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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 89. Go back in thread:
Posted by FinishBen on January 17, 2009, at 17:58:34
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
Hey "New Questions" - I too took SSRIs for a very extended period of time, approximately eleven years, first for OCD and later for depression. I also experienced a burnout after years of effectiveness. I have been off meds with few brief interludes for almost two years.
Just something to think about: I experience frequent mental fog, irritability, apathy, and other negative emotional and cognitive states, to an extent that I never did before taking SSRIs. However, I think Scott may be on to something - for me, at least, these seem to come with depression, and do not seem to be totally independent. I have never experienced these effects without also noticing - when I check - negative thinking patterns and general malaise. I know this might seem like mincing words, a bit, but in the brief periods when I have managed to NOT be depressed in my times off of SSRIs, I have noticed all these really negative cognitive and emotional side-effects abate. Not to say that long-term SSRI usage did not play a role in driving these symptoms, but I think they are also driven by depression too.
Also, there is absolutely no reason to think that these will be permanent issue. At times, I am intensely discomforted by the absence of long-term data on long-term SSRI usage and the possible damage that could result. However, there is real and anecdotal evidence of the brain healing itself.
While these may be long term issues for past SSRI users, and while it may seems that we can't live with or without SSRIs, there is no reason to think that it will always be like this. Though it is ever so tempting to fall into the trap of thinking that all is gone and lost....
Posted by Garnet71 on January 17, 2009, at 21:19:12
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"...Because it feels as if their success has hurt or damaged their parents, the child may end up as an adult, having unconscious feelings of guilt from wishing, striving for, or accomplishing success in an area or areas where a parent has failed. These areas may include relationships, career, finances, health, pleasure, or an overall sense of ones self-worth. The guilt is unconscious, so that the reasons for self-sabotage, e.g., lack of ambition, or over-avoidance of competition, may be hidden. Wishing, striving for, or accomplishing success unconsciously triggers anxiety and guilt, resulting in procrastination, an inability to concentrate, low motivation, or a decision to just drop the project altogether..."
Posted by Garnet71 on January 17, 2009, at 21:33:50
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
Amino acid - Arginine (to increase blood flow to the brain?):
"Claims, purported benefits: Prevents or treats heart disease and circulatory diseases, combats fatigue, stimulates the immune system, treats impotence, fights cancer, etc. Many studies have found that arginine supplements can boost nitric oxide production. Some have also suggested that the supplements can improve the function of blood vessels, enhance coronary blood flow, lower blood pressure, and even reduce angina or other symptoms in people with heart disease and/or vascular disease. "
Posted by Garnet71 on January 17, 2009, at 21:37:46
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"Coenzyme Q-10 (CoQ-10) has been the focus of scientific study for years and has become one of the most popular dietary supplements. This vitamin-like compound, it has been proposed, may help treat, or possibly even prevent, many disorders, including heart disease, hypertension, AIDS, asthma, Parkinsons and Huntingtons disease, certain cancers, lung disease, gum disease, chronic fatigue syndrome, migraines, and allergies. Its supposed to improve memory, boost immunity and energy, enhance exercise performance, and combat aging. Such sweeping claims should always arouse suspicion. Though in recent years scientists have learned a lot about CoQ-10, the clinical research is still in its infancyand thus the marketing claims remain overblown.
Claims, Benefits: Prevents and treats heart disease, Parkinsons disease, and many other disorders.
Bottom Line: This interesting antioxidant may be effective against heart failure and Parkinsons. If you try it to treat a disease, get medical advice about doses and formulationseven though its just guesswork at this pointas well as about potential drug interactions. Theres no reason to take it if you are healthy. The long-term effects are unknown, and the price is high."
Posted by Garnet71 on January 17, 2009, at 21:39:25
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"Some drugs, including certain cholesterol-lowering statins, beta-blockers, and antidepressants, can reduce CoQ-10 levels in the body, but there has been no evidence that this causes any adverse effects. "
Posted by Garnet71 on January 17, 2009, at 21:48:04
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"The genetic issue: hemochromatosis
There is no dispute that some people do need to worry about iron overload: about one million Americans (mostly of northern European descent) have a hereditary disorder known as hemochromatosis, which causes them to absorb and store too much iron. When untreated, this can lead to weakness, headaches, darkening of skin color, sexual dysfunction, and joint pain, and eventually diabetes, arthritis, liver disease, or heart failure (but not CAD and heart attacks). People with hemochromatosis must have blood removed frequently to lower their iron levels, and they must avoid iron supplements.
