Alarming report on persistent side effects of antidepressant drugs published online

An alarming report from patient online websites on persistent side effects of antidepressant drugs has been published in one of the last issue of Psychotherapy and Psychosomatics by investigators from the University of Bologna and North America.

In the present study, a group of investigators analyze online self-reporting from a variety of websites visited by patients who had discontinued selective serotonin reuptake inhibitor (SSRI) antidepressants and were reporting, spontaneously on those internet forums, significant withdrawal symptoms and postwithdrawal psychopathology, that they attributed to discontinuation of their SSRI antidepressants. SSRI withdrawal, like for other classes of CNS depressant type (alcohol, benzodiazepine, barbituric, narcotic, antipsychotic, antidepressant), needs to be divided into two phases: the immediate withdrawal phase consisting of new and rebound symptoms, occurring up to 6 weeks after drug withdrawal, depending on the drug elimination half-life, and the postwithdrawal phase, consisting of tardive receptor supersensitivity disorders, occurring after 6 weeks of drug withdrawal.

Between February 2010 and September 2010, qualitative Google searches of 8 websites including Paxilprogress.org, ehealthforum.com, depressionforums.org, about.com, medhelp. org, drugLib.com, topix.com and survivingantidepressants.org were carried out in English, using keywords as 'SSRIs withdrawal syndrome', 'Paxil withdrawal', 'SSRIs forums'. Links from the above websites/forums and other related material were also followed. Investigators listed selected online patient self-reporting of physical and psychiatric withdrawal symptoms for each of the 6 SSRIs: paroxetine (n = 3), sertraline (n = 2), citalopram (n = 2), fluoxetine (n = 1), fluvoxamine (n = 1) and escitalopram (n = 3), which they thought reflected best patient self-reporting of SSRI withdrawal symptoms. From online information available, gender is known for 4 patients (2 men and 2 women), the mean length of SSRI treatment (n = 9) was 5.13 years, range 0.25-15 years, median 4.5, and the mean duration of withdrawal symptoms (n = 7) was 2.5 years, range 0.125-6 years, median 2.1 years. 58% of patients (7 out of 12) reported persistent postwithdrawal symptoms: 3 of 3 paroxetine patients, 2 of 2 citalopram, 1 of 1 fluvoxamine, 1 of 3 escitalopram and none of both sertraline and fluoxetine patients. Persistent postwithdrawal disorders, which occur after 6 weeks of drug withdrawal, rarely disappear spontaneously, and are sufficiently severe and disabling to have patients returned to previous drug treatment. When their drug treatment is not restarted, postwithdrawal disorders may last several months to years.

Significant persistent postwithdrawal emergent symptoms noted consist of anxiety disorders, including generalized anxiety and panic attacks, tardive insomnia, and depressive disorders including major depression and bipolar illness. Anxiety, disturbed mood, depression, mood swings, emotional liability, persistent insomnia, irritability, poor stress tolerance, impaired concentration and impaired memory are the more frequent postwithdrawal symptoms reported online. In accordance with data from controlled trials, online self-reporting shows paroxetine to be the most likely to be associated with withdrawal symptoms, while fluoxetine the least. Online forums also show an association between citalopram withdrawal and a variety of persistent postwithdrawal symptoms, lasting more than 4 months. Fluvoxamine appears to be less prescribed, but still reported online to cause postwithdrawal panic disorder; controlled studies have also found fluvoxamine to be associated with a high frequency of withdrawal symptoms. With regard to minor new SSRI withdrawal symptoms, they are known to occur after drug discontinuation with a variable frequency and duration, from a few hours up to 6 weeks, depending on the SSRI discontinued. Its frequency and severity vary mainly according to the SSRI used. This online study confirms those reported to occur in the literature with the highest frequency: headaches, nausea, loose stools, dizziness, disorientation, inability to concentrate, tinnitus, and unstable gait. Thus, there is concordance between new SSRI withdrawal symptomatology described in scientific papers and those reported online by patients. As already discussed, a recurrent disabling withdrawal symptom described online by patients is 'brain zaps', 'electrical shock sensations', 'shocks and zaps', there were 5 patients included who had these new withdrawal symptoms. Even after a very gradual drug tapering and under careful psychiatrist monitoring, new withdrawal symptoms still occur according to most studies, which is also found in this online patient selfreporting study.

This research found a significantly great number of patients off SSRI, describing the same cluster of withdrawal symptoms for a longer time than expected. Paroxetine withdrawal and postwithdrawal symptoms as reported in the scientific literature were confirmed, as well as most frequent minor new symptoms reported in controlled clinical trials. Reappraisal of tardive persistent postwithdrawal disorders may also provide a better understanding of rebound, recurrence and relapse during long-term antidepressant drug therapy. The leading investigators of the study, Carlotta Belaise, Ph.D, comments: "What impressed me exploring these websites has been that these patients feel deserted from official psychiatry. New research on how to interpret and address this symptomatology is badly needed".

 

Source:

Psychotherapy and Psychosomatics

Comments

  1. christine cooper christine cooper United Kingdom says:

    protracted withdrawal continuing at 3 years post prozac/fluoxetine, study didn't pick up my withdrawal and have posted on at least three of the support sites mentioned.

