8 ms·

Antidepressants and medical uncertainty

69 points by luu 6y ago

PragmaticPulp 6y ago
My usual warning when these stories reach the front page: If you feel you might need medical help for a mental illness, please don't let stories like this dissuade you from seeking appropriate care. The author notes that the medications were effective at treating their condition. Too many people delay necessary treatment for years for fear of side effects, only to later discover that their underlying depression was far worse than any medication side effects. Medications aren't perfect, but untreated depression is no joke. The author's experience is also unlikely to match the average patient's, as their medications were also chosen to treat their very painful trigeminal neuralgia. That said, it's strange that the author's doctors didn't notice this earlier. The topic of which antidepressants cause somnolence is hardly new research. Even the author's own doctor knew that Medication 2 was responsible for the daytime sleepiness. I suspect they may have underestimated the degree of fatigue reported by the patient. From the article: > I did in fact know that fatigue was a possible side effect of the medication, but I was taking it off label at a drastically lower dosage than is typically prescribed (<1/20th), so it didn’t seem very applicable Counterintuitively, some medications are more sedating at lower doses than higher doses. Trazodone, for example, is frequently used for insomnia at low doses when taken only at night, but can also be an effective antidepressant at higher doses when taken multiple times per day. Mirtazapine is another example of a medication that can be very sedating at lower doses but become activating at higher doses. Low doses primarily antagonize the histamine H1 receptor (similar to antihistamines like Benadryl), while higher doses activate a wider range of receptors that can become stimulatory. With pharmacology, it's not safe to assume that a lower dose of a drug simply produces reduced effects relative to a full dose. The effects can change throughout the dosage range.
- fwip 6y ago
  > That said, it's strange that the author's doctors didn't notice this earlier. A number of medical professionals are shockingly unfamiliar with potential side effects of the drugs they prescribe. My partner was prescribed Zoloft. The prescribing psychiatrist simply did not believe my partner when they told him that they were experiencing a lot of jaw-clenching / teeth grinding. He insisted it must be unrelated to the medication. There are studies going back at least 20 years documenting this side effect with SSRIs, affecting something like 1 in 6 patients.
  - kar5pt 6y ago
    On top of that a lot of them are really unfamiliar with the withdrawal affects of ssri's. When I was tapering off of Paxil my psychiatrist seemed to think that withdrawals were just going to be a couple weeks of mild anxiety. In reality, each taper down took me over 3 months to get back to normal.
- dillondoyle 6y ago
  I think another important warning here is don't stop taking your meds without talking to your doctor first. Author was very candid in that treatment really helped but doesn't mention if the taper was done with their Dr. A lot of people end up thinking 'I feel great I'm cured,' so they stop and then relapse - or worse trigger episodes including suicide. I've made the mistake of stopping other meds without talking to Dr beforehand. I do think though we need more research and solutions for long term side effects AND withdrawal issues that for a long time weren't taken seriously. The 'zaps' etc
zander312 6y ago
I had crushing anxiety and panic attacks that were destroying my life. I almost smoked the business end of a 12 guage. I started taking Zoloft and my whole life changed. Anxiety and panic attacks completely dissappeared. Zero side effects. Happiness and joy all around. I get worried sometimes though about what's happening in my brain chemistry. Hopefully irreversable damage isn't occuring. But I suppose that damage is better than the alternative. I also wonder, since I feel so good, if I should try weaning off the Zoloft. But I can't risk going back into that place of darkness. Life is not worth living when you feel like that.
- PragmaticPulp 6y ago
  > Hopefully irreversable damage isn't occuring. But I suppose that damage is better than the alternative. On the contrary, untreated depression is far more likely to produce long-term damage than a well-studied medication that has been in use for several decades. Untreated depression really does a number on the brain and body, not to mention the downstream effects of reduced exercise, socialization, sleep, and other problems that come from depression. > I also wonder, since I feel so good, if I should try weaning off the Zoloft. Be careful and only proceed with the help of a psychiatrist. Depressive relapse is very common in patients who decide to discontinue their medication. The scary part is that the depression often returns very slowly over a long period of time, which the patient may not fully notice until they are deep within another depressive episode.
  - zander312 6y ago
