[Help] Coming off Anti Depressants

[Harry Wilson's tackle]

Out of interest H(WT), what's your take on the proven clinical effectiveness of placebo pills for depression? Some interesting stuff, if not all new, in David Robson's latest book The Expectation Effect.

A placebo effect is very simple. The subject is given a pill and told* it will cure them. If they have a certain type of illness, particularly anxiety and depression, the patient may feel better. The pill has not cured them, but their mind has triggered a cascade of events that have caused benefit. This is a real phenomenon, albeit the success rate diminishes in accordance with the severity of the condition, and the nature of the patient. For example the placebo effect would not remove pain and mend an untreated broken leg. Nor would it work on a teething baby. I would add that there may be a baby in Bolivia who was teething, and who had a leaf stroked on his head and stopped crying. That isn't the placebo effect. That is coincidence.

*Here is the problem. It is unethical to give a placebo pill (sugar coated sweetie, in effect) and tell a patient that it will cure them, if they have meaningful illness and viable treatments are available. The essence of medicine is the application of substances, exercises, lifestyle changes and other things we may call 'interventions' that have been shown (ideally in a randomized blinded trial that controls for the placebo effect) to provide added benefit (i.e., a greater chance of improvement, perhaps even a cure, compared with placebo alone).

If you think about all of this, you'd be a mug to volunteer for a placebo if you are ill.

That said, I am all for using trickery to add to the benefit of a medicine. This all very interesting from an academic point of view, too. I have had acupuncture and really enjoyed it. No obvious benefit, but I like to imagine it helped. Luckily there wasn't much wrong with me.

A mate of mine was head of anesthesiology at a big teaching hospital. He had a patient who asked if he could be hypnotized for a minor op, rather than be given anaesthetic drugs. My pal had a go, and it 'worked' (in that the patient tolerated the surgery without complaint).

Yes, the human mind can play great tricks. It is fun and interesting to explore this sort of thing. However.....I draw the line at 'alternative' treatments. Alternative means 'instead of'. These are essentially tricks that are applied instead of treatment. There have been cases of children dying because their parents have used 'alternative' healers rather than use conventional medicine to diagnose and treat what turned out to be life-threatening illness. That is criminal and a disgrace. Doing things additional to conventional medicine is fine though (if it is safe - like my taking evening primrose oil, as I do, 'for my fingers').

I looked up the book to which you refer. From a Grauniad review: "You knew about the placebo effect. But did you know it often works, a little mind-bendingly, even when the patient knows they’re taking a placebo? (This is promising, in terms of medical ethics, because it suggests that people need not be deceived in order to benefit.) And if you knew that, did you know there’s evidence that the placebo effect is growing more powerful over time, as more people learn of the placebo effect, and thus expect to experience it? That’s right: the placebo effect has a placebo effect. Expect your expectations to change your life, and they will.".

Yes. It's the placebo effect. It isn't something new. If you accept the basic premise that you can 'think' your body into changing in certain ways, and accept that rather like hypnotism it is connected with suggestibility, then these sort of books simply reduce to a sequence of anecdotes delivered for our entertainment.

Here is one for you (a bit like the blokes dying from sleep paralysis in the book). There have been numerous cases of military personnel in helicopters that have crashed into the sea dying with no identifiable injuries, and not by drowning. Similar deaths have not been reported if the helicopter crashes on land (in which case the passengers either die of physical injuries, or they don't die). What's the explanation?

The book review ends with "We defensive pessimists could do with remembering that sometimes things do actually turn out really well – especially if you expect them to.". Indeed. I would agree that expecting to succeed may give you an advantage. I am unaware of any football team that has trudged onto a pitch expecting that the far superior opposition would prevail, only to find themselves coming out on top. No, what we hear is that an underdog wins because the manager 'gave us unbelievable belief' etc.

Anyway, that's what I think. Other opinions are available

 

[Weststander]

With the best will in the world, this thread was bound to cause some anxiety.

I'm a pharmacologist, not a medic, so I know about how drugs work, and how they produce adverse effects, but a cannot give professional advice on the clinical use of drugs.

And indeed, the only advice worth anything is that we should all manage our health by working with physicians. For most of us this starts with our GP. If your mental health is too much of a challenge for the GP practice you can ask to be referred to a specialist.

