@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych There are a number of studies exploring both physician & patient attitudes towards going off #antidepressants.

Lack of physician confidence in tapering plays a large role. Their patients don't trust their knowledge, either, & rightly so. This is a subject nobody wants to unpack.
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych McCabe, J., Wilcock, M., Atkinson, K., Laugharne, R., & Shankar, R. (2020). General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal. BJPsych Open, 6(4). doi.org/10.1192/bjo.20…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych McCabe, J., Wilcock, M., Atkinson, K., Laugharne, R., & Shankar, R. (2020). General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal. BJPsych Open, 6(4). doi.org/10.1192/bjo.20…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Treadwell, J. S., Wong, G., Milburn-Curtis, C., Feakins, B., & Greenhalgh, T. (2020). GPs’ understanding of the benefits and harms of treatments for long-term conditions: An online survey. BJGP Open, bjgpopen20X101016. doi.org/10.3399/bjgpop…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Scholten, W., Batelaan, N., & Van Balkom, A. (2020). Barriers to discontinuing antidepressants in patients with depressive and anxiety disorders: A review of the literature .... Therapeutic Advances in Psychopharmacology, 10, 2045125320933404. doi.org/10.1177/204512…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Read, J., Grigoriu, M., Gee, A., Diggle, J., & Butler, H. (2020). The Positive and Negative Experiences of 342 Antidepressant Users. Community Mental Health Journal. doi.org/10.1007/s10597…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Chevance, et al. (2020). Identifying outcomes for depression that matter to patients, informal caregivers, and health-care professionals: Qualitative content analysis of a large international online survey. The Lancet Psychiatry, 7(8), 692–702. doi.org/10.1016/S2215-…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Zilcha-Mano, S., Roose, S. P., Brown, P. J., & Rutherford, B. R. (2019). Not Just Nonspecific Factors: The Roles of Alliance and Expectancy in Treatment, and Their Neurobiological Underpinnings. Frontiers in Behavioral Neuroscience, 12. doi.org/10.3389/fnbeh.…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Wentink, C., et al. (2019). Enhancing shared decision making about discontinuation of antidepressant medication: A concept-mapping study in primary and secondary mental health care. British Journal of General Practice, 69(688), e777–e785. doi.org/10.3399/bjgp19…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Tomlinson, A., Boaden, K., & Cipriani, A. (2019). Withdrawal, dependence and adverse events of antidepressants: Lessons from patients and data. Evidence Based Mental Health, 22(4), 137–138. doi.org/10.1136/ebment…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Tikkinen, et al. (2019). Public, health professional and legislator perspectives on the concept of psychiatric disease: A population-based survey. BMJ Open, 9(6), e024265. doi.org/10.1136/bmjope…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Taylor, et al. (2019). Public Health England: Dependence and withdrawal associated with some prescribed medicines: An evidence review. Public Health England. assets.publishing.service.gov.uk/government/upl…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Svensson, S. A., Hedenrud, T. M., & Wallerstedt, S. M. (2019). Attitudes and behaviour towards psychotropic drug prescribing in Swedish primary care: A questionnaire study. BMC Family Practice, 20(1), 4. doi.org/10.1186/s12875…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Krska, J., Corlett, S. A., & Katusiime, B. (2019). Complexity of Medicine Regimens and Patient Perception of Medicine Burden. Pharmacy: Journal of Pharmacy Education and Practice, 7(1). doi.org/10.3390/pharma…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Greenfield, B. (2019, January 3). In recovery—From antidepressants. How patients are helping each other withdraw. Yahoo. yahoo.com/lifestyle/reco…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Eveleigh, R., Speckens, A., van Weel, C., Oude Voshaar, R., & Lucassen, P. (2019). Patients’ attitudes to discontinuing not-indicated long-term antidepressant use: Barriers and facilitators. Therapeutic Advances in Psychopharmacology, 9. doi.org/10.1177/204512…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Duncan, P., Cabral, C., McCahon, D., Guthrie, B., & Ridd, M. J. (2019). Efficiency versus thoroughness in medication review: A qualitative interview study in UK primary care. British Journal of General Practice, 69(680), e190–e198. doi.org/10.3399/bjgp19…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Davies, J., & Read, J. (2019). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors, S0306460318308347. doi.org/10.1016/j.addb…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Carville, et al. (2019). Patients’ experience: Review of the evidence on dependence, short term discontinuation and longer term withdrawal symptoms associated with prescribed medicines (National Guideline Centre). Royal College of Physicians. rcplondon.ac.uk/projects/outpu…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Zolnoori, et al. (2018). Identifying the Underlying Factors Associated With Patients’ Attitudes Toward Antidepressants: Qualitative and Quantitative Analysis of Patient Drug Reviews. JMIR Mental Health, 5(4). doi.org/10.2196/10726
