• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Antidepressants

caledonia

Senior Member
I forgot to mention, they are non-addictive as well. :)

No, that's the propaganda the drug companies tell you. They're actually horribly addictive. Case in point, I'm 4.5 years into what will be a 9 year taper from Zoloft, which I was on at full dose for 12 years.

When I tried coming off faster than that, I experienced a horrendous withdrawal syndrome with akathisia and OCD thoughts - things I had never experienced before. It took me the better part of a year to gradually reinstate the drug and recover from that. In other words, reinstating the drug stopped the withdrawal symptoms, just like heroin, benzos, nicotine or any addictive drug.

What the drug companies tell you is that you've become mentally ill with a different sickness and you need to be on some kind of drug for life. The psychiatric nurse practitioner I was working with on reinstatement was parroting this.

I've been well below a therapeutic dose of Zoloft for several years now, and have no anxiety symptoms to speak of (what I originally went on it for). If I miss a dose or try to reduce too much too fast I get OCD thoughts or even akathisia - new symptoms I've never had before taking this drug.

So I clearly no longer need this drug, yet, I can't stop taking it because I will become very sick. Sounds like an addiction to me.
 

Hip

Senior Member
Messages
17,824
If I miss a dose or try to reduce too much too fast I get OCD thoughts or even akathisia - new symptoms I've never had before taking this drug.

Have you tried taking other known treatments for OCD, such as high dose inositol (eg, two heaped teaspoons of inositol powder daily) which like SSRIs also has a serotonergic effect? Maybe that might allow you to come off Zoloft faster.
 

caledonia

Senior Member
Have you tried taking other known treatments for OCD, such as high dose inositol (eg, two heaped teaspoons of inositol powder daily) which like SSRIs also has a serotonergic effect? Maybe that might allow you to come off Zoloft faster.

If I'm having issues, I do a bit of 5htp and that is very helpful. But I'm not to the point where I can take it on a daily basis.

As far as speed of getting off, I guess it is what it is. I seem to be more sensitive than most - I need 8 weeks between reductions. I will get there eventually.
 

Alvin2

The good news is patients don't die the bad news..
Messages
2,996

Oberon

Senior Member
Messages
214
No, that's the propaganda the drug companies tell you. They're actually horribly addictive. Case in point, I'm 4.5 years into what will be a 9 year taper from Zoloft, which I was on at full dose for 12 years.

When I tried coming off faster than that, I experienced a horrendous withdrawal syndrome with akathisia and OCD thoughts - things I had never experienced before. It took me the better part of a year to gradually reinstate the drug and recover from that. In other words, reinstating the drug stopped the withdrawal symptoms, just like heroin, benzos, nicotine or any addictive drug.

What the drug companies tell you is that you've become mentally ill with a different sickness and you need to be on some kind of drug for life. The psychiatric nurse practitioner I was working with on reinstatement was parroting this.

I've been well below a therapeutic dose of Zoloft for several years now, and have no anxiety symptoms to speak of (what I originally went on it for). If I miss a dose or try to reduce too much too fast I get OCD thoughts or even akathisia - new symptoms I've never had before taking this drug.

So I clearly no longer need this drug, yet, I can't stop taking it because I will become very sick. Sounds like an addiction to me.

I was on Paxil for 3 years and the withdrawal took me 1.5 years. I went faster than I should and I could feel each and every dose reduction the next day with extreme bouts of nauseau, fatigue, etc. I am convinced that Paxil withdrawal played a fairly decent role in me having CFS today. I was stubborn and overconfident and thought I would recover, but I never did and wound up with CFS after my withdrawal (note there were other factors like mono, etc.)

If you do not have a long-standing depression or anxiety problem I would not take SSRI's; especially one's like Paxil and Effexor which are known to have severe withdrawal symptoms. In my case SSRI's never helped my depression only my anxiety. They actually worsened my depression because they dulled my ability to feel any emotion at all.

I would encourage you to try CBT or other forms of therapy with a therapist. I know CBT isn't popular around here because it's touted as a CFS treatment with no actual scientific basis, but when it comes to depression and anxiety it really can help. It can teach you means to reframe your thoughts and to cope with your ongoing issues.

There are also relatively risk free supplements (compared to SSRI's) like Fish Oil, B12, SAM-E, Vitamin D (Note: all of these can be riskier for those with CFS). Make sure you try one at a time for at least a few weeks to accurately gauge their ability to help your depression. All the supplements I listed have studies showing efficacy with depression and are worth giving a go before subjecting yourself to a potential longstanding withdrawal with SSRI's.

With that said, if SSRI's worked to resolve my depression in the long-term I would take them again in a heartbeat. The biggest difference being that I have had issues with depression my entire life rather than having it directly associated with recent life events. If my depression was only caused by recent events I would never touch a pharmaceutical; it just isn't worth the long-term repercussions if you can cope with it through other means.

