4 ms·

> If there were substantial long-term risks associated with antidepressants, we would have seen them Drug makers have no incentive to see them. I can say from

by dimal 9y ago

> If there were substantial long-term risks associated with antidepressants, we would have seen them Drug makers have no incentive to see them. I can say from experience that I have seen them. I spent two months out of work when I had to discontinue Effexor. Other people complained about “brain zaps” and were largely ignored. My doctor never warned me. The evidence is there but there if you look, but there is no one with an economic incentive to pay attention. Just because there are few studies documenting these symptoms doesn’t mean they’re not. This is a wake up call that more studies need to be done.

DanBC 9y ago
Discontinuation effects are listed on the patient information leaflet for venlafaxine. Patients, at least in the UK, are always given this leaflet with every packet of medication. https://www.medicines.org.uk/emc/product/4487/pil https://www.medicines.org.uk/emc/product/4487/pil > If you stop taking venlafaxine suddenly you may get withdrawal reactions (see section 3) [...] > Do not stop taking your treatment or reduce the dose without the advice of your doctor even if you feel better. If your doctor thinks that you no longer need Venlafaxine tablets, he/she may ask you to reduce your dose slowly, before stopping treatment altogether. Side effects are known to occur when people stop using Venlafaxine tablets, especially when Venlafaxine tablets is stopped suddenly or the dose is reduced too quickly. Some patients may experience symptoms such as tiredness, dizziness, light-headedness, headache, sleeplessness, nightmares, dry mouth, loss of appetite, nausea, diarrhoea, nervousness, agitation, confusion, ringing in the ears, tingling or rarely, electric shock sensations, weakness, sweating, seizures or flu-like symptoms. Your doctor will advise you on how you should gradually discontinue Venlafaxine tablets treatment. If you experience any of these or other symptoms that are troublesome, ask your doctor for further advice.
- dimal 9y ago
  And of course, all patients read the long pamphlets extensively /s. We depend on our doctors to explain risks like this. And at the time I was discontinuing (not abruptly) the concept of “brain zaps” was met with great skepticism. I am fairly certain that some of the side effects you list (electric shock sensations) were added more recently. It took years of patients being ignored for the idea to be taken seriously.
  - pasabagi 9y ago
    I've also rarely received accurate advice regarding the likely effects and side-effects of anti-depressants - but I think calling brain zaps a 'risk' is a bit much. Maybe my zaps were nicer than yours, but I don't remember them being particularly painful - except one time I fell in the shower. Anti-depressants, especially something like venlafaxine, are strong meds for a strong condition. It would be surprising if they had no side effects - and honestly, if you go to a psychiatrist instead of a normal doctor, you usually get a dose that's fine-tuned to the extent that you don't get them.
    - dimal 9y ago
      Actually, I remember now, I called mine "brain shivers". Whenever I moved my head, my visual field would stutter as if the room was only lit with a strobe light. It didn't hurt, but it was nauseating and it made standing up and walking around very difficult. It was terrifying. I did go to a psychiatrist. He didn't fine tune anything, but at the time, I trusted him. In hindsight, I can see he was a terrible doctor.
    - verylittlemeat 9y ago
      I had brain zaps and they were very distracting. I took 2 SSRIs for about 3 years and went off them close to cold turkey. When I would move my eyes it felt like there was a delay between moving and seeing. This lasted for about a month. In general everything felt very disconnected/fuzzy/unreal. Sometimes it was close to what I imagine people describe as an out of body experience.
      - pasabagi 9y ago
        I think if you come off any kind of brain med cold turkey, you're gonna have a very bad time. I still find articles like the above absolutely horrible, and wish people would stop writing them. Meds saved my life. They save the life of millions of people every year - and they make depression hands-down easier to manage and to live with. That doctors over-proscribe is another problem. Muck-raking and fear-mongering about what are already scary drugs to very scared depressed people has real costs - people probably die because of articles like the above. Many, many people suffer for years without medication because they're afraid to start them.
- topmonk 9y ago
  This doesn't report the length of time one might experience these symptoms. A couple of days with the flu vs 2 months of electric shock sensations is a big difference, and could influence whether someone would want to start using these medications. (I personally experienced the latter side effect)
jdietrich 9y ago
>Drug makers have no incentive to see them. Drug makers aren't the people looking, the regulators are. Here in the UK, the medicines regulator operates an open reporting system for adverse drug effects. Any patient or healthcare professional can make a report of an adverse drug event, no matter how minor. The collected data is publicly available in anonymised summary form. 110 countries share detailed reports of adverse drug events through the WHO VigiBase, which is monitored for risk signals by a dedicated team at the Uppsala Monitoring Centre. Potential safety problems are then fed back to national regulators. All of this reporting apparatus was put in place after the thalidomide disaster. It's designed as an extremely sensitive early-warning system to detect subtle or rare adverse events. For the most part, it works. I'd suggest taking a look at the WHO Pharmaceuticals Newsletter, which shows how this information sharing works in practice. https://yellowcard.mhra.gov.uk/ https://yellowcard.mhra.gov.uk/ https://www.who-umc.org/vigibase/vigibase/ https://www.who-umc.org/vigibase/vigibase/ http://www.who.int/medicines/publications/WHO-Pharmaceuticals_Newsletter_No1-2018.pdf http://www.who.int/medicines/publications/WHO-Pharmaceutical...

