The People's Perspective on Medicine

The Dangerous Downsides of Antidepressants

Experience has uncovered some unanticipated downsides of antidepressants. Patients should be aware of the possibilities before they begin treatment.
Alone thoughtful sadness girl is sad at the window

When a new antidepressant made the cover of Newsweek over two decades ago, the headline announced: “Prozac: A Breakthrough Drug for Depression.” It was hoped that this medication (and many others to follow) would revolutionize the treatment of mood disorders.

There is now some doubt that these drugs have lived up to the promise, but they have made billions for drug manufacturers. Antidepressants have become one of the most prescribed categories of medicines in the U.S. It is estimated that 10% of Americans takes one of these drugs, and as many as 25% of middle-aged women depend on an antidepressant to stabilize their moods.

What Are the Downsides of Antidepressants?

What was not anticipated when these drugs were approved was the possibility that they would also have some serious side effects. One unexpected complication is hip fracture (Age and Ageing, July, 2013). Norwegian researchers reviewed data from more than 900,000 people born before 1945. They discovered roughly 40,000 hip fractures (4.4%). People taking newer generation antidepressants had a 60 to 80% increased (relative) risk of such breaks.

Antidepressants Linked to Hip Fracture:

  • Citalopram (Celexa)
  • Duloxetine (Cymbalta)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Mirtazepine (Remeron)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor)

The researchers reached the following conclusions:

“Key Points

  • The risk of hip fracture was markedly increased among older people exposed to antidepressant drugs.
  • Individuals exposed to SSRIs and other drugs with serotonergic properties were at greatest excess risk.
  • About 5% of hip fractures in Norwegian seniors were attributable to antidepressant drug exposure.”

This is a very big deal, since hip fractures are a major cause of disability and death in older people. According to the CDC, nearly 300,000 Americans over the age of 65 are admitted to hospitals each year because of hip fractures. About 1 in 5 will die within one year.

Although it is not clear why antidepressants increase the risk for broken hips, there are two possibilities. One is that drugs with a strong impact on the neurochemical serotonin may reduce bone mineral density and increase the risk for osteoporosis. The other is that antidepressants could make older people more vulnerable to falls. Weaker bones plus unsteadiness is a deadly combination.

Another Serious Complication: Bleeding

On April 29th, 2013, an article in JAMA Internal Medicine reported that SSRI-type antidepressants such as fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) were linked to an increased risk of post-surgical bleeding. The investigators hypothesize that such medications may affect blood platelets, which are responsible for blood clotting.

Because prior studies suggested that such drugs might pose a bleeding risk if taken around the time of surgery, investigators combed the records of more than half a million patients. Roughly 70,000 (13.7%) had taken one of the mentioned SSRIs or citalopram (Celexa) or escitalopram (Lexapro). The authors noted:

“Although the implications of bleeding clearly differ according to the surgical procedure, SSRI association with adverse outcomes appeared relatively consistent in a range of patient subgroups. Concern for the potential associations of SSRIs with bleeding outcomes has already been incorporated into available clinical practice references, several of which suggest stopping or holding SSRI therapy for 2 or more weeks before surgery, with particular attention to holding SSRI therapy in patients undergoing neurological or orthopedic surgery.”

That seems sensible enough, but what the researchers don’t seem to appreciate is that stopping antidepressants suddenly can trigger terrible withdrawal symptoms. When the FDA approved these drugs, most physicians and patients did not realize that there could be withdrawal symptoms if the drugs were stopped (“sudden discontinuation syndrome“). We have heard from hundreds of people who have experienced unbearable symptoms when they discontinued such drugs. This means that if surgeons tell their patients to stop an antidepressant a week or two prior to surgery, there could be hell to pay.

Sudden Withdrawal Symptoms:

  • Brain “zaps” (electric shock-like sensations in the brain)
  • Dizziness, light-headedness, vertigo, feeling faint

  • Headaches

  • Anxiety, irritability, hostility

  • Nausea, diarrhea, digestive upset

  • Tremor, hands shaking, nerve tingles, strange sensations

  • Fatigue, tiredness, lack of energy

  • Visual disturbances

Here are just a few stories from people who stopped an antidepressant medication suddenly:

“Due to a change in our insurance and lack of communication from our company, I wasn’t able to refill my prescription of Cymbalta. Saturday was my last dose and as of Monday I felt like I was losing my mind but didn’t know why. Ohhhh, how ignorance is NOT bliss in this situation.

