Tablets are dangerous.

Treatment and medication
1

I've always suffered from serious anxiety, not leaving the house and basically being scared of life. I gave up after Christmas and admitted I was depressed and I needed help. Ended up being given sertraline 50mg, I tried messing around with my dosage and had regular appointments at the doctors. I took the tablets for four months and I've now been off them for 3 weeks and I've never felt better and I wanted to tell my story.

I understand these tablets do help people and make people's lives better but I wanted to share the dark side and want people to know that tablets aren't always the way forward. I had every negative symptom possible, insomnia, shaking, sweating, didn't eat, I was snappy and aggressive and that wasn't even the worse part. Mentally the tablets destroyed me. I felt like they controlled my whole life, my mood was awful 24/7. I was so horrible to the people I loved, I insulted them, was aggressive and I was just such a horrible person. Suicide has always been on my mind but the tablets made it real, in the space of the four months I tried to kill myself 5 times, i was never this bad before the tablets. I had my friend rushing to the train station as I was stood on the tracks. Enough was enough after that, I stopped the tablets on my own accord. I've had some withdrawn symptoms, I tend to call them blackouts but I feel lost, almost drunk, in my own bubble at times, headaches and dizziness.

All of that is starting to clear and the last few days I've felt the happiest I've felt in years. So thankful to be alive and it's all because I'm off these horrific tablets. These tablets almost took my life from me, I just want people to know the serious side effects to them and know that having anxieties or whatever is sometimes way more manageable when you are in control.

Doctors should stop giving out these tablets so easily, mention the serious SERIOUS side effects as I'm lucky to be alive.

2

They are lifesavers not destroyers for the majority of people. 

This particular drug isn't for you obviously but you can't dismiss them when they help so many people! Pleased you've found happiness. X

3

I said they work for certain people? Fact is the majority of doctors give them out without much hesitation when they can cause serious problems.

4

Yo Josh, pills are not an end all, they are merely a walking stick to aid walking if you get my drift. If there was plenty of sunshine here in the UK I don't think I would have too much of a problem, it's a serotonin thing. For some though it is a must, and will be needed to be taken for ever more, as it helps these folks and many others. I can guarantee you that most comments here are due to concerns, the other 90% who take sertraline after are happy with life to bother themselves here. Sertraline gave me a huge lift that saved my life, Christmas 3 years ago I nearly ended it all but for sertraline and this site, which I'm glad to see has grown from strength to strength. I have recovered to my old self and I am happy, I just feel a duty to help others now. Don't give up and all the best....

5

yes I agree with you to an extent as it was citalopram that made me ill with depression and severe anxiety it was given to me when I wasn't even depressed , I was just needing some one to talk to tell day I was prescribed them.

only took one tablet and it turned my life upside down.

then after a month not on any medication I got worse and worse so then I had no choice but to try a an antidepresant that will help me get well and sertraline has saved my life tbh, well god has saved me and guided me to the right one.

the now I'm on them I'm scared of coming off!!!

6

That's how I feel, always here to help if I can.

are you still on sertraline?

7

Hi Josh,

You are correct that these tablets are very often over prescribed, partially because in the UK the wait list for psychotherapy / CBT is SOO long ! Drs feel they need to be doing something, quite rightly. A lt of studies show that the best results achieved are not with either therapy alone, but with a comination of the two, meds and CBT. Many people need CBT, but need the AD's t open them up to treatment. 

It wold be wrong to dismiss these meds though for everyone, as many many people do benefit from them. They are not a magic pill to solve peoples problems, but very often do help with motivation, postive thoughts etc....the receptor theory of depression is the most regarded theory presently, but still is not conclusive, but the best they have to work with. There are other AD's other than SSRI's too, such as SNRI's and mirtazipine which have diff. actions to SSRI's so at least there is something else to try for people who are not compatible with SSRI's, saying that diff. SSRI's suit diff. people, for eg, anxiety is a known side effect with fluoxetine more than the other SSRI;s, yet they all work on increasing level of serotonin. No one can fully explain these slight differences but they exist.

