If coming off antidepressants, the general rule of thumb is to add up the time you have taken any antidepressant, and divide that time in half to know how long you should take to wean off while working to rebuild your ability to metabolize serotonin. If you have taken 5 years or longer, a 1 - 1.5 year taper for every 5 years on. "Time" being the focus. HOWEVER, people tapering can't know how their nervous system will respond to a decrease in medication until they try it. Each person's different and some can go faster than others. It is advised to taper no more than 2% - 10% every 2-4 week's which is a conservative, harm reduction approach. This is EXTREMELY important. Many times, withdrawal is delayed so you may be doing large cuts and feel great, actually better than ever but just be blindsided with severe, debilitating withdrawal weeks or months later and at that point it's often too late to reinstate so it's a waiting game. Please be aware most doctors follow old tapering guidelines and the majority going through withdrawal did follow their doctors tapering advice. Most doctors and pharmacists are clueless about tapering off these drug's.
These recommendations sound excessive for the majority of people on antidepressants. There are controlled studies, focused on people who had trouble stopping after rapid tapers, and even in this subset, including people who had taken antidepressants for decades, the majority safely and comfortably tapered over 2-3 months. Yes, some people will need longer tapers than this, but all available evidence is that this is a small minority.
@@DrJohnKruse Withdrawal symptoms are common after antidepressant discontinuation. If you think otherwise, you're either misinformed or ignoring the real studies. Not a cherry picked pharma study. A survey of people who tried to stop using an antidepressant in the UK last year found that 84.6% experienced withdrawal symptoms. Common withdrawal symptoms include anxiety, tearfulness, dread, numbness, brain zaps, which are described like “electric shocks,” flu-like symptoms of nausea, vomiting, and diarrhea, dizziness, fatigue, insomnia, nightmares, sexual problems, confusion, and amnesia. Withdrawal symptoms just after discontinuing an antidepressant are also associated with a 60% increase in suicide attempts. In the UK survey, symptoms did not pass quickly. Of those on antidepressants, 38.6% had withdrawal symptoms that lasted for over a year. Of those who were on multiple drugs (usually including antidepressants and benzodiazepines), more than half (56.6%) had withdrawal symptoms that lasted for over a year. When asked to rate the severity of these symptoms, the average rating was a nine out of ten. Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. Published Online March 5, 2019.
Titrating down from 75 mg to 37.5 mg of Effexor . This is an evil drug- just this reduction in mg has made me nauseous , exhausted and spaced out. This will take much longer than the 2 weeks my dr seems to think
Hi Doc, thanks so much for uploading this video. I was on 200mg sertraline for 10yrs. I've tapered off of it over the past year or so. I would reduce by 25mg and wait a few months for the symptoms to settle before going down again. My last reduction was 25mg to 0, and that was 2 months ago. Whilst the major withdrawal issues have now passed, I no longer feel like myself. Im constantly anxious, im quicker to react emotionally, my partner says im not the person he used to know. How long will it take for me to return to myself, or is this my new personality? I cant seem to stop crying, or feeling negative and low. Thanks again.
It sounds important to talk with whoever had been prescribing the sertraline, to try to sort out how much of what you are feeling now are withdrawal effects, and how much is where you are in the absence of the sertraline. It certainly sounds like you took a gradual and reasonably slow taper off.
It seems like a very simple question to answer, if you take 1000 people who were on ssri for over 5yrs and how many had issues after stopping for more than 3 months vs stopped over a few months with no major issues. You may find only 1 in 20 people have an issues and 1 in 100 have a protracted issue. Yet if you were that 1 in 100, you will be the loudest to voice the problem, which is understandable. I was on lexapro for 5yrs and stopped in 3months and had zero issies , apart from a few isolated cases of anxiety spikes
Yes, it's simple, but with most medication research funded by drug companies, none are likely to invest money (and a five year study is expensive) seeing how people do once tehy stop their medication.
You were lucky. 50% have no problems quitting. 50% have difficulty quitting. 1/4 get maximally brutal withdrawal symptoms. Many describe it as chemical torture. Then there is also a big difference between slow safe taper and too fast or c/t. And more severe if you have taken them for 15 years.
@@DrJohnKruse Something very wrong with the medical profession these days. Can't treat all people with a headache for a brain tumor. People have many life events that they just have to get over with time. A GREAT disservice has been done. Shame on us all.
@@DrJohnKruse That is a pity. I am on Whitaker's side 1000%. You people do not know what you are doing and have ruined and destroyed so many people's lives.
@@shawnleong3605Whittaker is 100% correct. Trust in the patient who is before you. no one believes my severe muscle and bone pain could be from withdrawing from effexor. I'm perceived as drug seeking because of a hyperbolic taper- down to 50 beads. Pain unbearable. I look and feel like a junkie and am treated with disdain.
Hi doctor, appreciate the video. How would you recommend coming off 25mg sertraline after being on for 16 months? I already halve a a 50mg tablet and this is the minimum tablet dosage in Australia. Should I quarter to 12.5mg? I don't think I can realistically do the 5-10% taper that most people seem to recommend.
Individuals vary incredibly in their sensitivity to these medication and their withdrawal from them. I can't make medical recommendations without a doctor patient relationship, but a two month taper is adequate for the majority of individuals who have been on these drugs for less than two years, particularly with a low dose. If you have had bad reactions on missing doses, that would be a reason for greater caution.
I'm dying every day. I was on many drugs for my OCD and then they misdiagnosed me with bipolar put me on many other drugs my life is over. It's been six months. I am off my meds, but it's like nightmare😢 Akhatisia,anhedonia, cognitive impairment, insomnia, DPDR, racing thoughts, and severe mood swings،Hyper sensitive nervous system. Hyper salivation,horrofic nightmare. I'm getting worse every day. I can't take it anymore 😢😢 I really want to live, but I can't take it anymore. I am so close to suside everyday.
