Is it ok to take an SSRI for the rest of my life?!

I asked a nurse practitioner about it the last time I was at the doctors and she said that if the SSRI makes me feel better then she see’s no point in me stopping. I do have clinical depression but I also wonder is it not healthy to be on this medication all of my life?

The answer would be NO I think you shouldn’t be on them the rest of your life

Antidepressants were never intended for long term use.  The long term harms are unknown.  However concerns are growing.  There is ample evidence they make depression worse in the long term.

Like almost any med, the question  is "Does the benefit outweigh the risks.downside"

 

Yes, there are folks that need to be on ADs long term, perhaps even a lifetime.  But if they improve the quality of life is great enough, then that outweighs the negatives.

Antidepressants were never intended for long term use.  The long term harms are unknown.  However concerns are growing.  There is ample evidence they make depression worse in the long term.

 

Perhaps you could share some of the evidence here?  From reliable medical/academic sources?

Like almost any med, the question  is "Does the benefit outweigh the risks.downside"

 

Yes, there are folks that need to be on ADs long term, perhaps even a lifetime.  But if they improve the quality of life is great enough, then that outweighs the negatives.

 

:thumbsup:

 

Antidepressants were never intended for long term use.  The long term harms are unknown.  However concerns are growing.  There is ample evidence they make depression worse in the long term.

 

Perhaps you could share some of the evidence here?  From reliable medical/academic sources?

 

There is Robert Whitaker's Anatomy of an Epidemic which demonstrates that as AD prescribing increases so do disability claims for mental health issues.  It seems pretty clear that long term use is associated with worsening of condition.  Also a great many patients reporting this in the A/D withdrawal support forums along with other adverse long term effects.

 

This is Dr Allen Frances leading US psychiatrist speaking on CNN TV recently.  A/Ds never intended for long term use, most long term users will not benefit.  Then of course there are the difficulties of getting off the drugs.

 

https://edition.cnn.com/videos/tv/2018/05/17/amanpour-allen-frances-antidepressants-interview.cnn

 

There are academic papers .. but my memory isn't good and I find it hard to keep track.  This is a recent paper.

 

https://www.madinamerica.com/2017/10/rigorous-study-finds-antidepressants-worsen-long-term-outcomes/

 

Obviously it is up to the individual whether they want to keep taking A/Ds or not.  I took them myself for 35 years thinking I needed them but now I realise I was completely brainwashed into thinking I suffered from some sort of intractable depression.  I now know that the drugs are largely ineffective for most patients, so much I didn't know before that I now know. There is no evidence to support long term use, none whatsoever.

 

The idea that you should take them for life is not one to promote ... there are now links to dementia - recent BMJ study .. many other possible adverse effects in the long term. 

 

https://www.bmj.com/content/361/bmj.k1315

 

Depression is not a life-long condition for the vast majority of people, it gets better, and often can get better without medication.

 

They used to think that patients could be on benzodiazepines for life, now the prescribing guidelines are for a few weeks only.  History is repeating itself unfortunately.   

 

There are many patients now stuck on antidepressants for life, they are suffering adverse consequences and do not even have the choice of getting off them because it is far too difficult.  I think it is important that everyone makes an informed choice about these drugs.  I totally understand if people feel they need them, I just do not like to see people walking blindly into something without doing the research ....  A/Ds can be equally as harmful as benzodiazepines, I see it every day in the A/D support groups.

I think, this is very individual. The day, when you understand that they are only doing more harm than good, you have to make a decision.

For my part, I feel good of them. I have always been very skinny, and weight gain has been completely impossible. But now, I have normal weight. I sleep very well, 9-10 hours / night. Without these, I cry for everything, is very sensitive. But, I'm very afraid of the day I have to stop, it will be the same hell as Benzo. So, I take one day at a time.

Yes, it is an individual choice, of course it is but it is important that it is an informed choice.  So many of us are here because we blindly took benzodiazepines, trusting our doctors, having no idea what we were in for .. it is exactly the same with SSRIs.  I am glad they are helping you and you clearly know that withdrawal can be extremely difficult, not for everyone but for many many people. 

 

I would disagree with your second sentence.  So very many patients have no idea they are being harmed, they develop all sorts of unexplained symptoms and keep going to the doctor and they get more tablets and investigations and it can be years before they realise it is drug side effects.  They may try to withdraw and then they think it is a relapse of their original condition, then they go back on the drugs, perhaps at a higher dose or another drug is added in.  It really can be very difficult to know what is going on.  I have withdrawn from Effexor, 225 mg, I was on many different A/Ds for 35 years so it can be done but many cannot tolerate the withdrawal symptoms and find it impossible.  They no longer have any choice, it has been taken away from them.

 

I cannot turn the clock back for myself but I wish I had been informed many years ago ... when I was first prescribed drugs, there was no internet, not even patient information leaflets, I knew nothing ..  but I now see so many young people in the same boat despite all the information that is now available.

Like almost any med, the question  is "Does the benefit outweigh the risks.downside"

 

Yes, there are folks that need to be on ADs long term, perhaps even a lifetime.  But if they improve the quality of life is great enough, then that outweighs the negatives.

 

:thumbsup:

 

 

^ THIS! 

 

It's so important to make an informed decision factoring in the benefits and risks. In my opinion, having an informed and flexible medical/mental health professional to help guide that decision is key. They can be difficult to find, but they do exist!

 

I tried SSRIs a few times in the past, but always quit them within a few months because they made me feel like a zombie...a depressed zombie.  That's why I take the Wellbutrin, a prescription that my current NP disagrees with - she thinks it's making my anxiety worse, and I can't tell if it's helped with depression any because I was so far down the benzo hole by the time I started taking it.