If you have a family history of hemochromatosis or develop symptoms that may be related to it, a simple, inexpensive blood test can help diagnose it. Many doctors advise routine screening for hemochromatosis in middle age, especially for Caucasians."
http://wellnessletter.com/html/ds/dsIron.php
Posted by Garnet71 on January 17, 2009, at 21:55:25
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"When deficiency is the problem
Theres a lot of controversy about routine testing for vitamin B-12 deficiency, which may not even have symptoms. On the other hand, severe deficiency can cause confusion, memory loss, tingling and weakness in the limbs, hallucinations, and listlessness. This may be misdiagnosed as Alzheimers disease or other conditions. Or the person suffering from these symptoms may simply attribute them to "aging." If you suspect you are deficient, get medical help. Blood tests can diagnose deficiency, and levels of the vitamin can be brought up in various wayspills, nasal gels, and injections.
Extracting vitamin B-12 from foods is a complex process. The stomach must secrete adequate amounts of acid, plus the digestive enzyme pepsin, and then, in order to be absorbed, the free vitamin must combine with a protein known as "intrinsic factor." But in older people this process may be incomplete: 20 to 30% of people over age 50 dont produce enough stomach acid, and thus their B-12 absorption is reduced. A poor diet and heavy drinking can also contribute to a deficiency. Vegans (who eat no animal products, which are the best sources of B-12) can be deficient, as can those with diseases of the intestinal tract.
All these people may gradually develop the common form of B-12 deficiency. There is also a rare and more serious form, known as pernicious anemia (see below)."
http://wellnessletter.com/html/ds/old_ds/dsVitaminB12.php
Posted by Garnet71 on January 17, 2009, at 21:57:24
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
I'm really pissed off right now that NO doctor has ever mentioned ANY of these possibilities to me before prescribing me anti-depressants.
"Pernicious anemia: uncommon but serious
Only about 1% of us will ever develop pernicious anemia, a disease leading to B-12 deficiency. It can occur at any age, not just in those over 50. What happens is that the stomach nearly stops producing acid and intrinsic factor, and thus virtually no B-12 can be absorbed. Because the vitamin is stored so efficiently, it may take up to five years before stores are used up and symptoms develop. These may include extreme fatigue, dementia, disorientation, and weakness in the limbs. One consequence may be irreversible neurological damage, so its important to see a physician early. A high intake of another B vitamin, folate, can mask some signs of pernicious anemia, but does not stop the neurological damage. If your problem turns out to be pernicious anemia, it can be successfully treated with large doses of vitamin B-12. "
Posted by mav27 on January 18, 2009, at 0:32:18
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by linkadge on January 16, 2009, at 18:14:07
> Yes, I also agree with the above mentioned description of long term SSRI use. I agree with the notion that the REM disrupting property of the SSRI's could be mediating some of the of these long term effects.
>
> REM sleep is accompanied by growth hormone release. So, supressing REM sleep could have a detrimental effect to long term energy levels, learning, etc.
>
> The SSRI's activate all serotonin receptors in the brain and body, they are not specific to one subtype. As such, there is likely a whole host of strange metabolic and neuroendocrine changes that occur with long term SSRI use. As well, the SSRI's can reduce dopamine release after long term use, which can lead to apathy as well as reduced testosterone release.
>Is there a definate correlation between dopamine and testosterone, you say reduced dopamine can lead to reduced testosterone but can the reverse be true... could high amounts of testosterone indicate there maybe higher levels of dopamine in the brain... ?
