February 18, 2016

Be patient with depression meds

This is an old article I did for a national mental health website. I'm posting it again because I've had questions about it recently. 
I no longer take the same drugs. And not near as many. My life is better now, but it's still challenging to maintain good mental health. That's true for everyone, but especially those of us with mood disorders. We aren't just moody. We have an illness, no different than cancer or diabetes.
I'm now on an MAOI. I take it and a drug for anxiety on occasion and a sleep aid. That's it.
When I wrote this, I was on enough medication to sedate a large horse.
Genetic testing later showed most of what I had taken for years (SSRI's you've heard of) probably never had a chance to work for me. The merits of genetic testing are debatable, but that's another blog for another day.
Having the right doctor and the right plan is a huge part of recovery. At least it has been for me.
There should be no debate about that. I believe it's essential.
By Jack Smith
I’m an impatient patient.
When I was first diagnosed with depression seven or so years ago, my doctor prescribed me an antidepressant medication, warning me that it might take 2 to 4 weeks before it made any difference.
Boy was that an understatement. I vividly remember getting worse before getting better, even dealing with physical pain caused by my depression.
The first depression drug he prescribed proved ineffective, even after a month, so we tried another. The same cycle repeated itself. I didn’t start feeling better until my third antidepressant prescription—a few months after being diagnosed.
I know that is not very encouraging to those who have recently been diagnosed with depression. Hearing that it may get worse before it gets better is frustrating. But it’s true.
It takes patience to get the payoff from antidepressants. Two to four weeks is generally the minimum to see any improvement, and it may take up to six months to get the full benefit of a new depression drug. At least, that’s what my psychiatrist tells me.
Changing antidepressant medications can be just as frustrating as taking an antidepressant for the first time. The last couple of weeks have been extremely difficult for me. I began to slide back into a deep bout of depression, and my doctor wanted to be aggressive in trying to stop it. It got so bad that my stomach ached and I could barely get out of bed for a day or two, so we had no choice but to try something different.
And we did. We changed my antidepressant. While I’m generally a compliant patient, I didn’t follow the doctor’s orders exactly on how to switch antidepressants safely and make the transition. Big mistake.
Instead of slowly weaning off my old drug, which I was supposed to do over a three-day period, I suddenly stopped the antidepressant cold turkey and started taking the new drug. This led to what’s called antidepressant discontinuation symptoms. Several days of pure hell followed. I had suicidal thoughts. My anxiety increased exponentially, and I was feeling utterly hopeless and severely depressed.
I didn’t intentionally ignore the doctor’s orders. He told me to get off the old drug by cutting my dosage in half for three days before dropping it entirely. When I got home that night, I was frustrated to discover that the pill I had been taking was the type that can’t be cut in half. So I just quit taking it instead of asking for the smaller dosage.
Let’s just say I won’t ever do that again.
So if you are suffering from depression and have just been put on an antidepressant, my advice is to be patient. If you have been on an antidepressant and a decision is made to discontinue it, follow the doctor’s orders. I learned that lesson the hard way.