“I’m sitting in my office and I think today was the worst physical and emotional roller coaster ride I have EVER been on. I have literally gone from wanting to scream, throw things or hit someone to crying in a matter of minutes…ALL DAY.

“My head is spinning and every 30 seconds or so, I hear this ‘whoosh, whoosh, whoosh’ in my ears (similar to hearing your pulse when you have a bad migraine). I have this creeping crawling feeling going up the back of my neck when I feel an attack coming and need to quickly excuse myself from normal conversations. These are not stressful conversation by any means. Or, I suddenly just start sweating.

“This is absolute craziness!” Shel

“I took Pristiq for about two years. I tried to taper off as my MD advised. It was over 3 weeks but I experienced terrible brain zaps, anxiety, insomnia and irritability and did not go to work for about 10 days. It was one of the worst experiences I have ever had. I am on a healthier approach to handling life’s stresses: exercise, relaxation, aromatherapy, massage and vitamin support.” Cathy

“I have now been completely sertraline free for over a month, and my withdrawal symptoms are finally gone.

“I had them all: nausea, brain shocks/zaps, vertigo, headaches, digestive problems, numbness/tingling in my hands, feet, and face.

“I’m writing to let you know that it does get better, even on days when you think you cannot possibly survive one more hour of feeling so sick. SSRI withdrawal is painful and scary and, as many others who have commented on this website, if I had known what it would be like to wean off of this drug I would never have taken it.” Jess

Other unexpected complications of antidepressants may include:


Diarrhea caused by bacterial infections

Driving impairment


Recognized complications of modern antidepressant medications are listed below. There are serious downsides of antidepressants in some cases.

Antidepressant Side Effects:

  • Nausea, stomach pain, constipation, diarrhea, decreased appetite, vomiting

  • Dry mouth

  • Insomnia, anxiety, tremor

  • • Dizziness, fatigue, sleepiness

  • Sweating, hot flashes

  • Blurred vision

  • Headache

  • Sexual dysfunction, lowered libido, erection difficulties, lack of orgasm

  • Liver damage

  • Serious skin reactions, rash, hives (requires immediate MD assistance!)

  • Glaucoma

  • Irregular heart rhythms

  • Bleeding problems

  • Blood pressure problems

  • Interaction with other drugs (leading to serotonin syndrome among other reactions)

  • Pneumonia

  • Seizures

  • Depressed mood, suicidal thoughts and behavior, suicide

For people with major depression, antidepressant medication can be a lifesaver. Such drugs should NEVER be discontinued suddenly or without medical supervision!

Clinical trials have not revealed all the downsides of antidepressants. Paroxetine, for example, interacts dangerously with numerous other medications (Psychopharmacology Bulletin, March 1, 2016). In reviewing these as well as side effects such as problems with male fertility, birth defects, autism, weight gain and suicidality in adolescents, the clinicians titled their article: “Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required.”

Are Antidepressants Overprescribed?

We do worry that antidepressants have been prescribed too casually. A study (Psychotherapy and Psychosomatics, online, March 27, 2013) revealed that as many as two-thirds of the patients diagnosed with depression did not actually meet criteria for major depression. Older people (over 65) were especially vulnerable to overdiagnosis. When people are inappropriately diagnosed as being seriously depressed, they frequently get psychiatric medicine-not just antidepressants but antipsychotic drugs as well. The author concludes:

“Depression overdiagnosis and overtreatment is common in community settings in the USA. There is a need for improved targeting of diagnosis and treatments of depression and other mental disorders in these settings.”

To read more about the downsides of antidepressants and learn about other ways to treat the blues, you may find our Guide to Dealing with Depression helpful.

We would also like to hear from you. How well have antidepressants worked? Did you experience side effects or withdrawal symptoms? Share your story below.

Revised 10/27/16

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Dealing with Depression

Read up on the pros and cons of popular antidepressants, along with advice on getting off drugs like Cymbalta, Effexor or Paxil; the connection between antidepressants and suicide, and Non-drug approaches.