Here, I appreciate there can be a huge gap in delivery. For example, getting an NHS counselling appointment is near impossible in some places. Thirty years ago I waited 6 months, and the person I saw was useless. However, you should stick with the process if you suffer from anxiety/depression.

So back to you, ignore the chatter and noise. You take some meds and they work for you. If they start to work less well go to the GP and discuss how to deal with this. There is no hidden downside that you haven't heard about, if you are on any drug that has been used in people for 10 years or more. All the newer drugs are here because they have been shown to be potentially advantageous over older drugs (for example fewer adverse effects, but perhaps a less powerful therapeutic effect).

You will have heard about cases where millions take a drug only for it to be found to have serious side effects, perhaps with a cover up by the makers. Vioxx was one (an anti inflammatory). In more recent times we have had companies in America promoting narcotic analgesics (e.g., oxycodone) to the detriment of patients. These cases are rare, and becoming rarer.

So trust your GP, but press him/her when you don't feel quite right. And don't get spooked by whimsical posts on NSC!

This 100%, listen to your GP or mental health professional (CAMHS/Wellbeing) on dosage, alternatives or going cold turkey.


A few months ago I had a conversation with an NHS Consultant Psychiatrist regarding Sertraline and that class of AD’s. He explained that often folk have a natural deficiency in Serotonin, it’s inherent. Giving rise to chronic low mood and as kids get older depression. Sertraline can 100% solve that. Nothing to be ashamed or hung up about, a lifelong cure and live.

[Other help may be required too eg CBT or counselling. Listen to the genuine professionals].

 

[Gabbafella]

I was on Seroxat after losing my mum, I wasn't in a good place at all, I was also unemployed and not in a great relationship, life in general was a bit of a mess. What made it worse was I was never that good at talking to anyone about issues so I felt very alone and thought antidepressants would help.
Obviously antidepressants are supposed to do exactly what the say on the tin, but after a while I absolutely hated them and what they did to me. I'm sure everyone is different, they almost certainly allow people to get on with their everyday lives, it allows people to think and act clearly whilst going through things, for me though I felt like they weren't allowing me to be myself, I felt mentally sluggish, like my life was in slow motion. I didn't feel happy or sad, just this empty shell trudging along, and worst of all was I hadn't grieved for my mum so all that emotion was bottled up somewhere which is never a good thing, so I made the decision to stop taking them in a way that you're told not to, I literally stopped. Supposedly very dangerous to do so probably not recommended.
Not long after coming off them, I moved to Brighton, got myself a job, a flat, had decent mates and was enjoying being myself again. I had arranged to meet up with my dad and uncle for a few beers, I felt like something wasn't quite right, I felt jittery, on edge, but went out anyway.
After about half hour in the pub I got smacked with all that emotion that I had been suppressing for all those years, I made my excuses and literally legged it home, as soon as my front door shut I broke down in floods of tears and it lasted for hours, my girlfriend came round to sit with me, I didn't really say much to her, just cried for hours and told her I missed my mum. 5 years worth of bottled up grief finally being let go was such a huge weight off and it would never have happened if I hadn't got myself of the antidepressants and allowed my body to do what it needed to do.
Sorry, I know I've waffled on, and may not even be of any use to you, just thought I'd share my experience with them. Ultimately I did change a lot of things in my life too, I dropped mates that weren't good for my mental health, finding a secure job and home to call my own was a huge help in finding happiness, I now have a fantastic girlfriend who I've been with for over 7 years, life in general is very good, but I also don't think I'd have been able to do any of that whilst suppressing my personality.

 

[Harry Wilson's tackle]

I have similar family experiences and that’s my view. Someone in my extended family has been largely depressed for 50+ years and flatly rejects any intervention, a life mainly wasted.

That raises a question of where the line should be drawn over forcible intervention. We don't 'section' people who refuse help (for depression, alcoholism and other conditions - smoking even) unless they are a significant risk to themselves or people in their care. I am not talking about paranoid schizophrenia here, which can present a threat to members of the public). This means that as you say, people can waste their lives in depression, or damage their lives and the lives of family members via booze.

