Article: Treating Anxiety By Discontinuing Antidepressants: A Case Series
#1
Posted 19 April 2014 - 11:16 AM
Abstract:
When a patient has symptoms of anxiety, while taking an antidepressant for depression, is it possible that the antidepressant is part of the problem? Can antidepressants cause anxiety? If this were so, even if relatively rare, it would have widespread implications because of the broad use of antidepressants. However, antidepressants are widely used as a treatment for anxiety. Therefore, unless suggestive evidence were to emerge to implicate them as a potential exacerbating factor, broad use of antidepressants would likely continue for patients whose depression has improved but whose anxiety has not responded, or worsened. In that context we present 12 patients whose anxiety diminished substantially when antidepressants were tapered off, as reflected in Clinical Global Improvement Scale scores assigned by their respective clinicians. Mean duration of antidepressant taper was 17 weeks (range 0-48), as suggested by limited prior evidence supporting very slow taper rates for this purpose. Alternative treatments for depression were often used for these patients as antidepressants were tapered, particularly lithium and lamotrigine, but none of the alternatives used are generally regarded as having anti-anxiety effects. Patients with bipolar disorder diagnoses, including schizoaffective disorder, were specifically excluded. In many of these cases, other medications that might have anti-anxiety effects (including buspirone, quetiapine, olanzapine, gabapentin, and diphenhydramine) were also tapered off. Results suggest that antidepressants may actually cause anxiety in some patients with unipolar depression. Alternatively, lamotrigine or lithium may have more anti-anxiety effects than generally recognized; or these patients may have had subtle bipolar disorder despite the absence of symptoms meeting formal criteria, supporting the "bipolar spectrum" perspective on mood disorder diagnosis. This study is limited by the outcome measure used, which assesses anxiety only indirectly in the context of global improvement. However, in view of the broad implications of the findings, these preliminary observations warrant further consideration. Some patients with anxiety
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#2
Posted 19 April 2014 - 12:33 PM
Indeed Fn, very interesting article, which prooved half my point.
Cymbalta created havoc in my anxieties worst than never, lexapro was not as damagable, but did not help at all. Along those 9 months on them, my condition worsened gradually till it blew up at 8 months use. Full mode anxiety.
Before this, at least, I could have 15 to 18 good days a month, After 8 months, I was at Zero good days. Needless to say, most of the stressors had been removed from my life situation. So, go figure it out! What a shit it did.
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#4
Posted 19 April 2014 - 07:58 PM
I will be devastated to have to give in & do this but I'm not functioning well enough to have any quality of life ATM .
Any advise will be greatly appreciated !...
My ship is sinking ..:-(((((((((
#8
Posted 20 April 2014 - 06:12 AM
That is not the only article out there like that. In addition, if you look at the side effects of some of the ssri in particular, you will note anxiety listed.
Hello Fh, with all the research you have done, would you by any chance have other articles related to this?
Thanks
#10
Posted 20 April 2014 - 09:23 AM
-Fivenotions, thank you for the article. I can't wait to get back to school where I have free access to research articles. I get angry, but it's something I need to know.
-Wagtail, I hope you can talk to someone soon. Until February 2012, I used talk therapy for anxiety. Group therapy is good also. My therapist has a women's group and I have access to a another weekly group. From what I've seen you post, your diet and activity is very good, so talking may help you.
Have a relaxing Sunday everyone.
- Wagtail likes this
#11
Posted 20 April 2014 - 10:57 AM
To Wagtail, I read that you do not have a GP. Is it related to health care insurance? I too think you need a GOOD doctor to check blood panels and do a good assessment. The best way to find a good doctor is on the recommendations of a savvy friend. Or...the www looking for CV and reviews. My thought is you need Internal Medicine rather than Generalist. You have a complexity of issues that may be over the average GP's level of practice. Sending you hope down under.
#12
Posted 20 April 2014 - 03:26 PM
Thanks everyone for your help .
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#13
Posted 20 April 2014 - 07:32 PM
Hello Fh, with all the research you have done, would you by any chance have other articles related to this?