Dealing with Depression
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I have been on every antidepressant known to man. At one point, I was on 5 of them at once! These drugs are way overprescribed, many of them off-label. I was prescribed gabapentin for sleep, then increased for anxiety, and I’m afraid to withdraw from the crap! I’ve tried, and got down to 300 mg 2x day. Any lower than that and it’s paralyzing anxiety, restless leg syndrome, insomnia, hives, tremors, etc. Friggin drug is the Devil. Never should be prescribed to anyone who isn’t epileptic.

I am on Sertraline for several years now. Tapered off in May. Felt fine for about a month. Then “crashed”. All symptoms returned.
Went back on and am stabilized now, but wonder if I can ever get off these?
This is what scares me.
I am 66 yr.old female

Oh, swell. Now I have to be concerned about breaking my hip. I wondered why my last bone density test revealed osteopenia and risk of hip fracture. I get plenty of calcium from my diet; take vitamin D3, and magnesium supplements. My internist doesn’t want me taking calcium supplements anymore due to some evidence it harms the arteries and therefore the heart.

What’s missing is that I don’t exercise enough. I usually feel too lousy to exercise. By lousy, I mean mood, arthritic pain, and muscle spasms. I’ve been taking antidepressants off and on for 30+ years, just about all of them. I guess I’d better drag myself to the gym and pray the drug combo I’m taking right now keeps working. I can tell already that it’s beginning to lose its effectiveness.

KAREN AND KENYA – For what it’s worth, I think Paxil is the worst anti-depressant I’ve ever used. If it works for others, that’s great. All it did for me was cause weight gain and constant fatigue. It’s short half-life makes it difficult to discontinue. PLEASE don’t discontinue without medical supervision, and do it very, very gradually unless you want to land in the emergency room. Some doctors don’t think you need to taper off for as long as you really need to. You might also need an anti-anxiety med (like I did) to assist you during withdrawal. Prozac has a longer half-life, and is somewhat easier to discontinue, but still very gradually and under medical supervision.

I hope researchers will continue working on developing medications that finally make depression and it’s cousins a thing of the past. This illness causes so much suffering, and we lose too many to suicide. And you pharmaceutical corporations. – there isn’t time for sick people to wait for your expensive new drug patents to expire; and we know that you then tweak them a little and sell them under a new name at prices only the wealthy can afford.

I too had a bad experience with Pristiq, not only while trying to wean off of it but while taking it as well. While taking it, I developed classic serotonin syndrome symptoms: horrible hallucinations, irritability and it aggravated my existing A-fib symptoms. Getting off of it, following the directions of my psychiatrist, was even worse. I even ended up in the emergency room with myoclonus and A-fib so bad I passed out frequently. My psychiatrist at the time retired soon after. My new psychiatrist diagnosed me with Asperger’s syndrome. Which means I am more sensitive to anti-depressants than others. Which is something not mentioned in the article.

I have been on anti-depressents for 29 years–first Prozac, then Effexor. I have had relief from depression, with no side effects of which I am aware. I have withdrawn three times to see if I still need the medication–always very, very slowly over a three month period, choosing to be drug free in the summer when there is lots of light. Result each time: renewed depression and irritability. I stayed off for 4 months to be sure the symptoms were not from withdrawal. I resumed taking meds and symptoms were relieved. –Anne. age 77

I have been on Prozac @120mg per day for the last 13 yrs. After losing the best MD that I have had for quite awhile I have been going thru new MDs. Like water.
l was told I had clinical depression but I never felt better after all these yrs.
So I finally found a MD who would listen to ME! His therapist thinks I am bi-polar & that is why I am not getting better.I have tried suicide twice and even went thru shock therapy!!
Now I have to look forward to withdrawal symptoms from coming of my Prozac, and how am I supposed to handle that. SOMEONE PLEASE HELP!!!

Hi, I suggest you take counseling from a psychologist, someone who can even hypnotize you not to try committing suicide again, if needed.

I must say, that depression can be a side effect of something else. I had very low thyroid function that effected my intake of iron. I was already on thyroid meds, so I did not realize that with age and stress my dosage needed to be adjusted. I quickly gained weight, my moods were blue, and the headaches were severe, thus I became very depressed and did not feel like myself. Please insist on getting a full blood evaluation before starting on antidepressants.