Personally I would be happy with greater intervention, but it would be expensive, and people on the right and the left would be up in arms about 'the state taking over and telling us what to do'.

Thus our 'freedoms' are balanced by our right to do ourselves harm. Sadly I suspect most of us consider the balance to be about right.

 

[timbha]

I was on Seroxat after losing my mum, I wasn't in a good place at all, I was also unemployed and not in a great relationship, life in general was a bit of a mess. What made it worse was I was never that good at talking to anyone about issues so I felt very alone and thought antidepressants would help.
Obviously antidepressants are supposed to do exactly what the say on the tin, but after a while I absolutely hated them and what they did to me. I'm sure everyone is different, they almost certainly allow people to get on with their everyday lives, it allows people to think and act clearly whilst going through things, for me though I felt like they weren't allowing me to be myself, I felt mentally sluggish, like my life was in slow motion. I didn't feel happy or sad, just this empty shell trudging along, and worst of all was I hadn't grieved for my mum so all that emotion was bottled up somewhere which is never a good thing, so I made the decision to stop taking them in a way that you're told not to, I literally stopped. Supposedly very dangerous to do so probably not recommended.
Not long after coming off them, I moved to Brighton, got myself a job, a flat, had decent mates and was enjoying being myself again. I had arranged to meet up with my dad and uncle for a few beers, I felt like something wasn't quite right, I felt jittery, on edge, but went out anyway.
After about half hour in the pub I got smacked with all that emotion that I had been suppressing for all those years, I made my excuses and literally legged it home, as soon as my front door shut I broke down in floods of tears and it lasted for hours, my girlfriend came round to sit with me, I didn't really say much to her, just cried for hours and told her I missed my mum. 5 years worth of bottled up grief finally being let go was such a huge weight off and it would never have happened if I hadn't got myself of the antidepressants and allowed my body to do what it needed to do.
Sorry, I know I've waffled on, and may not even be of any use to you, just thought I'd share my experience with them. Ultimately I did change a lot of things in my life too, I dropped mates that weren't good for my mental health, finding a secure job and home to call my own was a huge help in finding happiness, I now have a fantastic girlfriend who I've been with for over 7 years, life in general is very good, but I also don't think I'd have been able to do any of that whilst suppressing my personality.

Great post.

 

[Harry Wilson's tackle]

I was on Seroxat after losing my mum, I wasn't in a good place at all, I was also unemployed and not in a great relationship, life in general was a bit of a mess. What made it worse was I was never that good at talking to anyone about issues so I felt very alone and thought antidepressants would help.
Obviously antidepressants are supposed to do exactly what the say on the tin, but after a while I absolutely hated them and what they did to me. I'm sure everyone is different, they almost certainly allow people to get on with their everyday lives, it allows people to think and act clearly whilst going through things, for me though I felt like they weren't allowing me to be myself, I felt mentally sluggish, like my life was in slow motion. I didn't feel happy or sad, just this empty shell trudging along, and worst of all was I hadn't grieved for my mum so all that emotion was bottled up somewhere which is never a good thing, so I made the decision to stop taking them in a way that you're told not to, I literally stopped. Supposedly very dangerous to do so probably not recommended.
Not long after coming off them, I moved to Brighton, got myself a job, a flat, had decent mates and was enjoying being myself again. I had arranged to meet up with my dad and uncle for a few beers, I felt like something wasn't quite right, I felt jittery, on edge, but went out anyway.
After about half hour in the pub I got smacked with all that emotion that I had been suppressing for all those years, I made my excuses and literally legged it home, as soon as my front door shut I broke down in floods of tears and it lasted for hours, my girlfriend came round to sit with me, I didn't really say much to her, just cried for hours and told her I missed my mum. 5 years worth of bottled up grief finally being let go was such a huge weight off and it would never have happened if I hadn't got myself of the antidepressants and allowed my body to do what it needed to do.
Sorry, I know I've waffled on, and may not even be of any use to you, just thought I'd share my experience with them. Ultimately I did change a lot of things in my life too, I dropped mates that weren't good for my mental health, finding a secure job and home to call my own was a huge help in finding happiness, I now have a fantastic girlfriend who I've been with for over 7 years, life in general is very good, but I also don't think I'd have been able to do any of that whilst suppressing my personality.

