Question regarding coming off of anti-depressants
February 25, 2013 5:26 PM   Subscribe

What was your experience coming off of anti-depressants? When you were on them, did you experience blunting of feelings and emotions and when you were tapering or went off cold turkey, did you feel a return to your former self/return of your personality?

A few other questions I have regarding anti-depressants - did you find that the medication changed your ability to recall information, make you feel foggy, or have intrusive thoughts/impulses, and when you lowered the dose or went off, did that improve? If you went off of the medication and then found you needed to go back on, how long did it take you to realize you needed to go back on the medication?

For those that went off of medication - what kinds of things did you do to keep depression at bay - for example, I know that exercise, yoga and meditation are some practices that definitely help improve mood. Were you able to go off of meds completely and treat your depression through an increase in these activities (or others?)? If yes, pls share what you did that helped go med free.

Your insight/experience with taking these meds is appreciated. If you'd like to share which medications and what the dosage was/is that would be helpful too.
posted by BlueMartini7 to Health & Fitness (14 answers total) 9 users marked this as a favorite
Taper off -- slowly! And make sure you talk to a doctor first.

I went off of Zoloft cold turkey. I was out of the country, and my insurance wouldn't pay for a refill before I left, so I decided to chance it. It's miserable. Zoloft has a long half-life, as many similar drugs do, so the first two days were fine. After that, I had a miserable headache that I couldn't kill, and I got violent shakes every afternoon for about a week. Think high fever shivers, but minus the fever. I had no appetite, and no energy, and wouldn't wish that misery on anyone.

I was (and still am) on Zoloft for anxiety, and I don't have any of the symptoms you mention (recalling information, fogginess, etc.). Perhaps you're on the wrong drug -- there are so many options! Quitting cold turkey is nothing to mess with. Talk to your doctor.
posted by eenagy at 5:44 PM on February 25, 2013 [2 favorites]

I've taken Prozac twice, for about a year each time. The first time, I definitely felt a blunting of both highs and lows in my emotions. (I read the book Prozac Diary by Lauren Slater around that time and felt it very accurately portrayed my experience with the medication.) In my case this was a welcome thing at that time; the lows were so bad that losing the highs was absolutely worth it. I tapered off in a half-assed unsupervised way after about a year, and did not experience a drastic change in sense of self at that point. I think the mood peaks/troughs I was experience before I went on the meds were unhealthy and far beyond a regular mood, so by the time I was stabilized and went off the meds, I did not have those extremes of feeling to go back to. Thank goodness.

The second time, about a decade later, I did not feel the blunting of emotions to the same extent. I think because the second time I recognized what was happening and sought help sooner, so things never got to the extreme they'd gotten to the first time around. That time I also was on the meds for a bit less than a year and then eventually tapered myself off, a bit half-assedly.

Both times, I experienced about 1-2 weeks where I had some jitteriness and trouble concentrating. I adjusted quickly and had no ongoing cognitive side effects, while I was on the meds or going off them.

As for ongoing life without meds - I have dysthymia. I will always have dysthymia. I don't regulate it with any particular regimen of exercise/meditation/whatever, but as the years go by my moods and I have wrestled each other to a draw, for the most part. I've learned to monitor myself and take care of myself and, once a decade or so when things get a lot worse, to be proactive about going after meds and/or therapy to get through the major episodes.

There are a lot of meds in the world, and finding the right one for you can be so exhausting. (I've been very lucky myself to respond beautifully to the first-line treatment, but a loved one has been on the medication merry-go-round for three years now and is just beginning to settle into a good regimen. It's exhausting to watch, much less live with, much less live through.) But the right meds can change your life. You don't have to be scared of them. Hang in there, and work with your doctor, and remember that you don't have to stick with any medication that's working badly for you. And you don't necessarily have to be on meds forever, either.
posted by Stacey at 5:51 PM on February 25, 2013

I've never felt any blunting of emotions on antidepressants. For me, it's always been like tuning a radio to get a clear signal, without the static of "everything is terrible, kill yourself" getting in the way.
posted by Sidhedevil at 5:57 PM on February 25, 2013 [16 favorites]

I've tapered off of celexa/citalopram (20mg/day) following doctor's instructions, no problems. My experience was that the medication helped with all the things you mention - depression itself was making me foggy and struggling with short-term memory, and medication made me much sharper immediately. It also reduced intrusive thoughts, if anything. Because of other side effects I switched to wellbutrin/buproprion; it doesn't speed me up the way the celexa did, but doesn't have the blunting effect you're talking about either.
posted by songs about trains at 6:02 PM on February 25, 2013 [1 favorite]

What was your experience coming off of anti-depressants? When you were on them, did you experience blunting of feelings and emotions and when you were tapering or went off cold turkey, did you feel a return to your former self/return of your personality?

