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Safety Of SSRIs/SNRIs


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I hesitated to post this question as I am pro-med and I know the website is largely pro-med.  

But I've had this feeling Effexor left me with something missing since I stopped taking it.  While it worked beautifully when I was on it, stopping it I feel like it made have left some damage, and I'm hoping to see if anyone more researched in this topic can enlighten me.  It's hard for me to determine if it's just a withdrawal from the medicine or if something permanent has occurred. 

Is there any proof or does anybody know of anything that shows SSRIs causing damage to people long-term or after use?  Specifically Effexor is what I'm wondering about but also would like to hear about the other drugs involved.

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7 minutes ago, BrianOCD said:

I hesitated to post this question as I am pro-med and I know the website is largely pro-med.  

But I've had this feeling Effexor left me with something missing since I stopped taking it.  While it worked beautifully when I was on it, stopping it I feel like it made have left some damage, and I'm hoping to see if anyone more researched in this topic can enlighten me.  It's hard for me to determine if it's just a withdrawal from the medicine or if something permanent has occurred. 

Is there any proof or does anybody know of anything that shows SSRIs causing damage to people long-term or after use?  Specifically Effexor is what I'm wondering about but also would like to hear about the other drugs involved.

What specific damage symptoms? 

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22 minutes ago, Iceberg said:

What specific damage symptoms? 

Well it's hard to describe, and it seems anything can fall under "depression"

But specifically I'd say some weird things with my memory.  It was much sharper on Effexor.  I've had a host of cognitive issues since coming off it.  Attention problems, more anxiety, lots of things I couldnt even put in to words.  My personality also went from extrovert to introvert real fast.  I realize all of this could be categorized under depression, however I feel some of it may be Effexor linked.

I guess I'm concerned I burned out the receptors that Effexor targeted specifically, and wondering if that's a thing?  Is it possible to permanently damage the receptors ?  After taking Cymbalta, it feels like it's not ever touching my serotonin.  I was on a hefty dose, 300mg for 8 years before weaning off of it over the course of a year after it began pooping out.  Once I stopped it completely these things began popping up in increasing intensity.

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13 minutes ago, BrianOCD said:

Well it's hard to describe, and it seems anything can fall under "depression"

But specifically I'd say some weird things with my memory.  It was much sharper on Effexor.  I've had a host of cognitive issues since coming off it.  Attention problems, more anxiety, lots of things I couldnt even put in to words.  My personality also went from extrovert to introvert real fast.  I realize all of this could be categorized under depression, however I feel some of it may be Effexor linked.

I guess I'm concerned I burned out the receptors that Effexor targeted specifically, and wondering if that's a thing?  Is it possible to permanently damage the receptors ?  After taking Cymbalta, it feels like it's not ever touching my serotonin.

I have never read anything very credible about that sort of long term damage, outside of some people getting slow, long withdrawal symptoms....although it is plausible to feel "different" on meds I don't think it's from permanent damage...although I clearly haven't read every study there is. What does your pdoc think? Cuz your right that all does sound like untreated depression symptoms that maybe were hit by Effexor but not ur new SNRI...maybe the new med needs new/different augmentation

Edited by Iceberg
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1 minute ago, Iceberg said:

I have never read anything very credible about that sort of long term damage, outside of some people getting slow, long withdrawal symptoms....although it is plausible to feel "different" on meds I don't think it's from permanent damage...although I clearly haven't read every study there is. What does your pdoc think? Cuz your right that all does sound like untreated depression symptoms that maybe were hit by Effexor but not ur new SNRI...maybe the new med needs new/different argumentation.  

He just keeps upping the medication, I'm on 120 mg cymbalta now for a few days, hopefully something happens in a week...

I haven't seen any evidence of damage, but also not many long-term studies (are there any?), the only thing you hear on the net are other people complaining after being on some for years.

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Unfortunately Internet antecdotes are often highly negatively skewed cuz it seems people with bad experiences report more than good ones. I found one report on a source which cited some research suggesting that long term effects are possible... He called it "tardive dysphoria" ... But I don't think he was an MD (or other Doctor). It's not totally what you described but it does suggest that after taking ADs to their "peak effectiveness" there can be changes which can cause the mood worsen again. However, this person sounded like they had an agenda and I couldn't find much corroboration from credible sources ( although I didn't look super hard so their possibly could be some.)...so I'm not sure I'm buying it. Like you said, lack of long term studies is problematic. But i would still try and actively treat the symptoms with conventional meds cuz they could definitely be depression, and a new combo may be address the symptoms no matter what 

https://www.google.com/amp/s/www.psychologytoday.com/us/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria%3famp 

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  • 2 weeks later...

I would Google it and see if their have been any medical reports written up about it.

I do know that Benzodiazepines can cause early onset dementia if taken in higher doses over a long period of time.  I was told by 2 of my psychiatrists.  

I have suffered memory issues from years of taking antidepressant medications so I believe it messes with your brain in a "not" so good way.

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First, I want to second what notloki said about benzos. Correlation is not causation. There is no hard evidence of benzos even being linked to early-onset dementia, rather people with early-onset dementia experience anxiety and are prescribed benzos to treat it. I've been on varying, steady doses of Klonopin for what is about to be 6 years. My memory, both long-term and short-term are excellent.

Second, BrianOCD your brain may be adjusting to not having Effexor. I highly doubt there is any permanent damage, your brain was just so used to receiving it that it is now trying to reach homeostasis without it. I promise the symptoms will get better in time. May I ask why you stopped Effexor? These mental disorders tend to be chronic conditions. These medications are safe, but like any drug we introduce into our body for long periods of time, it will take the body and mind time to adjust to life without it. I wouldn't worry at all.

