It's really sad how understudied these phenomena are. I'm often hesitant to really bring it up anywhere because of how the usage of medication for mental health is often still stigmatized. At the...
It's really sad how understudied these phenomena are. I'm often hesitant to really bring it up anywhere because of how the usage of medication for mental health is often still stigmatized. At the same time, these are genuine concerns and it's questionable whether people can really consent to use medication if this isn't more wildly known.
Back when I still modded mental health community there was one person in particular that was quite intense about it. To the point we eventually had to ban that individual, as well as some obvious alts. I don't regret the ban as it was necessary, at the same time their behaviour was also a measure of just how unheard some of these victims are.
I don't think I need to say it here of all places, but still: people suffer from the stigma of using medication for mental health. And this is a genuine problem that needs to be addressed.
The stigma cuts both ways: in my province, one is automatically not able to apply1 for disability or any further gate kept benefits if one refuses to take medication for mental health problems....
The stigma cuts both ways: in my province, one is automatically not able to apply1 for disability or any further gate kept benefits if one refuses to take medication for mental health problems. Nevermind that the doctors refuse to listen to your complains of negative side effects.
The stigma is both of "you shouldn't rely on meds you're simply not helping yourself" and "you're not well because you refuse meds and not helping yourself".
1 - you can apply but their criteria denies based on this
Edit: forgot relevant quote - this is what Munari is experiencing
To receive disability, she agreed to go back on the drug she'd been on
I honestly legit thought it isn't anymore for antidepressants and antianxiety medicine... It definitely was 10 years ago in my home country but I feel honestly almost everyone is on...
how the usage of medication for mental health is often still stigmatized.
I honestly legit thought it isn't anymore for antidepressants and antianxiety medicine... It definitely was 10 years ago in my home country but I feel honestly almost everyone is on antidepressants or xanax now... from relatives old enough to belong to the silent generation all the way to teenagers.
Now, antipsychotics etc on the other hand, yeah, definitely still a thing.
An increased number of people being on antidepressants definitely doesn't entail that they aren't still stigmatized (even though they definitely are less than they once were and less than other...
An increased number of people being on antidepressants definitely doesn't entail that they aren't still stigmatized (even though they definitely are less than they once were and less than other medications for mental health).
Doctors have long understood that stopping antidepressants can cause short-term withdrawal, with patients suffering from symptoms like dizziness, anxiety, insomnia and nausea.
What most prescribers and patients don't understand is that "you can have symptoms that persist for long periods after you stop them," said British psychiatrist Mark Horowitz, who specializes in antidepressant withdrawal. According to one analysis of patient narratives, people who experienced long-term withdrawal suffered for an average of eight years.
Although psychiatrists have been documenting cases like Munari's for decades, no large-scale studies on the problem exist. Because of that, experts still disagree on how common this kind of condition is, how to prevent it, or even what to call it.
"It should be very concerning to the medical system and the public that there are tens of millions of people walking around on drugs whose long-term exposure and withdrawal effects we do not understand," Horowitz said.
It’s been about two years since I was on escitalopram and I still get the occasional brain zap. Just this morning I had one, in fact. Had I realized a few months of being on the drug would have...
It’s been about two years since I was on escitalopram and I still get the occasional brain zap. Just this morning I had one, in fact. Had I realized a few months of being on the drug would have years of withdrawal symptoms, I would have reconsidered ever starting taking them for sure. At least now the effects arent daily and Ive made great progress in my mental wellbeing without drugs and with the help of psychotherapy. I personally wouldn’t recommend anyone start using them unless you are in an acute danger of self harm.
huh I didn't know escitalopram caused brain zaps! I must've lucked out not getting that symptom with it (either when I took it regularly or when I weaned myself off it)
huh I didn't know escitalopram caused brain zaps! I must've lucked out not getting that symptom with it (either when I took it regularly or when I weaned myself off it)
Long term zaps/shocks are pretty rare but the prevelance is about 42% for withdrawal effects. It's just that most don't last more than a month and may even be a one-off.