I could be wrong as I am not everyone, but I don't really think most people understand how bad severe depression can get. You quite literally spend every single second in absolute agony, misery and emotional turmoil to the point where the only thing you want to do is off yourself to make it end. If there was a pill I could take to make sure I never go through that again I would take in seconds even if it meant it would take 10 years off of my life. That pill doesn't exist though :).
 

Hip

Senior Member
Messages
17,824
I could be wrong as I am not everyone, but I don't really think most people understand how bad severe depression can get. You quite literally spend every single second in absolute agony, misery and emotional turmoil to the point where the only thing you want to do is off yourself to make it end. If there was a pill I could take to make sure I never go through that again I would take in seconds even if it meant it would take 10 years off of my life. That pill doesn't exist though

How many different classes of antidepressant had you tried? There are several classes other than SSRIs.
 

Oberon

Senior Member
Messages
214
How many different classes of antidepressant had you tried? There are several classes other than SSRIs.

Hi Hip,

I don't want to hijack the thread too much so I've PMed you. If anyone else wants to learn more about my story feel free to PM Me.
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
I've taken antidepressants for about half my life and I will probably take them until I die. I had a nasty withdrawal from Effexor but it was not an addiction. (I had no craving for the drug.) Cymbalta makes me normal and functional as opposed to being a suicidal zombie. It has no effect on my ME/CFS, unfortunately.

Psychotherapy, including CBT, was absolutely useless to me. Some people find it helpful.
 

caledonia

Senior Member
I was on Paxil for 3 years and the withdrawal took me 1.5 years. I went faster than I should and I could feel each and every dose reduction the next day with extreme bouts of nauseau, fatigue, etc. I am convinced that Paxil withdrawal played a fairly decent role in me having CFS today. I was stubborn and overconfident and thought I would recover, but I never did and wound up with CFS after my withdrawal (note there were other factors like mono, etc.)

If you do not have a long-standing depression or anxiety problem I would not take SSRI's; especially one's like Paxil and Effexor which are known to have severe withdrawal symptoms. In my case SSRI's never helped my depression only my anxiety. They actually worsened my depression because they dulled my ability to feel any emotion at all.

I would encourage you to try CBT or other forms of therapy with a therapist. I know CBT isn't popular around here because it's touted as a CFS treatment with no actual scientific basis, but when it comes to depression and anxiety it really can help. It can teach you means to reframe your thoughts and to cope with your ongoing issues.

There are also relatively risk free supplements (compared to SSRI's) like Fish Oil, B12, SAM-E, Vitamin D (Note: all of these can be riskier for those with CFS). Make sure you try one at a time for at least a few weeks to accurately gauge their ability to help your depression. All the supplements I listed have studies showing efficacy with depression and are worth giving a go before subjecting yourself to a potential longstanding withdrawal with SSRI's.

With that said, if SSRI's worked to resolve my depression in the long-term I would take them again in a heartbeat. The biggest difference being that I have had issues with depression my entire life rather than having it directly associated with recent life events. If my depression was only caused by recent events I would never touch a pharmaceutical; it just isn't worth the long-term repercussions if you can cope with it through other means.

I could be wrong as I am not everyone, but I don't really think most people understand how bad severe depression can get. You quite literally spend every single second in absolute agony, misery and emotional turmoil to the point where the only thing you want to do is off yourself to make it end. If there was a pill I could take to make sure I never go through that again I would take in seconds even if it meant it would take 10 years off of my life. That pill doesn't exist though :).

Yes, if I had it to do over, knowing what I know now, I would never have taken Zoloft.

Short answer - CBT (not the UK kind) was helpful for thought patterns that increased anxiety, but that wasn't sufficient to treat the problem. The root cause (at last for me) seems to be mercury and other toxic metals. There are many supplements you can do which are helpful until you can get the metals safely removed and/or chelated out. I would add GABA and 5htp to the list.
 
Messages
11
This is a subject dear to my heart. I have both ME/CFS and depression, but which came first isn't clear; I'd had the odd bout of depression over the years when the neurotic/unstable aspects of my personality struggled in times of stress and change, but I wasn't depressed when ME/CFS hit me. I think the depression I have now is due to living with ME/CFS and the other issues that I link to it rather than the reverse.

Alas, the issues are very complicated and there is far too much deliberate misrepresentation, ignorance and lazy thinking.

IMO anti-depressants are grossly over-rated. Most do little better than placebos and even then are symptom-hiders rather than cures. Many people like me are resistant to them and they often do more harm than good (I have had some horrendous withdrawal symptoms and many increase the risk of suicide). As much as I dream of a miracle cure in a little pill, experience has drained the hope out of me. Sure, they are useful - even a placebo effect is a success that wouldn't be achieved without the anti-depressant hype - but that doesn't mean that they're effective.

I also got excited recently when I saw that several studies had shown that higher doses of the Modafinil/Provigil that I currently take (my only medication) had great effects on depression. Alas, further digging showed that the studies weren't rigorous and that other, double-blind, trials had shown that Modafinil was no better than a placebo.