I can fully understand how you feel, I too took a medication for nerve pain which has left me with what appears to be permanent short/ medium term memory loss even though I have been off it a year, I too weaned myself off it - ps. you need to be careful playing around with the doses of these meds, much better if under advice of dr. 

I too took a different SSRI before being Rx'ed sertraline, and even on a low dose within a week I suffered a horrific bout of mania over a weekend, fortunatley for me I recognised the symptoms as I have worked in Mental Health in times past, and I stopped the SSRI in question and got to the dr on the Monday, she still said I was high, but nowhere near what I had been, it was truly awful. The problem was I was depressed, no motivation with suicidal ideation, i live in chronic pain due to spinal disability and after over 5 years I couldn't take it any more....I needed help. So yes I took sertraline, and a psychiatrists also checked I wasn't manic depressive ( as GP wanted me checking by a specialist ) and she said def. not, but I would benefit from antidperessants and CBT. 

I am glad you are now feelinbg better, and hope that it stays this way. Talking therpies are v good for a lot of people, you may still wish to pursue these. But I think it's impt that anyone else reading this knows that these are not smarties, they can have side effects. but they also help a great many people, and yes many people so have some side effects ( discontinuation ) when coming off them, as they do effectively change your brain chemisty, and also 80 % of serotonin recpetors are found in the gut, ( thus the saying ''gut feeling '' ), which is why many people get GI side effects ! 

Good luck x

8

it was citalopram that gave me a horrific episode of mania, on low dose, within a week or starting it - because I have worked in this field I also knew to stop it and that I could do so safely in such a short time, but like you I then went on to sertraline and am much better. In fact I had successfulyy managed to drop from 150mg to 100mg of serraline before the UK winter set in, I have always suffered from SAD, and ended up having to inc. dose again.....as I live in chronic pain ( take morphine ) for spinal problems, I may / may not need sthg long term. I agree many meds are over prescribed, just look at what's happened with antibiotics in last 20 years, and now we have problems. It should be that everyone is presented within reason a balanced view of pro's and cons of the meds, but sometimes people are too ill / don't listen etc and the dr needs to take charge. 

9

I agree with you about the sunshine in UK !! If we could get some better weather in UK, more time outdoors and less stress all the better. I have always suffered from SAD too, since being a teenager and am now in my early 40's. I worked in this area and would never have taken decision to take the meds lightly, as I know both sides, but I was depserate, I was not coping with the pain issues I have, my mood and motivation were through the floor and my marriage and relationship with my two teens was suffering....I had to do something. A bit like you I agree with the people who write on sites like this and Trip Advisor etc...but being disabled and having time on my hands these days I try to write to help folks from evry angle, and with my background in the sciences hope I am able to put some of it into context. x

10

very helpful indeed holly, I really don't understand how we are able to come off the AD if AD act as a blocker to serotonin going in to the receptors? ? are you able to explain this at all??

hope I made sense lool

11

As I said from the start, I understand these tablets can help people but from a personal experience they almost cost me my life. My point was that the serious effects aren't told to people. I was told 'you may have a few bad weeks before you start to feel better' I never got told of all the bad symptoms and the fact I lost control of my mental state competely

My dosages were controlled, I had regular doctors and I did whatever they said......

After not getting on with 50mg after two months the doctor honestly said I could do what I want, I even explained all my side effects and she said I can get more tablets and decide what I want to do. I had little guidance so I just kept taking them and taking them and if it wasn't for my girlfriend being so so supportive, I'd be competely lost. If I was taking these alone with the little help I was getting from the doctors, I don't like to think where I would of ended up

12

I do agree that all medications have drawbacks and some work for people and they have no side effects, others suffer and cannot tolerate them. Sometimes GP's are to quick in giving out antidepressants without really listening to the patient and indeed talking about side effects, I was only really told they may increase anxiety for about a week, I was vomiting, shaking , diarrhoea , had to stop.Once I suffered these side effects I looked at the patient leaflet. I already suffer with chronic migraine ( cause of anxiety) with vomiting etc , so no good for me. It is a balance and all down to the individuals capability to tolerate drugs and hope that they work, sometimes it is a case of changing the drug. If you think about it the doseage fora 7st patient may be the same as a12 st patient, none of this seems to be taken into account the same as some people can tolerate alcohol others can't . Think sometimes we are not really treated as an individual , we all react to things differently. Have to say I would not try them again even on a lower dose , but I am glad that they help some people , and glad that you are feeling so much better.