Long term zaps/shocks are pretty rare but the prevelance is about 42% for withdrawal effects. It's just that most don't last more than a month and may even be a one-off.
How would you describe a "brain zap"? Just curious, as I weened myself off the same thing, I'm not sure how many years ago now, maybe 5-6? I don't personally recall any adverse affects, but my...
How would you describe a "brain zap"? Just curious, as I weened myself off the same thing, I'm not sure how many years ago now, maybe 5-6? I don't personally recall any adverse affects, but my memory is terrible.
Personally, ive gotten them since I was a kid. I'd describe it as a kind of extrasensory jolt. Maybe relate it to the feeling of jolting awake when half asleep? Its not one to one but I think its...
Personally, ive gotten them since I was a kid. I'd describe it as a kind of extrasensory jolt. Maybe relate it to the feeling of jolting awake when half asleep? Its not one to one but I think its a good enough comparison.
Yeah, for me it was like an electric zap — like when you build up static electricity and discharge it by touching metal. Alternate comparison: it was like a rubber band snapping inside my brain....
Yeah, for me it was like an electric zap — like when you build up static electricity and discharge it by touching metal.
Alternate comparison: it was like a rubber band snapping inside my brain.
It never hurt at all; it was just surprising and unexpected.
Thanks. Weird, I don't get most those symptoms, at least, I can't recall, but I do get unexplained dizzy spells periodically, which is listed as a symptom.
Thanks.
Weird, I don't get most those symptoms, at least, I can't recall, but I do get unexplained dizzy spells periodically, which is listed as a symptom.
I started taking Effexor around 2011, and then switched to Pristiq around 2015. For both of them the major side effect is withdrawal. You can get some high blood pressure issues at higher doses...
I started taking Effexor around 2011, and then switched to Pristiq around 2015. For both of them the major side effect is withdrawal. You can get some high blood pressure issues at higher doses but I haven't had that problem.
When I first started taking Effexor, my doctor warned me that if I missed a dose it would feel pretty bad. She said, "If you miss a dose, you'll get the zaps." I asked what that was and she said, "Oh you'll find out." She was not wrong. If I miss a dose by more than about 4 hours, I start to feel really bad. Kind of like if you were coming down with the flu. Body aches, dizziness, general malaise. If I go a little bit longer than I get the zaps, which are hard to describe. It's kind of like a visual flash coupled with vertigo and a jolty sensation in my body.
I knew all about all this going in, and it seems like the course for me is going to be to stay on the antidepressants as long as I can. If I ever do have to go off them, I know it's going to really suck. Even switching from Effexor to Pristiq, which are almost the same drug, and even with ramping one down and ramping one up at the same time, it was a terrible month. Once I take a dose, it takes about an hour or two feel mostly normal again.
That said, the antidepressant seems to be necessary for me. I was at what I thought was the maximum dose of Pristiq (100mg), and then I had a serious medical issue and some follow on PTSD. My doctor had me start taking another 50 mg. My doctor said that it has been studied and is effective at higher doses, they just don't have it approved by the FDA at those doses.
I don't miss a dose very often. Probably a late dose around once a month and a missed dose around twice a year. My combo system for keeping track is:
I have a very reliable reminder app (it is also available on android). It's main virtue is that if you just swipe the reminder off, it will come back in 15 minutes. You have to explicitly clear the reminder. It goes off every day, and I don't clear it unless I take my pills.
I keep the pills in a bottle with a Timer Cap it shows the time since the bottle was last opened, and is automatically reset when you uncap the bottle. It's great for when I'm not sure if I took my pills or not, I can check it.