Thanks
Research articles on sssri being anxiogenic.
http://www.ncbi.nlm....pubmed/21397628
Research articles on ssri and causing anxiety
http://www.ncbi.nlm....pubmed/12527473
http://www.ncbi.nlm....pubmed/11485052
http://www.ncbi.nlm....pubmed/18454279
http://www.ncbi.nlm....pubmed/24155299
http://www.ncbi.nlm....pubmed/19440190
http://www.ncbi.nlm....pubmed/19840819
fluoxetine is acutely anxiogenic.
Many more articles are available on this ssri.
http://www.ncbi.nlm....pubmed/16971899
http://www.ncbi.nlm....pubmed/18830239
citalopram is anxiogenic.
http://www.ncbi.nlm....les/PMC2129095/
http://www.ncbi.nlm....pubmed/17524369
fluoxetine and citalopram is angiogenic in early stage of use.
http://www.ncbi.nlm....pubmed/22232580
http://www.ncbi.nlm....pubmed/10347793
http://www.ncbi.nlm....pubmed/21315769
Long term and short term anxiogenicity of fluoxetine
http://www.ncbi.nlm....pubmed/11271409
Paxil is anxiogenic.
http://www.ncbi.nlm....pubmed/11806866
http://www.ncbi.nlm....pubmed/11037770
sertraline and fluoxetine are angiogenic.
Drug data sheets on ssris.
citalopram (Celexa, Cipramil, Cipram, Dalsan, Recital, Emocal, Sepram, Seropram, Citox, Cital)
http://www.drugs.com/pro/citalopram-capsules.html
4% experience anxiety as a side effect.
http://www.ehealthme.com/ds/celexa/anxiety
8.6% report increased anxiety.
escitalopram (Lexapro, Cipralex, Seroplex, Esertia)
http://www.drugs.com...ph/lexapro.html
Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania may be precursors to emerging suicidality
Side Effects - anxiety attacks
http://www.ehealthme...lexapro/anxiety
9.3% report anxiety as a side effect.
fluoxetine (Depex, Prozac, Fontex, Seromex, Seronil, Sarafem, Ladose, Motivest, Flutop, Fluctin (EUR), Fluox (NZ), Depress (UZB), Lovan (AUS), Prodep (IND))
http://www.ehealthme.com/ds/prozac/stress+and+anxiety
6.5% report anxiety as a side effect.
http://www.drugs.com/sfx/prozac-side-effects.html
Psychiatric side effects including hypomania, mania, transient psychosis, development of obsessive-compulsive symptoms, paranoid reaction, delusions, agitation, and a depersonalization syndrome have been reported.
fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox, Floxyfral)
http://www.ehealthme.com/ds/fluvoxamine+maleate/anxiety
4.6% report it causes anxiety as a side effect.
http://www.rxlist.com/luvox-cr-side-effects-drug-center.htm
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.
http://www.drugs.com...de-effects.html
Psychiatric side effects including cases of hypomania and mania, apathy, indifference, disinhibition (without concurrent hypomania), hallucinations, paranoid, suicidal or antisocial ideation, abnormal thinking, and panic attacks have been reported.
paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Divarius, Rexetin, Xetanor, Paroxat, Loxamine, Deparoc)
http://www.drugs.com...de-effects.html
Psychiatric side effects have frequently included anxiety (2% to 5%), agitation (2% to 5%),
http://www.ehealthme.com/ds/paxil/anxiety
8.9% reported anxiety as a side effect.
sertraline (Zoloft, Lustral, Serlain, Asentra, Tresleen)
http://www.ehealthme.com/ds/sertraline+hydrochloride/anxiety
6.6% report anxiety as a side effect.
http://www.drugs.com/sfx/sertraline-side-effects.html
Psychiatric side effects including agitation and changes to hypomania have been observed infrequently. Although the drug has been reported to be an effective agent in the treatment of panic attacks, several cases of sertraline- induced panic attacks have been reported.
