Yesterday saw my regular prescription check-up with the GP. Having now come to the end of my counselling and having thought long and hard, both on my own and together with MrsAB, I’ve taken the next positive step in starting to come off the anti-depressants. Now, I have tried this before but as they say, hindsight is a wonderful thing and at the time I think I was making too large a leap far too soon. This time I feel I am in a much better place mentally and physically. As I’ve previously said, the counselling has provided me with the skills and tools that I need to get through the ups and downs life invariably throws at us. So its time to throw away the crutch.
That’s almost an aside though from the real story I wanted to share, one which follows on neatly from last week’s series of posts about the eagerness of the medical profession to prescribe solutions via a pill. Yesterday I went to see the GP for his professional and scientific advice about the best way to reduce and stop the dosage of anti-depressant I am on. I have been taking an SSRI called Citalopram and I am all too aware that you cannot just stop taking the pills. Instead it is recommended that you taper the dosage to prevent withdrawal symptoms. Not only did the GP, my sister in law (a former mental health social worker) and my cycling buddy (a medical writer who worked on developing Citalopram) all tell me this but my previous experiences of trying to come off it have shown that you can withdraw too quickly and spike when taking the next dose. This latter experience though highlights another problem: how do you reduce the dosage and still feel good?
As I said, I sought professional, scientific advice from the GP about how best to do this. I was expecting a definitive answer. Actually, I wasn’t expecting a definitive answer as each time I’ve asked a different GP I’ve received a different answer. At least yesterday the GP told me that there is insufficient advice about how to do this. It would appear the instruction manuals only go up to prescribing the stuff. Conspiracy theorists might want to suggest that this is evidence of the drug companies locking themselves into a lucrative profit cycle. I’m not really bought by that. What concerns me more is that having been too ready to prescribe medication, the medical profession themselves are running blind during the treatment. Surely this is wrong. Surely a profession based on science should have a basis in hard, scientific evidence. Surely if you are to prescribe a form of treatment you want to understand the odds of it working and ultimately what the outcome for the patient should be.
Instead it seems that we have placed our trust and faith in a little white pill. As the pressures of modern life continue to build the answer seems to be to mask the real causes and try and carry on as normal. To break that cycle takes guts on the part of the patient and shows up the medical profession for its blind faith. If anti-depressants are part of the solution then we really need to understand the full course of treatment from prescription to end, patients and doctors need to be fully informed about the true extent of the course of action.
So I’ve taken another step. I’ve now reduced my dosage and we’ll see how it goes.
Reclaiming the AbandonedBicycle 
Well said Rob & very much hope the transition goes smoothly. You have come a long way xxxx
Couldn’t agree more, Rob. My little pink capsules (venlafaxine) are absolute beggars, to the extent that on the odd occasion that I have forgotten to take one in the morining, by tea time I have been having cold sweats, shakes and general mad thinking. One day I would like to rid myself of them, but goodness only knows when that will be – I need to be a lot braver before I have taken the step you have.
I am not totally sure that the doctors really fully understand what these little magic pills actually do to us, and by that I mean in the minutae of the millions of transactions that go on in our brains. I could well believe that they affect everyone who takes them completely differently, so that it is a completely different process for every single person to come off them. Some folk might manage cold turkey – I did with a previous course of another variant, and it was a hellish two weeks! – and others might need to take things more slowly and need more support. That is certainly true for me with my current crutch!
Anyhow, not sure of the conclusion of that really – I suppose it’s a little in support of the GP, but I think it is also that they should maybe have a little more caution before prescribing them and setting folk like us on the road you have started.
Cheers,
Stu
It’s an interesting problem. I was on anti-depressants for about two years and after counselling I simply came to the conclusion to stop. I felt the pills weren’t helping anymore and didn’t inform my doctor. I just stopped. For me, it worked out fine.
I stress the words, “for me”.
The problem I feel medical professionals and sufferers have here is that depression is such a subjective things. With cancer you can measure the amount of cancer cells with bone breakages you can see how the bone is repairing. You can’t really measure depression and as human beings we are awful at being witness to anything, let alone our own mental state. There are so many factors involved. Do we really have the tools to cope with the pills? Have the pills become a crutch and knowing we are coming off the pills does that therefore make us more stressed and anxious at the thought of living without them? Do we come off the pills only to then have something go dramatically wrong in our lives?
For me I got a sense of self-confidence and self-esteem from my counselling and I think that helped me to ditch the pills. I knew I was getting better, I knew I had strategies in place and maybe I’d also convinced myself by that point that they weren’t needed or weren’t helping. So I was able to drop them and feel confident that I’d done the right thing. Someone who still sees their pills as “helping them” will no doubt have a harder time than I did.
Whatever happens, best of luck and hopefully we can catch up soon.
I was on Citalopram for about three months a few years back. I stopped fairly suddenly, and found it was OK: I had decided the side-effects were no longer worth the benefits and wanted to test my belief that I could get my act together without medication. The key factors for me were regular counselling and seeing a consultant psychologist just once (also having good occupational health at work): the citalopram kept me together enough to take advantage of the other help I was getting, but outlived its usefulness fairly quickly.
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