These days, attempting to navigate my way through life feels like swimming through quicksand. As I slowly recover from the aftermath of my run-in with psychiatry, I can only conclude that they are capable of being evil, legal drug pushers. What would compel a so-called “doctor” to prescribe a new class of drugs (SNRI) at 33.33% over the FDA recommended maximum dose for over a decade and expect no negative consequences?
This “doctor” was in no uncertain terms gambling with my very sanity. When he began prescribing, he wrote, by his own hand, in my medical record, “Imp. No current MDE,” or “Impression, no current major depressive episode.” At the time, I was a 38-year-old man in my prime who truly had it all. What in Dr. Michael’s (not his real name) training taught him that it was alright to prescribe an ungodly amount of medication at up to two times the FDA recommended maximum? What protocol was he following that indicated it was okay to treat his patient as a lab rat?
I recently asked Dr. Michael in an email what guidelines he was following that made him think it was a good idea to prescribe the antidepressant Effexor at doses over the FDA maximum for such a long period of time, among other questions. Because he would not respond by email, he sent me a typewritten letter by mail that was obviously coached by a legal professional. In his letter reads the following:
“While I prescribed Effexor XR to you in a dose over the FDA suggested maximum, the doses that I prescribed were within the range that psychiatrists in practice use. I was guided by my clinical judgement and consultation with colleagues who specialize in psychopharmacology, who made clear to me that doses over 225 mg per day are acceptable if the trade-off between benefit and side effects is carefully taken into account.” (Dr. Michael had me on a dose of 300 mg per day for a decade with doses initially as high as 450 mg per day.)
He had responded with the “Everyone’s doing it” defense! I believe that doses of Effexor specifically (and antidepressants in general for that matter), should NEVER be prescribed over the FDA recommended maximum except in the case of severely depressed inpatients as stated in the drug labeling.
When I began punching my wife in the face while I was sleeping, maybe I should have seen the writing on the wall. Maybe this was all my fault. Within the first year of overdosing on Effexor, my whole body started violently shaking and twitching in my sleep. It progressed to swinging my arm and knocking over a lamp on my night table. During the second year was when I began having vivid violent dreams and frequently touching, slapping and on more than one occasion punching my wife in the face while sleeping. You would think this would be an indication to Dr. Michael to lower the dose, but instead he recommended adding Klonopin or Wellbutrin to quell my sleeping disturbances. It would appear that once the psychiatrist has gotten a foothold, once you are hooked, they are loathe to let you wiggle off of that hook.
My wife made me sleep with my head at the foot of the bed because she was afraid of what I might do to her in my sleep. I put up with all of this because the Effexor was beginning to take hold of me. Its power was ascending in a linear trajectory over time. In the third year the drug continued to wield its power in ever-increasing strength; I was not willingly going to make it stop, and Dr. Michael was more than willing to provide it.
Did we not learn from Peter Kramer’s “Listening To Prozac” at the dawn of the SSRI era that the effects of these drugs strengthen over time? From my experience, it takes much longer than psychiatry believes for the full effects on the human psyche to become apparent. They measure the efficacy of these psychotropic drugs on an initial reaction within weeks while ignoring the changes that occur over months and years. A study in nonhuman primates has shown a significant increase in the volume of the anterior cingulate cortex, a region of the brain, in depressed subjects given sertraline (Zoloft) for a time period analogous to five years for humans. The study also showed a decrease in volume of the same brain structure along with the hippocampus in non-depressed subjects. These areas of the brain are critical in a wide range of higher brain functions that influence behavior. What could this study demonstrate for my situation, given that Dr. Michael stated that I was not depressed at the beginning of treatment and anything but depressed throughout the duration? It may be difficult to draw definitive conclusions from this study, but what is clear is that only god can possibly know the dangers of the long-term use of modern antidepressants and its effect on the brain and on behavior.
