7 ms·

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. Afte

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general I feel like I am much better off without the antidepressants now than with them - and I've also noticed that pulling an all nighter would actually fix the rebounds for a bit. A small dose of melatonin before bed worked wonders for me now. I sleep better and the rebounds are extremely rare.

erikpukinskis 3y ago
Just a side note for anyone reading: you can get an SSRI prescription from your GP (general practitioner i.e. normal doctor) you don’t need to go through a psychiatrist. This is especially true if you are at risk for withdrawal, they will want to prevent that.
- fsckboy 3y ago
  any medical doctor of any specialization can legally prescribe anything. that doesn't make it a good idea. a piece of supporting evidence is that the doctor's malpractice insurance may not cover any "cowboy" prescribing tendencies.
  - ksenzee 3y ago
    GPs routinely prescribe SSRIs. Even pediatricians. At least in the US.
    - H8crilA 3y ago
      A lot of non-psychiatrist doctors prescribe SSRIs around the world, and that's a very good thing. These drugs are safe.
      - ksenzee 3y ago
        Agreed.
      - Gud 3y ago
        Please don’t make such blanket statements. They can have many harmful side effects, including sexual dysfunction.
        manquer 3y ago
        I think OP meant to say, these are not drugs is not something you can OD with easily and kill yourself, not that they are side effect free .
        Gud 3y ago
        In many cases they have induced suicide. There are many ways something can be unsafe.
        manquer 3y ago
        There are many ways to regulate too. SSRIs are not OTC for the same reason. There are many drugs a GP can prescribe that are just as dangerous or more so. There is a reason SSRI are schedule 4 and not schedule 2 . They cannot kill you the same way [1] --- [1] While there is a lot of politics in the classification and putting weed or LSD in schedule 1 is very questionable the list is generally medically accurate.
        deleted 3y ago
        [deleted]
  - erikpukinskis 3y ago
    That’s fair. But I’ll note that the “General” in “General Practitioner” means they specialize in the wide range of health problems that occur frequently in the general population. That includes things like depression, anxiety, ADHD, etc. I wouldn’t advocate you get a prescription for antipsychotics from your orthopedist, but SSRIs from a GP is probably pretty safe. Obviously, it depends on the doctor and the symptoms. But a good GP will also refer you out to a specialist when needed. That’s a big part of their job: assessing when to call in a specialist.
  - rl3 3y ago
    As other comments said, GPs routinely prescribe SSRIs. Moreover, it's not remotely cowboy to ensure continuity of care arising from exigent circumstances.
    - fsckboy 3y ago
      I didn't say it was "cowboy" which I put in quotes and you didn't, I simply said what I said, that insurers can put restrictions on doctors based on their specialties (true fact), that you (as a doctor) fear your insurer considering you to be a cowboy (also a true fact). Malpractice is something to worry about, including whoever educated you :) to look for the worst possible interpretation of what somebody says.
  - 3c6bYDXLMj 3y ago
    [flagged]
  - brokencode 3y ago
    If all you need is a refill on a prescription you’ve been taking for 10 years, how is that “cowboy” prescribing? Also, these are trained professionals with years of education we’re talking about, not some random dude off the street.
    - fsckboy 3y ago
      anti depressants (and other drugs) have side effects, both in the short term and the long. Patients who want drugs may lie. Trained professionals, yes exactly, but need to have practical experience in an area of medicine to be an effective advocate for the patient. I can't even believe I'm having to defend this position in front of this crowd, but now many GP's dismissed the symptoms of women's post-partum depression before it become a topic of mainstream discussion on television talk shows? Doctors are not perfect and are not free from various biases, and having had experience with your particular condition is invaluable to you.
      - alpaca128 3y ago
        > but now many GP's dismissed the symptoms of women's post-partum depression Weird example given you're arguing against GPs prescribing antidepressants because patients may lie. And I'd like to see someone lying to get SSRIs out of all the possible choices.
        fsckboy 3y ago
        I'm arguing that in the US doctors can prescribe all medications regardless of their specialty (because it's true) and that it's not always a good idea, for example if the doctor is not familiar with recognizing the side effects which are outside of his specialty. (because that's also true) Your shrink is not going to prescribe you statins, as an example, but they could. It's important for a GP to recognize depression, but that doesn't mean they should treat depression, just as they should not give you a heart transplant. You're arguing like something as at stake for you or you have bone to pick, I'm saying very generic anodyne things, i'm arguing for sober reasonableness.
- xenadu02 3y ago
  This works unless you GP is a huge jerkface in which case find a new one. Just be honest: tell your GP that your previous provider quit/retired/changed insurance. Bring your prior RX bottles or paperwork. Let them know you have an appointment with your new provider on X date and ask them to cover you until then. I've done this when changing insurance (twice) and when moving states (New provider had a waitlist. First time she wrote one month then when I reported the waitlist situation she ended up covering it for 3-4 months).
