One thing you won't see on SSRI patient information leaflets is how to combat the withdrawal effects. There are literally dozens and dozens of Facebook groups offering support to those struggling the debilitating withdrawal effects of SSRIs such as Prozac, Paxil, Zoloft etc. These groups are patients who have either gone through or are going through SSRI withdrawal - they shouldn't be dismissed, in fact, they are far better than what health care professionals have to offer.
The drug companies or medicine regulators won't help, to do so would be an admittance that SSRIs can, for many, cause serious problems when withdrawing and if they admit there's a problem then this will be a sign that they have licensed a drug, or drugs, to the public that can make matters worse rather than rectify or subdue the problem they were originally prescribed for.
When one takes a look at the patient information leaflet one sees the phrase that the benefits of taking an antidepressant outweigh the risks - the risks being thoughts of self-harm, suicide and akathisia, which, in essence, is a pre-cursor to completion of suicide.
Health committees spring up every now and again, their sole purpose, it appears, is to recognise there is a problem withdrawing from SSRIs and, well, and nothing. They offer no advice, they don't tell us why - they merely give you hope by stopping the carousel, asking you for your story then, putting you back on the carousel, ergo leaving you to deal with your problems by yourself - they will of course throw out the one line that covers their arse, "Talk to your doctor."
Most people that have wrote me over the years have told me that their doctors either up their dose when they experience withdrawal or change/substitute one SSRI for another - these patients then leave armed with a prescription and a ticket to ride the carousel.
For years the line 'Talk to your doctor' has been used as a tool by the pharmaceutical industry. To promote the use of SSRIs adverts have appeared on TV, in magazines, by proxy on radio shows where the host has been paid vast amounts of money to persuade listeners to use a certain brand of drug. When the problem of withdrawal kicks in, pharmaceutical companies and medicine regulators continue to use the 'Talk to you doctor' line, knowing that any prescribing doctor does not have a clue how to help people suffering severe withdrawal - Okay, there are some who know how to help, eg; Healy et al, but these are few and far between - perfect for the industry and regulators because it means they continue passing the buck, at the same time avoiding potential lawsuits for defective products.
Speaking of lawsuits, in 2002 GlaxoSmithKline settled with over 3,000 plaintiffs who had claimed that Paxil caused serious withdrawal problems of many kinds, resulting in patients unable to stop taking the drug. The settlement (with each plaintiff) saw them sign a confidentiality agreement whereby they could not discuss the award (monetary) they received from Glaxo. Here's how it works...
Any lawsuit claiming severe withdrawal effects from an SSRI will be denied and defended in a number of stages.
A - We warned them (the patient) already.
B - It was the condition whereby the patient declined into a spiral of decline, ergo this caused depression and the patient suffered anxiety as a result of his underlying illness and coming off the drug that was treating his underlying illness.. (In other words it wasn't a withdrawal effect, it was agitation caused by him stopping the drug. We utterly refute this claim as our drug has benefited millions of people world wide...yadda yadda.
Prosecution team will point out that even by the drug company's own admission their drug can induce severe withdrawal effects and this is where the pharmaceutical company will argue point C.
C - Yes your honour, but we don't believe that to be the case in this particular litigation, we believe it to be the underlying illness that caused what plaintiff deems as 'withdrawal effects'.
When they feel the case slipping out of their hands they offer a settlement, one which they don't have to admit any wrong-doing.
It's a game and pharmaceutical companies play it to their advantage.
One problem that exists with SSRI withdrawal is the "brain zaps" - if you've never experienced these you are one of the lucky ones - the only way to combat these (to make them go away) is to stop withdrawing and start taking your medication again at the prescribed dose (back on the carousel you go)
Looking through the Facebook support groups it seems the brain zaps is one of the more common side effects - it's played down by pharmaceutical companies and regulators.
In laypersons terms, or to use an analogy, brain zaps is basically your brain trying to deal with something it has become accustomed to over the months, years you having been taking the drug - it's no different to any other reduction you may encounter apart from the fact it gives you this feeling like your brain is being poked by a cattle prod, resulting in your whole body jerking, twitching. Turning your head too quick gives the effect of dizziness - this 'dizziness' is, once again, played down by the pharmaceutical industry and regulators. When reading the patient information leaflet you will see 'dizziness' as a common side effect - it looks harmless - hey, what's a bit of dizziness? For some the dizziness is best described as feeling like a cartoon character, you know they type, the kind of characters whose eyes are able to be pulled out before being let go and retracting at high speed back into their sockets.
More often than not withdrawal will cause this problem. You may turn your head and feel that your eyes do not follow your turn, they are left temporarily stationary in their original position. Once your head is turned it will take them a split second longer to follow the movement of your head - this will cause you the 'dizziness' referred to in the patient information leaflets - this is what taking, or withdrawing from an SSRI, can be like for a lot of people. The vast majority of which find it difficult to describe this 'dizziness' to their doctors.
