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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by no_rose_garden on August 28, 2008, at 23:40:23
I was taking celexa (generic) for a little over 2 years and tried going off it. I was off it a little over a month, but i got worse and wasn't getting better with time, so I decided to go back on it...i've been on it about a week...and am more tired than I was.
...Thinking about trying to get off it again. Is it bad to go on/off ssri's like this? Will it eventually stop working if I don't stay consistent?
Thanks :/
Posted by Phillipa on August 28, 2008, at 23:42:23
In reply to Going on/off/on/off meds, posted by no_rose_garden on August 28, 2008, at 23:40:23
Seems to happen to those they work for don't work again. Phillipa
Posted by Racer on August 29, 2008, at 11:04:02
In reply to Going on/off/on/off meds, posted by no_rose_garden on August 28, 2008, at 23:40:23
Some people say that they won't work again, some people say they will work again -- and I say they may work again.
What happens with SSRI discontinuation is that there's a risk of rebound depression. It's not necessarily true depression -- I tend to think of it as more withdrawal, but it can spiral into true depression, so it's worth taking seriously.
The best way to avoid it is to taper off the medications. How slowly depends on the medication and the person -- Prozac, for instance, doesn't have much in the way of discontinuation symptoms, but Effexor does. And some people are more sensitive to the effects than others. (And never underestimate the psychosomatic reactions -- I know I've had psychosomatic reactions to starting medications, and they're *real,* even though I *know* that they're psychosomatic!)
My advice would be to talk to your doctor. If it sounds to him/her like discontinuation symptoms, a single low dose of Prozac can sometimes help a great deal. Or, maybe it's too soon to go off, or maybe there are stressors in your life right now that make this a bad time to go off, etc. Talking to your doctor about all those variables is a good starting point.
By the way, why did you decide to go off?
Posted by SLS on August 29, 2008, at 13:29:37
In reply to Going on/off/on/off meds, posted by no_rose_garden on August 28, 2008, at 23:40:23
As Racer has indicated, returning to an antidepressant may or may not produce a response equipotent to the fist exposure. However, what you are doing is called "pulsing". This is usually discouraged for fear of either setting off mania or becoming treatment resistant.
- Scott
Posted by ricker on August 29, 2008, at 14:32:21
In reply to Going on/off/on/off meds, posted by no_rose_garden on August 28, 2008, at 23:40:23
> ...Thinking about trying to get off it again. Is it bad to go on/off ssri's like this? Will it eventually stop working if I don't stay consistent?
>
One would think it would be counter-productive.
Antidepressants are prescribed according to their scientific ingredients/physical actions.But..... that's where I start to scratch my head and ask, says who?
If I had a penny for every theory and or suggestion I've read, from doctors, scientists, pharmacologists and even the people that presume to know more that the so called experts??
Your question suggests taking antidepressants "as prescribed", would prevent, or, at least slow down their theraputic value.
Lots of people take them daily and lots of people experience the good old "poop-out", that is, if they are fortunate enough to get any relief to begin with.
Common sence would say yes, regular dosing is advised.
I'm beginning to think there comes a point when enough is enough. Maybe I'm out to lunch, but untill proven otherwise , I will continue to experiment with dosing. I have nothing to lose... 21 years of "regular" pill popping is getting old. Untill I find the perfect med capable of delivering theraputic relief on a consistent basis.... I'm on the fence?
Rick
Posted by copper on August 29, 2008, at 15:15:21
In reply to Re: Going on/off/on/off meds » no_rose_garden, posted by ricker on August 29, 2008, at 14:32:21
I went off effexor back in 2000 and only had to take 75mg. When I had to go back on effexor in 2001 I had to go up to 225mg for it to work again.
So I do think it does stop to work at the dose you were orginally on.
copper
Posted by ricker on August 29, 2008, at 15:49:38
In reply to Re: Going on/off/on/off meds, posted by copper on August 29, 2008, at 15:15:21
> I went off effexor back in 2000 and only had to take 75mg. When I had to go back on effexor in 2001 I had to go up to 225mg for it to work again.