Again I preface this by saying I am a scientist, not a medic.

My view is that reactive depression (what you had) should NOT be treated by drugs unless you are bordering on self harm. For the very reasons you so eloquently (and movingly) explained. Something in my eye....For reactive depression a cause exists, by definition, and should be sought and addressed.

Endogenous depression (where there is no external trigger) is entirely different, and intervention to target the depression is appropriate.

The two types of depression can, unfortunately, intertwine over time, with a trigger causing a step down in affect, so mixed treatment may be necessary, but even so if my depression were reactive then I wouldn't accept medication, and I would try to fix the cause. I don't wish to be sedated.

I hope your world is back in balance

 

[Cotton Socks]

Out of interest H(WT), what's your take on the proven clinical effectiveness of placebo pills for depression? Some interesting stuff, if not all new, in David Robson's latest book The Expectation Effect.

There is a myth that has long continued that depression is 'caused' by a chemical imbalance in the brain this is no longer thought to be the case. Functional MRI imaging does show changes in the brain in patients who are experiencing depression but it is not longer thought to be the 'cause'. https://www.medicalnewstoday.com/articles/326475

David Healey in his book Psychiatric Drugs explained suggests that 50% of patients found that antidepressants had an effect, 40% taking the placebo's also found an effect. If large enough randomised control trials are carried out with sliding scale responses, even small differences in responses can give the effect of creating statistical significance, ie the anti depressants 'work'.

Drug manufacturing companies 'allegedly' do not publish the research that shows there is no statistical significance when taking anti-depressants. It's not in their interest to. Large drug companies also have the funding to carry out large scale research where for 'small scale' researchers, funding is difficult to obtain. Patient information leaflets for antidepressants now have to put 'withdrawal effects' on the sheet. These used to be called 'discontinuation symptoms' as withdrawal effects made it sound like they are addictive. Along with 'brain zaps' and other symptoms, research has shown that depression is a side effect of coming off the medication, rather than reoccurrence of depression (if that makes sense?). It does pass in most cases but for some it doesn't. How long it takes generally can depend on how long you've been taking it. If the anti-depressants have been affecting your brain chemistry then it will take some time for it to adjust without the chemicals. In the same way that starting anti-depressants can make you feel worse at 1st. I do have a lot of references for the above but it will take some time to find them all as I've read a lot on the subject. Including published peer review papers. Might be easier if I find some 'Ted Talks' on the subject.

People are different and there is no right or wrong answers, people just have to do what they feel is best for them. Good luck [MENTION=17322]Lenny Rider[/MENTION], it's good to hear that things are working out for you

P,s apologies if I have offended anyone with this post.

 

[amexer]

I’m in agreement with several others Harty.

When Mrs Corner and I got together over 20 years ago she was on Prozac for anxiety/depression. Over time I encouraged her to try and reduce them but was never wholly successful. She was keen to as well and the GP was happy to gradually put her on something a little less strong but it was pretty clear after a while that she definitely functioned better with ‘something’! The doc’s explanation was that everybody’s brain is different and that some people DO need long-term medication to keep everything balanced. That has undoubtedly proved to be correct for her.
She has been on Venlafaxine for many years now and it is definitely the right call for her.

Don’t assume it’s a bad idea to be on such medication long term and potentially for the rest of your life. Always discuss concerns with your GP - I still think that on most occasions they do know what they’re doing.

Good luck - I’m sure you’ll make the right call for you and your family

He is in touch with NHS. Dont think he is asking for advice as such. Just asking others who have had same problem how they coped. Seems sensible thing to discuss with others with same issues what ever it is

 

[Baldseagull]

A placebo effect is very simple. The subject is given a pill and told* it will cure them. If they have a certain type of illness, particularly anxiety and depression, the patient may feel better. The pill has not cured them, but their mind has triggered a cascade of events that have caused benefit. This is a real phenomenon, albeit the success rate diminishes in accordance with the severity of the condition, and the nature of the patient. For example the placebo effect would not remove pain and mend an untreated broken leg. Nor would it work on a teething baby. I would add that there may be a baby in Bolivia who was teething, and who had a leaf stroked on his head and stopped crying. That isn't the placebo effect. That is coincidence.