Posted by Garnet71 on January 18, 2009, at 0:55:48
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
"Cerebral insufficiency
Multiple clinical trials have evaluated ginkgo for a syndrome called "cerebral insufficiency." This condition, more commonly diagnosed in Europe than the United States, may include poor concentration, confusion, absent-mindedness, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety. It is believed that cerebral insufficiency is caused by decreased blood flow to the brain due to clogged blood vessels. Some research reports benefits of ginkgo in patients with these symptoms, but most have been poorly designed without reliable results. Better studies are needed before a strong recommendation can be made. "http://www.mayoclinic.com/health/ginkgo-biloba/NS_patient-ginkgo/UPDATEAPP=false&FLUSHCACHE=0
Posted by Garnet71 on January 18, 2009, at 0:57:30
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
Uses based on scientific evidence Grade*
Claudication (painful legs from clogged arteries)
Numerous studies suggest that Ginkgo biloba taken by mouth causes small improvements in claudication symptoms (leg pain with exercise or at rest due to clogged arteries). However, ginkgo may not be as helpful for this condition as exercise therapy or prescription drugs. Additional evidence is needed. A
Dementia (multi-infarct and Alzheimer's type)
The scientific literature overall does suggest that ginkgo benefits people with early stage Alzheimer's disease and multi-infarct dementia, and may be as helpful as acetylcholinesterase inhibitor drugs such as donepezil (Aricept?). Well-designed research comparing ginkgo to prescription drug therapies is needed. A
Cerebral insufficiency
Multiple clinical trials have evaluated ginkgo for a syndrome called "cerebral insufficiency." This condition, more commonly diagnosed in Europe than the United States, may include poor concentration, confusion, absent-mindedness, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety. It is believed that cerebral insufficiency is caused by decreased blood flow to the brain due to clogged blood vessels. Some research reports benefits of ginkgo in patients with these symptoms, but most have been poorly designed without reliable results. Better studies are needed before a strong recommendation can be made. B
Posted by SLS on January 18, 2009, at 3:07:21
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Garnet71 on January 18, 2009, at 0:57:30
Depression yields a cerebral insufficiency. Although this is often concentrated in the prefrontal lobes, in severe cases (like mine), this observed hypoactivity is more widespread.
P.E.T. scans, MRI, and psychometric exams test for this.
- Scott
Posted by desolationrower on January 18, 2009, at 5:24:11
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by linkadge on January 16, 2009, at 18:14:07
> Yes, I also agree with the above mentioned description of long term SSRI use. I agree with the notion that the REM disrupting property of the SSRI's could be mediating some of the of these long term effects.
>
> REM sleep is accompanied by growth hormone release. So, supressing REM sleep could have a detrimental effect to long term energy levels, learning, etc.
>
> The SSRI's activate all serotonin receptors in the brain and body, they are not specific to one subtype. As such, there is likely a whole host of strange metabolic and neuroendocrine changes that occur with long term SSRI use. As well, the SSRI's can reduce dopamine release after long term use, which can lead to apathy as well as reduced testosterone release.
>
> After long term use, serotonin transporter producing upregulates it self to compensate for the drug induced interference with the transporter. This means that, after discontinuation, there can be an enhanced uptake of serotonin. Mice treated with SSRI's in early life show increased serotonin transporter levels even after the drugs are discontinued.
>
> Finally, SSRI's reduce melatonin release. Melatonin has potent antioxidant effects and the supression of this hormone may, over time, lead to diminished antioxidant defences.
>
> I wish I had never used SSRI's. At this point, its like I can't live with them and can't live without them.
>
> Linkadge
>
>
>
>are you thinking of slow-wave-sleep?
-d/r
Posted by linkadge on January 18, 2009, at 8:47:17
In reply to Re: Long Term SSRI Use Has Destabilzed Me » linkadge, posted by mav27 on January 18, 2009, at 0:32:18
Good question, I am not entirely sure. I know that the agonism of certain dopamine receptors is ncessary for testosterone release. On the other hand, I believe that testosterone does infact promote dopamine release in certain brain regions.
Its far too complicated for me to understand though.
Linkadge
Posted by Garnet71 on January 18, 2009, at 9:04:57
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by SLS on January 18, 2009, at 3:07:21
> Depression yields a cerebral insufficiency. Although this is often concentrated in the prefrontal lobes, in severe cases (like mine), this observed hypoactivity is more widespread.
