SSRI Discontinuation Syndrome (SDS) and How to Overcome It
This applies to most antidepressants; however, due to the popularity of SSRIs, this problem is often discussed in terms of “SSRI discontinuation syndrome.” Here are the main points –
* SDS is basically the drug withdrawal your brain and body go through when you stop taking the drug in question. It’s essentially the same concept as quitting smoking or heroin – your brain is used to having that substance, and when you take it away, you’re under stress.
* Pharmaceutical companies initially denied the existence of this and physicians previously failed to notice. I think most doctors now warn you when they prescribe, but there will always be exceptions.
* This is why your doctor will tell you not to stop taking the medicine suddenly without supervision. All kinds of strange things can happen, some of them life threatening.
* The likelihood that you have SDS and the severity of your symptoms are generally determined by:
1. The length of time you have been taking the medications (the longer, the more likely you are to have adverse symptoms)
2. The dose you were taking (the higher the dose, the more difficult it is to remove)
* In general, I would say that you should expect SDS if and when you decide to stop taking SSRIs.
* Many people have said that SDS can be one of the most unpleasant experiences around – it has been unfavorably compared to heroin withdrawal! So don’t think you’re alone if you’re going through (temporary) hell.
Some key questions to consider before deciding to quit SSRIs:
1. Why do I want to quit SSRIs? Is it a trivial reason? Or is it due to debilitating side effects?
2. Were you at risk of suicide before taking SSRIs? If so, you should seriously speak to a trained professional (doctor or psychologist) before proceeding.
3. Have the SSRIs worked for me?
4. Have my personality changed? (for better or worse)
5. While taking SSRIs, have I changed the circumstances that triggered or contributed to my initial symptoms?
6. Have I worked to change the thoughts and behaviors that contributed to my initial problems?
My plastic brain plan to quit SSRIs (and other DAs)
1. Three words: TAPER, TAPER, TAPER. You’re not going to like this – the easiest way to get off your meds takes A LOT of time. I recommend the following regimen:
* First 3 months – 1/2 of the original dose
* Second 3 months – 1/4 of the original dose
* Third 3 months – 1/8 of the original dose
* When you go down to 1/8 the dose, you will probably need a pill cutter that you can buy at a pharmacy. Also check with your doctor if your medicine is available in a lower dosage.
* Why 3 months? This is roughly the time it takes for your brain to adjust and make plastic changes to changing doses.
2. Exercise –
1. Exercise stimulates the production of BDNF. You can think of BDNF as a kind of fertilizer for your brain. It helps make plastic changes in your brain that will help your brain adjust to its new, non-medicated state.
2. Exercise stimulates the production of all kinds of good hormones and neurochemicals, such as endorphins, serotonin (which will be low when you get out of AD), norepinephrine (norepinephrine), and dopamine.
3. When you quit SSRIs, you can feel physically and mentally horrible: If you go out and exercise vigorously, you feel great and are distracted from how you were feeling.
4. Depression unconsciously involves an element of “helplessness.” You may feel that the situation is inescapable. On a subconscious level, when you go out and exercise, you are sending a message to yourself that you have the power to overcome your situation.
3. Nutrition / Supplements
Apart from Omega-3, the others are optional. Too many supplements can be expensive and burdensome to keep taking every day. However, if you have the budget and the inclination, others also have reasonably strong evidence to back up their effectiveness claims. I won’t go into too much detail for each of these; you can search for them if you are interested. Supplements are just little helpers – whatever you do, don’t sit back and expect supplements to do all the work! Also, the other thing that worries me about trying to rely on supplements is that it perpetuates the subconscious belief in your mind that you need some external agent (drug, supplement) to recover.
Omega-3 / fish oil
For at least the first month, I would recommend a high dose of this, 8 capsules a day, which you can then cut in half whenever you want. There is no risk of overdose, so feel free to continue with 8 capsules per day; it won’t suddenly turn into a tuna. Why Omega-3? The brain essentially builds parts of itself from Omega-3s, so it provides you with enough fuel to give you the building blocks you need.
Group B multivitamin
A single Mega B (or equivalent) should be sufficient. Among other things, B vitamins are vital for a healthy nervous system. In this case, B6 is particularly important due to its participation in the conversion of the amino acid L-Tryptophan into Serotonin.
