My doctor wants me to come off antidepressants. What should I discuss with him?

Question

I have been on SSRI antidepressants on and off for over 3 years now, and they work well with few side effects, and stop my depression completely.
Whenever I have tried coming off them in the past my depression has relapsed after a few months.
I have been on them continuously now since the end of 2005 (with a 3 month gap early this year but I relapsed again so went back on them).
A psychiatrist I saw 2 years ago said it would be best for me to take a maintenance dose of them indefinitely.
But now a new GP I am seeing is saying that I should come off them because they are not supposed to be taken for more than 9 months, that the long term effects are unknown, and that he doesn't want me to become dependant on them.

How should I discuss this with him?
Thanks

Answer 1

I have been on cipralex for four years now and have on occasions fazed out and reintroduced them without too many side effects. Unfortunately all drugs effect the body in different ways, but certainly these seem less troublesome than other antidepressants on the market. If you are quite young I would take your GPs advice and try to faze them out.

Answer 2

I would not advice you to listen to the opinion of a GP over that of a psychiatrist who understands the depression and the medication. GPs should be kept out of the loop and should not be prescribing mood related medication. Traeting depression isn;t merely a hit and run treatment whereby if a drug does not work then try another. It is clear that you have found a medication that works for you. Stay with it and use it the way your psychiatrists tells you to use it. He knows 10X as much about depression than your GP. Don't go off or even reduce the dosage unless your psychiatrist tells you to do so. One doctor at at time and always chose the one with the proper background and knowledge. Your anti-depressant is working. Don't play with it. If you will some day have to off the drug then the psychiatrist will take you off slowly and you will not be hooked. I word to the wise!

Answer 3

I would get a new GP. If they werent supposed to be taken for more than 9 months then why did a PSYCHIATRIST say that you would need to be on a maintenance dose indefinately? That makes absolutely no sense. I was told tha they do the meds thing in stages. You take for 1 year then wean off. If depression comes back you take for 3 years then wean off. Then 5. If depression comes back after 5 years then you may need them indefinately. Your GP is not giving meds enough time to change the brain chemistry. For alot of people it is a lifetime struggle, not just a funk.

Answer 4

Hello Neil M.

Although General Practioners (GP's) have some training in diagnosing and treating mental health conditions he/she is not very likely an expert. Therefore a psychiatrist is generally the more knowledgeable and experienced in treating mental health patients. GP's also do have some expertise in treating psychiatric patients and with pharmacology (drug combinations and interactions and their prescription and short-long term use) however they are more capable in dealing with physical not emotional or cogitive issues and therapies which need to be applied in your case.

Coming off your meds can be tried but as you've seen there are either severe withdrawl effects and or relapse. I suspect your GP is concerned about possible future side effects such as muscle twitching &/or negative side effects of withdrawal such as vomiting, cold sweats, dizziness/disorientation etc. which may be more severe with longer treatment. Discuss these concerns with him/her and see how things proceed.

The fact that your depression has reappeared does suggest that you need more long term drug therapy, at least the depression is drastically alieviated when you are taking your meds. Another way to see your long term prognosis is to consider that a remission of symptoms is the cure/goal and not a complete withdrawl from meds, certainly not at this point. Difficult/challenging life situations may predispose you to relapse without the meds to buffer you. As the psychiatrist suggested a low long-term dose of antidepressants may work better with you. For now I tend to agree. I am an academic social psychologist with some training and particular interest and experience in treating mental disorders.

To reiterate you do need counselling/therapy with either a psychologist &/or psychiatrist. One primary feature of depressed persons aside from being more sensitive emotionally than the average person (but still potentially in the normal range) is low self-esteem/self confidence which is generally created in the mind and emotions by negative thinking. This negative thinking can show up as poor body image, social or generalized anxiety in everday situations or even suicidal thoughts. If you have none of these count your blessings but even if you do possess one or more such symptoms a psychatrist is the best person to help you through this. Discuss some of these ideas with you GP and see if he/she agrees. I hope the 'cost' to work with a psychiatrist is not prohibitive.

In Christ's love and blessings,

Barry H

PS. It does sound like you get along fairly well with your GP, that's a good thing. Try to maintain the friendship.

Answer 5

From what I know depression is divided in two main categories: the one that is physical, which is due to a lack of sth in your body, and the second one, which is sentimental and is due to some bad experiences. In the first case it is normal and necessary to take intidepressants, in the second case, though possible, it would be better not to. If your case is the second one then I think you should cut it off coz it only covers the problem and doesn't fight it. You are the one who will, with your psychiatrist's help. Though it might seem difficult in the beginning you will feel very good when it will start fading away. I used to have depression for two years. I never took medication, though I could. With my pshchologist's help I started reducing the days of depression. Now I rarely feel depressed. I wish you success and courage. You can make it!!

Answer 6

You have a very smart GP that is on the mark with this. Your psychiatrist was off (no surprise there).

Psychotropic meds were not designed for long term use. Depression is something that is to be dealt with in therapy to get past it and not be medicated which does nothing to solve the problem.

I don't know what your mental health issue is to be on them (what evaluation was done and what were the findings), but unless you are suicidal or have a major mental health problem, you should be in counseling not taking pills.

Answer 7

Well i believe if it's not broke don't fix it.