The U.K. Advises Coming off Antidepressants Very, Very Slowly

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From Undark: “In 2015, psychiatrist Mark Horowitz tried to come off his antidepressants. He reduced his dosage by a set proportion over the course of several months, which is much longer than what the United Kingdom’s guidelines recommended. But in the process of tapering, he experienced a storm of new symptoms, including anxiety, dizziness, and bouts of insomnia. ‘I’d wake in the morning, feeling like I was being chased by an animal on the edge of a cliff,’ he says. Ultimately, he felt he had no choice but to go back on his medication.

As it happened, Horowitz had recently completed a Ph.D. on the neurobiology of antidepressants. During his training, he recalls, his professors had told him that stopping antidepressants was fairly easy. Their view was supported by the scientific literature, which had found that any withdrawal symptoms were minor and faded quickly. Experiences such as Horowitz’s were considered an anomaly.

But a series of widely reported studies published over the past seven years suggest that discontinuation symptoms are common and can be severe, including everything from panic attacks and flu-like symptoms to electric shock sensations in the head. The longer people remain on antidepressants and the higher their dose, the more likely they are to experience withdrawal symptoms.”

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8 COMMENTS

  1. Lovely balanced article. If I had the conch I would say that nobody under the age of twenty five should be given ANY psychiatric drug. And even after that age better counselling of the risks of dependency and the yoyo of withrawals should be stated. And as Mark says only staying on the drugs short term should be considered. Each drug is like a bottle of whiskey. At some stage it becomes a bigger problem than the one it tries to mend.

    What I have always been concerned about is the effects on young mothers. In the years prior to questioning withdrawal impacts those young mothers may have thought it was their kids driving them up the wall when really it may have been adrenalin panic from withdrawals. Mothering has to be one of the most important jobs. Having the equivallent of dilirum tremens at the breakfast table is a form of neglect to the baby left to make sense of a howling mother. And what of the foetus having SSRI’s daily tipped into shared blood supply of the placenta? I imagine that the newborn will go through sudden untapered withdrawals after birth. But maybe the drugs can cross over into breast milk, but maybe at sporadic doses. I have always felt that the paediatricians should be looking into this more. We already take specific care of neonatal babies of heroin addict mothers and alcoholic mothers. There may need to be a better monitoring of SSRI babies whose brains are forming by the very hour. There once was a question mark over the cause of autism in children. Is it possible that the numbing of feelings from SSRI’s becomes a brain damage issue with some children of mothers who were given such medication?

    On a broader theme the world as it is, is no friend to new mothers. It is no wonder they turn to psychiatric medicatons when the people support is non existent.

    Often a screamy baby will be regarded as colicky rather than screaming from withdrawals. If a grown up Mark Horowitz cannot stomach sudden withdrawal anxiety/adrenalin surges then what do we expect a poor little baby to do?

    A baby is supposed to be patterning a feeling of calm upon seeing its mother up close, but if all the baby feels is adrenalin then they will feel threat, anxiety, fight or flight, danger, for months, since withdrawal takes months. It takes months for the adult brain to return to its default setting of natural normal but a neonatal brain doew not know what a natural normal brain is since they havent grown the brain yet, so is it even possible that they ever can return to normal?

    Never let it be said that I am on the “side” of psychiatry, or the “side” of antipsychiatry. I see positive and negative in both. I do know that some babies might not make it at all were it not for some mothers getting respite in a short course of calming medicine. But this ought to be time honoured gentle herbal or alternative care.

    I am not going to lambast doctors for doing what they are given mistaken faith in. We do not heckle pub owners that serve bottles of whiskey to the pregnant, or shout slurs at corner store purveyors of cigarrettes. What needs to occur is mass education about all of these risks. Studies need done on the SSRI withdrawal experiences of neonatals. A panic stricken newborn is not going to give mom any sleep. A panic stricken newborn is not going to bond in quite the same way. The newborn’s experience of emerging into the world may be the experience of wanting to die. If the mother was on SSRIs plus cigarettes, plus alcohol, that is a lot of detox landing in the baby’s bonnet.

  2. I also would be wondering if the research into a link between autism and maternal psychiatric medication might miss the link if there was no concept of withdrawals lasting months to a year or two.

    If the research was done by asking dim questions like…

    “Have you taken any antidepressants in the last two weeks before giving birth to your baby?”

    that would look like the mother and the baby were not affected by antidepressants and so no link to autism or ADHD would be arrived at.

    But I know not much about all this so I must leave this as is. But I thank you Mark for making it welcome for me to voice my ponderings.

    When there are only “sides” there is blame. I am bored with blame. It gets in the way of moving forward with much needed practical solutions. There were nightingale hospitals got up in a week when the pandemic began. A mass drive to attend to the pandemic was speedily created. Humans can galvanize a war in a week. So why can’t a mass detox from antidepressants be started?

    • Such a mass action would require the current beneficiaries of SSRI sales to agree that such a mass action would be beneficial, or for society at large to strip such people of their power to insist that we use “antidepressants” widely regardless of their actual utility and risks. That is the reason that “logic” becomes important in such cases, though it must be admitted that logic and facts don’t seem to have much effects on the beneficiaries mentioned above.

        • https://youtu.be/elf61L2BkD8

          Medicine is so logical that it divorces the emotional person who inhabits the physical body as if these two phenomena are like two different people, one welcome, the physical one, and the other unwelcome, the emotional ineffable illogical one. Until things done to the physical one are like attempts to make orderly and neat and logical the messy emotional one.

          BOTH are needed for BALANCE.

          Medicine as a field is understanding its past errors but it is struggling to attend to the emotional inhabitant of the human body without reducing some of its glorification of logic.

          It is not that logic is “wrong” as a free choice. All of any individual’s free choices are beautiful if harmless. Most choices are harmless. So I never have said that logic is bad. The over emphasis on only logic can leave no room for spirit or emotion. All of these are good when combined in Balance.

  3. Maybe a mass action is possible if you become a new religion. Some faiths can insist that followers do not eat certain things. Some faiths insist on purity and the abstaining from drugs. Some faiths do not even permit the sharing of blood transfusions. Evangelical revivals fill soccer stadiums and make tent cities in a week. I said it before, MIA could easily become a faith if it stopped thinking that “logic” had to always be its God. There is a level of impudence that religions get away with that cuts corners in “logical” debates but people who fight “logic” with “logic” wait to “win” the right to freedom via “logic” when that right does not need “logic” at all, nor muscle, nor facts, but just love, self love enough to end being lured into “logic’s” never ending looping back in on itself.

    It is a stroke of genius when a toddler in a “logical” debate about rain suddenly says…

    “Well I dont care what reason says the rain is doing…I KNOW it is wraiynin”.

    “Well I dont care what medicine says these drugs are for I know the drugs are too toxic”.

    In other words “logic” can become a merry-go-round of unwinable argumentativemess that wastes valuable TIME and the best way to stop it is to choose to be “ILLOGICAL” in jumping free of the bickering and calling yourself a faith. A faith that believes drugs are sinful.

    You are obviously at liberty to be championing “logic” though I never meant to cast aspertions on the lovely use of logic nor enjoyable facts. Rather I mean that when overthinking and logic becomes adrift of emotion that is when logic can sometimes become clinical and petty and devoid of anchorage in heartfelt compassion. Or put another way what is needed is COMMON SENSE. What is that? It is when logic dovetails with practicality and emotions. My belief is that logic runs away with yet more logic until nobody has clue what they emotionally want anymore…it just becomes point scoring…even nuclear point scoring.

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