Hello all I’ve been on pills ads since nineteen due to stress in my life from issues such as violence in the home the most distressing thing has been the weight gain of twenty two kilos I am now forty one and also just the brain fog mood swings and theft of my identity I’m planning to get off paxil but I am staying on haloperidol as preventing paranoid thoughts I just want to tell u all that prayer helps could anyone out there suggest how to wean off paxil

For depression arising from problems in personal life, counseling from a good psychologist might help you overcome the problems without getting depressed.

I have been on Pristiq for about a year and I just went off it 5 days ago cold turkey for 3 days now I have had the brain zaps diarrhea tongue and mouth moving 100 miles an hour and today cried for the first time please tell me it gets better not sleeping well and night sweats what is happening to me any comment would be helpful thanks how long will this last?

I have been on Pristiq for a year or so and took myself off cold turkey 5 days ago for 3 days I have had the brain zaps really bad and today just started crying for a second my tongue and mouth have been moving non stop for weeks but worse the past 2 days and diarrhea had been bad also its really hard most of the time I don’t like going anywhere I just want to lay around does it get better for me can anyone please talk to me and tell me I’m doing the right thing.

I have suffered from depression for many years. I take Lexapro as well as Lamotrigine for depression. The information along with study has me very concerned. I was suicidal before taking these drugs and have found that they stabilize me and are needed. I exercise and am very active and involved in many service activities in my community. I don’t know how I would function without my medication.
I am going to order the suggested material but am very scared that if I discontinue taking them, I will go back to deep depression as well as suicidal thoughts.
Thank you for publishing this information.

I am 74 and going thru withdrawl from Cymbalta, I feel like I am going crazy. I took Cymbalta for 4 years for Fibromyalgia, it was like a “miracle pill”. I could lift my legs to put on my pants, I could walk almost pain free, my joints did not hurt and most of all I was happy, friendly and able to enjoy my job. Now I am retired & miserable. I had to quit Cymbalta because the new guidelines for 2014 has more than doubled my copay PLUS Medicare has denied the refill, I have to use a less expensive alternate so my doctor gave me a script for gabapentin…
Yikes, when I picked up the script & read the side effects they are the same as what I am experiencing now with the withdrawal from Cymbalta. It does not make sense, I want to be feeling good like I was when I was taking the Cymbalta 60mg but I would be afraid to start again knowing the bad effects of coming off it. Zaps in my head, swooshing in my ears, confusion, shaking, clumsiness, blurred vision, staggering, crying over everything everyday and the worse is uncontrollable rage with throwing things, screaming, clawing my face I get so mad. I relayed this to my doctor nurse & have not heard a thing, I will make an apt & tell her in person with documentation to back up my anger.

My reply was I thought going to go the SK who wrote last August 15th about her 25 year use of heavy meds. Sorry to have posted this in the wrong place.

I’m new to this site and as a long time user of a wide variety of mood stabilizers, anti-depressants, and a few anti-psychotic meds as well. I understand your pain and concerns. I was diagnosed initially with depression, which I knew before going to see a professional. My doctor relieved my biggest fear. He assured me I was NOT Manic Depressive nor Bi-Polar. It is hereditary and I had two older siblings who had suffered from it. I was only 37 years old and the fact that I had never had experienced depression OR any severe mood swing of any nature such as my siblings had he felt assured me I was OK. Not at all in that arena. He felt a little talk therapy and an Anti-depressant for a reasonable length of time and I would be back to my “normal” self. Thus began my long bumpy, scary road to near death. Medications finally ruled my body. Without them I became severely depressed. With them I was often out of “control” so to speak. And then strangely they could lead to a more severe state of depression. I eventually got a “new” diagnosis called Bi-Polar II, not as severe as my siblings issues, but still it was not a happy day to learn this news. It was not until 2 years ago, at age 52 that my condition was so bad I attempted suicide. Not ONE person I’ve ever met could ever imagine that happening to me. The girl with the calm presence, fun, outgoing, yet smart and cautious as well. I knew that medications were killing me and who I truly was and am. Thank goodness I had a dedicated husband who could pick up the phone and call the doctor when I could not even get out of bed. He did so much research online and peppered all the professionals with questions about my unique situation. My doctors worked hard, yet there seemed to finally be no solution. My intent to write you is one of encouragement. DON’T STOP. Don’t stop searching for a doctor who FULLY understands your medical health. Yet don’t feel you can trust any doctor 100% of the time. The majority of the docs out there are smart, well educated and really do want to help their patients. They just can’t always do the job alone. Trust your gut. It’s well connected to your brain. I hope you are able to take advantage of private therapy. It really can help in so very many ways. If not private then a support group. My previous therapist taught me a ton about my illness. The one I never understood I could have. Research has proven that for people with mental illness i.e. mood disorders, etc. the BEST treatment is NOT drugs alone. It is Therapy combined with good medication management. The 3rd most effective treatment is medication alone. Our nation has become a pill popping society eager for a easy solution. We want an instant fix to ANY issue we are dealing with, whether it be our medical health or a wrong entree sent out at a sit-down restaurant. We move fast here in the states. We are PROUD of our country and all it can achieve. I could continue on complaining about big Pharm and greed and the almighty dollar. I won’t. Just wanted to give you some encouragement to keep looking. Keeping researching. You WILL find the right connection somewhere and some combination of doctors who can treat you. Until then stay diligent and mindful. Take care of yourself and DO NOT GIVE UP HOPE!!