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9 hours ago, l'appel du vide said:

First, I want to second what notloki said about benzos. Correlation is not causation. There is no hard evidence of benzos even being linked to early-onset dementia, rather people with early-onset dementia experience anxiety and are prescribed benzos to treat it. I've been on varying, steady doses of Klonopin for what is about to be 6 years. My memory, both long-term and short-term are excellent.

Second, BrianOCD your brain may be adjusting to not having Effexor. I highly doubt there is any permanent damage, your brain was just so used to receiving it that it is now trying to reach homeostasis without it. I promise the symptoms will get better in time. May I ask why you stopped Effexor? These mental disorders tend to be chronic conditions. These medications are safe, but like any drug we introduce into our body for long periods of time, it will take the body and mind time to adjust to life without it. I wouldn't worry at all.

Well I hope you're right, it has been several months and unfortunately I'm still struggling.

The Effexor pooped out on me...

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There's definitely a discussion to be had about the long term benefits of antidepressants considering ~10% of the western population take them and most of the patients would just benefit from higher self esteem, more/better relationships and more purpose in life. We shouldn't really treat the symptoms and ignore the underlying causes of such high rates of depression and anxiety - as we do now. 

As for acute, long term physiological damage, there's no real evidence that antidepressants can do that.

 

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I don't know about damage but I have wondered about long term effects. I've only been taking meds for a few years and have spent most of the time on Sertraline after the Prozac didn't work out. Many people will have been through a lot of different meds, and I've known people who have been on a medication for years before it stopped working, and people who have been on every medication but nothing seems to work anymore. Why would a medication stop working unless it's caused some sort of change in your brain? I may be wrong but I haven't heard of anyone going back on a medication which used to work after coming off it. It seems to be the case that if a medication stops working then there's no going back to it. If there are no long term effects then shouldn't you be able to go back on a med which worked after having a long enough break to get it out of your system? You can build up a tolerance perhaps, and I've had to increase my dosage a couple of times, but that tolerance should lessen over time surely?

I don't mean to cause any worry but I think there is a question there. I saw a report not so long ago which found that anti-depressants can have severe withdrawl symptoms. No shit! If they've just worked that out then it seems unlikely that there's been any research on long term effects. But I'm not selling any paranoid conspiracy theory here. My meds help me and I'm not going to stop taking them, and I wouldn't want to put anyone else off taking them. I may well be talking a load of shite and if anyone wants to call bullshit and set me straight then that's fine by me.

Oh and when meds stop working it's called Tachyphylaxis. I say as if I've always known that and didn't learn it 5 minutes ago on a Google search.

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10 hours ago, trophy said:

There's definitely a discussion to be had about the long term benefits of antidepressants considering ~10% of the western population take them and most of the patients would just benefit from higher self esteem, more/better relationships and more purpose in life. We shouldn't really treat the symptoms and ignore the underlying causes of such high rates of depression and anxiety - as we do now. 

As for acute, long term physiological damage, there's no real evidence that antidepressants can do that.

 

I'm not disagreeing with you, @trophy.

However if it were truly just a matter of developing higher self esteem, more connectedness and quality of relationships, and a stronger sense of purpose in life don't you think people would be able to take care of that without meds?

Major depressive disorder can be fatal if untreated. Best to not fuck around with it on one's own.

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11 hours ago, trophy said:

most of the patients would just benefit from higher self esteem, more/better relationships and more purpose in life.

That's like saying people with cancer shouldn't need to take meds and that the cells should just replicate themselves normally. Or people with diabetes shouldn't need medicine because all that is needed is for the pancreas to function normally.

You are describing what makes people healthy. A person with clinical depression cannot reach those goals because that is exactly the way the illness operates. It robs you of all that. People need hope too. A person with depression has no hope or very little.

The current gold standard for treating depression is meds + therapy. Meds are needed to alleviate some symptoms, however imperfectly, and therapy tries to help the person get into the position you suggested. There is no miracle med nor is there a miracle therapy modality. But we know for sure that prescribing that which is impossible for someone with depression to do is useless.

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I agree with everyone above me. It does nothing to state that we could improve our conditions by having better connections, better self esteem, whatever. We all work on that, it's basically unsaid. We have all tried everything in our power. When your brain wants to terminate itself, better self esteem will not save you. Period.

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Oh I'm not trying to debate the severity of the disease, or the fact that it's a disease to begin with, or the fact the antidepressants help millions of people. Just saying that for the majority of people there is no physiological cause of mental illness and it was never inevitable that they became mentally ill. Hence we should look at the reasons it's become such an epidemic rather than solely relying on medications to treat an unhappy population. 

Edit: and you're all welcome to disagree and debate with me on this. 

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Trophy, are you talking about alienation, lack of connection to each other, feeling valued and useful? About systemic oppression like racism that contributes to poor mental health? About poverty and trauma and basically all the bullshit that comes with living in a modern capitalist xenophobic society?

in that case I absolutely agree there are contributing factors

it seems like you’re talking about “the worried well” rather than people with mentally interesting/mental illness.

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Not at all. I'm stating that most cases of depression and anxiety have no biological basis and are instead caused by learned maladaptive cognitive processes and/or external stressors. Hence, most cases are preventable.

My original point was that in a society with an epidemic of preventable mental illness, there is obviously something wrong. The fact we can effectively treat patients with drugs might be removing the impetus to address the underlying problem. 

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