*Here is the problem. It is unethical to give a placebo pill (sugar coated sweetie, in effect) and tell a patient that it will cure them, if they have meaningful illness and viable treatments are available. The essence of medicine is the application of substances, exercises, lifestyle changes and other things we may call 'interventions' that have been shown (ideally in a randomized blinded trial that controls for the placebo effect) to provide added benefit (i.e., a greater chance of improvement, perhaps even a cure, compared with placebo alone).

If you think about all of this, you'd be a mug to volunteer for a placebo if you are ill.

That said, I am all for using trickery to add to the benefit of a medicine. This all very interesting from an academic point of view, too. I have had acupuncture and really enjoyed it. No obvious benefit, but I like to imagine it helped. Luckily there wasn't much wrong with me.

A mate of mine was head of anesthesiology at a big teaching hospital. He had a patient who asked if he could be hypnotized for a minor op, rather than be given anaesthetic drugs. My pal had a go, and it 'worked' (in that the patient tolerated the surgery without complaint).

Yes, the human mind can play great tricks. It is fun and interesting to explore this sort of thing. However.....I draw the line at 'alternative' treatments. Alternative means 'instead of'. These are essentially tricks that are applied instead of treatment. There have been cases of children dying because their parents have used 'alternative' healers rather than use conventional medicine to diagnose and treat what turned out to be life-threatening illness. That is criminal and a disgrace. Doing things additional to conventional medicine is fine though (if it is safe - like my taking evening primrose oil, as I do, 'for my fingers').

I looked up the book to which you refer. From a Grauniad review: "You knew about the placebo effect. But did you know it often works, a little mind-bendingly, even when the patient knows they’re taking a placebo? (This is promising, in terms of medical ethics, because it suggests that people need not be deceived in order to benefit.) And if you knew that, did you know there’s evidence that the placebo effect is growing more powerful over time, as more people learn of the placebo effect, and thus expect to experience it? That’s right: the placebo effect has a placebo effect. Expect your expectations to change your life, and they will.".

Yes. It's the placebo effect. It isn't something new. If you accept the basic premise that you can 'think' your body into changing in certain ways, and accept that rather like hypnotism it is connected with suggestibility, then these sort of books simply reduce to a sequence of anecdotes delivered for our entertainment.

Here is one for you (a bit like the blokes dying from sleep paralysis in the book). There have been numerous cases of military personnel in helicopters that have crashed into the sea dying with no identifiable injuries, and not by drowning. Similar deaths have not been reported if the helicopter crashes on land (in which case the passengers either die of physical injuries, or they don't die). What's the explanation?

The book review ends with "We defensive pessimists could do with remembering that sometimes things do actually turn out really well – especially if you expect them to.". Indeed. I would agree that expecting to succeed may give you an advantage. I am unaware of any football team that has trudged onto a pitch expecting that the far superior opposition would prevail, only to find themselves coming out on top. No, what we hear is that an underdog wins because the manager 'gave us unbelievable belief' etc.

Anyway, that's what I think. Other opinions are available

I read some time ago that Prozac, although performing better than a placebo in trials, is not very effective unless the patient knows they are taking it.
Is this something factored into trials these days? I mean, if a patient on a trial knows there is a chance they could be receiving a placebo, and they are a glass half empty sort by nature, or a depressed person, who is likely to think negatively, is the reverse placebo effect a thing that is considered?

 

[Jam The Man]

About 5 years ago I too was on Sertraline. I had become a person that people were not so keen to be around - which I’d like to think wasn’t the case beforehand - but for the life of me I couldn’t put my finger on why it was happening or what I was doing wrong.
The events that triggered me to speak to my GP were when I started getting over snappy with my little girl (obviously not physically I should add ) - the realisation of this wracked me with guilt so I sought help. My GP reassured me somewhat by saying it was just modern life, and folk have too much on their plate sometimes without realising it, and that it has become normal to go through less stable spells.

I went onto Sertraline and there’s no doubt it ‘took the edge off’.
I remained on them for 2 years before gradually weaning them off over a period of 3-4 months.

