The Case Against Antidepressants

[BigTex]

Like @ Fortunate, I am truly sorry to hear about some of the hard issues you guys have. I feel fortunate that I don't have any of these problems. I have enough physical issues to have to deal with each day. Hope you guys find some peace.

 

[tareload]

Gee that was depressing...

Ashkaye: took Lexapro for a week for heart palpitations

Hello all. I was prescribed Lexapro 10mg for heart palpitations and blood pressure. Never struggled with anxiety but the cardiologist determined my heart rate issues were from anxiety and I even argued with him over it and his reply was that my heart was anxious. So I attempted the Lexapro as the...

www.survivingantidepressants.org

I can see where some post COVID inappropriate sinus tachycardia or autonomic dysfunction can really turn you into basket case. Hurray!

Inappropriate sinus tachycardia in post-COVID-19 syndrome - Scientific Reports

Figure 2 | Scientific Reports

www.nature.com

Figure 3 | Scientific Reports

www.nature.com

Whoa talk about a mind bender. The nervous system kinda important.

Severe Post-COVID-19 dysautonomia: a case report - BMC Infectious Diseases

Background The emergence of dysautonomia as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; or COVID-19) is becoming more prevalent. We have seen evidence in several post-COVID patients and in the literature of varying degrees of autonomic dysfunction. Symptoms...

bmcinfectdis.biomedcentral.com

 

[FunkOdyssey]

Gee that was depressing...

Ashkaye: took Lexapro for a week for heart palpitations

Hello all. I was prescribed Lexapro 10mg for heart palpitations and blood pressure. Never struggled with anxiety but the cardiologist determined my heart rate issues were from anxiety and I even argued with him over it and his reply was that my heart was anxious. So I attempted the Lexapro as the...

www.survivingantidepressants.org

You don't want to ruin an entire year of your life with one week of SSRI treatment? To be fair, that is a very unusual reaction. Most doctors would deny such a thing is possible though.

The beginning of an SSRI was always hypomanic for me. For awhile when you first start, your serotonin levels are elevated in the synapses and the receptors haven't downregulated yet. It can be a bit like MDMA-lite (very lite). Then you settle in to your new numb normal as the brain adapts.

 

[Nelson Vergel]

Antidepressants have helped me at least 5 times in my life to keep me from going downhill through several traumatic experiences. I am glad there are many available.

If you have been in the "hole", then you know what I mean. Yes, they are overprescribed but they save lives.

I am glad the psychedelic therapy tsunami is approaching in the U.S. It will be interesting to see what happens with the regular antidepressant market.

 

[tareload]

If you have been in the "hole", then you know what I mean.

Oh I am in the hole just trying to not dig a deeper one. Thanks for sharing your experiences.

 

[Hyrulewarrior1978]

Antidepressants have helped me at least 5 times in my life to keep me from going downhill through several traumatic experiences. I am glad there are many available.

If you have been in the "hole", then you know what I mean. Yes, they are overprescribed but they save lives.

I am glad the psychedelic therapy tsunami is approaching in the U.S. It will be interesting to see what happens with the regular antidepressant market.

Yes this is interesting. I mean mushrooms don’t do anything for my depression and I take them regularly lol. It’s more for when I’m bored and want a trip. Also which antidepressants have you found most helpful? I see many having succes with welloft (wellbutrin plus zoloft)

 

[HarryCat2]

The beginning of an SSRI was always hypomanic for me. For awhile when you first start, your serotonin levels are elevated in the synapses and the receptors haven't downregulated yet. It can be a bit like MDMA-lite (very lite). Then you settle in to your new numb normal as the brain adapts.

I didn't feel anything starting SSRI's, several different types at different times. Nor did I feel any different after reaching steady state and being on them for months. Which is to say I felt like crap before, during, and after taking them.

 

[tareload]

Have been relying on metoprolol when attacks come on but finally did the experiment to replace metoprolol tartrate with 1 mg clonazepam about an hour before going to gym. Whoa. Night and day difference in exercise performance and was back to almost same intensity. I don't recommend using benzo when lifting heavy but it was a very eye opening experiment. Clearly my heart is not the issue here. Must have developed some type of anxiety panic issue upon any arousal and engagement of sympathetic nervous system. Hence my head is my worst enemy. Cool experiment to decouple brain from heart.