I'm sorry to hear about your terrible ongoing experiences. I hope that you can find supportive family, friends, or actual support groups to get you through this time. Anxiety can certainly compound and complicate withdrawal reactions, so in similar circumstances, others try to find breathing, meditation or other approaches that help with relaxation and sleep as major factors helping with recovery.
I was put on pristiq by a doctor when I was 15, 100mg, I was on them for 10 years I weaned off over 3 months only, it’s been a year now and I am SO SICK. I was so sick from day one to now, I have autonomic nervous system dysfunction, heart rate blood pressure issues, adrenaline issues, cognitive issues, extreme pain, weakness and fatigue, heart problems, the weirdest symptoms, my only option now to get better is to try to go back on it but if i do I run the risk of having bad side effects from them and it’s not guaranteed my symptoms will get better because it’s been so long and I’m so sick now, iv lost my whole life my job, everything. I’m always in hospital and doctors and specialists no one can help me. If anyone is the same please let me know, or if someone can point me in the right direction.
How long does this last? I stopped taking sertraline and I feel as if I have shocks sent through my body and it is very uncomfortable but I am not taking that medicine again. Done with it. How long does this last tho 😢
There is a very broad range in how long withdrawal can last. The majority of individuals with any withdrawal have it resolve in just a few weeks. But for some people it can last much longer, particularly if there are feedback loops of anxiety adding to the withdrawal effects.
No one, and I say NO ONE should talk about SSRI withdrawal if he didn`t experienced it. Man, the worst is the anger. Not the electric shocks in the head, not the dizziness, not the mood swaps, not the vertigo, not the fear, not the depression. Nothing compares to the anger and pure aggression that comes with the withdrawal. What are you talking about 2-3-4 years tapering off. That`s crazy. It`s like telling an alcoholic with cirrhosis that after he had abused for 20 years he should taper off for another 4 years. If this is the case, why should one prescribe such idiotic "medicine". It`s like prescribing heroine for bad mood or depression, isn`t it? BTW, current benzos are far more efficient and fast acting with a total course of 1 month along with the boost and tapering doses. Just forget about ever taking SSRI, SNRI or similar. It`s the end of your life as you once had, remember or looking for. Just never start these. NEVER, AT ANY COST. However, if you did fell in the trap of this so called "medicine" and if you are trying to stop it ... well, perhaps you wont be able to do it or at least it will haunt you for the rest of your life. BUT TAKE MY ADVISES to protect yourself and the others around you when you go for the last 5 or 2.5 mg dose and completely stop: 1. Don`t drink alcohol. DO NOT. DON`T. DON`T YOU EVEN THINK ABOUT IT. NOT EVEN A DROP. DO NOT EVEN SNIFF. DON`T LOOK AT IT. JUST NO NO NO. 2. Avoid potentially stressful situations. Better take some days off work. Better to get at least 2 weeks off. If you are looking over your children, make sure you have a helping hand to do some stuff if you are not in good condition or if they are really young and/or annoying. 3. It is better to be in your home during this period. No vacations, no visits to parents, etc. In others homes or places there could be a lot of things that frustrate you and you most probably wouldn`t be able to be in control of them or if you try to control them, you might get yourself into some arguing situation, which is really not good for you or the people around during this period. 4. Don`t work with machinery. Avoid climbing, high altitudes etc. Get some rest. You should also know this - the horrific nightmares that you will have are pure and clear withdrawal symptom. For people like me, they are somehow interesting because they are so vivid, but also so absurd that it is like experiencing the most freaking horror-comedy-sci-fi situations without the bad consequences if it was real. Some people won`t like it. I also don`t like some of them. Particularly when the dead relatives came in around day 3-5. After that, it`s somehow easier, especially if you try to interact with the dream`s topic- just think intensively about something interesting for you the last 20-30 minutes before falling asleep (you should think about it when you are already in your bed). If there is a way to have at least some good time during withdrawal period - it is the time sleeping. 5. Talk to the people around you about what you are trying to do. They should be prepared for some arguing, bad mood, mood swings and all the idiotic behavior you might show. You should also remind yourself constantly that these are the effects of the withdrawal and find a way to calm. 6. Avoid unfriendly people and environments. 7. Consider avoiding long distance driving. 8. Try to stay in well-lit environment. Better use the sunshine during the day if possible. Dark environment during withdrawal of SSRIs is a real mood killer. 9. You should know that this is some really hard stuff to accomplish. If you get off these "medicines", then you are a hero, a legend ... or both, BUT 10. If the situation gets out of control, if you think that your actions might really hurt you or people around you, get yourself some time, take a 2.5 or 5 mg dose. Prepare yourself better for your next hit. Think over the mistakes and the solutions. SAFETY FIRST !!!
I'm sorry about your experience. The vast majority of people, even after years, can safely and without problems taper off of SSRI in two months. It is only a very small percentage who need a longer taper than that. All benzos have a potential for addiction, and virtually everyone develops tolerance to them very rapidly, so no, the evidence does not support that they are safer for anxiety, and very little data supports that they are helpful for depression.
@@DrJohnKruse Mr. John, 1. It`s not only my experience and this is the reality. No study needed, no fancy long term double blind, double visioned, spot-lighted or whatever you call it idiotic study, made by retards and paid by manufacturers of "Poison promises" will do the job. And believe me, many of your patients that are on SSRIs and especially the ones with cases like mine won`t ever come back to you. Just like I never got back to the first doctor that prescribed them to me. Another point is that not everybody is opened to talk about his failure to taper off. Just take 1000 random people between 20 and 80 and ask them if they have ever had problems with SSRIs or Benzos. Can you bet which answer will prevail? I can 2. Ok, we go ahead ... so why the initial course of SSRI and SNRI usually is prescribed along with benzos? It`s simple - they act fast and bullet-proof. You know it, you do it. I know that you know why you do it. Meanwhile, SSRI hideously makes you addicted zombie and turn your life around for years. However, the reason that pharma clusters don`t want doctors to prescribe benzos is because they are not really a money-maker. If you only take benzos, after a month you will forget the anxiety and depression and you will flawlessly finish your therapy cycle. With SSRIs you go for years supporting the pharma industry. 3. All benzos have a potential for addiction and it`s understandable. You feel good taking them. Just like alcohol, smoking, eating sweets etc. With SSRIs the addiction is 100% sure and the problem is that you don`t get anything good by taking them, it`s just that you can not stop them because of the withdrawal. You just pay the pharmas to keep yourself moving on. 4. Data supports what the money wants it to support. However, you completely flushed the water by saying that benzos are not safer for anxiety. They are not only safer, but faster and in many cases live saving drugs. This is why when you go to the ER with yet another false heart attack (consider it panic attack) they don`t inject you with SSRI, but with benzos. 5. But wait, if you are sure that SSRIs are safe and great, why don`t you try some SSRIs, for example paroxetine for just a month. To know some insights, to be a good professional. Then come again here and we will talk. I will give you some special hints how to cope with the withdrawal, I promise.