The final piece is that I keep two doses of my medicine in a little metal tube that goes on my keychain so if I end up somewhere unexpected I can still take it.
side note: My doc was straight up with me that we have no idea really how most of these drugs work. Sure we have some idea of some of their mechanisms, like ssris block certain transports, but we...
side note: My doc was straight up with me that we have no idea really how most of these drugs work. Sure we have some idea of some of their mechanisms, like ssris block certain transports, but we don’t know why that has the effect that it does (in a few people, I think last I checked the nnt for most if these drugs is four or more)(nnt=number needed to treat, or number of people in a general population of sufferers who will have to receive treatment before 1 person sees an effect. It’s a statistical statement on efficacy among individuals.) Recent evidence suggests seratonin may play no role in depression. Other recent evidence suggests that how much you believe your doctor also plays a big role in efficacy. This last is a hopeful sign for me: I’ve long marveled at how little we study the placebo effect-which is a real measurable effect. Also someone recently pointed out to me there is also a “no-cebo” effect, where disbelief inhibits a med’s efficacy.
Edit: Based on @sparksbet clarification, I wonder if these lingering symptoms could be explained by the nocebo effect, or at least some instances?
This is not what the nocebo effect is. The nocebo effect is when patient expectations lead to worsened symptoms or increased side effects. I am not aware of its being widely used for meds becoming...
Also someone recently pointed out to me there is also a “no-cebo” effect, where disbelief inhibits a med’s efficacy.
This is not what the nocebo effect is. The nocebo effect is when patient expectations lead to worsened symptoms or increased side effects. I am not aware of its being widely used for meds becoming less effective than otherwise due to patient expectations, at least not outside the degree to which worsened symptoms would count as less effective. Tbqh, I have never read anything about that phenomenon existing -- if it does, I suspect it has a different name than the nocebo effect.
It's really sad how understudied these phenomena are. I'm often hesitant to really bring it up anywhere because of how the usage of medication for mental health is often still stigmatized. At the same time, these are genuine concerns and it's questionable whether people can really consent to use medication if this isn't more wildly known.
Back when I still modded mental health community there was one person in particular that was quite intense about it. To the point we eventually had to ban that individual, as well as some obvious alts. I don't regret the ban as it was necessary, at the same time their behaviour was also a measure of just how unheard some of these victims are.
I don't think I need to say it here of all places, but still: people suffer from the stigma of using medication for mental health. And this is a genuine problem that needs to be addressed.
The stigma cuts both ways: in my province, one is automatically not able to apply1 for disability or any further gate kept benefits if one refuses to take medication for mental health problems. Nevermind that the doctors refuse to listen to your complains of negative side effects.
The stigma is both of "you shouldn't rely on meds you're simply not helping yourself" and "you're not well because you refuse meds and not helping yourself".
1 - you can apply but their criteria denies based on this
Edit: forgot relevant quote - this is what Munari is experiencing
I honestly legit thought it isn't anymore for antidepressants and antianxiety medicine... It definitely was 10 years ago in my home country but I feel honestly almost everyone is on antidepressants or xanax now... from relatives old enough to belong to the silent generation all the way to teenagers.
Now, antipsychotics etc on the other hand, yeah, definitely still a thing.
An increased number of people being on antidepressants definitely doesn't entail that they aren't still stigmatized (even though they definitely are less than they once were and less than other medications for mental health).
It’s been about two years since I was on escitalopram and I still get the occasional brain zap. Just this morning I had one, in fact. Had I realized a few months of being on the drug would have years of withdrawal symptoms, I would have reconsidered ever starting taking them for sure. At least now the effects arent daily and Ive made great progress in my mental wellbeing without drugs and with the help of psychotherapy. I personally wouldn’t recommend anyone start using them unless you are in an acute danger of self harm.
huh I didn't know escitalopram caused brain zaps! I must've lucked out not getting that symptom with it (either when I took it regularly or when I weaned myself off it)
Long term zaps/shocks are pretty rare but the prevelance is about 42% for withdrawal effects. It's just that most don't last more than a month and may even be a one-off.