For the record, I've been on Prozac, Effexor, Effexor with Lithium and Imipramine/Tofranil. The Imipramine was as much for a neurological issue as it was for depression. None had any lasting effect. Prozac didn't do much. The Effexor gave me rashes and coming off was weird. I came off Imipramine as the neurological issue was under control and it has tiredness and fatigue as major common side-effects; coming off had horrendously uncomfortable withdrawal symptoms and eventually took well over a year.

I had CBT for my depression well before ME/CFS hit. I found it very useful for my particular circumstances and think that it addressed all the issues that had previously caused my depressive bouts. My depression now does not have the self-critical thoughts that were its previous hallmarks. As for the use of CBT in ME/CFS, I'm with the vast majority who see it as pretty useless here, albeit having embraced and practised CBT before ME/CFS rather than the other way around; that said, I think a minority of people's ME/CFS is psychological and CBT might help them.

I find psychosomatic/psychogenic issues very interesting and did a lot of work to see if they could be behind my ME/CFS. I decided that they weren't. At the risk of getting me head chopped off, I'll say that I think there are some people claiming to have ME/CFS who are faking for attention (I knew one) or who have a psychosomatic cause (as is the case, for example, in over 20% of epilepsy sufferers), but that the vast majority have a genuine illness not cured by mind disciplines such as psychiatry, psychology and CBT. BTW I interpret 'psychosomatic' as 'caused by a mis-firing brain or neurological system' and very different to 'putting it on' or 'can be cured by the right mindset'.
 
Messages
1,055
I'm doing ok with Mirtazipine, helps me initiate sleep and I only spend PMT week wanting to kill myself and everyone else.
Fluoxetine was awful, I only slept 2 hours a night, crashed the hardest and longest I've ever crashed and had some spectacular falls - but I was weirdly happy, despite the bruising! And it was great for PMT.
 

Basilico

Florida
Messages
948
Selective MAO-A inhibitors — like moclobemide
Selective MAO-B inhibitors — like deprenyl / selegiline

@Jessie 107 , I have had excellent experiences with selegiline. More recently, I started moclobomide, which I also had a good experience with. I ordered both from an online pharmacy (no prescription needed).

The reason moclobemide never got approved in the US is that Prozac was released shortly before moclobemide was set to get approval, and the pharma company selling Prozac had such an orchestrated marketing campaign that they were able to inundate doctors with 'motivation' for prescribing it, the makers of moclobemide knew they'd never stand a chance at getting their drug to reach actual patients, so they gave up and focused on other countries. It's really a shame, because moclobemide is a reversible MAOI (as far as I know the only one of its kind) so there is absolutely no danger of serotonin syndrome from diet mistakes.

The other great thing about both of these medicines is that they start working within a short time frame, have a relatively short half life, and are used by many people for their neuroprotective qualities (the process of breaking down neurotransmitters creates oxidative stress in the brain).

In my case, I believe my MAO system breaks down neurotransmitters way too quickly. Selegiline and moclobamide slow this process down. I've had some extremely dark depressive episodes, and Selegiline was a godsend. Also, I can take them just during periods when I need them...it's not necessary to take them long term. I really can't say enough good things about these. I think it's a real travesty that doctors are prescribing most of the junk that they do just because they get kickbacks from pharma companies when there are much better options...though, not as much profit to be made.
 
Last edited:

Skycloud

Senior Member
Messages
508
Location
UK
@Jessie 107, How are you doing with coming off citalopram?

I have been absolutely ok so far and am currently at 12.5mg using pill cutting, and am taking it slowly. I'm keeping the reduction advice here in mind but as yet have not needed to be quite so cautious. I shall drop, probably to 10mg, in 2 or 3 more weeks, and see how that is. (I'm taking a month+ between redu)
 

Jessie 107

Senior Member
Messages
291
Location
Brighton
@Jessie 107, How are you doing with coming off citalopram?

I have been absolutely ok so far and am currently at 12.5mg using pill cutting, and am taking it slowly. I'm keeping the reduction advice here in mind but as yet have not needed to be quite so cautious. I shall drop, probably to 10mg, in 2 or 3 more weeks, and see how that is. (I'm taking a month+ between redu)
Hello Skycloud,
Yes I am also doing well, I did get insomnia a few weeks ago but I got a few sleeping tablets and they got me through it (think I cut too much off the tablet).
When I saw my doctor I told him I was tapering off the cit and how I was doing it, he didn't agree with me because he said you can't be accurate cutting them. He and told me to drop to 10mg from 15mg overnight! And then carry on for two weeks then just take about three a week after that, I told him I already feel ill with M. E. And didn't want to feel anymore ill. So I just ignored his advice, I will do my way by cutting the tablet like you. I am also just down to about 12 mg and will stick with this for 3 to 4 weeks.
The only other symptom I had early on was a slight headache but I could get rid of it easily with my usual painkillers. I am happy with how it is going and looking forward to being completely off.
Let me know how get on, good luck.
Regards
Jessie