    Thanks for the reply. That makes sense to me. I am totally fine with taking the meds forever. I am one of the lucky cases where I experience basically zero side effects and it's been 2 years so far. I have heard of the horror story side effects like getting really overweight, not being able to bone, feeling fatigued, constantly napping etc. But I have never felt any of that. These last two years have been the best of my life. I always have this concern though that these meds must be doing something sketchy to my brain chemistry. But it makes sense that the constant terror of anxiety could also produce some neural pathways and brain chemistry that would be very bad...
kosyblysk2 6y ago
10% of people need antidepressants 90% of people are depressed for a good reason and should reflect on themselves instead of looking for an easy way out of their self-inflicted/not understood issues. “fitter, healthier and more productive a pig in a cage on antidepressants “
- rybosworld 6y ago
  This is a pretty ridiculous comment. Not only are you citing suspiciously rounded percentages (and we know what they say about percentages), you are potentially planting a dangerous idea in some people's heads. Many people that take antidepressants (myself included) are constantly doubting if they still need a drug. In my case, and in many cases, the answer is yes. Don't make people doubt themselves just because you felt the need to toss your amateur opinion in the ring.
- The_rationalist 6y ago
  Did you know that 40% of well being is determined by genetics? https://en.m.wikipedia.org/wiki/Well-being_contributing_factors https://en.m.wikipedia.org/wiki/Well-being_contributing_fact...
- summm 6y ago
  Maybe, but for most of these 90% there is not much they can improve themselves. The system does not work for many people. In former times they would have just started a revolution, nowadays the get pills...
- exdsq 6y ago
  I am surprised you created an account just to say this drivel
- temp0826 6y ago
  Often the reasons can be hard or even impossible to face. The brain is amazing at hiding traumatic events. Sometimes these can be examined and processed with meditation and reflection; sometimes the big guns (psilocybin or ayahuasca) are the tool for the job. I do think traumas are worth examining and processing, but meds may be the most pertinent first step for some: even a short breath of fresh air that they can provide could be the difference between life and death
seibelj 6y ago
A lot of these posts have been appearing on the front page. I post something like this when I see them - SSRIs (Lexapro for me) saved my life. Absolute night and day difference. Until you experience true anxiety and depression for years, you can’t possibly understand what a game changer this medication is for those it works for. Don’t let articles spook you - if you are suffering get help.
carols10cents 6y ago
I find the "medical uncertainty" part of this more interesting than the "antidepressant" part. There are a number of medical problems, side effects, interactions, etc that only a very, very small number of people experience. Doctors, rightly, seem skeptical of anecdotes that haven't been borne out in large studies - they're likely to go with the most common explanation for something and usually be right. But how do people who really are experiencing rare problems get the right care for them? Doing their own research, talking to doctor after doctor until someone believes them? Why should the medical community do research into problems that only affect a few people? Even if they do decide it's worth it, is it possible if the sample sizes are going to be small? Say I could volunteer to prove through experimentation that if you give me medication X, I get symptom Y, and when you give me a placebo, I don't get symptom Y, but no one else has ever experienced symptom Y from medication X, does anyone care? All hard questions that I wish there were answers to.
- PragmaticPulp 6y ago
  There's another layer to this which makes it all the more difficult: The nocebo effect. In short, the nocebo effect is like the placebo effect but for side effects. If a patient consumes a lot of articles and anecdotes about negative side effects of a certain drug, they are far more likely to experience those side effects for themself, even if they receive placebo. This is becoming a greater problem as more patients read up on side effects through the worst of the worst side effect stories shared on social media.
  - flatline 6y ago
    I always thought nocebo was a belief that the medicine would have not therapeutic effect, which is then borne out in reality. But the amplified side effects dovetail with my understanding. As an anecdotal data point, I'm a redhead with a periodic liver condition and a fast metabolism, and I don't metabolize medications normally. I take an antispasmodic for pain relief in doses that leave some people catatonic and it has little to no negative effects on me, over a decade of use. I've tried low doses of muscle relaxants that leave me reeling drunk for hours. Had two awful experiences on SSRIs, I will never try those again should I ever have the need of an antidepressant. I suspect there are sub-populations of people like me who are statistical outliers.
Simulacra 6y ago