Perhaps in the third year of treatment at 300 mg per day of venlafaxine (Effexor), Dr. Michael should have at least raised an eyebrow when I reported an “absence of negative feelings,” that I was “more assertive” and that I “yelled at boss.” At this session Dr. Michael noted there was an incident of “touching (not punching) wife in sleep.” What should have been early alarm bells going off as the medication began to radically change my behavior only resulted in Dr. Michael reporting, “Imp [impression] Doing (for him) quite well.” How condescending! I was a self-made millionaire with a family I treasured. I was truly living out my dreams when I was forced to see Dr. Michael, referred to him when my primary care physician no longer wanted to prescribe the standard dose of Zoloft that had served me well.
In the fourth and fifth year, I reported that I had begun taking on risk in my stock portfolio. Dr. Michael noted that I had leveraged my account with $800,000 in margin debt where I had never used margin before. A telltale twitch of my eyelid that began around this time and would not go away now seems like an ominous warning. Severe constipation as a side effect of the medication led to rectal bleeding resulting in anemia which necessitated a colonoscopy. The first reports of irritability and marital conflict occurred during this time, and I continued to hit my wife in my sleep.
My medical record is littered with warning signs that I was headed to full-blown hypomania. I was slowly and progressively transforming into someone that in retrospect I no longer recognize. From the beginning I was constantly bringing up my intention of reducing the dose to Dr. Michael, but as the euphoria increased, and my inhibitions evaporated, I failed to follow through. The seductive power of the drugs that were changing my personality was overwhelming.
In the sixth year of treatment, I reported to Dr. Michael that I had blown through three quarters of a million dollars due to risky investments in the stock market. I was fired from a job on account of my behavior, however, at this time I was highly functioning and found a better job and was earning more money at work than I had previously made in my 45 years of life. At this time I began complaining to Dr. Michael of memory problems and cognitive issues and an “electric feeling” in my brain. These issues were apparently the precursor to a more acute phase of hypomania to come.
I canceled appointments with Dr. Michael, and did not reschedule. 14 months went by without a session. I had embarked on an antidepressant-fueled pleasure-seeking rampage of self-destruction. In the eighth and ninth year of 300 mg per day of venlafaxine my libido began to shift into overdrive. At 47 years of age I had developed sexual urges that I had not felt since I was a teenager. While driving in my Boston neighborhood I became obsessed with looking at women and felt an uncontrollable need to have them. My personality had transformed to where I felt an ease around women that I had never before felt. My inhibitions had completely melted away and the power I seemed to exert over women was intoxicating.
Among numerous other indiscretions, I started a deep, emotional love affair with a stunning 20-year-old college student who was three inches taller than me and twice as good-looking. Unbeknownst to her, she had fallen victim to my chemically engineered charms and was powerless against its spell. I felt completely immune to the consequences of my actions and did little to conceal them. This relationship would ultimately cause the break-up of my formerly fairy-tale marriage and cause my two young sons to grow up as children of divorce.
As my life began spiraling out of control, I called Dr. Michael with urgency to set an extra appointment. I knew I was in danger and not able to control my actions. This was the first time in our nine year professional relationship that I asked to see him outside of regularly scheduled sessions. Dr. Michael wrote in his notes of this session that I was “anxious, sl. pressured, looked distressed.” I told him in detail of the surge in my libido, that I “Have been feeling like an 18 yo,” about my relationship with the 20 year old and how I was caught drinking in my car with two young women by my wife. In Dr. Michael’s notes it states that I asked him, “am I manic? am I crazy? are the meds doing this to me?”
Dr. Michael stated, “This must be very exciting,” and he asked me to “describe the pleasure.” He noted that later in the session I again questioned the medication. “Re: meds: are they making [me] more excited? more risk-taking? more impulsive? less concerned w/ consequences?” His response to these questions was, “Possible—but it could be you.” Obviously it was foolish of me to turn to my well-paid legal drug dealer for help with my drug problem. I left the session with the man who knew more of my most intimate secrets than any other human being, the professional entrusted to keep me safe, feeling like I had been given the thumbs-up to continue partying like there was no tomorrow.