I haven’t returned to need them again but a few stresses were resurfacing about 18 months ago so I did consider it.
However, I then suffered two back to back tragedies. In June last year my best friend took his own life after a rapid MH descent into depression, and just 3 months after, my lovely Dad also passed away after two decades of various pain and suffering.
Bizarrely, off the back of these two traumatic events (when I cried more than I think I’ve ever done in my whole life) I’ve been incredibly chilled and stress free.

It’s almost become a defining moment on my life to just take one day, one week at a time. Enjoy the weekend, then start again - it’s helped me to breathe easier about the world.
Why it’s had this effect I don’t know - and I wouldn’t wish the upset I had last year on anybody - but the conscious effort of trying to worry less has just fallen into place. I’m not even bothered about Potter going! I AM peeved about him wiping out the entire coaching staff though.

It’s not that I don’t care. I care passionately about lots of things, but I simply strive to not let the stress back. Somehow it works.

I’m changing jobs after 23 years in October, and I’ve loved my job intensely - yet I haven’t fretted about this major change at all.

Life is so unpredictable, but I guess everyone has to see what works best for them. Just take it easy and focus on yourself it’s the best advice I can offer anyone.

[MENTION=17322]Lenny Rider[/MENTION]
- you know where I am for a chat

 

[Shropshire Seagull]

Not had any links to depression personally so all I can say is best wishes and good luck to all who are affected.

However, 30 years ago I was diagnosed as a type 1 diabetic [insulin dependant] and within a couple of years was prescribed a cocktail of drugs.
I put on weight during my 50's, going from mid 13 stone to 17 stone now. Researched via NHS [diabetic specialist nurse, dietician, diabetes consultant] and learnt the affects of injecting insulin 4/5/6 times every day.
Turns out that the presence of insulin in the system prevents the body from switching to fat burn but not taking insulin puts me at risk of ketoacidosis [very ill & potentially fatal].

So, to help me come to terms with being overweight I've traded the alternatives in my head.
This concluded that being overweight but with a decent quality of life trumped being lighter and unwell.

Obviously not saying this is going to be applicable for depression, just my angle of taking "life enhancing" drugs ad infinitum.

 

[Lenny Rider]

2 positives, actually 3 from this thread.

I’m not the only one in this position so I’m not alone as I felt at the darkest times, fellow NSCers are opening up which is half the battle and three, having just walked 10km, the endorphins created/given off do so much.

 

[TugWilson]

I’m sorry but that is a very different scenario to ADs and whatever your opinion, you can’t just dismiss GPs years of professional experience based on your opinion in one situation. That’s ludicrous. Anyway, back on topic…

The point you don`t seem to understand is that no matter how good your GP , he is not a Mental Health specialist , the best he can do is to refer you to your local MHCT or Mental Health Community Team . They in turn will eventually , in one instance nearly 5 months later for me , give you an initial evaluation , followed by months more waiting before you are assigned a CPN or a Psychologists appointment , after some more waiting you will get offered Medication depending on their findings based on how you felt when they first evaluated you all those months ago , which may well have got worse or changed in the mean time . As i said in total i took about 9 different types of anti-psychotics and or anti-depressants along with beta blockers and good old valium .

My first GP (now retired) actually used the phrase when examining me , " oh i don`t do heads" he openly addmitted MH was for MH specialists . A GP can however issue you with certain ADs , but without an evaluation can imo be a little hit and miss if you have a specific problem that requires tailor made drugs .

You consider me rude on this matter , what i consider rude is someone telling me that all my years at the sharp end of the stick doesn`t qualify me to offer an opinion when asked for it .

 

[Questions]

I take Citalapram and often wonder about coming off them but if they aren’t doing me any long term damage I don’t see the point.

 

[Harry Wilson's tackle]

I read some time ago that Prozac, although performing better than a placebo in trials, is not very effective unless the patient knows they are taking it.
Is this something factored into trials these days? I mean, if a patient on a trial knows there is a chance they could be receiving a placebo, and they are a glass half empty sort by nature, or a depressed person, who is likely to think negatively, is the reverse placebo effect a thing that is considered?

I don't know about that, but it would make sense that in a trial, if those on placebo don't know they are on placebo, and those on the drug know they are on the drug, the placebo effect would be bigger in the drug group.

But nobody would do a trial like that.

Also once a drug is approved there are no more trials. People are simply prescribed the drug. They would not be prescribed a placebo.

