Keywords<\/em><\/strong>: Mental health, depression, psychiatric drugs, physician-patient communication. After seeing yet more evidence of the long-term dangers of psychiatric drugs, I recently decided that I would discontinue the antidepressant I had been taking the past 5 years. This article is more about what I did wrong than what I did right, and I hope it can serve as a warning to others. Evidently it’s very common for people to run into numerous problems when trying to discontinue psych drugs. Very little information, assistance, or support is available for doing this, perhaps because no one is making money when a patient stops as they do when you start taking a drug. <\/p>\n This is an area where there clearly needs to be much more dialogue and participation between doctor and patient. My experiences with psych drugs, which I believe are fairly typical based on what I’ve learned from my reading and from speaking with other users, suggest that the current situation falls far short on many of the “parameters of participatory medicine.” <\/p>\n As I sought out information on how to discontinue safely, I saw that users of these drugs by and large are not kept well informed about their proper use or discontinuation — not by their psychiatrists, the drug makers or government regulators. I tried all these sources, but it was as if I were the first person to ever try to safely taper down and discontinue. Users of psych drugs are not treated like active participants in decisions, which I suspect may relate to the lower credibility that a “mentally ill” person has in the eyes of others, including some medical professionals. Too often when someone even thinks you may suffer from a mental illness — a term that I despise by the way — they start to treat you like a child. I’ve been there. This can only inhibit the development of productive dialogue between doctor and patient. <\/p>\n What really convinced me to finally get off psych drugs completely were two recently published books, Not Crazy<\/em> by Dr. Charles Whitfield, and Anatomy of an Epidemic<\/em> by Robert Whitaker. These books contain compelling evidence of the many dangerous side effects and dependency-producing properties of various psych drugs. When used long-term, such medications can lead to numerous ailments and even a shorter lifespan. But very few users are ever warned about these long-term dangers, perhaps because nearly all the studies of the drugs’ effects are short-term only. <\/p>\n It’s remarkable that despite the skyrocketing use of psych drugs, little seems to be known about exactly how they affect people. Do they compensate for chemical imbalances in the brain or cause them? How toxic are they? Are they addictive? How do you discontinue and what are the withdrawal effects? Why do people who are on psych drugs for long periods tend to become more prone to a variety of illnesses? Do they tend to die young, and if so, why? In spite of this dearth of hard scientific evidence, psychiatrists everywhere seem perfectly comfortable prescribing more and more of these drugs. <\/p>\n What’s more, once you’re on a drug, they don’t seem to want to take you off. Often, one drug is just the beginning, as you find yourself taking another to offset any side effects from the first, and so on. For the past six months I’ve been looking and asking around for a psychiatrist who specializes in taking people off psych drugs. You’re not supposed to stop abruptly — that message has gotten out loud and clear — but little more information is available. I have yet to find a psychiatrist in my area who specializes in tapering down and discontinuing. With the growing need for assistance here, a support group was recently created for by a local peer mental health services agency, Collaborative Support Programs of New Jersey<\/a>. <\/p>\n I actually have a fair amount of trust in my current psychiatrist, because I selected him carefully after bad experiences with several others. But like most psychiatrists, he seems to be blindly committed to drugs as the sole form of treatment. For several years now he’s been opposed to my getting off antidepressants, insisting that I need to stay on them despite my improved condition. I think he sincerely believes this; he’s been trained and indoctrinated for decades to believe this. He only went along with my plan to discontinue the antidepressant after I repeatedly assured him I felt all right and showed him I was determined to stop. <\/p>\n Ironically, despite my psychiatrist’s glowing endorsement of psych drugs, he hasn’t been able to answer some basic, critical questions about them, such as why I experience immediate and disabling symptoms when I forget a single day’s dose. Several times over a period of years I described to him my symptoms of constant dizziness, upset stomach, and severe fatigue late in the day after forgetting a daily dose. He just said he was surprised and couldn’t explain it; couldn’t he research it? <\/p>\n For people like me the real question is: when you stop taking the drug or reduce the dosage and then experience symptoms such as fatigue or dizziness, are these