Discover and read the best of Twitter Threads about #antidepressant

Most recents (9)

I'm in a particularly bad mood about the delusions of #psychiatry having spent the last week analyzing the case histories of 70 people with #antidepressant post-acute withdrawal syndrome #PAWS: duration 5-166 months, median 29.5 months. Lots of #psychiatrists involved. /1
5/70 reported recovered, 2 reported suicides. One suicide, better after 69 months of #PAWS, had an adverse reaction to an antibiotic that threw her back into the depths of withdrawal. The other, a 21-year-old woman, because of 38 months of post-SSRI sexual dysfunction #PSSD. /2
The 63 for whom I do not have reports of recovery from antidepressant post-acute withdrawal syndrome #PAWS or suicide have mostly been lost to follow-up. After years of reporting grueling symptoms, they didn't come back to tell us how they were doing. I hope they did recover.
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@dianamswancutt @shayla__love Truly excellent article, Shayla.

I know you couldn't cover everything -- @angpeacock1111 represents the epidemic of misdiagnosis & overprescribing affecting millions of people. Issues around psychosis are fascinating to academics, but there's a larger public health issue..../1
@dianamswancutt @shayla__love @angpeacock1111 Please consider another in-depth article on the patient movement represented in Medicating Normal. It is huge. There is a large peer support underground helping people deprescribe themselves -- they can't find doctors who know how to taper. Millions are looking for this help. /2
@dianamswancutt @shayla__love @angpeacock1111 Millions have been misdiagnosed & overprescribed. GPs mostly do this, but #psychiatry ignores it.

This is a patient movement that is not academic anti- or critical psychiatry, but very angry with #psychiatry for not stepping up for patient safety in #psychiatric treatment. /3
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"I sit here now in disbelief that I suffered from increasing anxiety for 9 years on Celexa (& 5 years on Zoloft), & the doctors simply raised the dose, not by a little, but by 50% each time....I developed dystonia in my feet & toes & my chest & neck...."…
10 years of citalopram: "I had no idea what [dystonia] was, & doctors' appointments resulted in no doctor suggesting the [#antidepressant] could be the culprit. I didn't even know the terms dyskinesia or dystonia. No one mentioned them either."…
"In 2011 I gave birth to a girl....the OB...switched me from Celexa 150 mg to Zoloft 10 mg with no cross taper, no advice, & no warning of the Hell I was about to endure. After many nights with no sleep due to this switch I finally started to sleep again."…
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@DBDouble @f_hieronymus @awaisaftab @rcpsych I took it as "contend" but @f_hieronymus does not seem to be aware that while #antidepressant withdrawal problems are well-documented, this awareness has not translated to clinical practice for 60 years. What is the nature of the barrier? This is the epistemiological question.
@DBDouble @f_hieronymus @awaisaftab @rcpsych First, late '80s-early '90s, new #antidepressants were held not to have a withdrawal syndrome (despite known pharmacological principles of psychotropics & appearance in clinical trials).

Then, starting with Schatzberg et al., 1997, withdrawal syndrome was held to be trivial /1
@DBDouble @f_hieronymus @awaisaftab @rcpsych Schatzberg et al., 1997 claimed #antidepressants "discontinuation" symptoms were mild, transitory, lasting only a few weeks, barely needing tapering. This held sway to the present day (despite decades of many, many patient complaints of more severe problems). /2
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Hyman & Nestler, 1996 Initiation & adaptation: a paradigm for understanding psychotropic drug action

"...describes a conceptualize the drug-induced neural plasticity that underlies the long-term actions of psychotropic drugs in the brain."
Hyman & Nestler, 1996 Initiation & adaptation: a paradigm for understanding psychotropic drug action

"Chronic perturbations can produce different types of adaptations in the brain. Many adaptations can be viewed as compensatory homeostatic responses...."
Hyman & Nestler, 1996 Initiation & adaptation: a paradigm for understanding psychotropic drug action

"Rather than conceptualizing receptor down-regulation as the mechanism of action of #antidepressant drugs, a marker of adaptation."
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Why #psychiatry research seems to exist in a parallel universe: "Academic psychiatrists who pursue research careers may not have patients after residency, let alone practice psychotherapy." -- psychologist Jonathan Shedler…
"But aren’t we seeing the same kind of arrogance & reductionism in #psychiatry today?....I cannot tell you how many depressed patients I’ve worked with...successfully....who had been on 1 medication after another for years or decades with little benefit."…
"These patients often go from #antidepressants to mood stabilizers to atypicals....We see polypharmacy nightmares, with patients on 5 or 6 or more #psychiatric medications, and they are just as depressed as when they started."…
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"I was eventually convinced by a psychologist (and my wife) to try Zoloft because I was one of those people that was either born with a chemical imbalance or I acquired one due to my childhood traumas. Well...those 3 days were...pure hell on earth."…
After 2 years on #antidepressants: Diagnosed Paroxysmal Supra Ventricular Tachycardia "24 years of my life chasing this, never not once did any medical or other professional suggest I go see a cardiologist but they were all too willing to take my money.."…
"I was very very ill about a week after I started Pristiq & I told my GP numerous times but she just said to "keep going" as it takes about 6-8 weeks to kick in and start was obvious she was in too far over her head..."…
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At age 33: "I ran into a situation that required me to confront someone. As that time approached, I became increasingly anxious about my ability to handle the situation....I went to my doctor for help. He immediately threw 20 mg of Prozac at me...."…
"I left my GP & sought out the top Psychiatrist in my city...By this time, I was such a mess due to the effects of the Prozac, I was diagnosed with GAD Generalized Anxiety Disorder....We tried several other types of antidepressants...."…
"we tried several other types of antidepressants over the following months....Each one effecting me the same way....Over the last 20 years I ran into a few occasions that required the medication to be increased....Again, I would lose my mind!"…
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1/ Thread: New study forthcoming on whether #gene-testing can help guide #antidepressant selection for #depressed patients who have failed to respond to 1 or (on average) 3-4 trials of medication. I have been skeptical: mostly, scant added value…
2/ & I found the reporting of this study annoying. On the primary endpoint, improvement in average #depression rating scores, the gene-testing failed. Patients whose MDs chose new meds w/o help of gene tests did just as well—& yet news reports suggested that tests can help…
3/ That's because the gene testing led to a choice of new meds that led to significantly more remissions (patient no longer depressed) and responses (halving of symptom burden). In general, in drug trials, response/remission shows antidepressants to better effect…
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