Neuroscience and depression is so fascinating because the idea that you have a chemical imbalance in your brain is, still, a theory. I'm more intrigued by the studies coming out about Ketamine, psybicilin, marijuana therapies, as a new angle to augment antidepressants and other prescriptions. I truly believe the switch is in there somewhere and through science we'll find it, so that mental illness can be corrected where appropriate.
- PragmaticPulp 6y ago
  > the idea that you have a chemical imbalance in your brain is, still, a theory. The idea that psychiatry believes depression to be a "chemical imbalance" is a myth. It's a common strawman argument against psychiatry or SSRIs, but the truth is that the field of psychiatry doesn't put much weight on "chemical imbalance" takes. More information in this article: https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again https://www.psychiatrictimes.com/view/debunking-two-chemical... > I'm more intrigued by the studies coming out about Ketamine, psybicilin, marijuana therapies, as a new angle to augment antidepressants and other prescriptions. Ketamine is interesting as a short-term rescue for severe cases, but it's not a long-term solution. Some doctors are trialing long-term maintenance therapy, but the effects tend to wane over time and tolerance is a major issue. Most providers who use ketamine will use it to kick-start regular treatment. Marijuana is not a treatment for depression and should not be viewed as such.
  - deleted 6y ago
    [deleted]
  - loveistheanswer 6y ago
    >the truth is that the field of psychiatry doesn't put much weight on "chemical imbalance" takes. Plenty of psychiatrists still assume mental illness of all sorts are primarily caused by chemical imbalance, which is why so many of them solely rely on chemicals to treat mental illness. "Schizophrenia is caused by a chemical imbalance and other changes in the brain."[1] [1]https://www.hopkinsmedicine.org/health/conditions-and-diseases/schizophrenia https://www.hopkinsmedicine.org/health/conditions-and-diseas...
kjrose 6y ago
One of the biggest surprises to me when I was taking advanced psychopathology courses was how little certainty there was around antidepressants and much of the drugs used to treat psychological disorders. For some people they work absolutely amazingly. For others it can actually have precisely the opposite intended effect. And for some it can have literally no effect. I had a long discussion with a psychiatrist about this and they more or less acknowledged that it really isn't a science and is more of an art. You try this SSRI or that SSDI with a low dosage and see what happens. Then you Amp it up gently. If it works great. If it doesn't, then you dial it back and try something else. Slowly working to drugs with more and more adverse side effects until something works. They have an idea of why it works but they don't really know precisely for every person.
- lumost 6y ago
  There is a profound negative consequence to this that long-term patient outcomes aren't very good with pharmaceutical interventions. In a different set of conditions I recall that Cognitive Behavioral Therapy has equivalent outcomes to medical intervention for ADHD at the 5 year mark, and afterwards wins as resistance to the medication is built. I wouldn't be surprised if similar outcomes are observed for depression. This is particularly problematic when it comes to medicating children/teenagers who are much earlier in how their brains adapt to stimulus.
  - kjrose 6y ago
    Oh absolutely. Medication should be a last option or an emergency option for most cases.
  - pseudalopex 6y ago
    Combining therapy and medication is more effective than either alone. For ADHD and depression. And "CBT has not been found to be particularly beneficial for children with ADHD."[1] [1] https://focus.psychiatryonline.org/doi/full/10.1176/appi.focus.10.3.334 https://focus.psychiatryonline.org/doi/full/10.1176/appi.foc...
Protostome 6y ago
I've been on Zoloft on and off for the past 10 years, and over the years I've come to notice its not-so-subtle effects. I would start by saying that overall, Zoloft has been a life saver for me. I was living with a debilitating level of OCD which interfered with all aspects of my life - from parenting to work. Personally, I suffered from 2 major side effects: 1. Fatigue/Drowsiness - I started falling asleep everywhere and am tired during most of the afternoon. SSRIs are known to affect the brain's ability to induce REM sleep, which in turn have a negative effect not only on our/my wakefulness but also on memory, cognitive skills and mood. 2. My sexual drive was completely obliterated. I can go for weeks without any sexual experience, which is very unusual for a guy my age. To my frustration, even when I had periods when I took time off the drug, my libido didn't really change and remain low. I did some research online and found out that this phenomenon has a name - PSSD (Post SSRI Sexual Dysfunction).
jheriko 6y ago
why is this here? there is barely a comment of content. the conclusion feels weird and naive...
PeterStuer 6y ago
I have been on SSRI's and on the 'normal' dose I would be sleeping around 14 to 16 hours a day. On the half dose I can get away with 12 hours, but then anxiety would flare up.