>
> P.E.T. scans, MRI, and psychometric exams test for this.
>
> - Scott------------------
Scott-how on earth did you manage to get diagnosed with this-a yet tested for it?
What do you think caused it?
Posted by SLS on January 18, 2009, at 13:40:21
In reply to Re: Long Term SSRI Use Has Destabilzed Me » SLS, posted by Garnet71 on January 18, 2009, at 9:04:57
> > Depression yields a cerebral insufficiency. Although this is often concentrated in the prefrontal lobes, in severe cases (like mine), this observed hypoactivity is more widespread.
> >
> > P.E.T. scans, MRI, and psychometric exams test for this.
> >
> > - Scott
>
> ------------------
>
> Scott-how on earth did you manage to get diagnosed with this-a yet tested for it?
>
> What do you think caused it?
>I entered the NIMH, NIH (U.S. National Institutions of Health) as a research patient in May of 1992 for bipolar depression. I was one of the first subjects that underwent a P.E.T. scan of the brain (deoxyglucose). The scan demonstrated that most of my cerebrum was "blue", indicating that it was hypoactive. Normal brains are yellow, orange, and red, indicating increasing levels of brain activity. I was taken back when I was shown the pictures of my brain compared to those of healthy subjects. It was wrenching to witness, but not totally unexpected.
- Scott
Posted by linkadge on January 18, 2009, at 17:21:05
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by desolationrower on January 18, 2009, at 5:24:11
Not necessarily. Slow wave sleep and REM sleep both affect learning, but different types of learniing. I think REM sleep affects procedural learning.
Linkadge
Posted by 49er on January 19, 2009, at 5:45:39
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
New Questions,
I am so sorry for your difficulties and can relate to wha tyou said.
Did you taper slowly off or your meds? If you didn't or cold turkeyed them, that could be the reason for the problems you mentioned.
It sounds like you have hit poop out with the Ativan.
As I said, I relate to everything you have said. Finally, in 2006, fed up with side effects, which included a mild to moderate hearing loss, tinnitus, and a worsening of learning disability issues, I started slowly tapering off of a 4 med cocktail. I am down to one med.
Other than tapering Wellbutrin XL very fast ( I got away with it thankfully), I tapered the other meds very slowly. It doesn't completely eliminate problems but it has enabled me to at least have some type of life.
I know I sound like a broken record but I will say it again. The best way to taper is 10% of the current dose every 3 to 6 weeks. Send me an email if you want to know how to do it. Free advice:))
49er
PS - Have you tried fish oil capsules for the cognitive issues? They help me depending on where I am in my withdrawal phase
Posted by NewQuestions on January 20, 2009, at 11:23:19
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by Garnet71 on January 16, 2009, at 12:43:57
Garnet71--Can we talk over the phone or via email? I have a bunch of questions and more information.
Posted by Connor on January 20, 2009, at 20:00:13
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
Same thing has happened to me. I've been off ssris for a while, I am in my early 20s and I'm still experiencing absolute hell because of the way ssris have rewired my brain.
I have no libido anymore (never a problem before), cognitive problems are rampant, most notably memory problems and articulation difficulties, quality of sleep never feels like it should, low energy, low motivation, emotional numbness, inability to cry not being able to experience enjoyment, emotions are out of wack. I know how I was when I was depressed and this was DEFINITELY not it, this happened during ssri use.
Like you ssris also sped me up when I first started them, I would feel great emotionally and mentally, but then eventually after a while it would just become terrible. I hated my life while I was on them and now I'm trying to recover. I've been using nootropics like piracetam and such with pretty good results, but not all my problems are fixed and supplements are only so reliable (stop working etc) I am so completely frustrated with the state that I am in now, that it IS making me depressed.. but then what are my options, go on another psycho-tropic and risk screwing myself up more?? It's really a sh*tty situation and I hate it. Each day is a struggle and it really sucks. Wish I never went onthose drugs
Posted by Garnet71 on January 20, 2009, at 20:44:25
In reply to Re: Long Term SSRI Use Has Destabilzed Me--Garnet7, posted by NewQuestions on January 20, 2009, at 11:23:19
> Garnet71--Can we talk over the phone or via email? I have a bunch of questions and more information.