When I went off anti-depressants for a year, I was sad all the time for no reason, and I cried a bunch. I was happy maybe two or three days. When I went back on them... it's complicated. I think my emotions are dulled, and I don't feel affection for people I should. But I also feel a baseline level of not-sadness. Like every day I'm not sad, I'm just dull. And I can feel pleasure - I can enjoy the beach and the sunshine and my friends and alcohol and videogames. It's like resetting things to zero - I don't feel positive emotions as strongly, but I can feel them, and I don't feel negative emotions as bad.
posted by Charlemagne In Sweatpants at 7:04 PM on February 25, 2013 [1 favorite]

I'm currently in the process of tapering off Cymbalta. I've been on 60mg daily for about five years. It helped a ton when I started and I have not had problems with blunting of emotions on it. (I have heard of people having it with other drugs, though.) In the intervening five years I've acquired a bunch of coping skills I lacked when I was diagnosed (with anxiety and depression, which equals depression that often takes the form of anxiety), and I'd been feeling the urge to try quitting for a while, but had trouble timing it right because I tend to get SAD in the winter. A few months ago, having noticed that accidentally skipping pills wasn't turning out to be nearly the horrorshow that it used to be for me, I figured I must be doing ok and dropped back to 60mg every other day. So far, so good.

At this point I checked in with both my primary care doctor and my talk therapist, who I plan to keep seeing throughout the tapering process. Cymbalta has a particularly heinous discontinuation syndrome which the manufacturer lies its face off about, so I'm being extremely careful. There are several discussion forums on the internets where people talk about side effects and tapering, and the information you find on them is kind of a double-edged sword; some people have very helpful things to say that doctors don't know or aren't really supposed to tell you, and others are...well, people who have mental health problems which perhaps impact the content and quality of their postings. Anyway: I read several posts from people who (1) determined that you can take apart Cymbalta capsules and it won't kill you though the label says not to and (2) worked out gradual tapering protocols for themselves that wouldn't be possible without taking the capsules apart and (3) self-reported success without any really awful withdrawal symptoms. So I'm tapering gradually by taking pills apart, and I'm down to 15mg every other day now. So far, I have had withdrawal symptoms that are no worse than when I'd forget to take my full dose: ever so slight mood swings and a few instances of brain-zap paresthesia. (For what it's worth, the paresthesias I experience are not painful or very strong at all; I've heard other people describe them as feeling really intense and awful but mine are not.)

And for the non-meds part of the equation: exercise and meditation and yoga are all good ideas. I've been working on exercising more regularly than I ever had before, both cardio and strength, and I do notice the mood boosts. Meditation seems to be helpful, but not crucial, so I don't sweat it if I can't make much time for it. (YMMV; I am very new at meditation, so not great at it.) I've also been working hard on eating well with special attention to essential fatty acids, vitamin D, and vitamin B5 (turns into acetylcholine, which is an important neurotransmitter like serotonin and dopamine). When I feel withdrawal symptoms, my strategy is to keep my Cymbalta dose static and watch my diet and exercise extra carefully. It seems to be working well.
posted by clavicle at 7:17 PM on February 25, 2013

I had a really interesting experience with anti-depressants. I think they helped me a lot at one point in my life. I was on "a drug" and my psychiatrist started me on a low dosage and slowly built me up to "the normal dosage." I'm being intentionally vague here because the specifics aren't important. That experience was pretty crazy. Mind you, I don't partake in any other mind-altering substances. So at very low dosages I was getting bowled over by the effect. But I did plateau and eventually worked my way up.

About a year later I would tell you I wasn't depressed. However, I stopped going to the gym, I was eating compulsively, I had gained about 30 pounds, picked up smoking again, and was not sleeping well at all. By not sleeping well I mean I was getting about 3 hours of sleep for weeks at a time and operating on full-speed the next day, maybe now a nap in the middle of the day was necessary. I tried taking the meds in the morning, I tried taking them at night. Nothing worked, and I wasn't about to take Ambien to sleep better. I didn't like this. Up until that point I had been a really good sleeper - slept early and woke up early, like a clock.

I also had a significant personality change when I was on anti-depressants. Very detached, which at times was a good thing. Focused on work, which was a good thing. Not very outgoing. Unable to deal with anything too serious. My girlfriend complained at the time that I was incapable of being intimate. In retrospect, yes, there was a part of me that became severely muted, perhaps what I would call my emotional side. Now that you mention it, I did have intrusive thoughts, sometimes about aggression, but I rarely acted out on it.