69 points by luu 6y ago

My usual warning when these stories reach the front page: If you feel you might need medical help for a mental illness, please don't let stories like this dissuade you from seeking appropriate care. The author notes that the medications were effective at treating their condition. Too many people delay necessary treatment for years for fear of side effects, only to later discover that their underlying depression was far worse than any medication side effects. Medications aren't perfect, but untreated depression is no joke. The author's experience is also unlikely to match the average patient's, as their medications were also chosen to treat their very painful trigeminal neuralgia. That said, it's strange that the author's doctors didn't notice this earlier. The topic of which antidepressants cause somnolence is hardly new research. Even the author's own doctor knew that Medication 2 was responsible for the daytime sleepiness. I suspect they may have underestimated the degree of fatigue reported by the patient. From the article: > I did in fact know that fatigue was a possible side effect of the medication, but I was taking it off label at a drastically lower dosage than is typically prescribed (<1/20th), so it didn’t seem very applicable Counterintuitively, some medications are more sedating at lower doses than higher doses. Trazodone, for example, is frequently used for insomnia at low doses when taken only at night, but can also be an effective antidepressant at higher doses when taken multiple times per day. Mirtazapine is another example of a medication that can be very sedating at lower doses but become activating at higher doses. Low doses primarily antagonize the histamine H1 receptor (similar to antihistamines like Benadryl), while higher doses activate a wider range of receptors that can become stimulatory. With pharmacology, it's not safe to assume that a lower dose of a drug simply produces reduced effects relative to a full dose. The effects can change throughout the dosage range.

fwip 6y ago
> That said, it's strange that the author's doctors didn't notice this earlier. A number of medical professionals are shockingly unfamiliar with potential side effects of the drugs they prescribe. My partner was prescribed Zoloft. The prescribing psychiatrist simply did not believe my partner when they told him that they were experiencing a lot of jaw-clenching / teeth grinding. He insisted it must be unrelated to the medication. There are studies going back at least 20 years documenting this side effect with SSRIs, affecting something like 1 in 6 patients.
- kar5pt 6y ago
  On top of that a lot of them are really unfamiliar with the withdrawal affects of ssri's. When I was tapering off of Paxil my psychiatrist seemed to think that withdrawals were just going to be a couple weeks of mild anxiety. In reality, each taper down took me over 3 months to get back to normal.
dillondoyle 6y ago
I think another important warning here is don't stop taking your meds without talking to your doctor first. Author was very candid in that treatment really helped but doesn't mention if the taper was done with their Dr. A lot of people end up thinking 'I feel great I'm cured,' so they stop and then relapse - or worse trigger episodes including suicide. I've made the mistake of stopping other meds without talking to Dr beforehand. I do think though we need more research and solutions for long term side effects AND withdrawal issues that for a long time weren't taken seriously. The 'zaps' etc

zander312 6y ago

I had crushing anxiety and panic attacks that were destroying my life. I almost smoked the business end of a 12 guage. I started taking Zoloft and my whole life changed. Anxiety and panic attacks completely dissappeared. Zero side effects. Happiness and joy all around. I get worried sometimes though about what's happening in my brain chemistry. Hopefully irreversable damage isn't occuring. But I suppose that damage is better than the alternative. I also wonder, since I feel so good, if I should try weaning off the Zoloft. But I can't risk going back into that place of darkness. Life is not worth living when you feel like that.

PragmaticPulp 6y ago
> Hopefully irreversable damage isn't occuring. But I suppose that damage is better than the alternative. On the contrary, untreated depression is far more likely to produce long-term damage than a well-studied medication that has been in use for several decades. Untreated depression really does a number on the brain and body, not to mention the downstream effects of reduced exercise, socialization, sleep, and other problems that come from depression. > I also wonder, since I feel so good, if I should try weaning off the Zoloft. Be careful and only proceed with the help of a psychiatrist. Depressive relapse is very common in patients who decide to discontinue their medication. The scary part is that the depression often returns very slowly over a long period of time, which the patient may not fully notice until they are deep within another depressive episode.
- zander312 6y ago
  Thanks for the reply. That makes sense to me. I am totally fine with taking the meds forever. I am one of the lucky cases where I experience basically zero side effects and it's been 2 years so far. I have heard of the horror story side effects like getting really overweight, not being able to bone, feeling fatigued, constantly napping etc. But I have never felt any of that. These last two years have been the best of my life. I always have this concern though that these meds must be doing something sketchy to my brain chemistry. But it makes sense that the constant terror of anxiety could also produce some neural pathways and brain chemistry that would be very bad...