  - kridsdale3 3y ago
    People in Canada aren't allowed to "find a new one". My parents live on a fairly highly populated island, and the only doctor decided to leave. No new one is allowed to move in to serve the population until the government gets around to setting that up. It will probably be a year or more of thousands of elderly people having no medical care at all. I explained on the phone that in the US, this demand and lack of supply would quickly sort itself out by someone moving in and setting up. Being a certified MD in the state is all they'd need. This was mind-blowing to my socialized-medicine parents.
- thowaway91234 3y ago
  I tried this once, Family Doctor actually ended up giving me a dose that was twice the maximum anyone is ever supposed to take. Thankfully the Pharmacist told me that was an extremely bad idea and he just gave me my normal dose and I continued on for a bit. After that was when I ended up cold turkey because I lost my doctor and psychiatrists during a big move and couldn't get a refill at any clinic in the new town. It ended up working out, but it took about a year of absolute torture and probably about another year of just "weirdness". But these days I'm "normal" and off the drugs and never been happier.
  - t0bia_s 3y ago
    Those drugs you used contains benzodiazepine [1]. It's addictive and if used long, do more harm than helping. I'm glad you get rid of it. [1] https://en.m.wikipedia.org/wiki/Benzodiazepine https://en.m.wikipedia.org/wiki/Benzodiazepine
    - PawgerZ 3y ago
      Why would you think they're taking benzos on a thread about SSRIs?
    - tnecniv 3y ago
      Benzos and SSRIs are different things. The former is a CNS depressant that acts instantly. The latter builds up in your system over a month to increase the seretonin levels in your brain. They’re not really related except that someone with, e.g., anxiety might be prescribed both
    - thowaway91234 3y ago
      Thankfully I wasn’t on Benzos, but my mother has been and they definitey can do a lot more harm than good.
  - PH95VuimJjqBqy 3y ago
    2 years of recovery just sounds scary
- firecall 3y ago
  In Australia it’s standard for a GP to prescribe SSRIs.
- doktrin 3y ago
  Indeed, and this easy availability is potentially a double edged sword.
- s__s 3y ago
  My pharmacist can even prescribe a month’s supply if I’m running out. Stopping an SSRI cold turkey is a really bad idea.
  - thowaway91234 3y ago
    Definitely a very bad idea. The first 2 or so weeks felt euphoric to me but after that it was pure hell for months and months.
Hard_Space 3y ago
> would actually fix the rebounds for a bit. I can't prove it, but even dumb teenage me felt instinctively that extreme sleep deprivation was likely to take a long and possibly permanent toll. I don't think anything that extreme can really be practiced in moderation, because it's more like taking heroin than eating too many cakes, etc., i.e., it's not a 'granular' indulgence. I would hesitate to call this a hot take on my part, since I am guessing that in that period of my life, I probably stayed up for two days on several hundred occasions, if not more. For anyone else suffering from severe depression, this is an easy answer, maybe; but there are better easy answers than this. Cannabis (I am not a partaker since I was an student) would be better than this. Really, do anything but this. It's not 'free'; nothing that works is free.
Mortiffer 3y ago
That's terrible man. I hate being dependent on a doc. Try to reduce this horrible risk by going up and down on dose to get a little stock pile to feel a bit safer. But changes little I guess
- thowaway91234 3y ago
  I'm totally off the SSRIs now and will never go back. Rebounds used to be frequent, then like 6-12 months apart now - now I don't remember when my last one was... Going cold turkey was absolute hell, but it worked out well for me because of my excellent support system. Would not recommend at all for anyone else though, absolutely not: tapering with a doctor is 100% the best course of action.
tennisflyi 3y ago
I get them (sertraline and escitalopram) pretty much on demand from Hims and Lemonaide.
biohacker85 3y ago
Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works because they feel awful without it.
- piuantiderp 3y ago
  You just discovered most prescriptions in the US. Big example, insulin, once you take it, ooof, never going back...
- VHRanger 3y ago
  I mean, obviously removing a serotoninergic med will change your homeostasis. The real reason SSRIs are so popular is that they work (not always, but often to some extent) and for depression it's much cheaper to make a pill than book a therapists time
- yosame 3y ago
  Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work. They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.
  - arcticbull 3y ago
    Interestingly enough, SSRIs are only slightly but statistically significantly better than active placebos. While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap. FDA data shows a reduction of symptoms of about 30% in placebo vs 40% in antidepressants. [1] [edit] Doctors note that the difference between antidepressants and placebo isn't clinically significant. They do something, but not much which is why the revival and breakthrough drug designation of psychedelics in the treatment of - especially major - depression is so exciting. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/
ada1981 3y ago
I’ve yet to meet anyone who didn’t eventually do better off the SSRIs and the data supports this as well. You need to right plan and support, but it’s worth it in my opinion. Have you tried any trauma work or Transpersonal work?