Before going completely off, I managed to stay with half of the initial dose prescribed for about a year. Then, I stopped it completely along with ceasing alcohol consumption and starting OMAD carnivore diet in the same day. It took about 1 month in horror. For me personally, I didn't want to go again in tapering off slower because it is just prolongingthe suffering. Tapering off even slowly in my previous attempts felt almost same as going off cold turky. However, thats just my case. Most probably your personal withdrawal symptomps will differ. Now I am 4 months without having them and I honestly think that I managed to cope with all the withdrawal symptoms. I also lost 15 kg. and stopped BP drugs, sleep improved a lot, mood is already regular. BTW I think summer is best for stopping SSRI, because sunshine helps a lot. Maybe you can try few times to stop meds just for few days each time and feel what symptoms you will develop and their severity. And don't worry about trying it. If things go bad, be prapared to have the pill and believe me, almost immediately all withdrawal symptompswill go away. You will then know what to expext. I wish you faith and strong will, but safety is always first. And as you know, I am not a medical professional, so this is just my personal view of the situation as a patient being on these drugs for long time and then got off. @JesusSuarez-ht4dr
Pure evidence that so named dr dont know anything except writing receipts for drugs. And about statistics. If Jordan plays 1min and make 3 shots for 3 points, statistic there is no need to play the whole team. Jordan will beat opponents alone. That's about percentage and statistics.
Your example highlights the problem of extrapolating from very small sample sizes. It would be like having had a bad withdrawal responses yourself, or knowing a few other people who had bad withdrawals means that everyone experiences this, and that it is a major public health issue. Neither the data nor clinical experience supports that conclusion.
@@DrJohnKruse well they will response just in one case. Every psychiatrist Dr before opening practice, must be for 2 years on any antidepressant( paxil or lexapro,effexor) and to follow the medicine advice going off of them. Then we/you can talk about withdrawals whether it is fiction or not. the best experience is when you experience it on your own skin, survive and then give advice and instructions. and why do these drugs have a black box warning if it is as they say.
I respect your long experience but l want to know what SSRI intefer with thyroid gland ..l was on sertaline 20mg for 2 wks when l start to improve decrease dose to 10 mg for 2wks because l developed goiter with low thyroxine 0.7 and stop sertaline.. my depressive symptoms improved but l developed sever headache and neck pain. Now can l change to escitalopram ? and what SSRI that interfere with thyroid function ?
There do seem to be some people who have thyroid problems after taking sertraline, but this is an uncommon side effect. I'm not aware of it being associated with other SSRI, but I also don't know how individuals who have had thyroid problems with sertraline do when taking a different SSRI.
Most of the doctors that i have seen at the VA medical system, won't even admit that the syndrome even exists , the ones that do, will say that it shouldn't last very long. i have been suffering with it for a year, with no help from the VA. The only way i can get any sleep is with street drugs.
Hi Doctor, thanks for the video. Question : I stopped taking citalopram it's been 6 months. I have increase in anxiety after 6 months. Is it possible to its a withdrawl symptoms ? I took citalopram 4 years
It could be. Around 6 months is the worst for many. These symptoms can last for months to years. I have anxiety and extreme physical pain, it's clearly WD. Do you just have anxiety? It may be a way to distinguish WD from ordinary anxiety.
This guy clueless. Don’t call him doctor please. You have to wait 2-5 years for the anxiety to go away when it’s refractory from stopping the antidepressant. This info doesn’t make it into the studies because this subject just isn’t studied. But patients report this online in significant numbers. If you go back on antidepressants, your nervous and whatever transport systems all over your body (central and nervous system) will be irritated again. You will have higher anxiety and whatever alphabet of “symptoms” when you quit the next time around. Or you have to stay on the antidepressant life long. And you have no idea what that shit does to your body. You could end up with a flat affect and tiny voice like the clown in this video (he is on meds too most likely.) if you have anxiety - just take it. It doesn’t make you unhealthy. But being on antidepressants does. If you don’t drink coffee, eat food from a local farm only (not the supermarket), and move different joints of your body with weight, walk outside in sunlight, and go swim outside during the summer - you may be surprised about it working quite well too.
Dear sir, last year I started to taper down from 30mg/d paroxetine to 10mg with little problems. But when I tried to go down to 5mg I suffered a lot from insomnia and postural hypotension. The latter is keeping me now bed ridden for more than a week. The moment I get up, i feel like my is head is exploding, my heart goes wild and i feel very, very terrible. I am using paroxetine since 2007 and suffered from orthostatic hypotension since the beginning but never as severe as now. Do you know of other people who suffer this much from this? I have had my heart and blood tested and they are fine. Thanks
Paroxetine is certainly the SSRI that causes the most withdrawal problems, so I usually avoid prescribing it. I haven't worked with anyone where orthostatic hypotension was a major feature of their withdrawal. I have seen some people successfully switch from paroxetine to fluoxetine (with a much longer half) life, and the successfully taper off the fluoxetine.
Sadly, SSRI withdrawal affects a lot more people than you care to admit. These antidepressants should be a last resort. And never for children, when the brain is still forming.