-----------
If you go to your settings and turn on the option for "babblemail", I can email you anonymously (unless you want to post your address or phone number here - I don't)
Posted by Garnet71 on January 20, 2009, at 20:46:55
In reply to Re: Long Term SSRI Use Has Destabilzed Me, posted by Connor on January 20, 2009, at 20:00:13
Join the club, Connor.
If we had any motivation, we could start our own advocacy group. Of course if we weren't so damn messed up, we could do things we want to do.
Let's please keep each other posted if we find anything. If I get enough energy, I want to some day start a group/message board for just this topic.
Posted by Garnet71 on January 21, 2009, at 12:14:46
In reply to Long Term SSRI Use Has Destabilzed Me, posted by NewQuestions on January 16, 2009, at 10:28:30
NewQuestions,
I was just re-reading your original post, and thought about your carb cravings. If you have excessive yeast in your body, you will crave white carbs and sugar to 'feed the yeast', to sustain it. Some say yeast causes cognitive difficulties too. I don't trust all the alternative doctors (or the conventional ones at that!), but am thinking this could be possible.
I think you should start eating yoghurt daily. Do this for months, because you may not notice right away. The homemade kind is better -instructions are on the internet. It's easy to make and you can just keep the batch in the fridge in one large bowl. Scooping up plain yoghurt in Majool dates is so yummy! If you feel you need the cookies/sugar to get by, consider eating those dates. They are expensive though, but better than candy, and full of nutrients.
There is no point for any of us to avoid changing our nutritional habits to see what helps. You never know, and it is a lot safer than taking one drug after another and risking chemical labotony.
It also could be you have several things going on at once - you could have a yeast imbalance, digestive problems, hormonal imbalance, and nutritional deficiency all at the same time!
What shocks me is that most of the doctors I have ever been too only consider that you have ONE ailment at a time -as if sickness only appears serially..lol. That's how they behave, anyway. Think out of the box...
Posted by mav27 on January 21, 2009, at 12:52:10
In reply to Re: Long Term SSRI Use Has Destabilzed Me » NewQuestions, posted by Garnet71 on January 21, 2009, at 12:14:46
Are there any alternatives to yoghurt I can't stand yoghurt. But are there any supplement type things that will give you the results you would want from him having yoghurt ?
does white carbs and sugar cravings include things like doughnuts?
Posted by MChain on January 22, 2009, at 4:06:32
In reply to Re: Long Term SSRI Use Has Destabilzed Me » Connor, posted by Garnet71 on January 20, 2009, at 20:46:55
Connor and Garnet,
I am both relieved and distressed to tell you that I feel exactly the same way you guys do. I'd like to know more particulars about your situations but let me tell you more about mine to see if you can relate.
I started a variety of SSRIs at the age of 12 for "clinical depression" and seemed to recover with the medication until around 3 years later when I noticed that I got less stimulation from the things I used to enjoy. I got off the medication for a few weeks at the age of 16 after tapering in the summer but had an unbearable time with social anxiety after returning to school and got back on the medications (this severe anxiety may have been withdrawal)
Anyway things continued more or less the same way, with constant boredom etc, and I also thought I began to notice a certain cognitive weakening, confusion and sometimes difficulty speaking. My recollection of the onset is fuzzy but it became difficult to concentrate, retain information, organize thoughts and speak.
After my first semester of college I decided I had enough and tapered quickly off the meds (zoloft at the time) and have been off for 10 months now but the status quo has seemingly not changed all that much. I managed good grades in school but didnt enjoy anything, was socially reclusive to say the least, didnt get involved in anything etc...and i still can't enjoy the things I used to movies, music, sports, nothing seems to affect me. Also I've noticed I can't cry, even at the death of close relatives for whom I feel (or once felt) much affection for.
I've felt days where things appear to be getting back to normal, like small waves, but nothing sustained. Anyway I hope you guys can relate to this and we can share our progress/trips to doctors/solutions.
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Dr. Bob is Robert Hsiung, MD,
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