13

I feel control of my body again which is the main thing. At least then I can deal with my anxieties more sensibly rather than committing suicide, which on the tablets seemed the only sensible outcome.

14

Thank you, Josh, for sharing your experience with all of us.  So happy your story has a happy ending.  Wishing you a peace-filled day! 

15

First of all, it is a myth that these pills correct a chemical imbalance in the brain; there has never been found a disease process for depression, anxiety, bi-polar, schizophrenia etc. though the drug companies manage to continue the myth.  Studies have found that there were as many people with high serotonin as low serotonin with depression!  And it was found that the same bell shaped curve for low, medium and high serotonin occured in people WHO DID NOT SUFFER DEPRESSION!  These pills actually CREATE an imbalance of serotonin in the brain when you begin taking them.  

SSRIs block serotonin receptors such that the level of serotonin increases in the gap between nerves.  The body counters this excess by eventually remodeling to take the drug's action into account, restoring the "default" level of serotonin in the gap.  It is these modifications that create an imbalance in reverse when we try to come off these drugs, withdrawal.  It takes the nervous system a very long time to undo the changes.  No one explains this to patients when they begin these drugs.

For some, this new imbalance causes all the horrid side effects,  including suicidal ideation.  I see people encouraging such patients to push on through this, it will get better.  Well, the reason it eventually gets better is because the body finally makes the adaptations against the drug to bring about homeostasis!  So, the very action that is supposedly going to help patients by taking the AD is zero'd out by the body!

Antidepressants have been found to be no more effective than placebo in studies.  It is in part the action of "doing something," ie. taking a drug, that actually benefits the patient!  CBT, meditation/mindfulness and even talk therapy are equally,  if not more so, effective, without the side effects.

Studies have also found that long term use of ADs causes treatment resistant depression.  This is why doctors end up increasing dosages, to overcome it, for awhile, and then switch to other ADs.  Many on this forum have switched and gone through so many ADs looking for the one that will work, when it was the meds that are causing the persistent depression - their nervous systems have become sensitized to all of them and now they are in a bind. 

ADs may be helpful for severe depressions, but even then should be used as a short term crutch to help one get their feet under them.  These drugs were never tested beyond 6-8 weeks before going to market.  Once folks feels good again, they should very SLOWLY taper off.  That is the next problem; doctors don't understand the remodeling problem and have their patients taper off way too fast.  Subsequent withdrawal, which includes mania, depression, anxiety and a host of physical symptoms, is deemed relapse if it lasts longer than 6 weeks, and back on an AD the patient goes.  

These drugs are very powerful and do not actually fix something that is broken. Instead, they numb and make people not care about the things that were causing them distress.  That's ok as a short term solution, but long term not so much.  

Josh0852, I am so glad that you survived your suicide attempts under the influence and are happy now.  Certainly after all that, you have a new appreciation for life, and all that plagued you before probably seems minor in perspective.  

Ultimately, I think we are medicating our inability to cope with "Life" in a healthy way.  Meds can be used short term to give a leg up, but then we need to do the work to change our thinking.  It's amazing what can be done in that regard.  The same neuorplasticity that allows us to heal from modifications due to ADs allows us to break old stress circuits and build new healthier ones.  We don't have to be slaves to the thoughts that seemingly run our lives and cause us unhappiness and fear.

Therapy is costly compared to drugs, which is why the docs are so quick to whip out the Rx pad, especially in countries where there is socialized health care.  Even in the US, the insurance companies would rather pay for scripts than expensive ongoing therapy.  But there's tons of self-help CBT, guided meditations and other helpful information that are equally beneficial online.  You just have to look, and you have to WANT improvement bad enough to do the work.  Take control!

16

have you actualy suffered with depression and anxiety ??