The party would continue for a time, but an inevitable crash ensued. As the intensity of the drug’s power over my mind continued upward over time, it transitioned from euphoria to agitation. In short order, I left my family, was fired from my job for uncontrollably screaming at my boss, and gambled away whatever money I had left in the stock market. A debilitating depression soon began, of a magnitude I could not previously have imagined. I had lost everyone and everything in my life. Throughout the ordeal, Dr. Michael never once suggested reducing the dose of venlafaxine, but as my situation deteriorated he recommended I take benzodiazepines and atypical antipsychotics; I declined. Luckily for me, I stumbled upon the definition of hypomania on the internet, and educated myself about drug-induced hypomania/mania, and decided to take matters into my own hands. I imagine scores of others have not been so lucky and in this situation have succumbed to psychiatry’s incessant drug-pushing.
I stopped seeing Dr. Michael, and began the grueling process of slowly withdrawing from venlafaxine of my own accord. I knew I was on the right track when, having halved the dose, a feeling of calm came over me. This was short-lived however, as when I reached 0 mg per day, I was overcome with unbearable withdrawal-induced anxiety that left me completely incapacitated and unable to even leave my home.
Having awoken from the horror of my drug-induced spell, I was forced to restart a similar medication at a low dose under the care of a new psychiatrist or I might not have survived. I had become an antidepressant junkie, but I was determined to get off of the psych drug rollercoaster that had nearly destroyed me. It turned out the new psychiatrist shared the same zeal for the prescription pad as Dr. Michael, and if I had followed her suggestions I would be on god knows what cocktail to this day. I am proud that I found the strength to resist and get off of the medication, a process that took a monumental effort and untold lost time.
I am now working on writing a detailed account of my experience with antidepressants, both the good and the bad. I have recovered from my ordeal and am feeling strong, though I still bear scars. I am seeking better employment in Boston currently; I am honest, hard-working, capable and intelligent—perhaps someone out there can assist me.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
I need to tell in advance that by no means I want to belittle your pain and all your negative experience.
But just wanted to say that from the text you story sounds like a lot of fun, actually.
Lol your comment made me chuckle but don’t be deceived. I took a high dose of Effexor and it made me manic as well. I was just good at hiding it. When you’re manic, you’re brain is basically hijaking you and your ability to make good decisions. There is nothing funny about it. It’s terrifying when you can’t trust yourself. The worst part is if a person hasn’t experienced mania they don’t understand so they judge quickly. So you feel alone, terrified, and judged at the same time. It made me suicidal. I have recovered since coming off of the medicine thankfully. I was an honor student, highly recommended upon graduating college. Effexor ruined my life!!! I know you didn’t mean anything disrespectful I’m just saying don’t be tricked into thinking there is anything fun about it.
I am glad for you that you finally realized what was happening. It also took me about 8 years to realize what was happening to me, although I was on an antipsychotic (Zyprexa) which has very different effects. I am sorry that you had to lose as much as you lost, and I hope that you, as I have been able to do, are able to recover what you have lost now that you are not drugged into oblivion.
I think that these drugs are creating a society of sociopaths. The drugs literally cause brain damage, and primarily damage the higher centers of the brain involving regulators such as guilt, shame, caring and compassion. It’s sort of like those zombie movies. Harming others no longer causes guilt and shame. The same process that might make a person “less depressed” also makes them less concerned with or oblivious to hurting people. Maybe the package insert should include a set of case studies such as this where actual patients describe real world side effects. I truely believe that most psychiatrists are unaware the harm these drugs inflict. If it’s not taught to them and they are not hearing stories such as this, they just are unaware. The process by which doctors learn pharmacology is not sufficient. More time should be dedicated to adverse events.
Antidepressant-induced mania destroyed my marriage, my career and many friendships. It provided me with a criminal record and a divorce. Your story speaks to me.
A lot of your story parallels mine. I feel robbed, just like you. A good therapist can’t hurt in terms of healing and getting some of your worth back. You are a survivor, like a lot of us. The damage these so-called doctors can cause is astounding.
i hope your book will sell lots of copies and get on the best seller list so more people of the ‘worried well’ will be advised to steer clear of psychiatry. As my friend Marcia says about living in our times, “If you are not disturbed, there is something wrong with you!” My belief that people experiencing overwhelming distress, anxiety or depression should steer clear of psychiatry is not to make light of people’s pain but only that we need to redouble our efforts to educate people that psychiatry can quickly compound one’s problems and what is needed is a full fledged common movement to create caring, tolerant and compassionate communities and sanctuaries for people whose emotional needs are not met by family members and friends.