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Yoon, S., Dang, V., Mertz, J., & Rottenberg, J. (2018). Are attitudes towards emotions associated with depression? A Conceptual and meta-analytic review. Journal of Affective Disorders, 232, 329–340. doi.org/10.1016/j.jad.…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Weinstein, et al. (2018). Tapering off and returning to buprenorphine maintenance in a primary care Office Based Addiction Treatment (OBAT) program. Drug and Alcohol Dependence, 189, 166–171. doi.org/10.1016/j.drug…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Guy, et al. (2018). The Patient Voice: An analysis of personal accounts of prescribed drug dependence and withdrawal....All-Party Parliamentary Group for Prescribed Drug Dependence. prescribeddrug.org/wp- content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych deBronkart, D. (2018). The patient’s voice in the emerging era of participatory medicine. The International Journal of Psychiatry in Medicine, 53(5–6), 350–360. doi.org/10.1177/009121…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Berzins, et al. (2018). A cross-sectional survey of mental health service users’, carers’ and professionals’ priorities for patient safety in the United Kingdom. International Journal of Public Participation in Health Care and Health Policy. doi.org/10.1111/hex.12…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Ostrow, L., Jessell, L., Hurd, M., Darrow, S. M., & Cohen, D. (2017). Discontinuing Psychiatric Medications: A Survey of Long-Term Users. Psychiatric Services, 68(12), 1232–1238. doi.org/10.1176/appi.p…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Mc Gillicuddy, et al. (2017). The knowledge, attitudes & beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature. Research in Social and Administrative Pharmacy. doi.org/10.1016/j.saph…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Goodwin, G. M., Price, J., De Bodinat, C., & Laredo, J. (2017). Emotional blunting with antidepressant treatments: A survey among depressed patients. Journal of Affective Disorders, 221, 31–35. doi.org/10.1016/j.jad.…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Fixsen, A. M., & Ridge, D. (2017). Stories of Hell and Healing: Internet Users’ Construction of Benzodiazepine Distress and Withdrawal. Qualitative Health Research, 27(13), 2030–2041. doi.org/10.1177/104973…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Duncan, P., Duerden, M., & Payne, R. A. (2017). Deprescribing: A primary care perspective. European Journal of Hospital Pharmacy, 24(1), 37–42. doi.org/10.1136/ejhpha…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Abbe, A., & Falissard, B. (2017). Stopping Antidepressants and Anxiolytics as Major Concerns Reported in Online Health Communities: A Text Mining Approach. JMIR Mental Health, 4(4), e48. doi.org/10.2196/mental…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Cartwright, C., Gibson, K., Read, J., Cowan, O., & Dehar, T. (2016). Long-term antidepressant use: Patient perspectives of benefits and adverse effects. Patient Preference and Adherence, Volume 10, 1401–1407. doi.org/10.2147/PPA.S1…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Linsky, A., Simon, S. R., & Bokhour, B. (2015). Patient perceptions of proactive medication discontinuation. Patient Education and Counseling, 98(2), 220–225. doi.org/10.1016/j.pec.…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych British Medical Association. (2015). Prescribed drugs associated with dependence and withdrawal – building a consensus for action. bma.org.uk/collective-voi…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Wouters, H., Van Dijk, L., Van Geffen, E. C. G., Gardarsdottir, H., Stiggelbout, A. M., & Bouvy, M. L. (2014). Primary-care patients’ trade-off preferences with regard to antidepressants. Psychological Medicine, 44(11), 2301–2308. doi.org/10.1017/S00332…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Vilhelmsson, A., Svensson, T., & Meeuwisse, A. (2013). A Pill for the Ill? Patients’ Reports of Their Experience of the Medical Encounter in the Treatment of Depression. PLoS ONE, 8(6), e66338. doi.org/10.1371/journa…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Hedenrud, T. M., Svensson, S. A., & Wallerstedt, S. M. (2013). “Psychiatry is not a science like others”—A focus group study on psychotropic prescribing in primary care. BMC Family Practice, 14(1), 115. doi.org/10.1186/1471-2…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Vilhelmsson, et al. (2012). Experiences from consumer reports on psychiatric adverse drug reactions with antidepressant medication: A qualitative study of reports to a consumer association. BMC Pharmacology and Toxicology, 13(1), 19. doi.org/10.1186/2050-6…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych Anthierens, S., Tansens, A., Petrovic, M., & Christiaens, T. (2010). Qualitative insights into general practitioners views on polypharmacy. BMC Family Practice, 11, 65. doi.org/10.1186/1471-2…
@benzosarebad @wendyburn @_eleven13_ @BubblesTapering @rcpsych And so forth.