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#15
Posted 21 April 2014 - 05:51 AM
Fishinghat, I love you! merci for all of this,
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#16
Posted 21 April 2014 - 07:10 AM
Wagtail, I do know one person (female 44) on Welbutrin. She does not have any side effects from it. However, as we ALL know by now, these meds affect people differently with side effects and general state of mind. If Wellbutrin was the magic pill, everyone would be jumping ship to go on it. On the other hand, how much suffering can one take? I believe from reading other posts, you've been off Cymbalta for quite a while. Considering your doctor is on a 6 week holiday and you've stated he seems to be oblivious to your plight, this may be the perfect time and reason for a second opinion of another doctor. One final comment, I can ONLY speak for me...if I cannot manage my anxiety and these pesky withdrawal symptoms after a certain period, I will go back on another med. Personally, I will be seeking a med in the other family of drugs like prozac, etc. It will be a med that has the good old fashioned withdrawal symptoms attributed to it. Not something that takes weeks/years to get rid of.
#17
Posted 21 April 2014 - 08:55 AM
I think you need to deal with the Lyme disease first...all those articles on depression/anxiety as a Lyme side effect that I posted yesterday on the other thread really opened my eyes..... You can't deal with your health issues piece meal any longer....I think you need a Lyme disease specialist !
I also think it would help for you to take your husband with you to the doctor appointments....having someone else there who knows what you've been taking and going through can be a big help when giving your initial medical history....two memories are better than one when things are complicated and confusing....it also helps to impress on the docs that your family takes this seriously and isn't going to let you get pushed around or forced into anything....
Keep us posted!
#19
Posted 21 April 2014 - 02:06 PM
http://www.medicalhe...amine-test.html
"Fortunately dopamine levels can be easily tested and adjusted. Dopamine levels can be tested by taking a simple dopamine blood test or a basic urine test. And dopamine levels can be easily adjusted by focusing on proper nutrition and medication."
Here is a site that might help.
#20
Posted 21 April 2014 - 04:17 PM
This article was just released here & it's very interesting ... Informed concent is mentioned & it is recognizing that antidepressants are causing suicides In the military .
You may need to google it because I'm on my iPad & it's not copying & pasting properly .
- thismoment likes this
#21
Posted 21 April 2014 - 09:12 PM
Keep us posted......
#22
Posted 22 April 2014 - 06:01 AM
http://www.medicalhe...amine-test.html
"Fortunately dopamine levels can be easily tested and adjusted. Dopamine levels can be tested by taking a simple dopamine blood test or a basic urine test. And dopamine levels can be easily adjusted by focusing on proper nutrition and medication."
Here is a site that might help.
Thismoment, that is quite a surprise. I was about sure that the answer would be negative. Thank you.
#23
Posted 23 April 2014 - 10:57 AM
http://www.nmh.org/nm/datscan
Thanks to a new diagnostic imaging technique, physicians now have an objective test to evaluate patients for parkinsonian syndromes, such as Parkinson’s disease. Northwestern Memorial Hospital is among the first institutions in the country to offer DaTscan™, the only FDA-approved imaging agent for assessment of movement disorders. Until now, there were no definitive tests to identify the disease, forcing physicians to rely on clinical examinations to make a diagnosis. This technology allows doctors to differentiate Parkinson’s from other movement disorders.
“The scan by itself does not make the diagnosis of Parkinson’s but it allows us to identify patients who have loss of dopamine, the major chemical responsible for the symptoms, from those who have no dopamine deficiency,” said Tanya Simuni, MD,, a neurologist at Northwestern Memorial and director of Northwestern’s Parkinson’s Disease and Movement Disorders Center. “This is a very important step in being able to accurately identify and treat movement disorders and hopefully allow us to better understand these diseases over time.”
#24
Posted 23 April 2014 - 11:01 AM
The Whacky, Wild and Misleading World Of Neurotransmitter Testing
http://www.primalbod...mitter-testing/
#27
Posted 24 April 2014 - 01:17 PM
FN - Sorry about my posting above . didn't mean to make it bold and scream at you. Sorry.
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