The brain zaps (your brain wanting it's normal daily fix) is your brain reminding you to feed it. For months or years you have been feeding it a regular dose - so, if you lived on three potatoes, chicken and vegetables for a year, and that meal satisfied you, gave you a sense of being full upon eating it, it then stands to reason if someone came along and removed a piece of chicken or potato, you'd be pretty pissed off - your meal wouldn't satisfy you anymore - you'd be left unfulfilled and you'd probably reach for a snack to fill the gap that the missing potato or chicken piece had left. Same goes for when you are tapering from an SSRI - Your brain has become used to it's regular meal of potatoes, chicken and vegetables.
Now, imagine if just one pea was taken from your daily meal, it wouldn't be so bad, and you probably wouldn't even notice it, right? This is how you have to taper. Personally, I came down by just half a milligram per week. Some weeks, when I wasn't ready to drop another half, I didn't. My body, my rules.
The God Factor
Throw a stethoscope around a neck, give that stethoscope-wearing person a title, such as 'Dr', and you have before you a person that can fix any ailment you may have. These people have been through years of training, they are clever, so much more intelligent than you and I, right?
They have been trained to basically spot symptoms then use a medicine to treat that symptom - that is all - they don't have a magic wand, they do not have healing hands - they are not your modern day Jesus Christ nor indeed should they be treated as such. They are just normal people who chose a career path because they felt the need to want to help people - it's admirable that any human would want to care for another human - Sadly, the pharmaceutical industry is a machine that is constantly striving to see a niche in the market - to take control of that niche they first need to target the agents who sell their wares - namely; your prescribing physician. They, through various methods, convince the young Dr going through med school that they are the good guys, that depression is a disease that can be stabilized and controlled. Somewhere along the line financial and marital problems have become a disease as have fears that have been with us since the year dot. Shyness, being anxious because you have to give a speech are just two examples - both treatable with an array of meds, or so we are told.
If you've read this far down then you are probably here because of the title of this post, "SSRI Tips and Tricks on Withdrawal."
It's important to know why you are here and reading all of the above will, hopefully, give you the reason. You are not crazy, you are not in the minority, you are not abnormal - the drug you were prescribed was licensed by a regulator based upon the benefits you may receive from it. To date, the British drug regulator, cannot list one single benefit for any of the SSRIs on the market. They claim that these invisible benefits outweigh the highly visible risks - You've been duped ladies and gentlemen, just like your prescribing physician. (Source - Correspondence between myself and the MHRA)
So, the zaps - horrible aren't they? Kind of make you curl up into the fetal position because that's the only way you can cope, right?
There is a way that may or may not help you. It's free, it doesn't involve putting anything into your body apart from tap water (or bottled water if you prefer) - in fact, water is used a lot in these series of tips.
You won't see these on the patient information leaflet because, well, because the whole idea of selling sickness is to not warn you about the severe side effects you may experience.
1. If you decide to taper do so in the winter months and not the summer months. I can't quite put my finger on why you should choose the colder months but I know, through my own tapering experience of Paxil withdrawal, that it seemed to be worse when it was warmer outside.
2. Never try to quit by going cold turkey. Don't attempt to taper by missing doses every other day. Don't attempt to taper by halving your pill, although for some (Cymbalta for example) there is no liquid formulation, which brings me on to tip number three.
3. Taper using the liquid formulation (if you can) - Don't ask your Dr for the liquid, tell him/her - Dr's are there to help you and, at the end of the day it is you that is suffering the withdrawal, it is your brain crying out for its extra potato each time you skip or halve a dose. Tell your Dr you want to be prescribed the liquid - Do not ask.
4. Go at your own pace when withdrawing, this is not a sprint, it's a marathon and may take many months or even years to get completely off the drug. Again, many Dr's will dispute this, if they do then give them the middle finger - remember, this is your plate you are eating from and not theirs.
5. The dreaded brain zaps - Okay, this is my own personal tip, it helped me somewhat.
Run a bath full of cold water. Find a suitably sized bath towel and soak the towel in the water. Wring the towel and wrap it around your head in the style of a turban. Keep repeating this process once the towel starts to dry or if the zaps appear again.
6. Run cold water over your wrists (the part where you feel your pulse)
7. Go for walks (again the winter months is probably best) - Don't overdress - wear loose clothing - this may be difficult as you have probably gained a lot of weight during your time on your SSRI. Walk and push yourself - don't just walk around the block, find a park, tell yourself you are going to lap the park just by walking - treat the cold weather as your friend. Treat the walk as a way of helping you and not as a chore - at the same time weight will fall off you - let the daily walk be your addiction.
8. Drink lots of water, up to 8 pints a day - yes, it seems a ridiculous amount but you are basically helping flush out the culprit causing you the problem - If you can't manage 8 pints then just drink as much as you can - in any event, water is good for you.
None of the above will cost you a single penny - give it a try and write to me in a few months time to let me know if you feel you are on the road to recovery after using these tips.
In the meantime, good luck - you will get there - maybe once you do, you can advocate and help others stuck in this rut of SSRI withdrawal, particularly children.
Former Paxil addict.