> Where are you getting this from? Withdrawal syndrome is a minor component in any real addition and is nothing without craving for the substance which is not present with SSRIs. As someone who has experienced both reasonably severe SSRI withdrawal and nicotine addiction I find your comparison ridiculous (no exp with opiates, but it seems safe to assume they aren't better than nicotine).
The issue is the way your body normalizes to the new default of higher Serotonin levels - when you suddenly return to normal the present state is worse than the it was before you started taking SSRI's (I read a few good papers on the topic a while ago, but I don't remember their titles now - wikipedia is probably a good place to start: http://en.wikipedia.org/wiki/Antidepressant_discontinuation_...).
Also lack of craving is a ridiculous justification for effectively prescribing substance abuse - for example aderol et. all are amphetamine salts - that people don't have a craving in the sense that they would for cocaine is just because the high lacks the euphoric effect -- they still can't function normally without dosing -- and it definitely doesn't mean it's fucking reasonable to prescribe to seven-year-olds.
Likewise people have cravings to watch their favorite tv-show or check their Facebook accounts - these cravings do not qualify these activities as substance abuse.
> Drug dependency on SSRI's is a very real thing - I honestly don't see how its any better than an opiate addiction.
Where are you getting this from? Withdrawal syndrome is a minor component in any real addition and is nothing without craving for the substance which is not present with SSRIs. As someone who has experienced both reasonably severe SSRI withdrawal and nicotine addiction I find your comparison ridiculous (no exp with opiates, but it seems safe to assume they aren't better than nicotine).
I've read my share of stuff on SSRI discontinuation, not in the last because I was experiencing it first hand. My point stands. Nothing you mentioned constitutes an addiction.
> Also lack of craving is a ridiculous justification for effectively prescribing substance abuse
What? The justification is improvement of patient's quality of life which is often unacceptably low without the treatment. Blinded by the anti-drug dogma you are unable to see that sometimes the only available alternative is endless suffering.
> these cravings do not qualify these activities as substance abuse.
And thats BS. It's completely physically and psychologically addictive for many people with severe withdrawal symptoms. If they're not considered addictive then thats an issue with the DSM and inconsistent metrics used by medical fields.
> As I mentioned to someone else, please take an earnest visit to https://www.reddit.com/r/StopSpeeding/ and consider the idea that a lot of our ADHD peers struggle with stimulants.
I'm sure many do struggle with abusing stimulants. They're not silver bullets, and do need appropriate care and monitoring by a medical professional. Especially when starting a new treatment.
However, I find that link is also full of things like "Bob was addicted to Adderal, and took 30mg everyday for 8 years". To me thats sounds like a successful therapeutic treatment without other supporting info like "Bob would use his monthly supply in a week". Few would consider "Bob took a normal dosage of an SSRI for 8 years" as an addiction.
> That's a myth. Take a double dose of your prescription and report back whether you feel it (sort of kidding, it's a dangerous path).
To clarify, I'm sure some do get a mild high. Many don't. Maybe I'd get one on a higher dose, but I've got no desire to do so as I get much more enjoyment over just feeling awake and being able to focus. Though I definitely get a "mild high" if I accidentally take an extra dose of my SSRI.
You say that with such authority, but in my personal experience they can absolutely cause dependency. I've had long-lasting withdrawal effects from certain SSRIs that were both physically and mentally painful.
> Some antidepressants can have terrible withdrawal symptoms too - I went through the worst couple of weeks of my life after tapering off dosulpine, and I know someone else who had it rough after tapering off a tricyclic.
Apples and oranges. Not all withdrawals are equally bad.
Savvy healthcare providers will switch you to Fluoxetine, which has an extremely long half-life, and then taper the Fluoxetine.
Phenibut's withdrawal symptoms are on another level entirely, especially when people take abuse-level dosages to feel temporary euphoria: https://www.reddit.com/r/quittingphenibut/
Anti depressants are addictive in the classical sense. But the pharmaceutical companies don't call it 'withdrawl' but rather 'discontinuation syndrome' when you're coming off them. Looks like not much as changed in 100 odd years of pharmaceutical marketing.
>I could not agree with you more: Both my partner and I have been on SSRIs / SNRIs before for LIMITED DURATION. Probably over 10 times between the two of us.
You might want to consider maintenance therapy. The actual evidence for severe discontinuation effects is quite limited, but we have fairly strong evidence that maintenance therapy significantly reduces the rate of relapse. It's natural to want to avoid taking drugs indefinitely, but it's often a better option than a long-term cycle of depression, treatment, discontinuation and relapse.
I suspect that a substantial proportion of people mistakenly believe that they're "addicted" to anti-depressants, when really they're just receiving an effective treatment for a chronic condition. They feel worse when they stop taking the pills, because the pills are doing what they're supposed to do.
> All stimulants are addictive and you will have physical side effects from discontinuing use.
I love those side effects though. It is so nice to stop taking them and feel cozy and rest for a few days. The best description I have for it is that it feels like when you get home from a hard days work and are tired and go sit down in your sofa and just relax. Just that the feeling lasts for days! Awesome, right?
I hate being on the meds and I never take them when I don't work, but I have to take them to do any kind of work requiring focus like for example filling out a form.