 

[FunkOdyssey]

Have been relying on metiprolol when attacks come on but finally did the experiment to replace metoprolol tartrate with 1 mg clonazepam about an hour before going to gym. Whoa. Night and day difference in exercise performance and was back to almost same intensity. I don't recommend using benzo when lifting heavy but it was a very eye opening experiment. Clearly my heart is not the issue here. Must have developed some type of anxiety panic issue upon any arousal and engagement of sympathetic nervous system. Hence my head is my worst enemy. Cool experiment to decouple brain from heart.

Yes, good experiment and major discovery. I'm very glad to hear it wasn't your heart. Now you just need to find a sustainable solution for the panic that doesn't dig you a hole ten times deeper than the one you're already in. The knowledge that there's nothing wrong with your heart and the panic symptoms are just panic symptoms should help.

 

[tareload]

Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time

Popular meds work no better than a placebo for depression and can come with severe withdrawal symptoms. Why do doctors prescribe them to 43 million Americans?

www.newsweek.com

Instead, she argues, the drugs change "normal brain states" and "normal mental states and processes" in ways not that much different than recreational drugs like alcohol. They obscure psychotic symptoms by "superimposing" an abnormal drug state over other effects. In SSRIs, the small advantages seen in placebo-controlled trials, she suggests, can be attributed to emotional numbing that reduces the intensity of feelings causing the depression and anxiety, at the expense of a fuller experience of the ups and downs of life. The crippling sadness that sometimes follows a reduction in SSRI medication is caused by the chemical dependence the drugs can cause in the brain and withdrawal effects.

 

[FunkOdyssey]

Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time

Popular meds work no better than a placebo for depression and can come with severe withdrawal symptoms. Why do doctors prescribe them to 43 million Americans?

www.newsweek.com

Instead, she argues, the drugs change "normal brain states" and "normal mental states and processes" in ways not that much different than recreational drugs like alcohol. They obscure psychotic symptoms by "superimposing" an abnormal drug state over other effects. In SSRIs, the small advantages seen in placebo-controlled trials, she suggests, can be attributed to emotional numbing that reduces the intensity of feelings causing the depression and anxiety, at the expense of a fuller experience of the ups and downs of life. The crippling sadness that sometimes follows a reduction in SSRI medication is caused by the chemical dependence the drugs can cause in the brain and withdrawal effects.

I emphatically agree with the entirety of that excellent article and with the quote above. That's quite an accurate characterization of antidepressant effects, and written like someone who's taken a few of them herself too.

 

[Fortunate]

Have been relying on metoprolol when attacks come on but finally did the experiment to replace metoprolol tartrate with 1 mg clonazepam about an hour before going to gym. Whoa. Night and day difference in exercise performance and was back to almost same intensity. I don't recommend using benzo when lifting heavy but it was a very eye opening experiment. Clearly my heart is not the issue here. Must have developed some type of anxiety panic issue upon any arousal and engagement of sympathetic nervous system. Hence my head is my worst enemy. Cool experiment to decouple brain from heart.

Interesting. If you are willing to try the beta blocker route, one more time, you might consider a small dose of propanolol. I’ve used 30 mg PRN on occasion with pretty good results.

 

[Fortunate]

I emphatically agree with the entirety of that excellent article and with the quote above. That's quite an accurate characterization of antidepressant effects, and written like someone who's taken a few of them herself too.

I will admit, I have not read the links yet, but I can attest to antidepressants causing severe withdrawal. I currently take trazodone at night time for sleep purposes only. Not that I have a normal mood, but I went on it for sleep specifically. On a few occasions, I have tried to get off of it and have gone through absolute hell. It’s a very uncomfortable feeling if I go without it for a few days.

 

[tareload]

Interesting. If you are willing to try the beta blocker route, one more time, you might consider a small dose of propanolol. I’ve used 30 mg PRN on occasion with pretty good results.

Propanolol just doesn't give me the same bang for the buck as metoprolol tartrate (short acting). Metoprolol is selective for heart but seems to calm my brain better than propanolol as well. My experiment showed me the heart is OK but if I really wanted full coverage I could use the benzo and low dose metoprolol succinate (long acting) for a little bit to give my nerves a reprieve.

Thanks for your thoughts.

 

[tareload]

I emphatically agree with the entirety of that excellent article and with the quote above. That's quite an accurate characterization of antidepressant effects, and written like someone who's taken a few of them herself too.

I enjoyed the article and did not judge simply because it was Newsweek. I read it on its merits. Glad you enjoyed it.

