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To provide one additional anecdote: I came off escitalopram with no taper after taking it for about five years (10mg). I got brain zaps for a while, got very ir

• delichon 1mo ago
  Good news, exposure therapy is quite effective for arachnophobia and is the first-line treatment. SSRIs do not have the same level of supporting evidence, and the effects are not as durable.
  • sandcat_ 1mo ago
    Thanks, yeah, but if I’m honest I don’t really care enough to go through with it. I almost did once, years ago, the London Zoo have a programme. I mentioned it though as one of the most stark changes I noticed after getting on an SSRI was pretty much immediately losing my fear of spiders. It was the first sign I had that showed it was doing something. I used to literally, on occasion, launch my phone across the room if I was scrolling and came across a spider (sometimes drenching myself with coffee or whatever in the process!) and then one day, shortly after getting on it, I stumbled across some awful tarantula video or something and I just stared at it like “huh, why am I not freaking out”.
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  • simiones 1mo ago
    > SSRIs do not have the same level of supporting evidence, and the effects are not as durable. To the extent that we can measure depression, SSRIs have been widely proven in gold standard phase III clinical trials to help with the treatment of major depression. What exactly is supposed to be lacking in the supported evidence?
    • avianlyric 1mo ago
      GP is talking about using SSRIs for treating arachnophobia, not depression.
    • movespebp 1mo ago
      Unfortunately many of the trials look like this : https://study329.org/ https://study329.org/ - the ghost written study concluded “Paroxetine is generally well tolerated and effective for major depression in adolescents.” The reality of the actual trial data was very different - with catastrophic results for many.
  • pcblues 1mo ago
    Exposure therapy does not work for everyone in all areas. Sometimes not at all. Also, see the debate around discussing traumatic events in therapy immediately versus waiting a year. Throwing people in the deep end doesn't always result in a swimmer :) YMMV of course.
• bsuvc 1mo ago
  It's been years since, but I too had brain zaps coming off of it. It took a few months for those to go away. I tried to describe it to my doctor and he seemed like he never heard of it before and sort of look at me like I was crazy, or at least that is what I sensed. But I ended up researching online and found it was a thing that happens.
  • zzzeek 1mo ago
    Interesting is your doctor a general practitioner or a psychiatrist? A psychiatrist definitely knows about this stuff. GPs in my experience know almost nothing about anything beyond what seems like a script they operate from.
    • simiones 1mo ago
      You are assuming a lot about the competency of some specific doctor who knows where in the world...
    • Aboutplants 1mo ago
      Honestly, this is where chatbots and AI come into play and make an astonishing difference. I’m an AI realist/pessimist but its usefulness in general medicine is going to save millions of lives due to doctor ineptitude. They are after all just well read mechanics
    • clsec 1mo ago
      A psychiatrist definitely does not always know these things. Mine told me there should be no Citalopram withdrawals and that I should taper by cutting my dose in half over a 2 week period. They were absolutely wrong as I have serious withdrawal reactions to Citalopram. It took me a month of micro-dosing down to safely get off a drug I was on for 15 yrs. And even then I was having constant brain & body zaps, that feel like short circuiting, for a full month after I dosed down to nothing. 6 mos later & I still can't sleep more than 6 hrs. How did I know this was going to happen? Going cold turkey when my script ran out. I even told my psych about it numerous times but they just brushed it off.
    • ulfw 1mo ago
• sheepscreek 1mo ago
  It can be catastrophic if one is managing family life, kids, taking them to and from activities on top of one’s own work. Then come misc stresses like tax returns, some expensive home repair, etc. Also dealing with depression without the anti-depressant. Switching mental health medication is no fun. I am glad your experience was tolerable but it’s a whole arc and everyone’s tolerance + circumstances are unique which makes it all the more challenging (even for doctors).
  • KurSix 1mo ago
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• sitharus 1mo ago
  Withdrawal effects, like the beneficial effects, are highly individual. I had no withdrawal effects from escitalopram after being on it for a couple of years but I know people who’ve had the issues described in the article. This isn’t a one size fits all area of medicine.
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  • DataDaoDe 1mo ago
    This. If there is one thing I've learned it is certainly not that you can generalize from yourself to others, especially for medication and its side-effects and withdrawal effects. I get so sick from taking novalgin that its a medical emergency (Agranulocytosis). Apparently, this occurs in like 1 case in a million. Conversely, I've heard of horrible side-effects or withdrawals from other medications where I experienced absolutely none of them.
• OptionOfT 1mo ago
  I tried to come off Trintellix. 4 weeks was fine. 5th week immense thoughts of doom. Had to take Xanax to bridge it kicking in again.
• ritcgab 1mo ago
  Same experience early this year but I did halve the dosage to 5mg for a month, which was of near zero difference. But the full withdrawal? Oh man it is no joke.
• lachlanj 1mo ago
  Is it possible for phobias to be treated with antidepressants or other medications? I need to look into this
  • sandcat_ 1mo ago
    Sure seems like it to me, but my doctor seemed bemused when I mentioned it to him and I don't think they're routinely prescribed for them. I reckon if I'd have paired the SSRI with some exposure therapy, it would have cured me of it long-term. I do have an additional phobia however (I'd rather not say which) and it didn't make any impact on that at all, so YMMV. Worth noting as well that I had no expectation of any changes to my arachnophobia going in. It didn't even cross my mind.