It honestly took me a long while to connect this with the medication I was taking. I wasn't even really sure that was it, but my psychiatrist wasn't doing a particularly good job communicating with me. I would go to him with something and his response would be "mmhm. we'll keep things the same and see you in three months." So I decided to ween myself off it and had plenty of medication to do that with.

I would strongly recommend a week or two or more of taking a very low dosage of your medication before going off completely. I experienced rolling headaches, confusion, and generally a feeling that I was doing something wrong with my life. But that went away. I started sleeping normally almost immediately, I started going to the gym almost immediately, and I suddenly found myself able to control my appetite. It's actually kind of amazing.

All in all, I think the anti-depressants put me in a better place. But I am glad I am off them. What I think is important to do is have someone you can openly communicate your feelings to, maybe even write down the positives and negatives you are experiencing on a daily basis, because the effects are going to be a little complicated - some plusses and some minuses - and ultimately, whether or not you are going to be on medication is going to be the result of whether you think you should be on them or not. And this is very tricky. You really have to be honest with yourself.

Side note: a lot of people talk to their psychiatrist and try a couple of different drugs until they find the "right fit." This was not my experience, but it is very common.
posted by phaedon at 7:23 PM on February 25, 2013

I've no personal knowledge of antidepressants, but I'd guess it's a very good idea to stay in touch with your clinician while doing this.

I dug up what looks like good advice here:
posted by sebastienbailard at 11:46 PM on February 25, 2013 [1 favorite]

I was on Desvenlafaxine (an SNRI) for about a year. I don't remember the dosage, but it wasn't the lowest prescribed. My doctor ramped it up twice before it started working. I didn't have any of the issues you mention (blunting of feelings/emotions/fogginess/difficulty recalling information/intrusive thoughts) while on the medication - for me those were symptoms of depression that went away with the SNRI. While on it I felt like my previous self of several years before: one that I had almost forgotten existed. The one blunting effect I did notice was that I was completely unable to cry. It was a physical issue, not an emotional one. Sometimes things happened that made me feel like crying, and I'd get choked up and a burning sensation in my eyes, but the tears never actually fell. It was super weird. That effect stayed around for about six months after I stopped taking the meds.

When I went off it I tapered gradually, and experienced a few withdrawal effects ("brain zaps", clumsiness and general lack of balance, nausea, and tiredness, trouble sleeping), all of which I had also had when tapering ON to the medication in the first place. They all went away within a couple of weeks in both cases.

I didn't make any big life changes to try to keep depression at bay, but I have always eaten healthily and exercised most days. I went off the medication because I felt like I had been better for a long time and wanted to see if I would stay that way without meds. (My depression had been triggered by situational short-term-ish things with longer term-ish effects that I had since worked through in therapy. The medication was what let me keep my shit together long enough to do that therapy, and what helped me to feel okay in the process.)

A couple of times since then (several years ago now) I have wondered if the depression was coming back and considered seeing my doctor about medication again, but each time the dark mood lifted within a few weeks, which wasn't the case that first time around. I still wonder sometimes whether I am really as happy now as I was in the past and when I was on the medication, but if not, it's not really interfering with my life anymore.

My husband has been on antidepressants (SNRIs) three times now. His experience has been a bit different from mine. He does think he feels a blunting of emotions (both happy and sad) when on them, and he does notice that this goes away quite soon after coming off (and is affected very noticeably by even small changes in dosage). He also experiences other side effects from the meds that I never had after the initial few weeks, particularly insomnia.

The first two times I think he went off the meds too soon, after 3 months the first time, and after 6 months the second time. Both times it seemed obvious to me that the depression was back within a couple of months of coming off his medication, but it took him about a year each time to accept that and go back to his doctor. I think the main difference between his depression and mine is that his was untreated for many more years (about eight years, at least), while mine was not (about a year, maybe) so he has more memories of dark times and more depression-facilitating habits to overcome.
posted by lollusc at 11:53 PM on February 25, 2013

Oh, and one other thing that MAYBE was due to the meds: I found while I was on them that I was overstimulated by loud environments. I couldn't handle going to the pub or being in a busy shopping centre. Noises seemed extra loud and lights extra bright. I still, several years afterwards, find many loud environments too much to handle, but I can't be sure whether this is a lasting effect from the depression, from the medication, or just a normal part of getting older. It might be, for example, due to the fact that I avoided loud bright places for a couple of years (while depressed and while medicated) and became unused to them.
posted by lollusc at 11:58 PM on February 25, 2013

The place to go for less- or differently-biased information on antidepressants and such is Crazy Meds. Go, read. Anecdotally, my experience quitting is similar to other posters' here, so I won't repeat them.

For what it's worth, my experience with antidepressants has been much like Sidhedevil's. They didn't blunt my emotions; I still cared about the same things, I was still sad about the same things, but I wasn't paralyzed by despair or ambushed by mysterious clouds of woe. So generally a positive experience— they don't work that well for everyone, though.

