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Is the cure worse than the symptoms?

I started on antidepressants when I was a teenager. In the span of 6 years I was on an entire host of antidepressants, with an intramuscular injection (during a hospital stay) being the only thing that made a noticeable difference. And that was, of course, temporary and transitory. I recovered on my own and was off meds for 9 years. Two years ago events led me to seek treatment again. I've tried a bunch of different things--the worst was a Trazadone-Effexor-Metoprolol-Geodon-Ativan combination that turned me into a zombie with hypertension, stomach aches, constipation, and severe dissociation.

I recently tapered off of 300mg Zoloft and am now off of all medications. I was getting debilitating headaches along with muscle aches, night sweats and insomnia, and I still wasn't feeling better. About 12 days ago I was on 50 mg and I just stopped. I feel physically and emotionally much better.

My first question regards the recent metastudy of antidepressants that showed only a tiny improvement over placebos-- Kirsch I, PLoS Med 5(2): doi:10.1371/journal.pmed.0050045  I definitely feel like the side effects haven't been worth any benefits I may have felt. I haven't seen any criticisms or reactions of the published study, but I'd like to hear what professionals are saying about it.

My second question regards SSRI withdrawal symptoms. After about a week off of zoloft I suddenly started feeling extreme anger. Over the last couple of days I've been dissociating a lot--my usual reaction to extreme emotions--and I feel full of rage. The other withdrawal symptoms--dizziness, lighthededness, crying jags--began almost immediately as I tapered off. I'm hoping the anger and aggression are related to withdrawal because these particular emotions are severe and unusual for me. My psychopharmacologist is no longer available--I tapered off AMA-- and my therapist obviously can't tell me for sure. Is it possible that this anger is related to being off of Zoloft?
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Avatar universal
Of course posters here are unhappy with something. I didn't search for this group until I was having problems and needed advice.

I'm not sure if my doctor downplayed the side-effects or if I was just hopeful that the meds would work without the side-effects getting too severe. I'm certain she didn't tell me about the difficulties of discontinuation. Since she's the one who went to med school, that particular burden falls on her and not me.

At any rate, it's probably not fair to compare antidepressants to Motrin. Motrin isn't addictive, as far as I know, and the stomach problems wear off once it's out of your system--a matter of hours. When I take Benedryl the drowsiness is temporary, too. Antidepressants affect various neurotransmitters and hormones and thus effect multiple bodily functions.

In regards to depression being a lifelong, chronic condition: that's not always the case. I suspect it's not even true in the majority of cases (though I'm obviously no specialist :-) ). Talk therapy along with changes in how a person moves through the world can be just effective as medications without the negative side effects. Some people need to be on medication for their whole lives, but numerous others can improve by talking with a trained and experienced professional. Talking about stuff can be harder than taking a drug, but it's often more permanent and more effective.

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Avatar universal
In re-reading the study, I see that it looked at just 4 new-generation ADs--Prozac, Effexor, Serzone, and Paxil. The authors used the freedom of information act to obtain ALL studies of the medications from the FDA (it says that most drug companies only publish information from successful studies). In fact, it seems that the main impetus here is to examine reporting bias, not drug efficacy. I don't know how to determine the difference between a poorly-done study and a well-constructed one, which is why I posted here. I'd be interested in hearing more about these Hummer-sized holes.

The report points out that the only significant difference in efficacy occurs in highly depressed people and, in fact, the authors state "the amount of improvement depended markedly on the quadratic function of baseline severity."

I have absolutely no doubt that antidepressants have helped many people struggling with severe depression. I've known many who were non-functional without them. (Of course, most of those individuals were on cocktails that included sedatives, anti-psychotics, and sleep aids.) I wonder, in light of this new study, whether these four new-generation medications, which all carry risks of side-effects, help as many people as we assume they do. I have asked various doctors about this in the past--though not armed with this most recent study--and the discussions have trended toward angry earnestness. I, of course, can only report what my experience has been and the doctors make livings based on the assumption that they can treat almost anything. The talk is certainly biased. It's an interesting thing to consider, though, and I hope more studies are done on this topic.
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