kosyblysk2 6y ago

10% of people need antidepressants 90% of people are depressed for a good reason and should reflect on themselves instead of looking for an easy way out of their self-inflicted/not understood issues. “fitter, healthier and more productive a pig in a cage on antidepressants “

rybosworld 6y ago
This is a pretty ridiculous comment. Not only are you citing suspiciously rounded percentages (and we know what they say about percentages), you are potentially planting a dangerous idea in some people's heads. Many people that take antidepressants (myself included) are constantly doubting if they still need a drug. In my case, and in many cases, the answer is yes. Don't make people doubt themselves just because you felt the need to toss your amateur opinion in the ring.
The_rationalist 6y ago
Did you know that 40% of well being is determined by genetics? https://en.m.wikipedia.org/wiki/Well-being_contributing_factors https://en.m.wikipedia.org/wiki/Well-being_contributing_fact...
summm 6y ago
Maybe, but for most of these 90% there is not much they can improve themselves. The system does not work for many people. In former times they would have just started a revolution, nowadays the get pills...
exdsq 6y ago
I am surprised you created an account just to say this drivel
temp0826 6y ago
Often the reasons can be hard or even impossible to face. The brain is amazing at hiding traumatic events. Sometimes these can be examined and processed with meditation and reflection; sometimes the big guns (psilocybin or ayahuasca) are the tool for the job. I do think traumas are worth examining and processing, but meds may be the most pertinent first step for some: even a short breath of fresh air that they can provide could be the difference between life and death

seibelj 6y ago

A lot of these posts have been appearing on the front page. I post something like this when I see them - SSRIs (Lexapro for me) saved my life. Absolute night and day difference. Until you experience true anxiety and depression for years, you can’t possibly understand what a game changer this medication is for those it works for. Don’t let articles spook you - if you are suffering get help.

carols10cents 6y ago

I find the "medical uncertainty" part of this more interesting than the "antidepressant" part. There are a number of medical problems, side effects, interactions, etc that only a very, very small number of people experience. Doctors, rightly, seem skeptical of anecdotes that haven't been borne out in large studies - they're likely to go with the most common explanation for something and usually be right. But how do people who really are experiencing rare problems get the right care for them? Doing their own research, talking to doctor after doctor until someone believes them? Why should the medical community do research into problems that only affect a few people? Even if they do decide it's worth it, is it possible if the sample sizes are going to be small? Say I could volunteer to prove through experimentation that if you give me medication X, I get symptom Y, and when you give me a placebo, I don't get symptom Y, but no one else has ever experienced symptom Y from medication X, does anyone care? All hard questions that I wish there were answers to.

PragmaticPulp 6y ago
There's another layer to this which makes it all the more difficult: The nocebo effect. In short, the nocebo effect is like the placebo effect but for side effects. If a patient consumes a lot of articles and anecdotes about negative side effects of a certain drug, they are far more likely to experience those side effects for themself, even if they receive placebo. This is becoming a greater problem as more patients read up on side effects through the worst of the worst side effect stories shared on social media.
- flatline 6y ago
  I always thought nocebo was a belief that the medicine would have not therapeutic effect, which is then borne out in reality. But the amplified side effects dovetail with my understanding. As an anecdotal data point, I'm a redhead with a periodic liver condition and a fast metabolism, and I don't metabolize medications normally. I take an antispasmodic for pain relief in doses that leave some people catatonic and it has little to no negative effects on me, over a decade of use. I've tried low doses of muscle relaxants that leave me reeling drunk for hours. Had two awful experiences on SSRIs, I will never try those again should I ever have the need of an antidepressant. I suspect there are sub-populations of people like me who are statistical outliers.

Simulacra 6y ago

Neuroscience and depression is so fascinating because the idea that you have a chemical imbalance in your brain is, still, a theory. I'm more intrigued by the studies coming out about Ketamine, psybicilin, marijuana therapies, as a new angle to augment antidepressants and other prescriptions. I truly believe the switch is in there somewhere and through science we'll find it, so that mental illness can be corrected where appropriate.

