SSRI Stories: Antidepressant nightmares

If you want the "full story", with peer-reviewed sources, about SSRIs, including a true/false on the various assertions that get passed around the Internet often with little justification, I strongly recommend http://slatestarcodex.com/2014/07/07/ssris-much-more-than-yo.... Scott is both a licensed psychiatrist and a very good rationalist with access to a lot of good data, who doesn't easily fall for Internet misinformation and definitely doesn't gloss over the "complicated bits" about the flaws and methodologies in clinical trials. This post is my go-to source for most discussions about SSRIs.

As someone who's been on SSRIs for the majority of my life for Panic Disorder[1] (from age 11 to age 28), there was a period of time when being on Paroxetine (Paxil in the US) I started to read these stories and sympathize with them, trying to blame all of my behavioral / mental problems on the drug, even though the drug literally saved my life. Paroxetine isn't without its issues, and it took many many years to taper off of it without side-effects, but these sorts of anecdotes do nothing to help people in these situations.

There's a stigma with SSRIs that you either a) lose your creative ability and become a pharmaceutical drone or b) become suicidal. I've heard people tell me that anti-depressants are bad since they are not "pure" and you aren't being "yourself". They clearly don't know what it's like to have something like Panic Disorder, or severe depression. It was this stigma that made me taper off Paroxetine. I felt like I was "cheating". Eventually my anxieties started coming back (though less severely) in my later years and I'm on Lexapro now, and I've realized that not only have these drugs worked, my life is in every way better than it was before. Who cares if it's cheating?

I know this is just an anecdote just like the ones in the link, but I think it's important that people do what they need to do to live a good life, and if you're reading this and considering anti-depressants, there is nothing wrong with trying, and the stigma should be fought.

[1] https://en.wikipedia.org/wiki/Panic_disorder

"science". This stuff comes from this org: https://en.wikipedia.org/wiki/International_Coalition_for_Dr... and Dr. David Healy, long time campaigners against antidepressants. Draw your own conclusions.

This article is alarmingly sloppy, even without getting into questions of core accuracy.

Statements like "it is important to withdraw slowly from these drugs, sometimes over a period of a year or more" paints with an unconscionably broad brush. The drawdown period for antidepressants is completely dependent on the actual drug, and some (like bupropion) have no withdrawal symptoms at all.

Similarly, the claim that antidepressants cause people to lose their fear of death treats an open question like settled science. The antidepressant-suicide correlation is complicated and ill-understood - failing to even mention that there are other theories (e.g. antidepressants treat low energy faster than low mood, which enables but doesn't cause suicides) is downright dishonest.

It's worth learning about SSRIs if they're relevant to your life, but this piece skips over open questions and conflates nearly-unrelated drugs to the point where it's essentially useless.

NSI-189 (https://en.wikipedia.org/wiki/NSI-189) is starting to look like a potentially big game changer in antidepressants. It's a novel drug that (to my understanding) works in a way that's different from any other drugs.

The plural of "anecdote" is not "data"

Exercise really is great and should be tried before anything else. It's the only thing that I've found that works for me in a reliable, safe way. As far as SSRIs and Wellbutrin (which is not an SSRI like the chart states), I can confirm that after about 8 months or so, I did indeed have unprecedented thoughts of suicide and no longer cared about living much. I can also confirm meeting many doctors who were extremely eager to prescribe it after as little as 5 minutes of getting to know me (I declined). Basically, taking SSRIs was indeed one of the worst decisions of my life and almost cost me my life. So I stick to exercise now.

I highly suspect melatonin-receptor (MT1 and MT2) agonists will be more useful in correcting mood disorders such as depression than anything that messes with monoamine neurotransmitters.