Thank you for posting your info. Though it was from some time ago I believe it still holds true. I’ve been battling the medication management war for many years and it almost took my life. I will most definitely read the book you recommended. Had I had that information 5 years ago I may have spared myself and my family a lot of suffering and trauma.

After 3 months of decreasing my meds I stopped decreasing them because of family emergency. My doc was very upset. I take a third of the medications. My medical Dr knew what I was doing. He’s been my Dr. long before these meds. I would not decrease it without some dr. helping me. I would never tell anyone to stop their meds. There has been withdrawl symptoms that I’ve been dealing with. My mind is clearer than I can remember. Only a few people know this. My life has improved.

Again, been on Dexedrine that I need a new monthly prescription for since the age of 5 and on it, I am quiet and lazy and off I am loud, hyper and childish. Oh and I eat like a horse too but I never gain weight if I stay off because I am so hyper. I have yet to experience anything like this. But my med is a dangerous drug and I get treated poorly filling it. I just don’t understand.

Look at the newest comments on the show Pharmagegon for other ways to help depression.

I have been taking anti-depression/anxiety meds for 8 years now, paxil, lexapro, cymbalta and now the generic for effexor now that Medicaid/emblem health no longer wants to cover cymbalta, but I’ve been having issues with it that seem to be comin on now that I’m almost 2 months into it, I’m withdrawal sick the next day and it’s the extended release, I asked my doc, he says that’s odd gotta check blood work, help!!

My 77 year old father committed suicide last week. Only after this happened did we discover that he had been prescribed Celexa about 6 months ago by his family physician. No one knew he was on the medication, so the subtle signs that he was exhibiting of negative side effects were attributed to other things. He was more hostile toward my mother, had a hard time sleeping, appeared more clumsy and absent-minded. His mind was not as sharp. All things that one might attribute to old age or just a “bad day”. But looking back, it is now pretty obvious that more was going on.
If we had only known, or he had only known, that these drugs could cause the emergence of suicidal behavior. He was not the type of person to do this. I obtained a copy of his medical record. There was no documentation that the physician informed him of this potential effect. No instructions to seek counseling or psychiatric help. No instructions to return after 30 days or so to see how he was doing. Only a note that he seemed anxious because of his wife’s chronic illness. Doctors are giving these meds out like candy! If there are any citizen groups that are out there to address this issue, or to help inform the public of this horrible effect, please tell me! I am going to report this to the FDA, for whatever good it will do.

I am on Cymbalta not for depression but for one of its side effects, combating hot flashes. It has worked much better than soy, black cohash, or Estroven. I like it because it helps me to control my crying at sad stories, news programs, etc., as well as eliminating the hot flashes. I’d like to get off the Cymbalta but didn’t find anything to successfully ease the hot flashes before. Any suggestions other than those I’ve already tried?