With a new drug, it would be compared in a clinical trial with no drug (disguised as a placebo) or the best in class, in either case using 'blinding' (disguising the nature of the intervention) with the choice of trial type made based on how safe it would be to 'treat' patients with nothing (a placebo). The design of clinical trials also depends on the question.

 

[portlock seagull]

The point you don`t seem to understand is that no matter how good your GP , he is not a Mental Health specialist , the best he can do is to refer you to your local MHCT or Mental Health Community Team . They in turn will eventually , in one instance nearly 5 months later for me , give you an initial evaluation , followed by months more waiting before you are assigned a CPN or a Psychologists appointment , after some more waiting you will get offered Medication depending on their findings based on how you felt when they first evaluated you all those months ago , which may well have got worse or changed in the mean time . As i said in total i took about 9 different types of anti-psychotics and or anti-depressants along with beta blockers and good old valium .

My first GP (now retired) actually used the phrase when examining me , " oh i don`t do heads" he openly addmitted MH was for MH specialists . A GP can however issue you with certain ADs , but without an evaluation can imo be a little hit and miss if you have a specific problem that requires tailor made drugs .

You consider me rude on this matter , what i consider rude is someone telling me that all my years at the sharp end of the stick doesn`t qualify me to offer an opinion when asked for it .

So now you make the rules for who can post what and when? (I never addressed anything to you). Your reply should started with a polite apology and then we’re done. Instead, you keep digging and now trying to justify your rudeness and OTT angry misinterpretation.

 

[TugWilson]

So now you make the rules for who can post what and when? (I never addressed anything to you). Your reply should started with a polite apology and then we’re done. Instead, you keep digging and now trying to justify your rudeness and OTT angry misinterpretation.

The person asking for advice from anyone was the OP . You were the one making the angry misinterpretation . If you ask an adult to read my second post to you , they may be able to point out the glaringly obvious description of my current situation , then you may choose not to be so damn precious . As for an apology

 

[portlock seagull]

The person asking for advice from anyone was the OP . You were the one making the angry misinterpretation . If you ask an adult to read my second post to you , they may be able to point out the glaringly obvious description of my current situation , then you may choose not to be so damn precious . As for an apology

You’re evidently quite angry, plus what you’ve subsequently decided to share shows you’ve not had the easiest times with mental health. I hope you manage to find some peace, get help needed and/or perhaps lashing out on NSC helps too. Better here to a stranger than otherwise. Stay safe, be kind to yourself and others too. Life’s a bit short for anything else.

 

[MattBackHome]

All the best with it, Harty x

 

[Wardy's twin]

With the best will in the world, this thread was bound to cause some anxiety.

I'm a pharmacologist, not a medic, so I know about how drugs work, and how they produce adverse effects, but a cannot give professional advice on the clinical use of drugs.

And indeed, the only advice worth anything is that we should all manage our health by working with physicians. For most of us this starts with our GP. If your mental health is too much of a challenge for the GP practice you can ask to be referred to a specialist.

Here, I appreciate there can be a huge gap in delivery. For example, getting an NHS counselling appointment is near impossible in some places. Thirty years ago I waited 6 months, and the person I saw was useless. However, you should stick with the process if you suffer from anxiety/depression.

So back to you, ignore the chatter and noise. You take some meds and they work for you. If they start to work less well go to the GP and discuss how to deal with this. There is no hidden downside that you haven't heard about, if you are on any drug that has been used in people for 10 years or more. All the newer drugs are here because they have been shown to be potentially advantageous over older drugs (for example fewer adverse effects, but perhaps a less powerful therapeutic effect).

You will have heard about cases where millions take a drug only for it to be found to have serious side effects, perhaps with a cover up by the makers. Vioxx was one (an anti inflammatory). In more recent times we have had companies in America promoting narcotic analgesics (e.g., oxycodone) to the detriment of patients. These cases are rare, and becoming rarer.

So trust your GP, but press him/her when you don't feel quite right. And don't get spooked by whimsical posts on NSC!

My GP has left it to me to decide and in the absence of side effects (other than weight gain & tiredness) I have decided to continue with them but at a much lower rate and the weight gain and sleepiness are greatly reduced.