Vitamin C –
Vitamin C is one of the cofactors your brain uses to make serotonin. It is also extremely important for a strong immune system that can be compromised as your body adjusts.
Hill
Choline is used to make the neurotransmitter acetylcholine, which is vital for various brain functions, such as mood and memory.
Rhodiola Rosea
This is a supplement characterized as an adaptogen, which means that it helps the body deal with stress. In general, I highly doubt adaptogens, as they have vague and difficult to quantify benefits that are attributed to them by various streams of natural medicine.
However, Rhodiola appears to have better than average efficacy (compared to other adaptogens). It appears to work as a mild antidepressant, affecting serotonin, dopamine, and norepinephrine.
Phosphatidyl serine (PS)
PS improves nerve transmission function in the brain, potentially exhibiting a therapeutic effect. This is one of the newer proposed supplements for the brain, so the research is still a bit sketchy.
Grass of San Juan
This is perhaps the most popular natural antidepressant in the world. It is supported by numerous placebo-controlled studies. It is believed to work as a mild SSRI. As such, it can aid in the transition from a strong SSRI to nothing.
5-htp
5-htp is the direct precursor to serotonin in the brain, and many people rely on 5-htp as a natural antidepressant. There is speculation about how much actually crosses the blood-brain barrier. It appears to be much stronger than its predecessor, L-tryptophan (milligram for milligram). It is also often used as a sleep aid and to aid in recovery for those who have “excited” you too much over the weekend.
L-theanine
L-theanine is the amino acid found almost exclusively in tea (green, black, white, oolong, made from Camellia Sinensis).
Theanine has strong evidence supporting the claims that it enhances the production of GABA (relaxation) and dopamine (energy, motivation).
The high levels of theanine in tea are claimed to be behind why drinking tea can be so relaxing despite its caffeine content.
4. Meditation
See the main section on this here.
Meditation has too many benefits to mention here. From a neurological perspective, it has been shown to increase serotonin levels. Simply put, it can calm you down and relax you.
However, meditation for the early stages of cessation of SSRIs is not recommended if you are not an experienced meditator. In fact, you can stir it up more if you’re not used to just sitting back and being with your thoughts. Exercise is a much better option for this stage, as it provides the opposite: a sweet distraction!
Meditation is not a quick fix; In fact, the mindset behind meditation is almost exactly the opposite of taking medication; There is no easy “take a pill” option, you have to push yourself, but the rewards are immense.
Other general points –
* One of the key questions that comes up when you are going through the interruption is “Is this interruption syndrome or is my depression / anxiety returning?” There is no definitive answer, but my sense of logic dictates the following: If you take a single dose of the drug and your symptoms have been alleviated within a day or two, it is most likely the discontinuation syndrome, and if it is possible, you should try to persist. As you may recall from when you first started taking the medication, it takes a while to start treating depression / anxiety, so if you ease your discontinuation symptoms quickly, it’s a good sign that it’s just withdrawal, not a return of your illness. original.
* If you have suicidal thoughts, as always, seek professional help immediately.
* If you feel that it is too difficult and you are not coping, talk with your doctor about the possibility of taking the medicine again; you can always try again later. It is relatively common, so you need to make several attempts before you can successfully stop SSRIs.
* If possible, schedule the start of each new, lower dose for a time when you have minimal stress at work or family life. Try to take time off from work during the first week of the first set-up.
* Do things you enjoy, like read a book or watch a movie.
* Stay connected with your friends: schedule as much social time as possible (even if you don’t feel like it); may have a natural inclination to isolate himself when retreating; You must fight this instinct as it is counterproductive.
* Do things that feel physically pleasant like getting a massage or taking a nice long bath.
* Avoid too much caffeine or alcohol. Caffeine increases anxiety and alcohol masses with sleep. That being said, if you are a heavy drinker or drink a lot of coffee, you should address this before you go off the meds. You don’t want caffeine withdrawal in addition to SSRI withdrawal!
* During the first few months, prepare for overly emotional reactions to everyday situations; It will take a while for your emotions to adjust.