I’ve been an RN for 35 years and unfortunately this alert is quite justified. I feel it would be irresponsible not to share this with us, given the large number of people who take the SSRI’s.
There are other serious issues with these meds. I personally have known 2 people who suicided on SSRI’s, one a teen. The behavior is indicative; quite calm and intent on their purpose, saying very little, as they discard or give away their belongings, etc. I wasn’t in a position to intervene then, so I speak out about this when I can.
As a nurse observing these trends for years,I suspect strongly that unexplained violence (ie suddenly shooting family or strangers for no reason) may be related to the SSRI’s as well. In each newspaper story there’s one line near the end, that reveals a “history of depression” or “he was being treated for depression”. It’s probable that the common practice of giving SSRIs to exhausted GI’s is contributing to some of the more bizarre incidents of violence among them also, here and abroad.
Those feelings of hopelessness are almost certainly chemical (nutritional), and LM’s benefit from the drug may be partially a placebo-effect; just believing that a drug is helping, helps. But nutritional testing to identify the imbalance, and correcting it might be better. Many people benefit emotionally from normalizing their Vitamin-D level.
The Graedons have never suggested going off any drug suddenly or without professional supervision. Many nurses are waiting and hoping for more data on these meds to come out. Most mass-media accept money to advertise SSRI’s and are reluctant to cover this type of story.
We can once again be very grateful to the courageous Graedons, who have carefully weighed their options and obligations and done the right thing.

Wow! Just happened on this information. Fourteen years ago I had a hysterectomy while on Zoloft with severe bleeding thereafter. Eventually I stopped taking Zoloft because of libido problems. The long term change I noted with Zoloft is while taking it I became unable to cry and since discontinuing, this has changed marginally with only a tear or two even when grieving the loss of a loved one.
I took Welbutrin with significant problems due to it’s effect on memory and forgetting a topic mid-sentence. These improved only about 70% and it has been several years since discontinuing.
At this point, I evaluate my ongoing depression as less concerning than the side effects of the SSRI’s. L.M.

I had a bad type of WITHDRAWAL myself from Prozac.I was having weight loss surgery and doctor told me to go off all my drugs ( 8 different ones).
I did as he instructed. The day after surgery and 2nd day without Prozac I couldn’t walk. I felt like my legs were gone. They hurt so bad I couldn’t stand the pain but yet couldn’t stand on them. Went back to hospital’s ER and my doctor met me there. We discussed what was wrong. He left and came back and ask me if I went cold turkey on all my drugs. I told him yes just like he said to.
Low and behold I was have withdrawals from Prozac. I was told to come home and take 2 then and 2 more that night. Next day all was ok. I then had to slowly stop taking Prozac. This is one withdrawal that is not mentioned anywhere and should be. Now not on but one drug due to losing 160 lbs.

Would 5-HTP be in this category? I’ve repeatedly seen how it is non-addictive and safe to use. It is however a pre-curser to serotonin.

Seems to me I’ve read that Vitamin D and fish oil (Omega 3 — could also be the algae form of this) both boost mood somehow in mildly depressed people. I forget by what mechanism — something to do with neurotransmitters. My Vitamin D was low and I started supplementing and noticed a huge boost in my mood, even though I hadn’t been particularly depressed before. Might be worth a try for those wary of the drugs.
Also, I have a question: these drugs are related to serotonin, right? Melatonin is a serotonin precursor. Does this mean that melatonin could cause these kinds of problems, too? I take this sometimes when I have problems sleeping. Not constantly or anything like that. But this makes me wonder.

Doctor prescribed Prozac for my relative who is on Plavix because of a heart attack in her early 50s caused by a blood clot. I have read that the FDA has a warning that those 2 drugs should not be taken together. Neither the doctors or the pharmacy seem to have any knowledge concerning this, or don’t think there is any reason to be concerned.
There is a genetic error (MTHFR) involved so there is no choice but to take the Plavix, and Prozac has been the only anti-depressant that has helped the depression. The side effects in trying to get off the SSRIs that didn’t work were horrendous, so there doesn’t seem to be any choice in this matter, but it’s a constant worry. I would be interested to know if any of your readers have this MTHFR genetic error.
Thank you.

I have been on different antidepressants for the last 30+ years. I don’t know what I would do without them. Chronic, long-term depression is not to be taken into your own hands. With counseling from my counselor and doctor, my depression rarely seeps through to rear its ugly head. I learned from attending many autism conferences (I have a daughter on the spectrum) basic knowledge about the brain.
I am referring specifically to serotonin deficiencies. Learning about my daughter helped me understand that I have a chemical deficiency of serotonin. I will continue on my regimen, but as one commenter posted, keep up with exercise and diet. Depression is horrible.