temporary withdrawal effects, or a return of the full force of depression? My psychiatrist insists this represents a return of the symptoms of depression. And they’re certainly similar. <\/p>\n But I think it’s significant that the symptoms are not identical. My recent symptoms were mainly physical, not emotional. I didn’t feel unusually sad, down or in despair, at least not to the extent I did before taking medication. The main challenge now was summoning the energy to do something, anything. If it involved physical effort, I especially had trouble. And if I did find the energy, I then had difficulty sustaining it, becoming quickly exhausted. After just an hour of moderately strenuous yard work one day, I became so weak that I had to struggle mightily to finish what I was doing. I was close to fainting at times and had to lie down the rest of the afternoon. I usually succumb to afternoon naps when working at home, but this kind of fatigue was just too much. I couldn’t function. <\/p>\n Rather than the stereotypical symptoms of sadness and despair, about the only feelings I’ve experienced above the norm are irritability and impatience. Although these symptoms often accompany depression, I think they may also stem from the fact that, as a result of my near-constant weakness and fatigue, everything is a chore. Even simple tasks can be a struggle — getting dressed, climbing stairs, or just trying to concentrate enough to read something. It tries my patience and just wears me down. <\/p>\n When I began tapering off the antidepressant Cymbalta (duloxetine) in the spring, I certainly expected withdrawal effects, but I didn’t expect them to be this severe or long-lasting. Since I’m still taking the drug, just a lower dose, I’m very concerned about what happens when I stop taking it altogether. But having come this far, I’m not about to give up now and return to the full dosage. Like many consumers, I’m at a loss to know what to think about the conflicting information I see about psych drugs. But I now lean toward believing the critics, who seem to have the evidence on their side. And unlike those advocating the drugs, they don’t have a vested financial interest. <\/p>\n In the dozens of books I’ve read about depression and related disorders, I learned that people who take antidepressants for long periods are more likely to suffer numerous physical disorders (see, for example, Dr. Charles Whitfield’s The Truth About Depression<\/em>). Withdrawing, in particular, can produce a number of troublesome ailments and symptoms. This was true in my case, as I’ve had an unusual number of other health problems since I started tapering off Cymbalta, including a torn cornea and disc problems. These included a pinched nerve in my neck, producing local pain and stiffness as well as numbness and weakness in my arms and hands. The disc problems are a return of an earlier condition, so I wouldn’t blame that on the drug or on withdrawal, although there is some evidence that depression itself is associated with conditions like these. And I’m suspicious about the torn cornea because I’ve read that eye problems such as a detached retina can result from withdrawal, and drying of fluid in the eye is the most common cause of a torn cornea. Cymbalta is known to cause dry mouth, dry eye, and overall dehydration. <\/p>\n But how can you really know what caused these things? The eye doctor and psychiatrist I asked were of no help. I don’t like speculating like this, but in the absence of good answers to these critical questions, that’s all I can do. The neck condition — a herniated disk that was pinching my spinal cord — required surgery a few weeks into my tapering down, so I elected to suspend the tapering a while to maintain a minimal level of strength because the pinched nerve was also beginning to cause weakness and fatigue. I resumed tapering down a couple of months later upon sufficiently recuperating from the surgery. <\/p>\n It’s curious that following my first episode of depression a dozen years ago, I had little trouble getting off antidepressants. But back then I only took them for maybe 2 years total. And while I took a variety of drugs during both episodes, sometimes two or three at a time, I was never on a drug for an extended period prior to the current 5-year stretch on Cymbalta. From what I’ve read, this kind of longer-term use might produce a dependency that leads to serious difficulties when withdrawing. Apparently, as the drug artificially elevates levels of neurotransmitters, the brain reduces its own production, and over time, it can begin to lose the ability to produce them at all. So the patient suffers as the brain struggles to readjust to a normal state without the drug. This can lead to the dizziness and severe fatigue I experienced. <\/p>\n
\nCitation<\/em><\/strong>: Giordano T. More support and information needed for getting off psych drugs. J Participat Med. 2011 Oct 24; 3:e48.
\nPublished<\/em><\/strong>: October 24, 2011.
\nCompeting Interests<\/em><\/strong>: The author has declared that no competing interests exist.
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