1. The results of this study are about long-term treatment, not a single dose.
2. The study makes absolutely zero claims about the epiphenomenal effects of receptor site increases/decreases, as far as I can see. That is your interpretation (with no evidence.) Sure, people describe withdrawal effects after quitting a drug that made them feel good, and there might be a correlation with decreasing receptor sites and those withdrawal symptoms, but you have not established any causal links, the main point I asked you about.
3. In the original comment you associated the generally positive effects that the OOP described as a consequence of decreasing serotonin receptor sites. Yet then you make a claim based on this study that decreasing receptor sites cause negative withdrawal effects. It very much seems like those two claims contradict themselves? Honestly a bit confused here what you're trying to say.
> I have been studying neurobiology for 20 years.
Well that's impressive. May I ask what your h-index is?
> I think they only work if you got anxiety or something
Probably something to that. I didn't feel much at the prescribed dose. Being curious and foolish, I took 3x. Did feel that. Socially effusive. Good sleep. There was a physical aspect. A warm glow, muscles that felt relaxed rather than stiff. Like waking up in warm sun after a particularly good night's sleep.
People without anxiety, who aren't literally and metaphorically tense, probably get far less of that. But that's what it does for a really anxious person like me, especially with a bit too much. So of course I did it again the next day.
You quickly come to long for, or believe that you're just better off, in that state all the time. But there is tolerance. It stops working like that at the same dose after a few days in my experience. So, take more. I was in big trouble within a month. That's the psychological addiction in my experience, the strong desire or preference for being in that state, emotionally.
I couldn't stop. No physical consequences but intolerable withdrawal mostly of rebound anxiety and insomnia. I eventually got off them with a very long taper. ~5 months with the dose adjusted weekly. No significant physical withdrawal. At the right dose of a long-lasting benzodiazepine, I felt like before I had started taking them, more or less. I did have to learn to deal with the psychological need to be more disinhibited than normal. If I could do that, and not escalate doses, getting off would be possible. It was, and I haven't taken any since the last dose of the taper. I think about that state and sometimes I do long for aspects of it, but they're not really cravings anymore. Only get those for nicotine.
>My father's psychiatrist even did a reset protocol, where she cut all medication for a few days and started over with new meds
That can be quite brutal when it comes to some drugs like venlafaxine. The withdrawal symptoms from that are awful. Some psychiatrist don't seem to think that the meds they prescribe can have withdrawal symptoms when you stop.
I think this varies highly from person to person. As someone who takes one to two days off a week, when possible, I must say I get some pretty brutal withdrawal side-effects.
None of the side-effects are really dangerous or life-threatening by any means, but they are still somewhat disabling. I've been taking my medication for about 8 years now, and I am starting to feel like the medication:
1. Has drastically diminished it positive returns
2. Is starting to take more away from me than it's giving back
Not sure, what other option I'll move to, but I do not have many of them left since I have tried almost all the various stimulant formulations multiple times minus Desoxyn.
You view of these things don't converge with my experiences at all. The flue-like 'withdrawal' from ssri's is not nice, but it is peanuts compared to drugs with a misuse potential like opioids. Opioids rewrite your brain's reward system, the withdrawals are excruciating, and your former addiction will be a part of you for the rest of your life.
As I wrote having first and second hand experience with both kinds of withdrawal I think talking the danger of opioids down while talking ssri's up is wrong and dangerous.
> Is it really that you're addicted to them? Would you suffer real withdrawal were the internet to be out of order for a few weeks?
There's various types of withdrawal. Your life wouldn't be at genuine risk compared to the withdrawal you get from various drugs. But yeah, it's entirely possible that you'd feel horrible for a while. True for me, at least. I suggest you try it to find out (never rely on your ability to perceive your own addiction! check and see what actually happens).
> users do not suffer from withdrawal symptoms/effects
I smoke a lot of weed. Withdrawal isn't a big deal, but it is a thing. It's closer to caffeine withdrawal than alcohol/nicotine withdrawal though. Symptoms I've experienced when taking a break are typically irritability and insomnia for about a day or two. And of course cravings over the longer term which often brings me back.
For other people reading this who are less familiar, there is a difference between dependence and addiction. This difference offers a clear explanation behind why someone can have withdrawal symptoms from abrupt SSRI cessation despite these not being addictive drugs. It also explains why some opioid use is considered beneficial while other use is considered harmful, despite all opioids having properties that can lead to dependence.
> tried to see if I had gotten past the point of needing it by tapering off
A small point, but the "discontinuation effects" for these meds can be severe, and they can make people think they still need to take the meds. This keeps people taking meds for very long amounts of time.
Some people are okay with the side effects, and they've made an informed choice about the risks of taking these meds long term.
The Guardian newspaper has been running a couple of stories about long term use. I think they're a little bit alarmist, but the personal experiences are useful.
The issue is the way your body normalizes to the new default of higher Serotonin levels - when you suddenly return to normal the present state is worse than the it was before you started taking SSRI's (I read a few good papers on the topic a while ago, but I don't remember their titles now - wikipedia is probably a good place to start: http://en.wikipedia.org/wiki/Antidepressant_discontinuation_...).
Also lack of craving is a ridiculous justification for effectively prescribing substance abuse - for example aderol et. all are amphetamine salts - that people don't have a craving in the sense that they would for cocaine is just because the high lacks the euphoric effect -- they still can't function normally without dosing -- and it definitely doesn't mean it's fucking reasonable to prescribe to seven-year-olds.
Likewise people have cravings to watch their favorite tv-show or check their Facebook accounts - these cravings do not qualify these activities as substance abuse.
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