If you're contemplating taking antidepressants, it really helps if you can find a doc who will listen to you when you tell them you don't like the way the meds are making you feel. You absolutely have the right to change things around if you feel blunted or foggy or even just wrong, and your doctor should be helping you with that. (On the flipside, you should try to give any change a couple of weeks at least to settle down before you decide.) All the meds are mixed bags: the might give you some things, but they might take some things as well, and people react differently. You will have to try a few to find something that you can live with.

what kinds of things did you do to keep depression at bay - for example, I know that exercise, yoga and meditation are some practices that definitely help improve mood.

To be honest, these are good things to do even if you are on meds; the drugs are just part of the equation. I do know it's not uncommon for people to take antidepressants for a while, develop non-depressed habits of thought and healthier habits of living, and then be able to go off the meds and be ok.
posted by hattifattener at 12:23 AM on February 26, 2013 [1 favorite]

I have taken several different SSRI/SNRI antidepressants over the past several years: Prozac, Celexa, Lexapro, Cymbalta, and Pristiq.

I haven't experienced blunting of emotions or personality on any of these meds, except in the desirable sense of having my anxiety dialed down to manageable levels. I still have a normal range of emotions -- I find things funny, frustrating, exciting, sad, heartwarming, etc. I haven't experienced an increase in intrusive thoughts or impulses. Quite the opposite, in fact. I had a lot of intrusive anxiety thoughts before going on the meds. Now I have far, far fewer of those thoughts, and am able to push them aside far more easily on the rare occasions they do occur.

However, on Prozac, Celexa, Lexapro, and Cymbalta, I experienced constant intense sleepiness. I slept 12-16 hours per day. Even when I was awake, I was fighting sleep so hard that I couldn't manage to get much done. But for whatever reason, Pristiq is very different for me. I still get the anxiety- and depression-reducing effects, but the sleepiness is gone.

The main things I've taken away from my experience are these:

1. SSRI/SNRI antidepressants affect different people differently. There is, unfortunately, no way to predict which one will work for a given individual other than just trying it. Corollary: You may respond very differently to one SSRI/SNRI than to another.

2. It is normal and expected to try several meds before finding one that works with your individual brain chemistry. If one has unacceptable side effects, don't just put up with it -- call your doctor back and try a different one. (The side effects you're describing, I would definitely consider unacceptable.)

My suggestions to you would be:

1. Evaluate whether it's worth your while to try different meds before deciding to go med-free entirely. Go to CrazyMeds for a decent overview of what antidepressants are available. Look at the ones you've tried and the ones you haven't. Is there a family of drugs that hit different neurotransmitters that might be worth a shot? Talk this over with your doctor.

The answer may well be that you still want to try going med-free. For all I know, you've tried everything and they all have this affect-blunting effect on you, in which case SSRIs/SNRIs may just not play well with your brain chemistry. But it's worth a careful evaluation first.

2. If you decide to go off meds, decide in advance exactly what symptoms will mean your depression has returned and you need to seek help. Like, quantitative, specific things. "I have cried at least once during five of the past seven days." "I have thought about suicide at least once a week for the past month." "I have slept more than 10 hours a day at least four times a week for a month," or "I have been unable to fall asleep at night at least three times a week for a month." Look back at the symptoms that led you to try meds in the first place to figure out what your warning signs might be. Write them down and check in with yourself frequently.

In fact, I'd do that regardless of whether you decide to go off meds or not. Depression is very good at making itself seem normal, just the way things are. It's good to have an external reality check to make sure depression is still under control.

3. Exercise, yoga, and meditation can certainly help, but you have to stay committed to practicing them regularly. I would also recommend cognitive-behavioral therapy. I tried CBT without meds first, and found that it did help me reshape my thoughts.

However, for me, depression interfered with practicing all of these things, which meant the depression got worse, which meant I was even less able to practice those things, etc. Meds were the only thing that could break that cycle for me. Your experience may be different. But it's something to be aware of.
posted by snowmentality at 11:20 AM on February 26, 2013 [1 favorite]

(Checking back in just to say: Do take a look at sebastienbailard's link, it is very good info.)
posted by clavicle at 12:09 PM on February 26, 2013

snowmentality, interesting to read what you say about the sleepiness, as I'm about to start tapering off Citolapram (Celexa) because much as my mood has improved I'm finding it increasingly difficult to not be asleep all the time. Also, libido, lack of.

As I had it explained to me, SSRI's help you build up your stores of serotonin in the brain. Then you can come off them and your brain and moods can function normally again for a while.
posted by glasseyes at 7:47 PM on February 26, 2013

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