvCyUC_LPc

    I took his books to my shrinks’ offices in Portugal and urged them to buy them and start refraining from ruining lives. They are unconsciously being undertakers, not the guardian angels patients expect them to be.

    Long term Zoloft use rendered my MDD untreatable and left me with persistent agony of suffering a medieval torture of acid being poured over my Left-Dorso-Lateral-Pre-Frontal Cortex (Left-DLPFC)and sensations of pins and needles on my corpus calossum, together with sensations of mild cognitive impairment and fears of probably early onset dementia. I feel hopeless for having been chosen by fate for such a unusually reported adverse effect, but meanwhile any 5HT related drug that I take seems to deepen this suffering.

    I’m truly afraid of my doctors’ prescriptions and can’t seem to trust them anymore. After having found that SSRIs and APs and others are actually being validated by nature in real-time, and haven’t been validated previously long-term either by medical-sciences, either by nature, makes me completely loose trust in the whole medical system.

    I was even taking Agomelatine (Valdoxan) as the most tolerable drug I have found after Zoloft’s lobotomy, but knowing that Agomelatine is in the European market only since 2009, gives me the “dejá vu” feeling that it’s just the same trap. History repeating itself, and the same gross failures perpetuated yet over and over again. And God people, how history is important!

    Whitaker contributed a lot to the rise of the collective consciousness of realities hidden from mainstream media.

    The discussion brought up by Dr. Shipko is important but informed consent will most likely take decades to become a common practice.

    For the millions of wounded sufferers like me, forsaken by psychiatry in the battlefield once their depressions turn treatment resistant, (and regardless of their recovery odds), the question I would ask is the following:

    If you had one last decision to make in life, and that would be choosing between embarking in a journey of popping every new-long-term-unproven-by-science-and-nature fishing-bait-AD in the market OR refraining to take these drugs no matter what the brutal personal and social consequences to your life may be, what would your choice be?

    One can certainly take the drugs and bear the side effects for a while even if they’re not being effective to lift the underlying depression, but with which consciousness can we take them, knowing that a multi-generational, market fueled and science unintentional arcane experiment is being done at a global scale?

    It appears to me that regardless if one chooses to stay on meds that hardly yield benefits; withdraw painfully from these meds no matter if they were working or not; or embark on a journey of anti-meds fundamentalism, it looks quite self-evident that independently of the chosen approach, sooner or later we’re perpetuating ourselves as martyrs.

    If in the disproportionate fight of depression it seems there’s no such thing as a free lunch, what type of martyrs do we want to be or will we able to be? With which help? And at which cost?

    • If I could change only one thing in life I would never, ever have popped those AD pills. Psychiatry has taken my life, my family, my marriage, my confidence, my career, my finances, even killed one of my babies…………… at 3 days old…… I was plain outright lied to, because I didnt believe in drugs, I was lied to. Pushed like lollies, and I never suffered MD. Now I do… Getting off the drugs is worse than dying and going to hell. Stay on them my body would be physically dead in 3 years anyway. Poisons kill livers, kidneys, hearts, you name it, they dont just affect your brain.

  63. I was put on paxil (paroxetine) when I was a teenager for severe anxiety and depression. I was being bullied hardcore but the solution seemed to be to put me on drugs instead of deal with the bullies. But I digress.

    After 3 years on this medication, it was agreed that I didn’t need to be on it anymore. I was taken off of it cold turkey and immediately went into withdrawal: unable to walk, severe dizziness and cognitive disorientation, night sweats, nausea, etc. When I brought these symptoms to my doctor and my psychiatrist, both said there was zero evidence of withdrawals from SSRIs and that my symptoms were psychosomatic. This was back before there was any research into the effects of immediate discontinuation.

    Despite these claims, my psychiatrist decided to put me back on another SSRI, efexxor, which I ended up having some kind of allergic reaction to. They put me back on paxil and my symptoms vanished. I noticed during the withdrawals that I noticed a greater range of emotional sensitivity against so I opted to get myself off these drugs.

    One Christmas on my break from high school, I spent all 2 weeks in bed. My family quietly acknowledged that I was going through drug withdrawal at the young age of 15 and supported me as best they could. Three years later, research came out about the dangers of discontinuing SSRIs, even in tapered doses. The industry quickly renamed these withdrawals to “discontinuation syndrome” so that it couldn’t be compared symptomatically to opiates, which really infuriated me.

    I have had severe episodes of depression since then and I have found that there is an emotional discontinuity within myself to work through these episodes partially due to the SSRIs I took in the formative stages of emotional coping strategies. I sincerely believe that my ability to cope now as an adult would not be as hampered if I hadn’t taken SSRIs. Their effects on my nervous system are unknown, and there is no long term evidence that SSRIs, in the long term, actually help depression. In many cases they make it way worse, as they did for me. Suicidal ideation became way easier while on the drugs than off because they put you into a false parasympathetic mode about your own suffering.

    These drugs are insidious and desperate people don’t know what they’re signing up for when they get prescribed them. Without supplementary mental health counseling they could get worse.