17

Uh, yes - I was always lacking confidence, had low self-esteem starting at puberty, was always a sensitive one.  Developed bulimia at 16, was never "happy," always negative.  At 30, started Prozac, figured I was broken and maybe the Happy Pill would work its wonders on me.  That was the mid-90's after all the Prozac hype.  Then the next one was Wellbutrin, the current wonder-drug on TV. That did nothing. Then was Effexor, starting 12 years ago.  Never did much either, but numbed me out and I plodded along taking the drug even though I was not "Happy," still had the negative thinking but just didn't care anymore.

 I had worse bouts of depression ON the drug than I ever had before drugs.I had a failed attempt to come off nearly 2 years ago, and withdrawal threw me into the worst symptoms I have experienced in my life, to where although I didn't WANT to die, I couldn't stand going on living like that.  I ended up on Remeron, which didn't work, and then Effexor was added back and within one hour, presto, I was feeling back to my "normal."  A junkie getting a fix.I still didn't recognize that I had been in protracted withdrawal for 10 months because I didn't have the bad WD symptoms that people usually have up front; things built to a crescendo months out.  Doctors don't acknowledge this.  

I only learned about protracted withdrawal after reinstating.  I have been slow tapering off both meds ever since, about a year now, and am on subtherapeutic doses of both now, and feel better than I have in 20 years.  I began learning about withdrawal, and what these meds do to the nervous sytem physically, the remodeling and the long term negative consequences of taking these meds, which I won't go into here because I don't want to scare people, but if you'd ike to know I'd be happy to PM about it. 

So, I've been in the trenches, still am.  I have since begun CBT, meditation/mindfulness, and used other helpful techniques to deal with the old wires in my brain that led me to my same old thinking.  I am breaking those wires and developing healthier ones in their place.  I no longer feel worthless, undeserving.  I have made greater strides in the last year than 20 years on meds.

18

Hi there,

my background is in pharmaceuticals and my degree similarly, so I'll try and put into context. Basically, SSRI stands for Selective Serotonin Reuptake Inhibitior. When the SSRI binds to the receptor it inhibits the reuptake of serotonin, therefore the level of serotonin increases in the synapse which is where the receptors are. One of the theories for depression is the Receptor Theory, thus TCADs initially on the market but the side effect profile pretty poor and risk of oevrdose higher, then realised that serotonin ( aka as 5-HT )  also involved and is known as feel good chemical. (There are other ways to inc. levels of serotonin, some people look at diet and try eating a diet rich in Tyramine, a precursor to 5-HT. ) 

Basically the SSRI blocks presynaptic reuptake of serotonin, meaning that there is more serotonin in the nerve synapse to act at the receptors on the post-synaptic side ( easier to understand if you look at a diagram of a synapse ). The other thing is that there is a thing known as ''down-regulation'' of receptors ( post synaptically ), basically the body can change the number of receptors able to accpet a serotonin molecule binding to it. ( this is why tolerance can develop to some drugs ). 

Regarding coming off an SSRI there is more than this to consider. You need to look at the ''half-life'' of the drug, for one, This is the time taken for the compound ( SSRI) to reduce in the body to half it's initial dose, this is impotant for  few reasons, and there are differences between the diff. SSRI's, for example fluoxetine has a very long half life and an active metabolite ( another compound that it is broken down to, which also is active ) thus when patients miss a dose it is less impt with fluoxetine as they are covered by it's long half-life. The rest of the SSRIs though are very similar and are in region of 24-36 hours, thus patients feel bit naff if miss a dose. ( I once forget to take my 150mg sertraline on a mini break, not to be advised at all, day 3 I felt hot flushes and clammy, intestinal cramping and frequent vists to bathroom !...I had no choice but to wait until I got back to UK and restarted on a dose of 100mg, and actually stayed on this dose fine for 6 months until SAD kicked in )...will try dropping to 100mg again soon I think. As soon as I put the sertraline back in my system all the side effects of discontuniuation dissappeared ! It was actually the flushing and GI side effects that alerted me to the fact I had forgot it !, as I take many meds for chronic pain too and hadn't realised.! 

So when you want to come off an SSRI you need to do it gradually, this gives the body time to readjust the receptor numbers in response to the chemical changes. Of all Serotonin receptors in the body, 80% are in the intestine and only 20% in the brain !! Thus, the high incidence of GI side effects with SSRI's. ( and the saying ''gut feeling''!).