>
> So I do think it does stop to work at the dose you were orginally on.
>
> copper
>Certainly everyone is unique in their response to retrials.
I've went off meds and required higher doses as well when I retried.
My current zoloft dose is 50mg as compared to 150mg 8 mths. ago so the opposite could be stated as well.
Thats not to say the medication is more or less effective.
I am not the same person I was 8 mths. ago.... meaning I have different circumstances in my life.... less stress, beter physical shape, seasonal environment etc.I really don't think it's fair to compare a drugs effectivness with dated responces as there are to many variables to consider?
Rick
Posted by no_rose_garden on August 29, 2008, at 17:52:33
In reply to Re: Going on/off/on/off meds, posted by Racer on August 29, 2008, at 11:04:02
>
> By the way, why did you decide to go off?I wasn't sure if they were working, so we did an "experiment." I went down from 40mg to 20mg for a month and didn't feel too different...just more irritable, which i could handle. So I decided to go off...It was pretty obvious at that point that they'd been doing something, but I didn't want to have to go back on and thought I could wait it out...I had to give up on that.
I just don't want to have to be on meds and depend on them and pay for them and have whatever side effects they may be causing. Since I went back on them (about a week ago) I've been super drowsy all day, but feel much better overall. It's hard to decide what I'd rather be....but with school coming soon, maybe it's best to stay on...but i wish i didn't have to
Posted by SLS on August 29, 2008, at 19:10:40
In reply to Re: Going on/off/on/off meds, posted by no_rose_garden on August 29, 2008, at 17:52:33
When I was first diagnosed properly for bipolar disorder, I was extremely angered that I should have to rely on some external substance to feel and operate normally. I didn't want to feel tethered.
Now, I am more than happy to have these substances be inside me for the rest of my life if they keep working for me. Acceptance did not come overnight.
Whether to continue or not continue taking psychotropics is a decision that very much must take into consideration one's case history. A recurrent or chronic course often suggests taking medication indefinitely, or at least until more curative treatments become available.
Yes. Relying on anything external in order to functional normally is demoralizing. Of course, there are worse things that can occur. One might not respond to any treatment conceived. Thank God that anything works at all. It is a matter of perception and attitude. The only hell that I am familiar with is my own. I have made up my mind that non-treatment is not an option for me.
Your story is, of course, different from mine. We both hope that you would no longer need drug treatment at some future point.
Good luck.
- Scott
Posted by seldomseen on August 31, 2008, at 8:15:38
In reply to Going on/off/on/off meds, posted by no_rose_garden on August 28, 2008, at 23:40:23
I'm a big taker/stopper of Prozac. I feel better, go off, start feeling bad, go back on.
I've done this for years. Prozac always works for me. For me at least, this on again off again dosing helps to prevent poop-out because I never really give it a chance to.
I don't know, it always varies from person to person.
Seldom
Posted by Phillipa on August 31, 2008, at 19:51:43
In reply to Re: Going on/off/on/off meds » no_rose_garden, posted by seldomseen on August 31, 2008, at 8:15:38
Seldom think the long life of prozac keeps it in your system too? Love Phillipa
Posted by Racer on September 1, 2008, at 15:02:50
In reply to Re: Going on/off/on/off meds » no_rose_garden, posted by seldomseen on August 31, 2008, at 8:15:38
> I'm a big taker/stopper of Prozac. I feel better, go off, start feeling bad, go back on.
>
> I don't know, it always varies from person to person.
>It also seems to vary from disorder to disorder.
Prozac taken for depression usually takes several weeks to be effective; Prozac taken for PMDD usually works almost immediately. That sort of thing reminds me of something I've always believed -- that Major Depressive Disorder (or any other psych disorder, for that matter) describes a set of symptoms, not a distinct disease state. When I think of it that way, it doesn't surprise me that people react so differently to these meds.
This is the end of the thread.
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