I’ve suffered from depression since childhood. For years I pursued an intense program of aerobics and weight training. It made the depression more manageable, but didn’t cure it. I’ve tried acupuncture. I’ve been in various regimens of talk therapy, group therapy off and on all my life. This was helpful; I didn’t feel so alone, but it didn’t cure it. I’ve been on a variety of antidepressants. For my particular case, Lexapro seems to work best.
In my case, events of depression come on rather like waves of nausea. Without the antidepressant drug, they can be incapacitating; I truly want to die. Also, without the drug, I have regular ghastly nightmares. If I miss one dose of Lexapro, the nightmares return that night.
Like other respondents, I tried to kick Lexapro last year. Effects of withdrawal were similar to those described by other respondents: weird buzzing in the brain, euphoric highs, devastating lows, strange feelings, and in my case, incidents of wild rage. I’m seventy years old. I’d never try withdrawal again without checking myself into a psych ward first, and I’d want experienced doctors to supervise the process.
On Lexapro, I sometimes just feel plain old good, like normal people feel. I can experience love, joy, empathy for others. I have good moments and good feelings. For people like myself, your warnings are certainly a matter for concern. Wish you’d proposed alternatives that would work for people like me. If you’ve never experienced authentic depression, thank your stars. Whether or not the victim elects suicide, the disease can take his life.

Two years ago I was incorrectly prescribed anti-psychotics and getting off them caused to me to have a horrible nervous/physical breakdown and extreme insomnia. It’s taken me almost 2 years to get back on my feet, I had to take anti-depressants to help my brain “even out”. The trial and error of those drugs made it worse.
Finally zoloft worked the best to even me out. It has helped with the depression and OCD for sure, but I’ve gained 25 pounds, have high blood pressure and have a lot of aches and pains. I went from an extremely in shape, mostly healthy person (if neurotic) to a physical mess.
It is unfortunate that these drugs are the only option for serious mental illness. It’s incredibly irresponsible that the majority of doctors prescribe them for minor depression/anxiety like they’re vitamins. I’ve heard it claimed that doctors don’t get kickbacks for pushing drugs, I do NOT believe that for a second!

Cymbalta has been a blessing in my life as our family has had some sad experiences to go through. Still, it is not something I wanted to be on for any length of time.
When life settled down it seemed to be a good time to wean myself from it. For years my hobby has been reading about a “Natural” lifestyle. Thus I knew about Sam E. As my supply of Cymbalta dwindled, I began adding it, in small doses, to my supplement routine.
My Cymbalta is gone but I am now more energetic and think clearer in some ways. I am grateful for the strength Cymbalta gave me in a very trying time but now I am happy to be facing life on my own. I still take Sam E as it treats other things besides depression, painful joints for one. Thanks for all your information on all subjects.

I have been taking antipsychotic and antidepressants for 25 years. I’ve always taken my medications as prescribed. I have fought for years to get my dosages reduced. I have been reducing my Seroquel for about 2 years. Doctors don’t want you to stop any medicine. How do you know the drug is even needed after taking such high dosages?
Diabetes, cataracts, and many side effects are permanent. I have so many neurological problems that may be permanent. But my research on withdrawal scares me because any more dosage reduction will be on my own.
The pychiatric profresionals need to think about what a drug does and how long is it really necessary. Once you start taking them they will change the drug with a “new and improved” and the dosage stays high.
Over the years and much Dr. shopping I have one who listens. But listening and action are two different things. It’s still an uphill battle. Was my diagnosis in the beginning correct? I’ll never know. But changes need to be made so I can have my life back.

I have taken Paxil, for anxiety, since 1999 when my husband had to have a heart stent. My docotor insisted and still does, that it has no side effects. After reading this from People’s Pharmacy, I am really bummed and ticked off! Thanks for the information, though it is probably too late to do me much good.

