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Article: Treating Anxiety By Discontinuing Antidepressants: A Case Series


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#1 FiveNotions

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Posted 19 April 2014 - 11:16 AM

http://www.ncbi.nlm....pubmed/22698959

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

#2 gail

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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.


#3 fishinghat

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Posted 19 April 2014 - 06:30 PM

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.


#4 Wagtail

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Posted 19 April 2014 - 07:58 PM

Can anyone advise me , if they take Wellbutrin can you recommend it please. I'm starting to think that I may need to go back onto some form of antidepressant but I want the one with the LEAST s/e's .
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 ..:-(((((((((

#5 thismoment

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Posted 20 April 2014 - 12:52 AM

Wagtail

 

Are you talking with a psychologist at this time? 

 

I am so sorry you are having some dreadful days. Take care.


#6 Wagtail

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Posted 20 April 2014 - 01:08 AM

Hi Thismoment , no I don't have a psychologist to talk to .. I don't even have a regular GP ATM .
I am reading anything & everything I can relating to my problem but sad to say I am getting more & more confused ..

#7 thismoment

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Posted 20 April 2014 - 01:43 AM

A therapist could surely help get you started in the right direction. Sometimes elements throughout the literature resonate with us, and soon we feel overwhelmed and more confused. I hope you can find someone to talk to.

#8 gail

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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


#9 fishinghat

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Posted 20 April 2014 - 08:39 AM

Gail I would be glad to see what I can come up with but I am off to church right now. I will get back on it this afternoon/evening. Sorry


#10 clearglass

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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. :hug:


#11 xman

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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 Wagtail

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Posted 20 April 2014 - 03:26 PM

Xman, I have moved to a new area & have just been using a local doctor for common ailments. He has absolutely no knowledge concerning withdrawel & is away on a 6 week holiday . I will make it a priority to find a suitable therapist now .
Thanks everyone for your help .

#13 fishinghat

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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

 Psychiatricicon1.png 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

Psychiatricicon1.png 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.


#14 xman

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Posted 20 April 2014 - 07:41 PM

Ironically I just made a post regarding rat studies! :lol:

 

Thanks to FH for the research.


#15 gail

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Posted 21 April 2014 - 05:51 AM

Fishinghat, I love you! merci for all of this,


#16 phillyguy1

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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 FiveNotions

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Posted 21 April 2014 - 08:55 AM

Wagtail, just a reminder, Welbutrin acts to increase dopamine...if someone who has enough dopamine takes it, it will jack them up very unpleasantly....I use it successfully because I have a dopamine-deficient type of depression....remember the trouble you got into with taking the amino tyrosine? Tyrosine also increases dopamine.... So, Welbutrin likely isn't the thing for you....

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!

#18 gail

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Posted 21 April 2014 - 09:51 AM

Fivenotions, tell me, is there a test you can take to know if you are dopamine deficient? I mean a medical test. Thanks


#19 thismoment

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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 Wagtail

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Posted 21 April 2014 - 04:17 PM

http://www.naturalne...y_suicides.html


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 .

#21 Carleeta

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Posted 21 April 2014 - 09:12 PM

Wagtail...You've been through this torment for too long...I feel your query..I think you might need a slight something to be implemented so you can experience some enjoyment in your life...Like I've always said, some individuals do need certain medications because of a chemical imbalance which no herbs, diet, vitamins, and etc will help...There is no shame in this, it's just the way we are created..Once you find the right doctor and therapist and tell them everything and even your fear of cymbalta and how you quit, I'm sure they will offer more options to get you back to enjoying your quality of life...

Keep us posted......

#22 gail

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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 FiveNotions

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Posted 23 April 2014 - 10:57 AM

Unfortunately, there seems to be a lot of disagreement about blood and urine testing....the experts arguing with the experts.... I think it was Fishinghat who pointed out to me in a different thread that blood and urine tests aren't precise for testing dopamine levels in the brain...I searched for that discussion in the archives, but couldn't find it....I did find this article, however, that describes a relatively recent development in testing .... A brain scan that accurately depicts brain dopamine levels....it was developed for Parkinson's diagnosis...

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 FiveNotions

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Posted 23 April 2014 - 11:01 AM

Well, I still didn't find the article Fishinghat referenced, but this popped up.... Xiaojie might be especially interested, as it's written from the paleo diet perspective.....

The Whacky, Wild and Misleading World Of Neurotransmitter Testing
http://www.primalbod...mitter-testing/

#25 fishinghat

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Posted 23 April 2014 - 07:32 PM

The only thing I remember is that we discussed that dopamine in blood and urine yield limited results as dopamine does not cross the blood brain barrier.


#26 xman

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Posted 24 April 2014 - 11:40 AM

Yes, that is my knowledge as well. Very difficult to quantify in the brain, if not impossible.


#27 fishinghat

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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.


#28 FiveNotions

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Posted 24 April 2014 - 01:44 PM

Gee, no apology needed FH, I didn't notice anything until you mentioned it ....it doesn't show as bold on my ipad....font is larger, but I just figured you were having a "bad-eye day"..... ;-)

#29 fishinghat

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Posted 24 April 2014 - 07:19 PM

For sure my eyes need the larger print. lol





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