The question of whether or not you should start taking antidepressants is complex and difficult to answer. But even fuzzier is the question of when or if you should stop. Last May, NPR ran a piece called "Coming Off Antidepressants Can Be Tricky Business."
Joanne Silberner writes:
Several top psychiatrists say there's just not enough data to say for sure when to try coming off an antidepressant. Drug companies generally test their new products for a few months or up to a year. They don't spend much time looking into how to taper off their products. The dense informational inserts that come with prescription drugs have a lot of information on how to take the product, but no information on how to stop.
According to the Johns Hopkins Depression and Anxiety White Papers, antidepressant use involves three phases:
The decision of when to go off is highly individualized. There is no "one size fits all" rule of thumb. Although many studies indicate that a year or more of an antidepressant is needed to treat a major episode of depression or anxiety, there are certainly patients that have needed only a few months of drug therapy.
Says Silberner of NPR:
There's enormous variation among people when they stop antidepressants. A person whose depression kicked in after a major life tragedy may do OK without drugs once life stabilizes. A person whose depression came out of the blue is likely to be at higher risk of chronic depression. And within all that, there's basic biology -- people react differently to drugs and to withdrawing from drugs.
The only rule that all doctors hold is that a person does not go off medication cold turkey, but by gradually lowering the dose. Stopping too suddenly puts you at risk for symptoms returning or for physical and mental withdrawal. Several of the newer antidepressants especially, including Paxil, Luvox, Effexor, trazodone, Remeron and Serzone will produce symptoms of dizziness, nausea, lethargy, headache, irritability, nervousness, crying spells, flu-like illness and sleep or sensory disturbances -- known as the "discontinuation syndrome" that occur within 24 to 72 hours after stopping the medication.
About 20 percent of people who abruptly stop taking an antidepressant after more than six weeks of treatment experience the discontinuation syndrome.
Whitney Blair Wyckoff of NPR lists these six suggestions from Dr. Richard Shelton, professor of psychiatry at Vanderbilt University, to keep in mind when considering coming off medication:
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Now, it's exercise, sunshine, good eating, avoidance of negative people (including any family members that meet this criteria), and walking away from stressful situations whenever possible.
Having said all that, can someone please explain to me why on earth pharmaceuticals would say " take this only for a week and if you don't feell results, we'll give you your money back"....No, instead they tell you "oh, you have to take this for at least a year before we'll even know if it helps". And then, once they determine that " it helps", why on earth would the pharmaceuticals say, " when you're ready to go off of these, just stop, return your unused pills and we'll refund them" . Instead they say" oh, you need to wean yourself off of these....amd take a year to do it". So how much more lining did we add to the pockets of the pharmaceuticals? What a racket.
People, don't be so quick to take the easiest route in a pill. Humans found a way before them, and still can now.
It just seems to be important to continue to bring Integrative Medicine up as a viable treatment option since it is rarely mentioned in the main stream media. Good luck to all who are suffering from this terrible condition.
It's taken me many years to learn what's best .. how to adjust dosages so that I don't have a flat affect yet still can experience human emotions in a healthy way, and allow me to feel some joy in day to day living. Diet, exercise, rest, healthy living is also important for clinically depressed people. It is beyond exhausting, and very, very expensive, to try to manage depression without the help of pharmaceuticals for some of us.