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Antidepressants - something you take for LIFE?


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Not sure, for depression, that it has to be for life. However, at a presentation at Mass General I heard that, on the average, the people who take them for 6 months or a year after relief of symptoms do better than the ones who stop sooner. Don't quote me exactly as that was last fall and I didn't write it down.

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Ido said what I was going to say, but with more detail as I didn't know where the source of info was.

I'm not planning on taking these forever, but every time I get a glimse of how I used to live (like this weekend forgetting my meds entirely) I realilze I was really struggling.

If you have something clean like Lexapro, besides the cost, it's no biggie.  If you haven't been on an SSRI, they don't make you high or anything.  Just get you within 10% of normal.  Well, sometimes that good.  Depends on who you are.

Ask as many questions as you want here.  There is lots of info that your doc won't know or won't have time to research.

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It depends on your particular flavor of the illness -- some people will take meds permanently and some people won't.

Speaking for antidepressants only:

The evidence suggests that people who continue the meds for up to a year or so after the depression is resolved have the best chance of continuing well. If you go off suddenly as soon as you feel better, the chance of relapse is quite large. Many people have one or sometimes two episodes in a lifetime and take meds only short term to deal with that.

However, every depression you have makes it more likely that you'll have another. By the time you get to three or four episodes the chances are over 95%. Some of us have a very recurrent illness, or treatment resistant, or very severe or all three. I expect to be medicated for the rest of my life, depending on advances in treatment and technology due to the recurrent, treatment resistant, and severe nature of them.

That probably created more questions than it answered. The real answer is closer to YMMV.

Fiona

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Veering off the subject a bit:

1. A. Has anyone had to become unemployed or quit work because of depression?  B. Have you felt that meds disrupt your concentration and  comprehension of things so that you can't really function at work that much anymore?

2.  Isn't anyone afraid of being inconsistent with your personality with the switching of meds....like with your friends and friends you meet through other friends? 

3.  Isn't anyone detrimentally afraid of AD's giving you dementia or somehow altering your nervous system and giving you long term damage? 

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Veering off the subject a bit:

1. A. Has anyone had to become unemployed or quit work because of depression?  B. Have you felt that meds disrupt your concentration and  comprehension of things so that you can't really function at work that much anymore?

2.  Isn't anyone afraid of being inconsistent with your personality with the switching of meds....like with your friends and friends you meet through other friends? 

3.  Isn't anyone detrimentally afraid of AD's giving you dementia or somehow altering your nervous system and giving you long term damage?

<{POST_SNAPBACK}>

1.  A. yep.  i'm on SSI/SSDI now. 

    B. yep.  i've finally found work that i can mostly keep doing as long as the depression doesn't get too horrendous, but it's still hard.  i'm starting to get overwhelmed now because i've had to keep putting off all activities involving lots of thought and decision making, which is starting to catch up on me.

2.  i'm sure i'm inconsistent, but it's more due to the level of depression than the meds.  and i finally have friends who understand, either because they're MI themselves or they've been around it a lot.

3.  definitely something that concerns me,  though i try not to dwell on it.  i figure i'll live longer and have a much better experience of life on meds and risking some unknown impact later in life than i would if i didn't take them.  i probably wouldn't be alive without them, and if i was it wouldn't be very much of a life.

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1. A. Has anyone had to become unemployed or quit work because of depression?  B. Have you felt that meds disrupt your concentration and  comprehension of things so that you can't really function at work that much anymore?

Yes, I took a year off from work due to depression. Fortunately, it was for various reasons affordable at the time. I had to stop teaching mid-semester because it was just too much for me, then I took the following year off.

The meds don't disrupt my functioning, they actually improve it. The depression, however, has definately had cognitive effects and some of them aren't going to be reversed. I'm still as 'smart' as ever, I just can't do things the same way I used to, it takes a little more effort in a little bit of a different direction. Of course, some of this is also due to age -- no one has the memory in their mid-30s that they had at 20. Without out the meds I can barely think coherent thoughts.

2.  Isn't anyone afraid of being inconsistent with your personality with the switching of meds....like with your friends and friends you meet through other friends?
Nope. Like the concentration, the meds make it possible for me to be "me." They suppress and alleviate the depression enough for my own personality to emerge. I suppose it may look inconsistent to others, sometimes I'm a suicidal wreck and sometimes I'm almost 'normal.' I mostly try to keep things looking like somewhere in the middle for the benefit of people who aren't my close friends.

3.  Isn't anyone detrimentally afraid of AD's giving you dementia or somehow altering your nervous system and giving you long term damage?

Maybe they will, maybe they won't. It doesn't matter to me in some ways. The way to prevent the damage would be to note take the medication, but uncontrolled illness also causes long term damage. And without the medication I wouldn't be around long enough to care or notice long term issues.

Fiona

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1. A. Has anyone had to become unemployed or quit work because of depression? 

Yes.  Improperly-diagnosed depression, anxiety, family issues + stressful job = nervous breakdown.

    B. Have you felt that meds disrupt your concentration and  comprehension of things so that you can't really function at work that much anymore?

When my meds are too high, yes, it affects my concentration and comprehension.  But when I wasn't on meds, or my meds weren't right, that affected 'em worse.

2.  Isn't anyone afraid of being inconsistent with your personality with the switching of meds....like with your friends and friends you meet through other friends?

No.  Without meds, I withdraw from everyone and everything, I'm crabby and stressed.  If anyone notices an inconsistency, they're just going to be pleased as hell. ;)  

3.  Isn't anyone detrimentally afraid of AD's giving you dementia or somehow altering your nervous system and giving you long term damage?

No.  There are studies showing that unmedicated depression eats your brain, and there are studies showing that antidepressants can protect from this, and even grow new brain cells.  A couple links, if you're interested:

Depression: a case of neuronal life and death? (Pubmed)

Sustained Use Of Anti-Depressants Increases Cell Growth And Protects Cells In The Brain

From the second article:

"The findings of our study are that chronic administration of anti-depressants increases the number of neurons in the adult hippocampus ," said Ronald Duman, M.D., professor of psychiatry and pharmacology. "This could explain in part how anti-depressants produce their therapeutic response." Duman was senior author of the study published Dec. 15 in The Journal of Neuroscience.

        The hippocampus is part of the limbic brain that is involved in learning, memory, mood and emotion. It is one of only a few regions of the brain where production of neurons occurs in the adult brain of animals, including humans. Several studies have demonstrated that stressful experiences, both physical and psychological, lead to neuronal loss or atrophy in the hippocampus. Other studies show that anti-depressants can block this cell loss. "

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1. I don't think I've lost jobs thru depression, or, in my case, dysthymia, except possibly once or twice where it's not clear. However, I think between the dysthymia and the ADD, I haven't done as well on the job, and when I'm unemployed, as now, my job searches are anemic.

B. I found that if anything, Prozac made me sharper (for instance, I was less likely to get sleepy while driving). Adderal definitely makes me sharper.

2. I was a bit afraid of losing some of my identity at first, but in practice, it doesn't seem to be a problem. Of course, maybe some subset of my brain is rattling the bars and trying to get out like that poor sucker in Being John Malkovich. After all, I'm much less of a curmudgeon, I dress better, and I'm neater. (I also drive faster, but that's a different story and related more to Adderall.)

3. I think if Prozac was so bad for damage, we'd know now. I note that in the older accounts people attributed some loss or other to it, but I don't seem to hear so much about it lately, except maybe flatness of affect, a problem I REALLY don't have.

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