I was just under the impression that brain zaps were only associated with certain antidepressants and didn't know escitalopram was one of them.
Yeah gotcha, I am not as familiar with pharmaceutical side effects myself.
How would you describe a "brain zap"? Just curious, as I weened myself off the same thing, I'm not sure how many years ago now, maybe 5-6? I don't personally recall any adverse affects, but my memory is terrible.
Personally, ive gotten them since I was a kid. I'd describe it as a kind of extrasensory jolt. Maybe relate it to the feeling of jolting awake when half asleep? Its not one to one but I think its a good enough comparison.
That’s a pretty good comparison. I usually say it feels like vertigo combined with the sensation of a small electrical shock/tingling sensation.
Yeah, that seems like a good description to me.
Yeah, for me it was like an electric zap — like when you build up static electricity and discharge it by touching metal.
Alternate comparison: it was like a rubber band snapping inside my brain.
It never hurt at all; it was just surprising and unexpected.
Can't speak for personal experience, but in the meantime here's a little article
Thanks.
Weird, I don't get most those symptoms, at least, I can't recall, but I do get unexplained dizzy spells periodically, which is listed as a symptom.
I started taking Effexor around 2011, and then switched to Pristiq around 2015. For both of them the major side effect is withdrawal. You can get some high blood pressure issues at higher doses but I haven't had that problem.
When I first started taking Effexor, my doctor warned me that if I missed a dose it would feel pretty bad. She said, "If you miss a dose, you'll get the zaps." I asked what that was and she said, "Oh you'll find out." She was not wrong. If I miss a dose by more than about 4 hours, I start to feel really bad. Kind of like if you were coming down with the flu. Body aches, dizziness, general malaise. If I go a little bit longer than I get the zaps, which are hard to describe. It's kind of like a visual flash coupled with vertigo and a jolty sensation in my body.
I knew all about all this going in, and it seems like the course for me is going to be to stay on the antidepressants as long as I can. If I ever do have to go off them, I know it's going to really suck. Even switching from Effexor to Pristiq, which are almost the same drug, and even with ramping one down and ramping one up at the same time, it was a terrible month. Once I take a dose, it takes about an hour or two feel mostly normal again.
That said, the antidepressant seems to be necessary for me. I was at what I thought was the maximum dose of Pristiq (100mg), and then I had a serious medical issue and some follow on PTSD. My doctor had me start taking another 50 mg. My doctor said that it has been studied and is effective at higher doses, they just don't have it approved by the FDA at those doses.
I don't miss a dose very often. Probably a late dose around once a month and a missed dose around twice a year. My combo system for keeping track is:
side note: My doc was straight up with me that we have no idea really how most of these drugs work. Sure we have some idea of some of their mechanisms, like ssris block certain transports, but we don’t know why that has the effect that it does (in a few people, I think last I checked the nnt for most if these drugs is four or more)(nnt=number needed to treat, or number of people in a general population of sufferers who will have to receive treatment before 1 person sees an effect. It’s a statistical statement on efficacy among individuals.) Recent evidence suggests seratonin may play no role in depression. Other recent evidence suggests that how much you believe your doctor also plays a big role in efficacy. This last is a hopeful sign for me: I’ve long marveled at how little we study the placebo effect-which is a real measurable effect. Also someone recently pointed out to me there is also a “no-cebo” effect, where disbelief inhibits a med’s efficacy.
Edit: Based on @sparksbet clarification, I wonder if these lingering symptoms could be explained by the nocebo effect, or at least some instances?
This is not what the nocebo effect is. The nocebo effect is when patient expectations lead to worsened symptoms or increased side effects. I am not aware of its being widely used for meds becoming less effective than otherwise due to patient expectations, at least not outside the degree to which worsened symptoms would count as less effective. Tbqh, I have never read anything about that phenomenon existing -- if it does, I suspect it has a different name than the nocebo effect.
Thanks for the clarification.