Actually, more rigorous data was published in the last month, supporting my statements that most individuals don't have issues with SSRI withdrawal. I agree that they should be a last resort. But the claim that never in children is inane, unless you have evidence that treating with the drugs harms their brains, rather than protects them. There is extensive evidence in adults treated with antidepressants that the medications are neuroprotective in the hippocampus. There is also extensive evidence that the more time one's brain experiences in a depressed state, the more likely they are to be depressed in the future. That could meant that depriving some children of antidepressants may consign them to a lifetime of depression.
@@DrJohnKruse Interesting. Maybe they still have some uses, but those studies, funded by pharma, have every incentive to minimize the harms. And they are all gov/pharma funded. I think the harms are much bigger than they care to admit, and the withdrawal effects may be committing to the rise of suicides. After several attempts to get off Paxil, having been on it for 25 years, I can attest to that. I finally found a way off of it, but it took much smaller dose drops over a much longer period of time than 8 weeks.
@@Snowflake1374 There is a deep-seated resistance to recognizing this as a problem, as is evident by this doctor's comments. All these studies done on SSRI withdrawal have a big financial incentive to minimize the harm. SSRIs are a cash cow. Having gone through it, I can fully understand why it might be a big cause of the suicide epidemic. When you taper too fast, it's like the nervous system collapses. The only thing is to reinstate a little higher and wait to stabilize. To suggest you can do it in two months is dismissive. These doctors are stuck reading these studies and are not talking to enough patients.
@@sd88g93 Everything went wrong for me due to Dr ignorance. They tapered off too fast. 16 years use. I have a collapsed nervous system and difficulty walking including SI. Brain pain. From normal to disabled. Scared. Tried to reinstate 3 months off but was too late, already injured. . Severe in my case. Exists but not function.
Have been on Paxil 60mg. For 23+yrs. Stopped working 3weeks ago! I am not needing it after this! I am tapering VERY slowly since it is in my system. I have so many side effects! It will be a very long w/d! Would be nice if it took less time plus there aren’t any meds to help it along!!!
Yep, that's a big dose, for a long time, with the SSRI that is most likely to cause problems, so a slow taper sounds appropriate. Some people switch over to fluoxetine/Prozac because it has a much much longer half life than paroxetine/Paxil. Most people obtain the same benefits and find it easier to taper off of, but that is something to discuss with your doctor.
I can't provide direct medical advice in this forum. The general outline is to go slowly, focus on one medication at a time, and see how your own body responds.
Thanks for the feedback. Feel free to share with others. I will probably take a week or two off near Christmas and New Years, but plan to be live on Tuesdays for the foreseeable future. (6:00 West Coast, 9:00 pm East Coast)
@@tyrel-fg7zf In contrast to antidepressant withdrawal, virtually everyone has some amount of withdrawal symptoms to benzodiazepines, like Klonopin (clonazepam). Most often it is an increase in anxiety, but headaches, tremor, and other symptoms including seizures can be present. Withdrawal is usually most severe with short acting benzodiazepines, and many people switch to longer acting benzos, like Klonopin, because usually withdrawal is less severe with them. The bigger the dose and the longer the time you were on the benzodiazepine, the more likely that withdrawal will be present and will be challenging.
My old doctor left me in a situation where I had to cold turkey Xanax and lexapro. I’ve been off Xan for 4 months now and lexapro I been off for about 2-3 weeks. I was on these for over 20yrs I have been bedridden
CVS Pharmacy PRETENDS they have no record of my SSRI prescription. SO ... I decided to pull off taking it, cold turkey. I am now known as Attila the Hun in my household. CVS is going to lose me as a customer (for ALL products) now as punishment in the Attila tredition.
I'm dying every day. I was on many drugs for my OCD and then they misdiagnosed me with bipolar put me on many other drugs my life is over. It's been six months. I am off my meds, but it's like nightmare😢 Akhatisia,anhedonia, cognitive impairment, insomnia, DPDR, racing thoughts, and severe mood swings،Hyper sensitive nervous system. Hyper salivation,horrofic nightmare. I'm getting worse every day. I can't take it anymore 😢😢 I really want to live, but I can't take it anymore. I am so close to suside everyday.
I'm so sorry about what you're going through, it sounds like torture. I'm just some random guy, so there's nothing I could say that would help you in this moment. Just know that many people in your situation have been able to recover, even when it seemed hopeless. It might seem impossible right now, but there is help out there that can find the right treatment for you. Please keep hope. There are many communities on the internet of people in similar situations to yours willing to talk about their experiences, which you can find on RUclips or Reddit. If you're thinking of doing something impulsive, please try to think about the potential future you that found the correct help and treatment and what he would like you to do today. Do not go gentle into that good night.
There's some private fb groups for people tapering antidepressants or who have cold turkeyed them that could be supportive for you. Or Inner Compass has some good information also. Try to connect on there.
If coming off antidepressants, the general rule of thumb is to add up the time you have taken any antidepressant, and divide that time in half to know how long you should take to wean off while working to rebuild your ability to metabolize serotonin. If you have taken 5 years or longer, a 1 - 1.5 year taper for every 5 years on. "Time" being the focus. HOWEVER, people tapering can't know how their nervous system will respond to a decrease in medication until they try it. Each person's different and some can go faster than others. It is advised to taper no more than
2% - 10% every 2-4 week's which is a conservative, harm reduction approach. This is EXTREMELY important. Many times, withdrawal is delayed so you may be doing large cuts and feel great, actually better than ever but just be blindsided with severe, debilitating withdrawal weeks or months later and at that point it's often too late to reinstate so it's a waiting game. Please be aware most doctors follow old tapering guidelines and the majority going through withdrawal did follow their doctors tapering advice.
Most doctors and pharmacists are clueless about tapering off these drug's.
