Depression and SRRI addiction

[HowardnDagny]

My wife is recovering from depression. 3 years ago she began treatment at as outpatient. The Dr. prescribed Luvox (I think the initial dosage was 50; it was cut to 25 about 1 year ago) which helped her work through the things causing depression and she is well on her way to recovery (by her own admission and I concur). She wants to stop the medication safely, but her doctor is reluctant to allow her to stop. FYI, we live in Japan and Japanese doctors are assured payment by Health Insurers by prescribing medication. [Please note that I not kidding, every doctor I have ever been to here has either prescribed or WANTED to prescribe some medicine.] In doing her own research and through a support group, she came to know the most depression patients are prescribed Luvox for only 6 months (here in Japan). We want to have a baby and met with the doctor last year in October, who all but assured us that by now my wife would be free from Luvox, but as he has not agreed to any changes in medication amount, my wife began taking things into her own hands. First was a drug holiday (6 days of medication, one day off). Over a period of months, she has been able to reduce the medication to 1/8 of one pill every other day.

2 questions: 1) is it safe for her to cut the pills and take only part of a pill.

2) when she goes for too long without taking the medicine, her symptoms are: dizziness, tightness in the back of her neck, and general malaise ... are these usual withdrawal symptoms?

Finally, do you have any advice? Should we continue to 'avoid' pregnancy to the best of our ability?

Thank you.

[Paxiled]

ssris aren't addictive, but really, there's not much difference between them and addictive drugs, so at this point it's just semantics.  What the above posters aren't realizing from your post, I think, is that your wife has already quit this drug -- she tapered off it probably at a slower and safer rate of speed than most doctors and psychiatrists would have done.  But Luvox has the shortest half-life of any antidepressant out there, which means it leaves the body very very quickly.  That makes it hard for the brain to adapt to operating normally again.  It's also a drug used rarely in the US because the company behind it didn't market it all that much here and it has many more contraindications with other meds than most antidepressants, so most of us here haven't taken it.  But again, at this point she's basically stopped the drug and is suffering some withdrawal.  That can last a long time or a shot time, depending on the person.  But the symptoms you describe are pretty minor as far as withdrawal goes, so far.  The protocol generally is, if the withdrawal gets to be more than one can handle, and if it turns into emotional problems you never had before, go back on the last dose at which you felt fine and taper off more slowly, but at some point, if you want to quit the drug, and you will have to quit this drug to have a child safely, not only because of its effect on the child but also because of all the drug contraindications, then she will have to stop taking it and see what happens.  As I see it, she's done this over a period of months, and is down to almost nothing, so this ship has sailed.  

[HowardnDagny]

Thanks for your comments, everyone.

Given the world-wide lack of understanding about mental health, and recognizing that everyone's situation is different, we are grateful for any information.

[Auntnita]

Hi just to let you know I tried to cut myself off of Prozac myself which is a ssri I've been on them for 15 yrs now I started slowly like u over six months but end result was I ended up having severe anxiety attacks and worse depression then I started with so now I'm on higher dose of Prozac and just started on klonipin . So wouldn't recommend doing this alone talk to dr for sure.

[nursegirl6572]

I concur completely with specialmom's advice!

Good luck to your wife!

[specialmom]

Hi there.  Well, the way depression works is that while some have 'episodes' of depression, it is most often a chronic condition.  THAT may be the main reason why your wife's doctor is reluctant to stop her medication.  Addiction to antidepressants and particularly ssri's is not really the right way to term it.  It's not a controlled substance.  There are many people that need and take antidepressants their entire life and there is no shame in that.  Again, it's not an addiction but a medical problem such as a heart issue in which people need medication to control it.  

If your wife is determined to give it a go without medication, there are a couple of things to keep in mind.  First, be on the lookout for returning depression.  If her depression was severe three years ago, there is a likelihood that she is prone to this and it very much can concur as depression is, as I said, often a chronic mental health condition to be dealt with.

Second, I would NOT ---  NOT---   just decide to stop and not do so under doctor's supervision.  She needs to tell her doctor that she IS going to stop and how does he recommend she does it?  He should answer this direct question

We are not allowed to give recommendations here at med help on dosing of medication nor should you get that over the internet.  The internet does not replace sound medical advice.  I will say that tapering is very important whenever stopping an ssri and while you may have a schedule in mind, adjusting it to your wife's reaction will be important.  

The symptoms you describe could be withdrawel symptoms and tapering gets away from that or frankly, they could be the return of anxiety/depression symptoms.  good luck

[CRSeaside]

I'm going to look up Luvox.