 

[tareload]

Have been relying on metoprolol when attacks come on but finally did the experiment to replace metoprolol tartrate with 1 mg clonazepam about an hour before going to gym. Whoa. Night and day difference in exercise performance and was back to almost same intensity. I don't recommend using benzo when lifting heavy but it was a very eye opening experiment. Clearly my heart is not the issue here. Must have developed some type of anxiety panic issue upon any arousal and engagement of sympathetic nervous system. Hence my head is my worst enemy. Cool experiment to decouple brain from heart.

Ok I am not very good at asking for help but given my inexperience with this I am soliciting experiences and feedback if you don't mind. I can read most of PubMed in a day but practical veteran experience is invaluable so appreciate you all considering providing any experience.

Started 0.5 to 1 mg per day of clonazepam this week. 1 mg was the bomb but 0.5 mg didn't quite cut it yesterday at the gym. How many weeks do I have until I start to lose effect and tolerance builds? I am trying to come up with medium term sustainable plan (as per @FunkOdyssey 's advice) that can kick in once I can no longer reliably leverage the short term win with clonazepam. If going the AD/SSRI route, you have to plan for the induction perod for those meds to kick in. I am not planning on escalating dosage with clonazepam.

So I have mirtazipine, sertraline, and lexapro on hand. Also may use metropolol succinate low dose (12.5 mg/daily) for extra insurance. Very experienced with CBT, breathing, meditation so I better be practicing all those as well although lately the chemical intervention made a huge difference. I am back in the gym at 50% pre-issues.

Thanks for any insight or feedback.

 

[Fortunate]

Ok I am not very good at asking for help but given my inexperience with this I am soliciting experiences and feedback if you don't mind. I can read most of PubMed in a day but practical veteran experience is invaluable so appreciate you all considering providing any experience.

Started 0.5 to 1 mg per day of clonazepam this week. 1 mg was the bomb but 0.5 mg didn't quite cut it yesterday at the gym. How many weeks do I have until I start to lose effect and tolerance builds? I am trying to come up with medium term sustainable plan (as per @FunkOdyssey 's advice) that can kick in once I can no longer reliably leverage the short term win with clonazepam. If going the AD/SSRI route, you have to plan for the induction perod for those meds to kick in. I am not planning on escalating dosage with clonazepam.

So I have mirtazipine, sertraline, and lexapro on hand. Also may use metropolol succinate low dose (12.5 mg/daily) for extra insurance. Very experienced with CBT, breathing, meditation so I better be practicing all those as well although lately the chemical intervention made a huge difference. I am back in the gym at 50% pre-issues.

Thanks for any insight or feedback.

I can't give a good scientific answer, but my response would be that you become tolerant and maybe even dependent fairly quickly. I think a benzodiazepine might be most useful in limited circumstances to get someone through something traumatic. That said, I think there are people that take them on a regular basis, but in those circumstances, it can be a bit of a one way street (hard to get off and feel normal). On the other hand, If this helps you get back into the gym, that's a good thing.

Here's a totally random thought: If you live anywhere near a lake and the weather is decent, take a Sea-Doo for a ride! A few weeks ago, I was at my in-law's lake place. I rode one of those suckers on a serene lake and it was absolutely fantastic. Liberating. I rode along my wife and we blasted through the water with warm wind and sun smashing us in the face. I was surprised at how damn fast those things can accelerate. I just felt free and at ease, and the afterglow lasted into the evening.

I know, it all sounds really corny. I guess the point I am making is that when we find ourselves "in the moment" or what some people describe as "flow", we tend to forget past regrets and future worries. It is truly liberating. I think there are innumerable ways to get into this state of mind: woodworking, bird watching, boating, etc. I truly think it's good for the soul and can be as useful as any pharmacologic approach.

 

[tareload]

I can't give a good scientific answer, but my response would be that you become tolerant and maybe even dependent fairly quickly. I think a benzodiazepine might be most useful in limited circumstances to get someone through something traumatic. That said, I think there are people that take them on a regular basis, but in those circumstances, it can be a bit of a one way street (hard to get off and feel normal). On the other hand, If this helps you get back into the gym, that's a good thing.

Here's a totally random thought: If you live anywhere near a lake and the weather is decent, take a Sea-Doo for a ride! A few weeks ago, I was at my in-law's lake place. I rode one of those suckers on a serene lake and it was absolutely fantastic. Liberating. I rode along my wife and we blasted through the water with warm wind and sun smashing us in the face. I was surprised at how damn fast those things can accelerate. I just felt free and at ease, and the afterglow lasted into the evening.