Basically, nobody knows what they're doing, patients are demoralized and stuck on #antidepressants because they keep getting told they have a life-long condition no matter the reason for initial prescription.

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8 Oct
@DrFulli @lapsyrevoltee I do agree, Dr. Fulli. Response to the drug most certainly is not a diagnosis, & those physicians who conclude an adverse reaction to an #antidepressant is diagnostic of bipolar disorder not only have poor pharmacology knowledge but poor logical skills as well. /1
@DrFulli @lapsyrevoltee Even people with no pre-existing #psychiatric symptoms may have a severe adverse reaction to an #antidepressant or any other psychotropic.

Conversely, any psychotropic might relieve "depression" in someone, eg. amphetamines or opiates. This is another law of psychotropics. /2
@DrFulli @lapsyrevoltee For what it's worth, I have a collection of case studies where people had immediate severe adverse reactions to #antidepressants & even though they quit within a handful of doses, suffered symptoms identical to post-acute withdrawal syndrome #PAWS for months or years. /3
Read 12 tweets
6 Oct
"Professionalism in any field requires keeping pace with change, & nowhere is it more true than medicine....valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change." #psychiatry /1 journals.sagepub.com/doi/10.1177/00…
"Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model." doi.org/10.1177/009121… /2
"standards of professionalism & appropriate care must be updated, lest we fail to achieve best possible care....new standard must be to teach clinicians to recognize, welcome, & work with empowered #epatients in the new model of participatory medicine." doi.org/10.1177/009121…
Read 4 tweets
6 Oct
"As the meaning of the term has expanded, some #ePatients have developed a high level of expertise & in turn have taken a leadership role within the ePatient movement. @StanfordMedX has coined the term ePatient scholar to describe these leaders...." /1

ojin.nursingworld.org/mainmenucatego…
Nelson, R., (September 13, 2016) "Informatics: Empowering ePatients to Drive Health Care Reform - Part I" OJIN: The Online Journal of Issues in Nursing Vol. 21, No. 3.

ojin.nursingworld.org/mainmenucatego… /2
"The leaders introduced below demonstrate what equipped, enabled, empowered, & engaged patients can and will do to gain a proactive role in managing their healthcare. They demand ‘Give me my own damn data’ & even point out that the data are often dirty." /3
Read 5 tweets
3 Oct
UK woman tapering paroxetine: "After 18 years of stupor—of emotionless head fog, of sleeping 14 hours a day, of apathy—I’m succeeding in getting off the #antidepressant Seroxat." /1

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After reducing to 7mg paroxetine: "I spent the first half of 2019 in continual, breathless, agitated terror.
....
I couldn’t sit still, and my constant squirming made my partner cry. I suspect I had something I’ve since found out is called #akathisia." linkedin.com/pulse/learning…
"Within days of that first panic attack in January [2109], I decided to stop tapering the Seroxat and stay on the same 7mg dose. I got in touch with my GP to tell her what had happened.

I was referred to the local mental health crisis team." /3 linkedin.com/pulse/learning…
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3 Oct
@psychunseen: "...if the goal of anti-psychiatry is to get #psychiatrists to listen...this is better done within a therapeutic relationship, not in a picket line at the American Psychiatric Association annual meeting or on social media" apparently refers to me personally. /1
I thought it stood out as particularly illogical in his most recent screed psychologytoday.com/us/blog/psych-…

Who pickets the APA other than Scientology?
Then I recalled I had attended an APA meeting where there were pickets. I did not do any picketing myself, but I was invited to speak outside:

/3
Read 16 tweets
21 Sep
"They considered their findings generalisable across healthcare....” bmj.com/content/370/bm… /1
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"The review panel found that healthcare providers’ dismissive attitude toward patients was underpinned by a reluctance in all parts of the system to collect evidence on potential harms...." /3
Read 8 tweets

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