 

Personally, I intend to finish tapering my Wellbutrin as well as Valium. I want to see how I feel when I'm med-free for a little while, because I was on V for so long that it worsened my anxiety and depression over time and really skewed my perspective until I had no idea what my "baseline" even is. 

 

But that doesn't mean I'll never take meds again. I'll make that decision once I've regained perspective, done more research, and started talk therapy again. If I do go back on any kind of medication, it will be in combination with CBT. For me, the trouble began when I finished the therapy work but kept taking the pills as "maintenance medication."

 

I wish the answer was a simple yes or no...but it isn't. At least not for me.

 

Gwinna

 

Like almost any med, the question  is "Does the benefit outweigh the risks.downside"

 

Yes, there are folks that need to be on ADs long term, perhaps even a lifetime.  But if they improve the quality of life is great enough, then that outweighs the negatives.

 

Agreed!

 

 

I see the University of Zurich is now running a trial into antidepressant withdrawal.  Sorry it is in German.  So that is Canada, England and the Netherlands and now Switzerland .. hopefully we will learn more in the next few years about withdrawal.

 

https://tnu-studien.ethz.ch/de/aktuelle-studien/aidaz.html

Good question; I never touched a AD till I came towards the end of my taper . I was and still am taking Gabapentin, which helped my anxiety but started to feel a tolerance and was at max dosage. Terrified I started the Effexor 2 weeks ago .  The lowest amount . And it has lowered my anxiety so I can work and function. My daughter said I seem more stable . Instead of the up /down that maybe was my Xanax? 

My question would be, what if you can't even get on an AD and you need it badly. What if you have tried everything. What if you can't just pin it on withdrawal anymore. Then what. Do you simply suffer through depression, hopelessness, and despair for the rest of your life?

I don't think it's healthy to take medication for you whole life, and we should all strive for that but sometimes there are exceptions.  I think with antidepressants they do stop working over time.  There is a definite period of benefits when you first take them, and for at least a few months for most people.

 

Dr. Breggin talks about the idea that the body and the brain try to compensate for medication like the antidepressants,which eventually cause them not only to not work, but also to make new symptoms and side effects, basically similar to what happens when benzos make you anxious over time.  Knowing this, I wouldn't plan to be on them for life.  I personally found no real benefit to being on them longer than 4-6 months, but everyone is different.

I don't think it's healthy to take medication for you whole life, and we should all strive for that but sometimes there are exceptions.  I think with antidepressants they do stop working over time.  There is a definite period of benefits when you first take them, and for at least a few months for most people.

 

Dr. Breggin talks about the idea that the body and the brain try to compensate for medication like the antidepressants,which eventually cause them not only to not work, but also to make new symptoms and side effects, basically similar to what happens when benzos make you anxious over time.  Knowing this, I wouldn't plan to be on them for life.  I personally found no real benefit to being on them longer than 4-6 months, but everyone is different.

 

 

 

 

 

I agreed after a while it’s just gonna be plecibo effect you might think they are working and felt good taking them think that they are effective but the reality is they actually stop working after a while

 

I asked a nurse practitioner about it the last time I was at the doctors and she said that if the SSRI makes me feel better then she see’s no point in me stopping. I do have clinical depression but I also wonder is it not healthy to be on this medication all of my life?

 

The withdrawal from antidepressants can be just a as long and rough as benzo withdrawal, and tolerance is a consideration. So I would definitely account for that when making your decision to stay on an AD is worth it.

I asked a nurse practitioner about it the last time I was at the doctors and she said that if the SSRI makes me feel better then she see’s no point in me stopping. I do have clinical depression but I also wonder is it not healthy to be on this medication all of my life?

 

The withdrawal from antidepressants can be just a as long and rough as benzo withdrawal, and tolerance is a consideration. So I would definitely account for that when making your decision to stay on an AD is worth it.

 

I had to taper several antidepressants, too. Whenever I read that people are fine with it I wonder "for how long" and "when will they reach tolerance" - its a trap. All of these meds are traps. I am so sorry that they were invented.

They're generally not meant to be taken forever, but if it is helping you with clinical depression, then it makes sense to keep taking it. Also, if you'd been on it for long time now (years), I wouldn't stop it anytime soon, considering you'd recently jumped from a benzo. if you'd been taking an SSRI for a very short time, then it's a tossup, because you may have an ability to stop it quickly, but may not really know if taking it will help you more than not taking it.

They're generally not meant to be taken forever, but if it is helping you with clinical depression, then it makes sense to keep taking it. Also, if you'd been on it for long time now (years), I wouldn't stop it anytime soon, considering you'd recently jumped from a benzo. if you'd been taking an SSRI for a very short time, then it's a tossup, because you may have an ability to stop it quickly, but may not really know if taking it will help you more than not taking it.

 

Yes, I agree. 

 

Gwinna

You know, a lot of people do take antidepressants for their whole life. If you feel like it is helping you and you benefit from it, take it as long as you feel that way.

My problems with SSRI's were that they would "poop out" and stop working after a couple years. Then I would get switched to a new SSRI with different side effects that may or may not help as well as the other did and it just seemed like a vicious cycle.

That's just my experience.

I think that you have to go with how you're feeling and whether you feel like you are benefiting from the antidepressant. Do what's right for you. Everybody is different.

Don't worry about whether you'll be on it forever.

If/when the time is right, you can go ahead and taper the ssri but don't worry about that now. You'll know when the time is right for you.

Take care of yourself and let yourself heal.