Has anyone gone back on an antidepressant after time off?
May 25, 2016 9:51 AM   Subscribe

I was on multiple SSRI's during adolescence but have been off for four years. I am now considering going back on something due to increasing anxiety/panic symptoms. Does anyone have experience with this? Is it something I should look into?

I was diagnosed with OCD just as I entered middle school and was put on Zoloft. A few years later I was switched to Prozac and then took Lexapro for a period of time. This was over an eight year span.

Since going off medication four years ago, I have had many ups and downs. I have had to drop out of school multiple times and currently live at home as a young adult (although I am moving out soon). I do have a great job and many friends but despite numerous efforts to apply CBT methods and make other lifestyle changes my day-to-day existence is heavily impacted by anxiety. As of this year I have started developing symptoms of panic disorder as well, which I had never experienced before.

Over the past week or two I've had a terrible episode of acute stress which I am just now recovering from. The triggers had accumulated over time - parents getting divorced, me deciding to take another break from school, a few small health issues I've had related to chronic stress, starting to take Xanax every day when I shouldn't have been (I am now tapering off). I lost over five pounds and my sleep has still not recovered. I have been feeling some derealization as well which is obviously uncomfortable.

I've been exercising every day for a week, eating better and have been reading through my CBT/ACT workbook. I also have a therapy appointment scheduled for the end of the week. However, I've been thinking a lot about going back on meds to give myself a jump-start, if you will. The problem is that I have a lot of anxiety about this very thing. Will going back on an SSRI after four years off create issues for me? Will I suffer from different side effects from the first time around? Will they even work at all?

I've been thinking for quite some time about how eight years of antidepressant use during adolescence might have affected my brain. The benefits of trying something again probably outweigh any potential side effects or the strain I am putting on my body right now, though. It's just very, very frightening for me.
posted by wisco9 to Health & Fitness (13 answers total) 1 user marked this as a favorite
I was on Celexa for depression for a number of years, off for a few, and am now on Remeron for anxiety. My doc tried Zoloft before the Remeron, but it gave me suicidal thoughts. Now that I'm on the right med it works beautifully, exactly as intended. My anxiety is back to normal levels and all my other emotions are totally normal (I still get happy, sad, etc.) You didn't permanently change your brain by being on meds before, they were just working to supply the deficiencies in your brain chemistry. Going back on them (the same or different ones) should fix that. It's an old cliche by this point, but no one tries to tell a diabetic that they don't NEED insulin and they can get through it by sheer force of will.
posted by MsMolly at 10:01 AM on May 25, 2016 [1 favorite]

I have a history somewhat similar to yours and I did this, although my time for the first go wasn't as long as yours and I didn't go back on an SSRI/SNRI specifically because it turns out my brain doesn't handle those very well (which is why I stopped taking them in the first place.) It helped a lot to go back on and it's made all the other non-med progress toward mental health and stability a lot more possible and accessible.
posted by griphus at 10:06 AM on May 25, 2016

I can only offer you anecdata, but in my experience, revisiting SSRIs down the road after taking them previously did not create any serious issues beyond the adjusting-to-a-new-med issues anyone might have. My side effect experiences were a little different. They worked just fine. I suggest it would be worth trying - if you don't like the results you can taper off them again, you're not making an irrevocable decision.

More specific details if other people's stories are helpful for you:

- I was on an SSRI for about a year and a half during college; I probably should have been on one years sooner, but it took that long for me to work up the nerve to ask for help. It was life-changing for me and I learned a lot of good coping skills that helped me eventually need the meds less, and I went off them.
- ~9 years later, a bunch of situational stuff piled up and sent me back into a spiralling depression. I went back on the same SSRI for another year or so. I believe the side effects were less the second time, but it was long enough between that I wouldn't swear to it.
- ~7 years after that I am back on an SSRI (a different one this time, as I had PTSD on top of the depression this time and my psych felt a different medication profile was in order), and this time I think it's probably best for me to just stay on meds long-term. The side effects were different this time but I assume that's partly a matter of it being a different medication.

In every case the meds were very helpful in pulling me out of a rough patch, I think I made the right choice taking them, and I only regret not doing it sooner. I seem to have a brain that spirals every once in a while into a really bad place that I need some help digging out of. One of the few upsides to that, is that each time it happens I get a little better about catching it sooner, taking proactive steps, and taking good care of myself in a variety of ways including medical treatment.
posted by Stacey at 10:21 AM on May 25, 2016 [3 favorites]

In college I was on Amitriptyline for a number of years before tapering off. At the time, I wasn't having any problems with anxiety, but had severe depression. I had a hard time making relationships work, I withdrew from school a few times (eventually completing a degree in 7 years of real time, though really only about 5 years of school time), and was overall in a bad place. I had tried Paxil, but the SSRI really wasn't doing anything for me, whereas Amitriptyline (a tricyclic antidepressant) really seemed to help. I tapered off after leaving college, and was happily medication-free for probably 10 or 15 years.

In the last couple years I have had increasingly severe anxiety problems, coupled with a recurrence of depression, and I'm on Celexa now. It has really been a big help. I didn't want to go back on medication, though, and I think that the anxiety was working against me. It was a change, and I couldn't handle the changes that were already happening around me. The panic, the anxiety, it was bad, but I had become used to it without even realizing it, and a new variable scared me.