These recommendations sound excessive for the majority of people on antidepressants. There are controlled studies, focused on people who had trouble stopping after rapid tapers, and even in this subset, including people who had taken antidepressants for decades, the majority safely and comfortably tapered over 2-3 months. Yes, some people will need longer tapers than this, but all available evidence is that this is a small minority.
@@DrJohnKruse
Withdrawal symptoms are common after antidepressant discontinuation. If you think otherwise, you're either misinformed or ignoring the real studies. Not a cherry picked pharma study.
A survey of people who tried to stop using an antidepressant in the UK last year found that 84.6% experienced withdrawal symptoms. Common withdrawal symptoms include anxiety, tearfulness, dread, numbness, brain zaps, which are described like “electric shocks,” flu-like symptoms of nausea, vomiting, and diarrhea, dizziness, fatigue, insomnia, nightmares, sexual problems, confusion, and amnesia.
Withdrawal symptoms just after discontinuing an antidepressant are also associated with a 60% increase in suicide attempts. In the UK survey, symptoms did not pass quickly. Of those on antidepressants, 38.6% had withdrawal symptoms that lasted for over a year. Of those who were on multiple drugs (usually including antidepressants and benzodiazepines), more than half (56.6%) had withdrawal symptoms that lasted for over a year. When asked to rate the severity of these symptoms, the average rating was a nine out of ten.
Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. Published Online March 5, 2019.
Thanks!
@@DrJohnKrusethere are thousands of people in the world who are in FB groups! Truly the withdrawal takes much time! Years not months or days!!!!
@@DrJohnKruselet me ask you, who provides this evidence? It is those big-Pharma sponsored scientists
Titrating down from 75 mg to 37.5 mg of Effexor . This is an evil drug- just this reduction in mg has made me nauseous , exhausted and spaced out. This will take much longer than the 2 weeks my dr seems to think
Two months is a more reasonable time frame than two weeks for most people.
Hi Doc, thanks so much for uploading this video. I was on 200mg sertraline for 10yrs. I've tapered off of it over the past year or so. I would reduce by 25mg and wait a few months for the symptoms to settle before going down again. My last reduction was 25mg to 0, and that was 2 months ago.
Whilst the major withdrawal issues have now passed, I no longer feel like myself. Im constantly anxious, im quicker to react emotionally, my partner says im not the person he used to know.
How long will it take for me to return to myself, or is this my new personality? I cant seem to stop crying, or feeling negative and low.
Thanks again.
It sounds important to talk with whoever had been prescribing the sertraline, to try to sort out how much of what you are feeling now are withdrawal effects, and how much is where you are in the absence of the sertraline. It certainly sounds like you took a gradual and reasonably slow taper off.
It seems like a very simple question to answer, if you take 1000 people who were on ssri for over 5yrs and how many had issues after stopping for more than 3 months vs stopped over a few months with no major issues.
You may find only 1 in 20 people have an issues and 1 in 100 have a protracted issue.
Yet if you were that 1 in 100, you will be the loudest to voice the problem, which is understandable.
I was on lexapro for 5yrs and stopped in 3months and had zero issies , apart from a few isolated cases of anxiety spikes
Yes, it's simple, but with most medication research funded by drug companies, none are likely to invest money (and a five year study is expensive) seeing how people do once tehy stop their medication.
You were lucky. 50% have no problems quitting. 50% have difficulty quitting. 1/4 get maximally brutal withdrawal symptoms. Many describe it as chemical torture. Then there is also a big difference between slow safe taper and too fast or c/t. And more severe if you have taken them for 15 years.
It goes on for years.
For some, but not for most.
@@DrJohnKruselies.I’ve seen so many ppl suffer.
@@DrJohnKruse
Something very wrong with the medical profession these days. Can't treat all people with a headache for a brain tumor. People have many life events that they just have to get over with time. A GREAT disservice has been done. Shame on us all.
@@DrJohnKruse How long does it go on for most people?
For many.
Have you read "Anatomy of an Epidemic" by Robert Whitaker?
I've read some of what Whitaker has written, but not the whole book. I do not share many of his conclusions.
@@DrJohnKruse That is a pity. I am on Whitaker's side 1000%. You people do not know what you are doing and have ruined and destroyed so many people's lives.
@@shawnleong3605Whittaker is 100% correct. Trust in the patient who is before you. no one believes my severe muscle and bone pain could be from withdrawing from effexor. I'm perceived as drug seeking because of a hyperbolic taper- down to 50 beads. Pain unbearable. I look and feel like a junkie and am treated with disdain.
Hi doctor, appreciate the video. How would you recommend coming off 25mg sertraline after being on for 16 months? I already halve a a 50mg tablet and this is the minimum tablet dosage in Australia. Should I quarter to 12.5mg? I don't think I can realistically do the 5-10% taper that most people seem to recommend.
Individuals vary incredibly in their sensitivity to these medication and their withdrawal from them. I can't make medical recommendations without a doctor patient relationship, but a two month taper is adequate for the majority of individuals who have been on these drugs for less than two years, particularly with a low dose. If you have had bad reactions on missing doses, that would be a reason for greater caution.
I'm dying every day. I was on many drugs for my OCD and then they misdiagnosed me with bipolar put me on many other drugs my life is over. It's been six months. I am off my meds, but it's like nightmare😢 Akhatisia,anhedonia, cognitive impairment, insomnia, DPDR, racing thoughts, and severe mood swings،Hyper sensitive nervous system. Hyper salivation,horrofic nightmare. I'm getting worse every day. I can't take it anymore 😢😢 I really want to live, but I can't take it anymore. I am so close to suside everyday.
I'm sorry to hear about your terrible ongoing experiences. I hope that you can find supportive family, friends, or actual support groups to get you through this time. Anxiety can certainly compound and complicate withdrawal reactions, so in similar circumstances, others try to find breathing, meditation or other approaches that help with relaxation and sleep as major factors helping with recovery.
