Bruce Stutz has an essay in today's New York Times magazine that should be read by anyone considering taking an antidepressant...and, perhaps, those already on one. Why? Because Stutz provides chilling details of the withdrawal he went through for months while tapering off his prescription antidepressant.
Stutz's decision to taper off the drug Effexor when he was no longer depressed (and had gone through three years of psychotherapy) was due in part to the symptoms he experienced when missing or delaying a dose (including panic attacks) and the resulting obsession he noted in himself about taking the drug.
In the past I experienced what happened if I didn't take it on time. When I missed my morning dose, by 2 p.m. I would begin to space out. A prickliness in my neck would give way to a restless agitation that left me edging toward panic. All I would be able to think of was how far away I was from my home, my pill, relief. Within 20 minutes of taking the pill, I would feel better. I would feel better just knowing I'd taken it.
Stutz began weaning himself off Effexor by initially halving his 150-milligram-capsule a day dose after his physician "mistakenly prescribed 75-milligram capsules to be taken twice a day."
I expected that for the first couple of days I would feel the muscle-twitching anxiety that came when I missed a dose, but it was not so bad, and I had hopes that I might taper off quickly. On the third day, however, I began to find it difficult to focus and was unable to sit at my desk for more than a half-hour at a time. I was agitated, restless and hyperaware of sounds....By early evening on that day, I felt so jittery and anxious that I decided I needed more medication. Somewhere, I recalled, a couple of years earlier I stashed a blister pack of 37.5-milligram capsules, a sample my doctor had passed on to me. But where? Although I could have split open a 75-milligram capsule, in my anxious state I became bent on finding those 37.5's. An hour or more later, after maniacally scavenging through everything in the apartment, I found them--six remaining in the blister pack. I took one and felt as if I could now go on.
Over the next few days he popped the 37.5-milligram capsules when he awoke
feeling dizzy, almost seasick, disoriented and in a heavy sweat, the pillow soaked. One night, awake and not eager to go back to lying restlessly in bed, I went online, typed in "Effexor withdrawal" and found bulletin boards full of pained, plaintive and sometimes angry posters who had quit taking their medication and were suffering a broad but surprisingly consistent range of symptoms: dry mouth, muscle twitching, sleeplessness, fatigue, dizziness, stomach cramps, nightmares, blurred vision, tinnitus, anxiety and/ weirdest of all, what were referred to as "brain zaps or "brain shivers."
As Stutz continued on the 75-milligram dosage,
my symptoms became more physical: the chills at night and the cold sweats continued. I felt tingling in my shoulders and hands, spasms in my legs....And then one night as I lay back to go to sleep, I felt a quick spasm in my head as if an electrical current had suddenly been sent through a circuit somewhere inside my brain. Two more followed in quick succession. With each came a wave of nausea....I realized these were the brain zaps, and over the next few weeks they would come, with no distinguishable pattern, several times a day.
There's more, of course, including Stutz's conversations with neuroscientists, psychiatrists and therapists to help him understand what was going on. Read the entire article here.
I wonder: Would anyone agree to take antidepressants like Effexor if they knew how hard it might be to stop taking them? And that (as Stutz notes in the latter part of the essay) such drugs may blunt or dull one's sensations of the world around them?
Lest you think I would blithely doom people to a life of depression without medication, I point out that there ARE proven alternatives to medication, including, of course, psychotherapy, that have fewer side effects and are easier to discontinue. IMO psychotherapy or counseling should always be the first line of "treatment" for depression, anxiety, or other problems in emotional well-being. Unfortunately, as Stutz points out, "drugs, not therapy, have become the first line of defense. Only some 20 percent of people prescribed an antidepressant ever have even a single follow-up appointment."
Maybe some people, if adequately informed of the side effects and potentially difficult withdrawal process of these psychiatric drugs, would decide to try psychological and behavioral interventions for depression instead of medication. Maybe not.
Stutz himself doesn't know if the medication (instead of his simultaneous psychotherapy) actually helped him at all in his recovery from depression. But he's very glad he got off it.
), "The Flame" (
). 
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