erikpukinskis 3y ago

Just a side note for anyone reading: you can get an SSRI prescription from your GP (general practitioner i.e. normal doctor) you don’t need to go through a psychiatrist. This is especially true if you are at risk for withdrawal, they will want to prevent that.

fsckboy 3y ago
any medical doctor of any specialization can legally prescribe anything. that doesn't make it a good idea. a piece of supporting evidence is that the doctor's malpractice insurance may not cover any "cowboy" prescribing tendencies.
- ksenzee 3y ago
  GPs routinely prescribe SSRIs. Even pediatricians. At least in the US.
  - H8crilA 3y ago
    A lot of non-psychiatrist doctors prescribe SSRIs around the world, and that's a very good thing. These drugs are safe.
    - ksenzee 3y ago
      Agreed.
    - Gud 3y ago
      Please don’t make such blanket statements. They can have many harmful side effects, including sexual dysfunction.
      - manquer 3y ago
        I think OP meant to say, these are not drugs is not something you can OD with easily and kill yourself, not that they are side effect free .
        Gud 3y ago
        In many cases they have induced suicide. There are many ways something can be unsafe.
        manquer 3y ago
        There are many ways to regulate too. SSRIs are not OTC for the same reason. There are many drugs a GP can prescribe that are just as dangerous or more so. There is a reason SSRI are schedule 4 and not schedule 2 . They cannot kill you the same way [1] --- [1] While there is a lot of politics in the classification and putting weed or LSD in schedule 1 is very questionable the list is generally medically accurate.
      - deleted 3y ago
        [deleted]
- erikpukinskis 3y ago
  That’s fair. But I’ll note that the “General” in “General Practitioner” means they specialize in the wide range of health problems that occur frequently in the general population. That includes things like depression, anxiety, ADHD, etc. I wouldn’t advocate you get a prescription for antipsychotics from your orthopedist, but SSRIs from a GP is probably pretty safe. Obviously, it depends on the doctor and the symptoms. But a good GP will also refer you out to a specialist when needed. That’s a big part of their job: assessing when to call in a specialist.
- rl3 3y ago
  As other comments said, GPs routinely prescribe SSRIs. Moreover, it's not remotely cowboy to ensure continuity of care arising from exigent circumstances.
  - fsckboy 3y ago
    I didn't say it was "cowboy" which I put in quotes and you didn't, I simply said what I said, that insurers can put restrictions on doctors based on their specialties (true fact), that you (as a doctor) fear your insurer considering you to be a cowboy (also a true fact). Malpractice is something to worry about, including whoever educated you :) to look for the worst possible interpretation of what somebody says.
- 3c6bYDXLMj 3y ago
  [flagged]
- brokencode 3y ago
  If all you need is a refill on a prescription you’ve been taking for 10 years, how is that “cowboy” prescribing? Also, these are trained professionals with years of education we’re talking about, not some random dude off the street.
  - fsckboy 3y ago
    anti depressants (and other drugs) have side effects, both in the short term and the long. Patients who want drugs may lie. Trained professionals, yes exactly, but need to have practical experience in an area of medicine to be an effective advocate for the patient. I can't even believe I'm having to defend this position in front of this crowd, but now many GP's dismissed the symptoms of women's post-partum depression before it become a topic of mainstream discussion on television talk shows? Doctors are not perfect and are not free from various biases, and having had experience with your particular condition is invaluable to you.
    - alpaca128 3y ago
      > but now many GP's dismissed the symptoms of women's post-partum depression Weird example given you're arguing against GPs prescribing antidepressants because patients may lie. And I'd like to see someone lying to get SSRIs out of all the possible choices.
      - fsckboy 3y ago
        I'm arguing that in the US doctors can prescribe all medications regardless of their specialty (because it's true) and that it's not always a good idea, for example if the doctor is not familiar with recognizing the side effects which are outside of his specialty. (because that's also true) Your shrink is not going to prescribe you statins, as an example, but they could. It's important for a GP to recognize depression, but that doesn't mean they should treat depression, just as they should not give you a heart transplant. You're arguing like something as at stake for you or you have bone to pick, I'm saying very generic anodyne things, i'm arguing for sober reasonableness.
xenadu02 3y ago
This works unless you GP is a huge jerkface in which case find a new one. Just be honest: tell your GP that your previous provider quit/retired/changed insurance. Bring your prior RX bottles or paperwork. Let them know you have an appointment with your new provider on X date and ask them to cover you until then. I've done this when changing insurance (twice) and when moving states (New provider had a waitlist. First time she wrote one month then when I reported the waitlist situation she ended up covering it for 3-4 months).
- kridsdale3 3y ago
  People in Canada aren't allowed to "find a new one". My parents live on a fairly highly populated island, and the only doctor decided to leave. No new one is allowed to move in to serve the population until the government gets around to setting that up. It will probably be a year or more of thousands of elderly people having no medical care at all. I explained on the phone that in the US, this demand and lack of supply would quickly sort itself out by someone moving in and setting up. Being a certified MD in the state is all they'd need. This was mind-blowing to my socialized-medicine parents.
thowaway91234 3y ago
I tried this once, Family Doctor actually ended up giving me a dose that was twice the maximum anyone is ever supposed to take. Thankfully the Pharmacist told me that was an extremely bad idea and he just gave me my normal dose and I continued on for a bit. After that was when I ended up cold turkey because I lost my doctor and psychiatrists during a big move and couldn't get a refill at any clinic in the new town. It ended up working out, but it took about a year of absolute torture and probably about another year of just "weirdness". But these days I'm "normal" and off the drugs and never been happier.
- t0bia_s 3y ago
  Those drugs you used contains benzodiazepine [1]. It's addictive and if used long, do more harm than helping. I'm glad you get rid of it. [1] https://en.m.wikipedia.org/wiki/Benzodiazepine https://en.m.wikipedia.org/wiki/Benzodiazepine
  - PawgerZ 3y ago
    Why would you think they're taking benzos on a thread about SSRIs?
  - tnecniv 3y ago
    Benzos and SSRIs are different things. The former is a CNS depressant that acts instantly. The latter builds up in your system over a month to increase the seretonin levels in your brain. They’re not really related except that someone with, e.g., anxiety might be prescribed both
  - thowaway91234 3y ago
    Thankfully I wasn’t on Benzos, but my mother has been and they definitey can do a lot more harm than good.
- PH95VuimJjqBqy 3y ago
  2 years of recovery just sounds scary
firecall 3y ago
In Australia it’s standard for a GP to prescribe SSRIs.
doktrin 3y ago
Indeed, and this easy availability is potentially a double edged sword.
s__s 3y ago
My pharmacist can even prescribe a month’s supply if I’m running out. Stopping an SSRI cold turkey is a really bad idea.
- thowaway91234 3y ago
  Definitely a very bad idea. The first 2 or so weeks felt euphoric to me but after that it was pure hell for months and months.