I was put on pristiq by a doctor when I was 15, 100mg, I was on them for 10 years I weaned off over 3 months only, it’s been a year now and I am SO SICK. I was so sick from day one to now, I have autonomic nervous system dysfunction, heart rate blood pressure issues, adrenaline issues, cognitive issues, extreme pain, weakness and fatigue, heart problems, the weirdest symptoms, my only option now to get better is to try to go back on it but if i do I run the risk of having bad side effects from them and it’s not guaranteed my symptoms will get better because it’s been so long and I’m so sick now, iv lost my whole life my job, everything. I’m always in hospital and doctors and specialists no one can help me. If anyone is the same please let me know, or if someone can point me in the right direction.
How long does this last? I stopped taking sertraline and I feel as if I have shocks sent through my body and it is very uncomfortable but I am not taking that medicine again. Done with it. How long does this last tho 😢
There is a very broad range in how long withdrawal can last. The majority of individuals with any withdrawal have it resolve in just a few weeks. But for some people it can last much longer, particularly if there are feedback loops of anxiety adding to the withdrawal effects.
No one, and I say NO ONE should talk about SSRI withdrawal if he didn`t experienced it. Man, the worst is the anger. Not the electric shocks in the head, not the dizziness, not the mood swaps, not the vertigo, not the fear, not the depression. Nothing compares to the anger and pure aggression that comes with the withdrawal. What are you talking about 2-3-4 years tapering off. That`s crazy. It`s like telling an alcoholic with cirrhosis that after he had abused for 20 years he should taper off for another 4 years. If this is the case, why should one prescribe such idiotic "medicine". It`s like prescribing heroine for bad mood or depression, isn`t it? BTW, current benzos are far more efficient and fast acting with a total course of 1 month along with the boost and tapering doses. Just forget about ever taking SSRI, SNRI or similar. It`s the end of your life as you once had, remember or looking for. Just never start these. NEVER, AT ANY COST. However, if you did fell in the trap of this so called "medicine" and if you are trying to stop it ... well, perhaps you wont be able to do it or at least it will haunt you for the rest of your life.
BUT TAKE MY ADVISES to protect yourself and the others around you when you go for the last 5 or 2.5 mg dose and completely stop:
1. Don`t drink alcohol. DO NOT. DON`T. DON`T YOU EVEN THINK ABOUT IT. NOT EVEN A DROP. DO NOT EVEN SNIFF. DON`T LOOK AT IT. JUST NO NO NO.
2. Avoid potentially stressful situations. Better take some days off work. Better to get at least 2 weeks off. If you are looking over your children, make sure you have a helping hand to do some stuff if you are not in good condition or if they are really young and/or annoying.
3. It is better to be in your home during this period. No vacations, no visits to parents, etc. In others homes or places there could be a lot of things that frustrate you and you most probably wouldn`t be able to be in control of them or if you try to control them, you might get yourself into some arguing situation, which is really not good for you or the people around during this period.
4. Don`t work with machinery. Avoid climbing, high altitudes etc. Get some rest. You should also know this - the horrific nightmares that you will have are pure and clear withdrawal symptom. For people like me, they are somehow interesting because they are so vivid, but also so absurd that it is like experiencing the most freaking horror-comedy-sci-fi situations without the bad consequences if it was real. Some people won`t like it. I also don`t like some of them. Particularly when the dead relatives came in around day 3-5. After that, it`s somehow easier, especially if you try to interact with the dream`s topic- just think intensively about something interesting for you the last 20-30 minutes before falling asleep (you should think about it when you are already in your bed). If there is a way to have at least some good time during withdrawal period - it is the time sleeping.
5. Talk to the people around you about what you are trying to do. They should be prepared for some arguing, bad mood, mood swings and all the idiotic behavior you might show. You should also remind yourself constantly that these are the effects of the withdrawal and find a way to calm.
6. Avoid unfriendly people and environments.
7. Consider avoiding long distance driving.
8. Try to stay in well-lit environment. Better use the sunshine during the day if possible. Dark environment during withdrawal of SSRIs is a real mood killer.
9. You should know that this is some really hard stuff to accomplish. If you get off these "medicines", then you are a hero, a legend ... or both, BUT
10. If the situation gets out of control, if you think that your actions might really hurt you or people around you, get yourself some time, take a 2.5 or 5 mg dose. Prepare yourself better for your next hit. Think over the mistakes and the solutions. SAFETY FIRST !!!
I'm sorry about your experience. The vast majority of people, even after years, can safely and without problems taper off of SSRI in two months. It is only a very small percentage who need a longer taper than that. All benzos have a potential for addiction, and virtually everyone develops tolerance to them very rapidly, so no, the evidence does not support that they are safer for anxiety, and very little data supports that they are helpful for depression.
@@DrJohnKruse
Mr. John,
1. It`s not only my experience and this is the reality. No study needed, no fancy long term double blind, double visioned, spot-lighted or whatever you call it idiotic study, made by retards and paid by manufacturers of "Poison promises" will do the job. And believe me, many of your patients that are on SSRIs and especially the ones with cases like mine won`t ever come back to you. Just like I never got back to the first doctor that prescribed them to me. Another point is that not everybody is opened to talk about his failure to taper off. Just take 1000 random people between 20 and 80 and ask them if they have ever had problems with SSRIs or Benzos. Can you bet which answer will prevail? I can
2. Ok, we go ahead ... so why the initial course of SSRI and SNRI usually is prescribed along with benzos? It`s simple - they act fast and bullet-proof. You know it, you do it. I know that you know why you do it. Meanwhile, SSRI hideously makes you addicted zombie and turn your life around for years. However, the reason that pharma clusters don`t want doctors to prescribe benzos is because they are not really a money-maker. If you only take benzos, after a month you will forget the anxiety and depression and you will flawlessly finish your therapy cycle. With SSRIs you go for years supporting the pharma industry.
3. All benzos have a potential for addiction and it`s understandable. You feel good taking them. Just like alcohol, smoking, eating sweets etc. With SSRIs the addiction is 100% sure and the problem is that you don`t get anything good by taking them, it`s just that you can not stop them because of the withdrawal. You just pay the pharmas to keep yourself moving on.