I know, it all sounds really corny. I guess the point I am making is that when we find ourselves "in the moment" or what some people describe as "flow", we tend to forget past regrets and future worries. It is truly liberating. I think there are innumerable ways to get into this state of mind: woodworking, bird watching, boating, etc. I truly think it's good for the soul and can be as useful as any pharmacologic approach.

Thank you for the suggestion. I have to say 1 mg of clonazepam is might scary. Can't feel my heart which is relieving and I feel like I am floating. Best I can describe it is when I used vicodin / muscle relaxant combo one time for a few days. Realized quickly I had to abort that asap or I would be in a halfway house. I have a strong aversion to becoming addicted to meds so I try to look out for these signs.

I am hopeful @FunkOdyssey doesn't mind me live streaming in his thread. Could be a decent example / case study given the thread title. Let me know if I wear out my welcome and I will shove off to a new thread of something. Thanks!

 

[FunkOdyssey]

Ok I am not very good at asking for help but given my inexperience with this I am soliciting experiences and feedback if you don't mind. I can read most of PubMed in a day but practical veteran experience is invaluable so appreciate you all considering providing any experience.

Started 0.5 to 1 mg per day of clonazepam this week. 1 mg was the bomb but 0.5 mg didn't quite cut it yesterday at the gym. How many weeks do I have until I start to lose effect and tolerance builds? I am trying to come up with medium term sustainable plan (as per @FunkOdyssey 's advice) that can kick in once I can no longer reliably leverage the short term win with clonazepam. If going the AD/SSRI route, you have to plan for the induction perod for those meds to kick in. I am not planning on escalating dosage with clonazepam.

So I have mirtazipine, sertraline, and lexapro on hand. Also may use metropolol succinate low dose (12.5 mg/daily) for extra insurance. Very experienced with CBT, breathing, meditation so I better be practicing all those as well although lately the chemical intervention made a huge difference. I am back in the gym at 50% pre-issues.

Thanks for any insight or feedback.

Tolerance and dependence are building immediately with the clonazepam. If you were to stop now, you would already have rebound anxiety and withdrawal effects, albeit relatively mild. So I think what you're really asking is how long before you cross the threshold where the anti-anxiety effect of your current dose is no longer significant. I do not have any practical experience with that because I never took them consistently enough.

If you are trying to use the benzo as a bridge to get onto an antidepressant that would serve as a longer-term anxiety therapy, you would want to start the antidepressant immediately. Otherwise, you are wasting this period of optimal benzo efficacy and building more tolerance and dependence than you need to.

It will probably take at least 4-6 weeks for an SSRI to deliver substantial anxiety relief. They often make anxiety worse than baseline when you first start (occasionally much worse), which is partly why this benzo bridge concept is pretty common in the psychiatric treatment of anxiety.

Escitalopram (lexapro) is probably the most effective SSRI for anxiety with the least side effects. It is the cleanest SSRI in terms of minimal off-target pharmacological effects and would be my preference here. Sertraline is more stimulating and not as well suited for anxiety. Mirtazapine raises norepinephrine levels tremendously by antagonizing a2 autoreceptors which is not ideal for someone experiencing panic attacks. It will also make you perpetually brain fogged with its strong H1 antagonism.

I would start escitalopram at 5 mg daily which strikes a better balance between efficacy and side effects than the typical 10 mg starting dose. You can increase if needed but there are diminishing returns as you move up. I personally could not stand the strongly altered state of consciousness produced by higher doses.

Am I understanding correctly that these panic symptoms are only occurring during high intensity gym sessions? Because you are about to take on some serious neurochemical debt with these drugs. You will be borrowing heavily from your future well-being in order to induce states of chemically-induced calmness in the present, and that will debt will have to be repaid in the future with interest. It is hard for me to imagine this as worthwhile only for the ability to work out at maximum capacity. Maybe I don't have the complete picture of how anxiety is affecting you outside of the gym.

I am happy to discuss the issues you are having in this thread and it seems like perfectly relevant content.

 

[sammmy]

I use sometimes benzos for sleep: short acting like triazolam, and long acting like temazepam. Tolerance develops in a matter of days. They still have an effect but it plateaus to a lower level, in this case to a shorter sleep duration.

You could try Gabapentin for anxiety instead - it may be anti-orgasmic since it seems to work by suppressing the brain-muscles communication.

Gabapentin reviews for Anxiety