    • Hi Robert I also got severely depressed around age 15. My wise doctor didnt believe in medicating children for this, after 12 months I came out of it naturally (I kept going to school, eating, sleeping).

      Yes, you can learn how to cope without the pills. Sadly, I was convinced 30 damn years later, that I was a depressive, and episodes would get worse and worse… what bull! I was depressed at the time, and believed that without my own logical mind saying,,, ok, get depressed once ever 30 years, I can cope with that.. done it before.

      Long story short 8 years on effexor? Destroyed my life, wish I was dead, but i keep waking up every day. I used to love life………….

  64. I think one of the things that is missing on this thread is that antidepressants do not resolve the root causes of depression, which means that – when medications are tapered – the underlying issues remain and depression can occur again. Inflammation, thyroid problems, vitamin deficiencies, allergic reactions to food, poor diet, poor gut function, can all play a role.. When people taper, it is a good idea to investigate these issues to try and determine what the reason for becoming depressed was in the first place.

    There is a growing body of evidence that depression is not a serotonin deficiency. The drugs are nasty, and withdrawal can be hell. But perhaps the reason so many people relapse years after quitting them, is because the underlying issues have not been addressed.

  65. Good God. What a thoroughly depressing and doom laden read.
    I certainly hope it’s possible to withdraw from SSRIs without being permanently disabled.
    After 16 plus years of use and preparing to withdraw, I’m not sure that you’re aware of the impact this kind of article has to cause utter hopelessness.
    There are many instances, not easy granted, where people have successfully withdrawn from psych drugs and flourished, not least Laura Delano the co-founder of this site.
    So, please, employ a little protective caution when laying people’s futures out.

    • If you have been on them for 16 years? Plan on taking 4 years to cut down slowly. Or just sty on them.
      I was only on them for 8 years, tapered over 3 months, had about 4 OK months, then the crash. I got my brain back, now realise how they changed me into an idiot, who lost everything I treasured in my life… On Disability for 5 years now.
      After the crash 6 months now of misery. Out of 4 people I know… Only one seems to have got off the drugs, but it is still early times, she has been off 5 months now.
      Better to know the truth, before you decide to come off the pills surely? I found out the truth to late to go back…… These drugs no longer work for me… so if you come off too fast, sometimes it makes you worse to try and go back on them. Good luck!

  66. They have made me extremely sick so staying on them is not a possibility.
    I’ve had Graves disease, pernicious anemia, tremor, huge weight gain, zero concentration, emotional numbness, rage attacks, palpitations, no sex drive, and persistent intermittent suicidal despair .

    So yes, I’ll be discontinuing and getting clear and factual information to do so.

  67. My husband of 20 was put on his first antidepressant about seven or eight years ago for GAD. He was also given xanax at the same time. The changes were slow & insidious, completely off my radar. To make a very long story short, he developed full blown mania on them but retained enough common sense to hide his manic behavior. He developed an on line gaming/gambling addiction, joined numerous dating websites and frequently paid for prostitution. Despite the fact the ssri’s left him physically unable to obtain an erection without more help from big pharma, he thought about sex 24/7. He blew through our life savings, lost his job & missed out on being a father to his young kids. Once I discovered what he’d been doing, it was easy to trace the begin of his decline to six weeks after his first dose of effexor. I wasn’t 100% sure but I was 80% the meds were to blame. Because I had just spent five years married to a total stranger and despite knowing how harmful quitting cold turkey was, I encouraged him to quit CT. I couldn’t wait a few more years of proper withdrawal to find out if I was simply married to a socio or if the meds were to blame. He is now two years post CT and while the worst is behind us, withdrawals are NO JOKE. I knew what to expect going in but he did not. He experienced every withdrawal in the book and I’m convinced he wouldn’t have made it through without xanax. And speaking of xanax, he is now two weeks post one year taper off of xanax and is doing well. These meds are devastating and life changing. I definitely suggest quitting ssris before benzos if a person is taking both, but don’t be a hero and go CT. It’s cruel to the mind and body and it’s dangerous business. Had we known the potential side effects he would have never taken the first pill. I truly believe illegal drugs are less dangerous & easier to withdrawal from, though not advocating ANY drug, legal or otherwise.

  68. Ps.. you are correct, there isn’t anything other than a benzo to help soften the blow of ssri withdrawal. Even if my husband hadn’t been taking them, I would have requested an rx to help mitigate the damage. Either that or we would have gone to cannabis but he is randomly drug tested at work so that would have been risky. Antidepressant withdrawal really requires an inpatient setting where people belong for at least 12 months, but that won’t ever happen. In addition to the benzo, a healthy died full of omega 3, magnesium & leafy greens does help, but as to how much remains debatable. It helped us, that’s for sure. I actually had to quit my job in order to get him off ssris. It truly was an all or nothing adventure and it required my attention 24/7. Our lives, our future, our kids lives were at stake. And I wanted to clarity he was on antidepressants for over 5 yrs solid. It wasn’t 15 yrs but it was enough to cause great harm.