4. Data supports what the money wants it to support. However, you completely flushed the water by saying that benzos are not safer for anxiety. They are not only safer, but faster and in many cases live saving drugs. This is why when you go to the ER with yet another false heart attack (consider it panic attack) they don`t inject you with SSRI, but with benzos.
5. But wait, if you are sure that SSRIs are safe and great, why don`t you try some SSRIs, for example paroxetine for just a month. To know some insights, to be a good professional. Then come again here and we will talk. I will give you some special hints how to cope with the withdrawal, I promise.
in your opinion what is better way to get off psych drugs: cold turkey or tapering off?
Before going completely off, I managed to stay with half of the initial dose prescribed for about a year. Then, I stopped it completely along with ceasing alcohol consumption and starting OMAD carnivore diet in the same day. It took about 1 month in horror. For me personally, I didn't want to go again in tapering off slower because it is just prolongingthe suffering. Tapering off even slowly in my previous attempts felt almost same as going off cold turky. However, thats just my case. Most probably your personal withdrawal symptomps will differ. Now I am 4 months without having them and I honestly think that I managed to cope with all the withdrawal symptoms. I also lost 15 kg. and stopped BP drugs, sleep improved a lot, mood is already regular. BTW I think summer is best for stopping SSRI, because sunshine helps a lot. Maybe you can try few times to stop meds just for few days each time and feel what symptoms you will develop and their severity. And don't worry about trying it. If things go bad, be prapared to have the pill and believe me, almost immediately all withdrawal symptompswill go away. You will then know what to expext. I wish you faith and strong will, but safety is always first. And as you know, I am not a medical professional, so this is just my personal view of the situation as a patient being on these drugs for long time and then got off. @JesusSuarez-ht4dr
@@standimitrov678 thanks for sharing your experience.
Pure evidence that so named dr dont know anything except writing receipts for drugs.
And about statistics. If Jordan plays 1min and make 3 shots for 3 points, statistic there is no need to play the whole team. Jordan will beat opponents alone.
That's about percentage and statistics.
Your example highlights the problem of extrapolating from very small sample sizes. It would be like having had a bad withdrawal responses yourself, or knowing a few other people who had bad withdrawals means that everyone experiences this, and that it is a major public health issue. Neither the data nor clinical experience supports that conclusion.
@@DrJohnKruse well they will response just in one case.
Every psychiatrist Dr before opening practice, must be for 2 years on any antidepressant( paxil or lexapro,effexor) and to follow the medicine advice going off of them. Then we/you can talk about withdrawals whether it is fiction or not.
the best experience is when you experience it on your own skin, survive and then give advice and instructions.
and why do these drugs have a black box warning if it is as they say.
I respect your long experience but l want to know what SSRI intefer with thyroid gland ..l was on sertaline 20mg for 2 wks when l start to improve decrease dose to 10 mg for 2wks because l developed goiter with low thyroxine 0.7 and stop sertaline.. my depressive symptoms improved but l developed sever headache and neck pain. Now can l change to escitalopram ? and what SSRI that interfere with thyroid function ?
There do seem to be some people who have thyroid problems after taking sertraline, but this is an uncommon side effect. I'm not aware of it being associated with other SSRI, but I also don't know how individuals who have had thyroid problems with sertraline do when taking a different SSRI.
Most of the doctors that i have seen at the VA medical system, won't even admit that the syndrome even exists , the ones that do, will say that it shouldn't last very long. i have been suffering with it for a year, with no help from the VA.
The only way i can get any sleep is with street drugs.
I'm sorry that the VA isn't providing the help you need.
Hi Doctor, thanks for the video. Question : I stopped taking citalopram it's been 6 months. I have increase in anxiety after 6 months. Is it possible to its a withdrawl symptoms ? I took citalopram 4 years
Most people would consider this timing to represent a recurrence of anxiety, or a new appearance of anxiety, rather than a withdrawal reaction.
It could be. Around 6 months is the worst for many. These symptoms can last for months to years.
I have anxiety and extreme physical pain, it's clearly WD. Do you just have anxiety? It may be a way to distinguish WD from ordinary anxiety.
This guy clueless. Don’t call him doctor please. You have to wait 2-5 years for the anxiety to go away when it’s refractory from stopping the antidepressant. This info doesn’t make it into the studies because this subject just isn’t studied. But patients report this online in significant numbers. If you go back on antidepressants, your nervous and whatever transport systems all over your body (central and nervous system) will be irritated again. You will have higher anxiety and whatever alphabet of “symptoms” when you quit the next time around. Or you have to stay on the antidepressant life long. And you have no idea what that shit does to your body. You could end up with a flat affect and tiny voice like the clown in this video (he is on meds too most likely.) if you have anxiety - just take it. It doesn’t make you unhealthy. But being on antidepressants does. If you don’t drink coffee, eat food from a local farm only (not the supermarket), and move different joints of your body with weight, walk outside in sunlight, and go swim outside during the summer - you may be surprised about it working quite well too.
Dear sir, last year I started to taper down from 30mg/d paroxetine to 10mg with little problems. But when I tried to go down to 5mg I suffered a lot from insomnia and postural hypotension. The latter is keeping me now bed ridden for more than a week. The moment I get up, i feel like my is head is exploding, my heart goes wild and i feel very, very terrible. I am using paroxetine since 2007 and suffered from orthostatic hypotension since the beginning but never as severe as now. Do you know of other people who suffer this much from this? I have had my heart and blood tested and they are fine. Thanks
Paroxetine is certainly the SSRI that causes the most withdrawal problems, so I usually avoid prescribing it. I haven't worked with anyone where orthostatic hypotension was a major feature of their withdrawal. I have seen some people successfully switch from paroxetine to fluoxetine (with a much longer half) life, and the successfully taper off the fluoxetine.
Sadly, SSRI withdrawal affects a lot more people than you care to admit. These antidepressants should be a last resort. And never for children, when the brain is still forming.