Hard_Space 3y ago

> would actually fix the rebounds for a bit. I can't prove it, but even dumb teenage me felt instinctively that extreme sleep deprivation was likely to take a long and possibly permanent toll. I don't think anything that extreme can really be practiced in moderation, because it's more like taking heroin than eating too many cakes, etc., i.e., it's not a 'granular' indulgence. I would hesitate to call this a hot take on my part, since I am guessing that in that period of my life, I probably stayed up for two days on several hundred occasions, if not more. For anyone else suffering from severe depression, this is an easy answer, maybe; but there are better easy answers than this. Cannabis (I am not a partaker since I was an student) would be better than this. Really, do anything but this. It's not 'free'; nothing that works is free.

Mortiffer 3y ago

That's terrible man. I hate being dependent on a doc. Try to reduce this horrible risk by going up and down on dose to get a little stock pile to feel a bit safer. But changes little I guess

thowaway91234 3y ago
I'm totally off the SSRIs now and will never go back. Rebounds used to be frequent, then like 6-12 months apart now - now I don't remember when my last one was... Going cold turkey was absolute hell, but it worked out well for me because of my excellent support system. Would not recommend at all for anyone else though, absolutely not: tapering with a doctor is 100% the best course of action.

tennisflyi 3y ago

I get them (sertraline and escitalopram) pretty much on demand from Hims and Lemonaide.

biohacker85 3y ago

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works because they feel awful without it.

piuantiderp 3y ago
You just discovered most prescriptions in the US. Big example, insulin, once you take it, ooof, never going back...
VHRanger 3y ago
I mean, obviously removing a serotoninergic med will change your homeostasis. The real reason SSRIs are so popular is that they work (not always, but often to some extent) and for depression it's much cheaper to make a pill than book a therapists time
yosame 3y ago
Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work. They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.
- arcticbull 3y ago
  Interestingly enough, SSRIs are only slightly but statistically significantly better than active placebos. While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap. FDA data shows a reduction of symptoms of about 30% in placebo vs 40% in antidepressants. [1] [edit] Doctors note that the difference between antidepressants and placebo isn't clinically significant. They do something, but not much which is why the revival and breakthrough drug designation of psychedelics in the treatment of - especially major - depression is so exciting. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/

ada1981 3y ago

I’ve yet to meet anyone who didn’t eventually do better off the SSRIs and the data supports this as well. You need to right plan and support, but it’s worth it in my opinion. Have you tried any trauma work or Transpersonal work?