It goes even deeper than this as there are sub-types of serotonin receptors, each with slightly diff. functions, but that would be going to in depth for the purpose of your question. 

What you need to make sense of what I have said is a simple diagram of a synapse, showing pre-synaptic receptors, the cleft into whish the serotonin is released, and the post-synaptic side, where the serotonin binds ( like a key into a lock ), to exert it's effect. Then you wil be able to understand how by blocking the re-uptake of the serotonin presynaptically this goes to increase the levels available to bind at the post-synaptic side of the synapse. ( you have diff. receptors on either side of the nerve synapse ). 

Whilst the Receptor Theory of depression is the one that people go with, it does not fully explain some things, and also bear in mind that there is a huge placebo effect too with people taking AD's ( roughly 40% )....

 

19

Hi there,

I would like to point out that you and I must have been looking at different data if you say that AD response is same as with placebo. there is a huge placebo effect when looking at trials of AD's. However, there are many many studies for each of these drugs showing and increase well beyond that of placebo. The trials are double-blind and placebo controlled for good reason !! 

It is also well known among physicians that one of the first things to improve is ''motivation'', circa 3 weeks into therapy with AD's. I you have a very depressed patient who prev. lacked any motivation then they were not in a position to carry through their suicidal ideation. However. very poorly patients should be closely monitored for the first month, as motivation returns there is a higher chance they may carry out their previous suicidal ideation. this is why they should be in close contact with CPN's, getting CBT or other talking therapy whilst waiting for CBT. It is also known that the other elements of depression and anxiety are treated later than the 3 weeks at which motivation returns. 

I agree with you on the pharmacolgy as I too have a degree in that area. 

I also stated that Receptor Theory is the current best thinking at treating depression / anxiety....but is not the entire story.

Of cousre pharma companies have made a lot of money with these drugs in the past, just as the global obesity epidemic now means statins and Type II diabetes drugs are the meds that keep the shareholders happy !! ( only have oursleves to blame for those !)

These drugs do work well beyong placebo and benefit a LOT of

people, who prev. may have been given TCADs, with horrid side effects and high risk of overdose ! or even worse given ECT !!

I do also agree that CBT and Mindfulness are very useful tools, and that the best long term solution is a combination of both AD's and CBT/Mindfulness therapies.....I have done both, I personally like Mindfulness and would recommend to anyone, I find it a useful tool with the meditation CDs after the 8 week course I went on, for focusing the mind and settling anxiety.

Just remember that before the advent of SSRIs, ''mummy's little helper'' was a dose of diazepam ! then the drs had to try and wean averyone off those some years later.....depression is not necessarily a new thing, and we shouldn't try and stigmatize something that has taken decades for people to feel open and happy to talk about their worries etc and seek help.

20

HI there, 

I do agree from a pharmacological stand with some of what betsy says, but I think she is taking it to the opposite extreme. Please read my response. the one major thing I would disagree with her on is that effects on sypmtoms of depression / anxiety are same with AD's as with placebo - they are NOT ! I have never seen that data and I have seen many double-blind placebo controlled trials. What is correct is that compared to other illnesses there is a HUGE placeo response when looking at trials for AD's, roughly 40% of patients will report improvements on a sugar pill !! ( no one said that AD's are the whole story ), however when trial are double-blind randomised it means that neither the patient nor the dr knows whether they have been given the placebo or drug, this is good scientific practice. 

As I said no one claims to have all the answers, but data I have seen generally shows 60 -70 % efficacy compared to placebo at roughly 40%. For most illnesses the placebo response is gnerally much lower ! It just shows what the power of suggestion can do. patients then need to have symtoms measured against recognised scales such as HAM-D etc, at diff. time intervals.....the WHO used to recommend that even once patients felt ''okay'' that they should continue AD treatment for a further 4-6 months to limit relapse.

There are many negative thought processes we all get into, mine was worsened by chronic pain...and poss. some of the meds I take for it !! I attended a Mindfulness Course for 8 weeks locally in UK, they gave us the resources as went along and CD's and taught us meditation which is very good at helping with anxiety.