Actually, more rigorous data was published in the last month, supporting my statements that most individuals don't have issues with SSRI withdrawal. I agree that they should be a last resort. But the claim that never in children is inane, unless you have evidence that treating with the drugs harms their brains, rather than protects them. There is extensive evidence in adults treated with antidepressants that the medications are neuroprotective in the hippocampus. There is also extensive evidence that the more time one's brain experiences in a depressed state, the more likely they are to be depressed in the future. That could meant that depriving some children of antidepressants may consign them to a lifetime of depression.
@@DrJohnKruse Interesting. Maybe they still have some uses, but those studies, funded by pharma, have every incentive to minimize the harms. And they are all gov/pharma funded. I think the harms are much bigger than they care to admit, and the withdrawal effects may be committing to the rise of suicides.
After several attempts to get off Paxil, having been on it for 25 years, I can attest to that. I finally found a way off of it, but it took much smaller dose drops over a much longer period of time than 8 weeks.
Yes it is not few. Its affecting many long term, hundred thousands if not millions all over the world in many countries.
@@Snowflake1374 There is a deep-seated resistance to recognizing this as a problem, as is evident by this doctor's comments. All these studies done on SSRI withdrawal have a big financial incentive to minimize the harm. SSRIs are a cash cow. Having gone through it, I can fully understand why it might be a big cause of the suicide epidemic. When you taper too fast, it's like the nervous system collapses. The only thing is to reinstate a little higher and wait to stabilize. To suggest you can do it in two months is dismissive. These doctors are stuck reading these studies and are not talking to enough patients.
@@sd88g93 Everything went wrong for me due to Dr ignorance. They tapered off too fast. 16 years use. I have a collapsed nervous system and difficulty walking including SI. Brain pain. From normal to disabled. Scared. Tried to reinstate 3 months off but was too late, already injured. . Severe in my case. Exists but not function.
Have been on Paxil 60mg. For 23+yrs. Stopped working 3weeks ago! I am not needing it after this! I am tapering VERY slowly since it is in my system. I have so many side effects! It will be a very long w/d! Would be nice if it took less time plus there aren’t any meds to help it along!!!
Yep, that's a big dose, for a long time, with the SSRI that is most likely to cause problems, so a slow taper sounds appropriate. Some people switch over to fluoxetine/Prozac because it has a much much longer half life than paroxetine/Paxil. Most people obtain the same benefits and find it easier to taper off of, but that is something to discuss with your doctor.
@@DrJohnKrusea bridge or cross taper should never be suggested.
Do anyone experience flushing in the face
I've certainly seen it in some patients, particularly with SNRI, venlafaxine and duloxetine.
I've been off Citalopram since October 22 and I've been dizzy ever since surely its not still not a withdrawal side effect
While anything is possible, it sounds worth exploring other possible causes beyond SSRI withdrawal with a health professional.
How i get withdrwal from proxtine cr
Setaline
Alprazome
Kindly guide me
I can't provide direct medical advice in this forum. The general outline is to go slowly, focus on one medication at a time, and see how your own body responds.
@@DrJohnKruse thanks but as i use to withdrwal one by one i feel low focus pulpatation panic attack heart beat issue headache and brain like empty box
It's not a big deal.
Not for most, but occasionally for some.
I missed the live. Excellent video
Thanks for the feedback. Feel free to share with others. I will probably take a week or two off near Christmas and New Years, but plan to be live on Tuesdays for the foreseeable future. (6:00 West Coast, 9:00 pm East Coast)
@@tyrel-fg7zf In contrast to antidepressant withdrawal, virtually everyone has some amount of withdrawal symptoms to benzodiazepines, like Klonopin (clonazepam). Most often it is an increase in anxiety, but headaches, tremor, and other symptoms including seizures can be present. Withdrawal is usually most severe with short acting benzodiazepines, and many people switch to longer acting benzos, like Klonopin, because usually withdrawal is less severe with them. The bigger the dose and the longer the time you were on the benzodiazepine, the more likely that withdrawal will be present and will be challenging.
My old doctor left me in a situation where I had to cold turkey Xanax and lexapro. I’ve been off Xan for 4 months now and lexapro I been off for about 2-3 weeks. I was on these for over 20yrs I have been bedridden
I hope that you find appropriate help so that you can get out of bed.
CVS Pharmacy PRETENDS they have no record of my SSRI prescription. SO ... I decided to pull off taking it, cold turkey. I am now known as Attila the Hun in my household.
CVS is going to lose me as a customer (for ALL products) now as punishment in the Attila tredition.
I hope that you, and your family, gets through this withdrawal quickly.
You don't want to get mixed up with a guy like me Pee Wee. I'm a loner. A rebel.....
Someone old enough should understand why I put this comment. 😂 🚗
I'm dying every day. I was on many drugs for my OCD and then they misdiagnosed me with bipolar put me on many other drugs my life is over. It's been six months. I am off my meds, but it's like nightmare😢 Akhatisia,anhedonia, cognitive impairment, insomnia, DPDR, racing thoughts, and severe mood swings،Hyper sensitive nervous system. Hyper salivation,horrofic nightmare. I'm getting worse every day. I can't take it anymore 😢😢 I really want to live, but I can't take it anymore. I am so close to suside everyday.
I'm so sorry about what you're going through, it sounds like torture.
I'm just some random guy, so there's nothing I could say that would help you in this moment. Just know that many people in your situation have been able to recover, even when it seemed hopeless.
It might seem impossible right now, but there is help out there that can find the right treatment for you. Please keep hope.
There are many communities on the internet of people in similar situations to yours willing to talk about their experiences, which you can find on RUclips or Reddit.
If you're thinking of doing something impulsive, please try to think about the potential future you that found the correct help and treatment and what he would like you to do today.
Do not go gentle into that good night.
There's some private fb groups for people tapering antidepressants or who have cold turkeyed them that could be supportive for you. Or Inner Compass has some good information also.
Try to connect on there.