Great. Yet another SSRI/SNRI induced mania story. The same thing happened to me, once in 2007, and then in between 2010-2011, with around the worst “episode” happening in around August 2011. Sertraline and Fluvoxamine were the culprits in each case, respectively. I did so many crazy things during that time, that the consequences of it are haunting me and negatively (a word that doesn’t really encapsulate the misery) impacting me to this day.
Unfortunately, psychiatry also defames those of us who are prescribed these drugs and experience mania as a result, as “bipolar”. But one half of the mood that comprises of that label is created by the very drugs prescribed by psychiatrists themselves. They are defaming us, after our lives have already been ruined. Naturally, once you are out of it and realise what you have done, depression follows, not as an illness, but as a consequence.
Imagine you have tuberculosis, and you are prescribed Isoniazid fo it. Then, imagine that the Izoniazid makes you psychotic, and the prescribing doctor tells you and your family that you have “schizophrenia” which was just “uncovered” by the dug. You would butcher that idiot. But a similar occurrence is happening everyday in psychiatry.
If a person takes a prescription drug and becomes manic and psychotic, they defame you as “bipolar”, though it is something that would likely have never happened without the drug in the first place.
Psychiatrists should be sued and their medical license should be cancelled for this practice. If you were smart, hardworking and functional enough to get a medical degree, you can do many other things in life.
If they didn’t defame us they might have to quit prescribing the drug! Better ruin our lives than the precious pills.
I too was on huge doses of Effexor XR for a number of years. I don’t think I ever became manic from it, but I did do some very impulsive and really stupid things near the end of taking it. Not having a car I walked to work every day. I’d be walking down the sidewalk alongside of the street and I’d think to myself, “Let’s see how lucky I am today”, and then I’d execute a beautiful and precise right angle turn right out onto the street. I could have caused many people to either be injured or killed but this never once ever entered into my mind. Effexor, like all other SSRI’s, made me very self-absorbed and uncaring towards the needs of anyone around me. It created a cocoon around me which separated me from everyone else. Needless to say, I was very lucky because I’m sitting here now typing at the computer. But I received a lot of irate responses from drivers that I walked out in front of. It’s lucky someone didn’t get out of their car and beat my sorry butt for me. These days I refer to Effexor as the devil’s tic tacs, this is not my original saying but belongs to someone else who used to post here on MIA. But I think it’s a very excellent description of the damned toxic drug. It also causes respiratory distress in babies born to mothers who were on the stuff while pregnant with their child. The stuff is dangerous.
I lived a similar story. Not many mention that the antidepressants, in my case, Wellbutrin given for smoking cessation, can function as a “happy, horny, skinny drug.” And absolutely, you are correct, “It would appear that once the psychiatrist has gotten a foothold, once you are hooked, they are loathe to let you wiggle off of that hook.” It took me 3 1/2 years to escape my psychiatrist, 8 years to totally escape “the system,” and 12 years to get the antidepressant induced “bipolar,” actual anticholinergic toxidrome poisoning, misdiagnosis taken off my medical records. It is deplorable that today’s psychiatrists are destroying people and families on such a massive scale. God bless, thanks for sharing your story, and best of luck on your healing journey.
Horrible stuff, Jonathan! I just finished tapering off 150 mg of Effexor. Much calmer. I talk less, like the person I was pre-psychiatry. Losing weight effortlessly too.
Holly smokes ! A roller coaster life I can partly relate to, having had “moderate” mood swings for most of my life. The thrill of hypomania has it’s terrible drawback : humiliation, shame, remorse, anxiety, feeling agitated and unable to feel calm, always in a rush or feeling like in an emergency. All this makes the “fun” part pale off or, seem way less attractive. But the “fucked” up part of your story is “how can a disinhibited person – induced by the drug – get out of such a vicious circle. Feeling uninhibited feels good and is addictive, of course. Same as “power trips”, seduction games, gambling, making a lot of money. I salute your moral cense and for having “woke up” from this form of chemical hypnosis that made you seem stronger than strong but eminently self destructive. Good for you !(and those around you, BTW)