by dimal 9y ago

DanBC 9y ago

Discontinuation effects are listed on the patient information leaflet for venlafaxine. Patients, at least in the UK, are always given this leaflet with every packet of medication. https://www.medicines.org.uk/emc/product/4487/pil https://www.medicines.org.uk/emc/product/4487/pil > If you stop taking venlafaxine suddenly you may get withdrawal reactions (see section 3) [...] > Do not stop taking your treatment or reduce the dose without the advice of your doctor even if you feel better. If your doctor thinks that you no longer need Venlafaxine tablets, he/she may ask you to reduce your dose slowly, before stopping treatment altogether. Side effects are known to occur when people stop using Venlafaxine tablets, especially when Venlafaxine tablets is stopped suddenly or the dose is reduced too quickly. Some patients may experience symptoms such as tiredness, dizziness, light-headedness, headache, sleeplessness, nightmares, dry mouth, loss of appetite, nausea, diarrhoea, nervousness, agitation, confusion, ringing in the ears, tingling or rarely, electric shock sensations, weakness, sweating, seizures or flu-like symptoms. Your doctor will advise you on how you should gradually discontinue Venlafaxine tablets treatment. If you experience any of these or other symptoms that are troublesome, ask your doctor for further advice.

dimal 9y ago
And of course, all patients read the long pamphlets extensively /s. We depend on our doctors to explain risks like this. And at the time I was discontinuing (not abruptly) the concept of “brain zaps” was met with great skepticism. I am fairly certain that some of the side effects you list (electric shock sensations) were added more recently. It took years of patients being ignored for the idea to be taken seriously.
- pasabagi 9y ago
  I've also rarely received accurate advice regarding the likely effects and side-effects of anti-depressants - but I think calling brain zaps a 'risk' is a bit much. Maybe my zaps were nicer than yours, but I don't remember them being particularly painful - except one time I fell in the shower. Anti-depressants, especially something like venlafaxine, are strong meds for a strong condition. It would be surprising if they had no side effects - and honestly, if you go to a psychiatrist instead of a normal doctor, you usually get a dose that's fine-tuned to the extent that you don't get them.
  - dimal 9y ago
    Actually, I remember now, I called mine "brain shivers". Whenever I moved my head, my visual field would stutter as if the room was only lit with a strobe light. It didn't hurt, but it was nauseating and it made standing up and walking around very difficult. It was terrifying. I did go to a psychiatrist. He didn't fine tune anything, but at the time, I trusted him. In hindsight, I can see he was a terrible doctor.
  - verylittlemeat 9y ago
    I had brain zaps and they were very distracting. I took 2 SSRIs for about 3 years and went off them close to cold turkey. When I would move my eyes it felt like there was a delay between moving and seeing. This lasted for about a month. In general everything felt very disconnected/fuzzy/unreal. Sometimes it was close to what I imagine people describe as an out of body experience.
    - pasabagi 9y ago
      I think if you come off any kind of brain med cold turkey, you're gonna have a very bad time. I still find articles like the above absolutely horrible, and wish people would stop writing them. Meds saved my life. They save the life of millions of people every year - and they make depression hands-down easier to manage and to live with. That doctors over-proscribe is another problem. Muck-raking and fear-mongering about what are already scary drugs to very scared depressed people has real costs - people probably die because of articles like the above. Many, many people suffer for years without medication because they're afraid to start them.
topmonk 9y ago
This doesn't report the length of time one might experience these symptoms. A couple of days with the flu vs 2 months of electric shock sensations is a big difference, and could influence whether someone would want to start using these medications. (I personally experienced the latter side effect)

jdietrich 9y ago

>Drug makers have no incentive to see them. Drug makers aren't the people looking, the regulators are. Here in the UK, the medicines regulator operates an open reporting system for adverse drug effects. Any patient or healthcare professional can make a report of an adverse drug event, no matter how minor. The collected data is publicly available in anonymised summary form. 110 countries share detailed reports of adverse drug events through the WHO VigiBase, which is monitored for risk signals by a dedicated team at the Uppsala Monitoring Centre. Potential safety problems are then fed back to national regulators. All of this reporting apparatus was put in place after the thalidomide disaster. It's designed as an extremely sensitive early-warning system to detect subtle or rare adverse events. For the most part, it works. I'd suggest taking a look at the WHO Pharmaceuticals Newsletter, which shows how this information sharing works in practice. https://yellowcard.mhra.gov.uk/ https://yellowcard.mhra.gov.uk/ https://www.who-umc.org/vigibase/vigibase/ https://www.who-umc.org/vigibase/vigibase/ http://www.who.int/medicines/publications/WHO-Pharmaceuticals_Newsletter_No1-2018.pdf http://www.who.int/medicines/publications/WHO-Pharmaceutical...