Your radio show and this site can be very helpful, serving up credentialed information and anecdotal natural alternatives, but this Special Alert is irresponsible and downright dangerous. (See SM’s Aug 15 comment: ” … made me feel normal on a long-term basis for the first time, ever. … going to try to be weaned off the drug, because this article has scared the heck out of me. … also scared of feeling hopeless …”)
The study cited in Age/Aging draws no firm conclusion and simply suggests that more definitive work should be done, based on the hypothesis. When and if there is harder evidence, then, maybe a carefully worded statement could be made — and, this time, with an important caveat like the one you stuck at the very bottom of the Alert (“can be a lifesaver … should never be discontinued suddenly or without medical supervision”) balanced with the assertions in the introduction.
Your audience takes your statements very seriously. Don’t feed them half baked scary stuff.
There is no doubt that antidepressant medications can indeed be lifesavers for people with major depression. Sadly, the majority of prescriptions are written for people with mild to moderate depression, for which there is little, if any, evidence of effectiveness. Take a moment to read a recent article in the New York Times by Roni Caryn Rabin titled “A Glut of Antidepressants” (Aug. 12, 2013). Here is a link:
You may also wish to listen to our Bonus Interviews with Dr. Irving Kirsch and Dr. Stephen Ilardi on the effectiveness of antidepressants:
Some people get experience fantastic improvement on modern-day antidepressants. For that we are very grateful.
But clinical trials involving thousands of patients do not demonstrate such benefit across the board. If we believe in “evidence-based medicine” and science, we have to conclude that antidepressant medications are barely better than placebo for the majority of patients. Sadly, side effects are not uncommon. That is why it is essential for each patient and provider to assess the benefits and risks of such drugs on an individual basis and monitor the situation periodically to make sure the benefits outweigh the harms.

Could the antidepressant “Serzone” have caused incontinence? I was on that for a while, maybe a year, but then I stopped it, and a short time after that, it was taken off the market.

I’ve been on fluoxetine twice, the last time for a loooooong time, and I am on it now. I was depressed on and off my whole life, and finally I could not cope with it any longer. I did talk therapy several times, but the pill made me feel normal on a long-term basis for the first time, ever.
I already have osteoporosis, so I am going to try to be weaned off the drug, because this article has scared the heck out of me. But I am also scared of feeling hopeless like I used to.

What many people are not aware of, including Physicians, and other prescribers, is the very real and deadly effect these drugs can have. I suggest obtaining the book by, Gwen Olsen, A former very successful Drug rep, who knew of these side effects when her niece was prescribed them, and took her own life. The book is called: Confessions of an Ex Rx Drug Pusher….very enlightening how our health care practioners are “educated” in this drug addicted nation. Book is less than $10 on Amazon…or look up Gwen Olsen on You Tube….Eye opening!

People taking SSRI antidepressants have more hip fractures. Assuming that therefore the SSRI’s are the CAUSE of those fractures is post hoc reasoning. (Remember: post hoc, ergo propter hoc.) It ain’t necessarily so. Those depressed people are not eating properly, not exercising properly, and so they are most likely suffering more from osteoporosis.
Could it be that the SSRIs, which often don’t help very much, don’t help these aforementioned symptoms of depression and so it is the depression, not the meds, which are the cause of the hip fractures?
One most always consider confounding variables…such as nutrition and exercise, etc. And there are always problems with epidemiological studies in that they can only ascertain association, not causation.
That said, this was a very well conducted prospective cohort study of over 900,000 Norwegians. They specifically looked at the kind of antidepressant that was taken, the length of exposure to the antidepressant and the risk of hip fracture. Because there was a distinct difference between type of antidepressant and the risk of a broken hip, the investigators felt reasonably confident that this was a true relationship.
In other words, antidepressants with no or low serotonergic properties had a lower risk. High serotonergic activity was linked to a substantially greater risk. SSRIs were 10 times more likely to cause problems than old-fashioned tricyclic antidepressants (TCAs). Other studies have demonstrated a metabolic effect on bone. SSRIs are associated with osteoporosis whereas TCAs have been linked to increased bone mineral density. If depression were the prime reason for hip fracture (poor nutrition and/or lack of exercise) then there should be no difference between classes of antidepressant medication.
There is also the issue of falls. Other studies have linked SSRI-type antidepressants to an increased risk of falling. Dr. Judi, you may wish to read the entire article so you can see for yourself. Here is one quote worth considering:
“SSRIs and other drugs with serotonergic properties may possibly contribute to an increased risk of hip fracture through falls in recently initiated treatment, due to hyponatraemia and haemodynamic disturbances, and through effects on bone physiology, assumedly impairing bone architecture and bone strength, in longer-lasting treatment.”

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