  • bgnn 1mo ago
    Exposure seems to be the best way out.
  • nvarsj 1mo ago
    I can believe it. They are used for general anxiety disorder which I imagine can be kind of similar - an over-reaction to some stimuli.
  • sixeyes 1mo ago
    both my social phobia and my fear of dark almost vanished on venlafaxine. i take walks in the dark these days, what the fuck.
• KurSix 1mo ago
  What seems most broken is that medicine apparently didn't have a great way to predict which group you’d fall into, or much of a plan for the people who had a really bad time stopping. Also, RIP the anti-spider benefits
• vermilingua 1mo ago
  I also went cold turkey from escitalopram about a decade ago, and my experience was not as tame as yours; my ideation kicked into 6th gear, with paranoia, nausea, and insanely intense and vivid dreams every night. That was while on a 10mg dose. I have been on over-max-dose venlafaxine for nearly a year now. I think it has been an enormous improvement in my life on nearly every axis, but if I miss a dose by even a few hours I get zaps, confusion, and dizziness. What happens to me now if I become unable to access my meds for more than a couple of days really keeps me up some nights.
  • dib258 1mo ago
    Venlafaxine has a small half-life so that might be why if you miss a dose by a few hours you'd get withdrawal symptoms. Drugs is leaving fast you body and so concentration is quickly decreasing. Apparently there's a extended-release, don't know if it's already what you have but maybe you could ask to try another SNRIs that has a longer half-life.
    • vermilingua 1mo ago
      Yep I’m on XR, I’ve tried taking half my dose twice daily instead, which did smooth out the effects a bit but also made me much more likely to miss a dose. Not really any other solution other than tapering afaict.
      • dib258 1mo ago
        Yes, or you could ask your doctor to go on another one with longer half-life. At least that would give you more room to miss by a few hours a dose and not going haywire into withdrawal. Especially when anxiety is already a problem and withdrawal symptoms kicks back the anxiety stronger... Hope you find something that suits you!
  • touisteur 1mo ago
    Venlafaxine has also been a godsend for me. My doctor started me on ut first and past the two weeks of rebalancing (big ideation swings and so much calling to act on it...) and all kinds of pains (digestive mostly), it literally allowed me to smile again, which my wife realized hadn't happened in over a year. I can relate to the feeling when missing a dose. No tolerance for being forgetful. Lots of anxiety brought by this tether... and the permanent anorgasmia (in my case) is sad but I was dying... Sadly I built tolerance over 2 years and had to stop, taper off (horrible experience) and try others (most that were cited in this comment section). All had painful and very annoying side effects and tapering was a pain after trying and each time feeling so disappointed and tired. Most worked on reducing ideation but the costs (inability to concentrate, brain fog, sometimes inability to work) were too high. Turns out tolerance to venlafaxine ebbs out after some time, so after a moment I was able to restart for a year until I didn't need antidepressants anymore. I've learned reading forums of the gamut of experiences with antidepressants and just want to add a voice to 'they can work, great even, not perfect' and between dying and trying them (with clear open eyes about the tradeoffs) I'd advise trying.
• dllrr 1mo ago
  I think you are the flip side of what you mentioned about the article. I don't see the article as saying withdrawal is catastrophic, in fact I see it being well balanced when stating numbers. But you just said many or most people don't experience that. If I were to take your approach, and make generalized statements based on my own experiences, I would say many if not most actually do experience significant withdrawal symptoms for an extended period of time. You need to take into account: dosage, age, health, life circumstances, and I would think even more before you can suggest even the slightest correlation or "average" experience. I get what you're saying and I'm very glad it was easier for you than others, clearly. I think though, it's dangerous to others to make claims based on one person's experience.
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  • sandcat_ 1mo ago
    For sure. That’s all I wanted to provide: an alternative anecdote from the article which led with an anecdote of perhaps the worst case for withdrawals. If I’d read an article like this five years ago, I might not have gotten the help I needed.
• karthikeyankc 1mo ago
  Me too. I was prescribed escitalopram along with other SSRIs when I lost my mom. Even with tapering, I had brain zaps for a while. Before I could stop it all completely, I was ramped up again after I lost my wife. I'm not sure if I'd be actually functional or even be here if it weren't for these meds.
  • mexicocitinluez 1mo ago
    What was the tapering like for an SSRI? Do you remember over what period of time and how it was decreased?
    • karthikeyankc 1mo ago
      It was monthly. I don't remember the order of the medications, but I remember the effects. The most prominent one were the brain zaps and some confusions, especially in the mornings. On the bright side, I had some creativity coming back to me and I started back on some of my creative outlets (mostly my wife and therapy helped me come back to reality). And my biggest relief was when my brain fog (sometimes I even forgot my colleagues' names) cleared up. But yeah, before I could stop it completely I was fast tracked back up on a different regimen of SSRI combinations after my wife's accident.
      • mexicocitinluez 1mo ago
        Sorry to hear about the accident and thanks for the response. I've been on celexa for a decade now and have always wondered what it would be like if I ever had to come off.