PragmaticPulp 6y ago
> the idea that you have a chemical imbalance in your brain is, still, a theory. The idea that psychiatry believes depression to be a "chemical imbalance" is a myth. It's a common strawman argument against psychiatry or SSRIs, but the truth is that the field of psychiatry doesn't put much weight on "chemical imbalance" takes. More information in this article: https://www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again https://www.psychiatrictimes.com/view/debunking-two-chemical... > I'm more intrigued by the studies coming out about Ketamine, psybicilin, marijuana therapies, as a new angle to augment antidepressants and other prescriptions. Ketamine is interesting as a short-term rescue for severe cases, but it's not a long-term solution. Some doctors are trialing long-term maintenance therapy, but the effects tend to wane over time and tolerance is a major issue. Most providers who use ketamine will use it to kick-start regular treatment. Marijuana is not a treatment for depression and should not be viewed as such.
- deleted 6y ago
  [deleted]
- loveistheanswer 6y ago
  >the truth is that the field of psychiatry doesn't put much weight on "chemical imbalance" takes. Plenty of psychiatrists still assume mental illness of all sorts are primarily caused by chemical imbalance, which is why so many of them solely rely on chemicals to treat mental illness. "Schizophrenia is caused by a chemical imbalance and other changes in the brain."[1] [1]https://www.hopkinsmedicine.org/health/conditions-and-diseases/schizophrenia https://www.hopkinsmedicine.org/health/conditions-and-diseas...

kjrose 6y ago

One of the biggest surprises to me when I was taking advanced psychopathology courses was how little certainty there was around antidepressants and much of the drugs used to treat psychological disorders. For some people they work absolutely amazingly. For others it can actually have precisely the opposite intended effect. And for some it can have literally no effect. I had a long discussion with a psychiatrist about this and they more or less acknowledged that it really isn't a science and is more of an art. You try this SSRI or that SSDI with a low dosage and see what happens. Then you Amp it up gently. If it works great. If it doesn't, then you dial it back and try something else. Slowly working to drugs with more and more adverse side effects until something works. They have an idea of why it works but they don't really know precisely for every person.

lumost 6y ago
There is a profound negative consequence to this that long-term patient outcomes aren't very good with pharmaceutical interventions. In a different set of conditions I recall that Cognitive Behavioral Therapy has equivalent outcomes to medical intervention for ADHD at the 5 year mark, and afterwards wins as resistance to the medication is built. I wouldn't be surprised if similar outcomes are observed for depression. This is particularly problematic when it comes to medicating children/teenagers who are much earlier in how their brains adapt to stimulus.
- kjrose 6y ago
  Oh absolutely. Medication should be a last option or an emergency option for most cases.
- pseudalopex 6y ago
  Combining therapy and medication is more effective than either alone. For ADHD and depression. And "CBT has not been found to be particularly beneficial for children with ADHD."[1] [1] https://focus.psychiatryonline.org/doi/full/10.1176/appi.focus.10.3.334 https://focus.psychiatryonline.org/doi/full/10.1176/appi.foc...

Protostome 6y ago

I've been on Zoloft on and off for the past 10 years, and over the years I've come to notice its not-so-subtle effects. I would start by saying that overall, Zoloft has been a life saver for me. I was living with a debilitating level of OCD which interfered with all aspects of my life - from parenting to work. Personally, I suffered from 2 major side effects: 1. Fatigue/Drowsiness - I started falling asleep everywhere and am tired during most of the afternoon. SSRIs are known to affect the brain's ability to induce REM sleep, which in turn have a negative effect not only on our/my wakefulness but also on memory, cognitive skills and mood. 2. My sexual drive was completely obliterated. I can go for weeks without any sexual experience, which is very unusual for a guy my age. To my frustration, even when I had periods when I took time off the drug, my libido didn't really change and remain low. I did some research online and found out that this phenomenon has a name - PSSD (Post SSRI Sexual Dysfunction).

jheriko 6y ago

why is this here? there is barely a comment of content. the conclusion feels weird and naive...

PeterStuer 6y ago

I have been on SSRI's and on the 'normal' dose I would be sleeping around 14 to 16 hours a day. On the half dose I can get away with 12 hours, but then anxiety would flare up.