  2. Cynthia Preston Cynthia Preston United States says:

    I was prescribed Fluoxitine and Clonazepam for anxiety and panic attacks 10 years ago. I took the Fluoxitine for 9 months and continued the Clonazepam rarely and at a very low dose, usually 1/2 of a .5 mg tablet as needed which involved more frequent use when I started having significant insomnia and anxiety episodes. I found that I had to take more to be able to sleep at all at night and I recognized that the drug was making matters worse not better and decided to come off of it. My doctor claimed I could just stop since it was such a low dose. However, I had severe withdrawal symptoms, extreme anxiety, nausea, panic attacks where I felt as though I was having a heart attack. No laughing matter and no way I could just stop, as little as I was taking. In short, it took me 6 months of tapering to successfully come off of the Clonazepam. I have been free of this horrible and dangerous drug for 2 years now. I still regularly have "brain zaps", which incidentally meets with a blank response or some other unspoken judgement whenever I have brought it up with any doctor I have seen, which includes my cardiologist, my PC physician and even a pulmonologist/sleep medical doctor. Interestingly enough, my dentist was the most interested and inquisitive about my symptoms! So little is known about the brain and admitting that they are playing Russian Roulette with it is something doctors do not want to acknowledge. I only took SSRIs for a total of about 1 year and these effects I am experiencing I attribute more to the use of Clonazepam, but perhaps they are both culprits in the ongoing withdrawal effects. The brain zaps are worse when I have not slept well and only occur at night when I am lying down. I hope that at some point they pass, but given that it has been 2 years now and they are still going strong, I am not optimistic. I am however feeling much better than when I was taking these drugs and have found natural ways to handle anxiety that for the most part are working for me.

    • Sandra Villarreal Sandra Villarreal United States says:

      Cynthia, I hope your doing much better now. Our mental healthcare field is so ignorant, and negligent of our suffering from the drugs they prescribe to us. My drug counselor told me that because I was on such a low dose of Klonopin, but I'd also been on it for 10 years, that it would be 'just fine' to 'cold turkey' so I did! This withdrawal took my mind places I never knew existed. I lived in sheer terror and psychosis with hallucinations, pounding heart palpitations, excruciating headaches (felt like my head was in a vise), nightmares, it induced every mental disorder listed in the DSM especially schizophrenia, paranoia, anxiety so high I never knew the mind could tolerate (which I prayed for a gun every moment), insomnia up to 5 days at a time, my mind had completely shut down it was overloaded. I ended up in the psych unit and the Emergency Room after day 5 of no sleep and my entire body started shaking uncontrollably, my bladder quit working so I developed UTI, ungodly panic, I was not able to relate to reality at all. And after I survived going through all this while home, alone, my mental Healthcare workers never believed what I had experienced. You know, enough is enough! I have learned that going to a psychiatrist for anything is one of the most dangerous things a person can ever do. And when we suffer from withdrawals that they gave up they ignore, and deny instead blaming the patient, once again, that's it's our own mental illness surfacing. This is a travesty that his happens in America and all over the world when they know. These drugs have been around for 50 years but they instead prescribe us addicting drugs and we are left to find a way to get off them. May god bless you Cynthia, I'm happy to see you were one of those that survived their withdrawals.

  3. Laura L Laura L Ireland says:

    I just took a couple of doses of an SSRI. Yet I'm going through the most horrific withdrawal symptoms for several months already. Personality changes, brain zaps, muscle twitching, headaches, psychotic thoughts, paranoia.

    I can say this so called "medication" has successfully erased my life. I'm struggling each day not to kill myself because of the horrific symptoms and the despair about doctors who refuse to believe me. I can't work, I can't do any activities, I'm sinking in a deeper and deeper depression because there is just no end to the symptoms in sight.

    Doctors just tell me "this is impossible, you're imagining it".

    • Sandra Villarreal Sandra Villarreal United States says:

      One year after my almost deadly Klonopin withdrawal I went off my Effexor, Trazodone & Lithium and not only became suicidal but I became extremely homicidal. I was going to be another one of the story's that makes the nightly news if I didn't do something. I can't believe that doctors will prescribe these drugs and it's for life, but they never, ever help you get off when patients are tires of taking toxic chemicals into our brains. They have completely ruined my entire life. I mistakenly believed I was mentally ill because of this 'chemical imbalance' theory that doesn't even exist. I was labeled for life. I had to give up my entire life all because I believed a psychiatrist when I was 21 years old. Psychiatric drugs induced so much depression, apathy, and suffering that I literally spent the next 3 decades trying to kill myself from drug induced pure misery. I am so happy I am drug free today. At the age of 58 I get to begin my life for the first time in over 35 years. When we experience psychiatric drug withdrawal symptoms our doctors won't and don't believe us. Instead we are hit with another diagnosis which prompts yet more drugs.  Psychiatry is the biggest healthcare fraud in American right next to the tobacco companies who claimed that cigarettes were not addicting. They claimed the benzo's weren't either. In fact, I still see this written in articles. This is abuse in the worst possible way. There is an end in sight Laura, I know, after healing for 2 years from my med withdrawals, I'm absolutely fine. Just hang in there and gather love & support from family and friends because we all it won't come from the medical or psychiatric field.

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