What MsMolly said is absolutely correct. You didn't modify your brain before, and what we deal with is an actual physical issue, with a physical cause. Exercise is great, you should keep that up. Eating better is a good idea for anybody. But also, you should discuss antidepressant medication with a doctor, and please do it soon. It is scary, but it'll be okay.
posted by curiousgene at 10:23 AM on May 25, 2016 [1 favorite]

There's nothing about having had them before that would contraindicate having them now; people do this all the time.

Keep in mind that your body has changed since then, as has the science, so what worked for you then may not work the same way or as well now, or you may have better options. Just like if you were starting for the first time, the first thing you try may not be the thing you end up with for the longer haul.

There is nothing to be terrified of here. Everything has side effects. Life has side effects, so does working, and aging, and stress, and sleep quality, and you are experiencing them and surviving even if you don't like them very much. Not being medicated has all the same risks as being medicated, from mild constipation to death, so there is no inherent security (or virtue!) in not being medicated.

Of course you're having anxiety about medication, you're having anxiety about everything right now. If you are able to sort of embrace that, in the absurdist sense of "I suppose if I wasn't freaking out about getting medicine for freaking out I wouldn't need medicine for freaking out ha ha bodies are bullshit ugh where's my cyborg nervous system already" and just remind yourself that you will still be a person with free will and can decide to do something else if trying this isn't helpful, but you won't know if you don't try.
posted by Lyn Never at 10:25 AM on May 25, 2016 [3 favorites]

I work for a psychologist, and I asked him once (out of curiosity) about long-term effects of taking antidepressants (I know he's not a psychiatrist or physician, but I value his insight), and he reassured me that the benefits of having a good quality of life with medication are worth the risks. Emphatically.

Having said that - I've gone off my meds over the years, and always ended up in some kind of "I absolutely cannot live like this" mental health crisis. I've come to terms with the fact that I do need medication to live with a good quality of life. To be a good wife, to work every day, to be able to function, to be able to laugh and take risks...

Having said THAT - it is TOTALLY worth discussing with your doctor. Each person is unique, and you may find a tiny dose could work to kick-start your therapy, or a longer, higher dose for the long-term. There is no shame in going on (or off) medications: just do it with proper supervision and some patience.
posted by Dressed to Kill at 10:27 AM on May 25, 2016 [4 favorites]

This is extremely common! I say you do have a leg up with regards to side effects. I have no idea if they will be the same if you take the same prescription again, but at least you have experienced the end results an gotten through the worry and stress of starting a new medication.

Also, I feel like both drugs and therapy make you better at dealing with mood disorders, but it doesn't necessarily cure everyone or prevent shitty things things from happening.
posted by Gor-ella at 10:30 AM on May 25, 2016

Will going back on an SSRI after four years off create issues for me? Will I suffer from different side effects from the first time around? Will they even work at all?

I've been thinking for quite some time about how eight years of antidepressant use during adolescence might have affected my brain.

I'm sure you know on some level that this is the anxiety talking and the OCD imp in your brain trying to take control. Isn't it funny that as soon as you start making those positive choices that little voice starts giving you these thoughts?

Talking to a good prescribing practitioner will help. You know meds have helped in the past. You know good food and good exercise also help. Chances are the meds will also help.

You can do this; OCD is a jerky lying monster.
posted by yes I said yes I will Yes at 10:31 AM on May 25, 2016 [4 favorites]

I've been on and off medication multiple times over the past five years, including a long stint with Lexapro. I went off that for several months, switched to something that didn't help at all and am now taking Prozac and Zispin.

Going back on medication after a period without it (admittedly not as long as you've been) was actually easier than the first time. I knew what kinds of side effects to expect, and more importantly, I knew not to freak out when it didn't immediately start working or temporarily seemed to make things worse. 'Doing treatment' is, I've found, something that you get better at with practise.

If you're thinking this much about whether to start on the medication again, it's probably a sign that you should at least seriously consider it. That's the rule I've been using for several years now, and so far it hasn't steered me wrong.
posted by anaximander at 12:32 PM on May 25, 2016

I was on Wellbutrin for several years. Then, back when there was a big problem with some of the generic versions* (which was the only thing insurance would pay for) I quit taking it.

About two years ago, I started back on Wellbutrin and am very happy I did. No problems with the generics now.

* Google "Teva Budeprion"
posted by Thorzdad at 1:03 PM on May 25, 2016

I have a similar history. Was loathe to restart a few years ago because previous SSRIs either did nothing at all or gave me weird side effects even at low doses. Luckily, my long-time healthcare provider encouraged me to try an SNRI for 1 month, which I found totally tolerable. After a week or two, I realized I hadn't even thought to check my shoes for spiders before I put them on! And that's not even what I was taking it for, so, bonus.
posted by ejvalentine at 1:24 PM on May 25, 2016

I went off antidepressants for a couple of years due to lack of insurance. I didn't experience any problems going back on them -- in fact, I actually had fewer side effects the second time around.

If you think you need to be on antidepressants or antianxiety medications, the sooner you start the better. Otherwise your brain just keeps digging deeper and deeper grooves into the depression and anxiety pathways.
posted by Jacqueline at 2:17 PM on May 25, 2016

Talk to your doctor. I've had to tweak my meds, from Prozac to Celexa, and Husbunny has tried a number of different meds at various times. He was off for a couple of years after he got his CPAP and then he went back on.

It's fine, don't fret, talk to your doctor.
posted by Ruthless Bunny at 3:02 PM on May 25, 2016

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