# Possible problems with long-term use of SSRI antidepressants & CFS



## Susan Purry

Paul Cheney, M.D., on SSRIs and Stimulants for Chronic Fatigue Syndrome: Frying the Brain?ImmuneSupport.com06-05-2002 By Carol Sieverling http://www.immunesupport.com/library/bulle...cle.cfm?ID=3618 Most relevant bits...


> quoter. Cheney recently came across some information regarding the dangers of Selective Serotonin Reuptake Inhibitors (SSRIs), such as Prozac, Zoloft and Paxil, and stimulants like Ritalin and Provigil. During office visits, Dr. Cheney shows patients the book Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil and Other Antidepressants by Joseph Glenmullen, M.D., a psychiatrist at Harvard Medical School. It includes endorsements from other Ivy League psychiatrists. Cheney calls the implications of this book "staggering." ...SSRIs and stimulants work by increasing the firing of neurons. While this often has great benefits in the short term, doctors are now realizing that long term use "fries" brain cells. The body views any neuron that fires excessively over time as damaged, and destroys it. SSRIs and stimulants, taken over a period of 10 years or so, can lead to a loss of brain cells, causing neurodegenerative disorders. Many doctors have recently seen a sudden increase in patients with neurological symptoms, and most have been on Prozac, or a similar drug, for about 10 years. Cheney is seeing this in his own practice...What mechanisms are at work causing neurons to be "fried?" SSRIs are often prescribed for depression, which involves a lack of serotonin. Serotonin is a neurotransmitter, a chemical messenger. One neuron releases a burst of it into the intersynaptic cleft, (the gap between neurons). The serotonin is then taken up by special receptors in the adjacent neuron. Thus a message is sent from one neuron to another, with serotonin carrying the message across the gap. Excess serotonin is cleared away before a new message is sent. A "reuptake channel" in one neuron vacuums up the left over serotonin. SSRIs are designed to address a lack of serotonin by blocking the reuptake channel from vacuuming up excess serotonin. While this allows more serotonin to connect with the receptors, often too much is left floating in the intersynaptic cleft. The only way the body can get rid of this excess serotonin is to oxidize it. Unfortunately, this turns it into a toxic compound that, over time, kills both the sending and receiving neurons. Cheney stated, "What starts out as an attempt to increase serotonin and reduce symptoms ends up with the destruction of the serotonergic system itself. It takes about a decade, more in some, less in others. Now when the serotonergic nerves are dead, you start getting these motor neuron problems, which is what we're seeing." Cheney commented, "You know what a lot of doctors (who do not understand CFIDS) are doing? They're saying 'Well, let's just give them an antidepressant'. And they are frying their (patients') brains and they don't even know it. In fact, a CFIDS patient on one of these drugs fries their brain even faster than a non-CFIDS person." (See the article on Klonopin for an explanation.) ...Cheney strongly urges anyone taking antidepressants or stimulants to read Glenmullen's book, which lists safe alternatives to SSRIs


Interesting, to say the least!


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## trbell

yes, interesting, but I think a little shaded toward the anti-antidepressant view of things.flux just posted something interesting n this in the ibs forum?tom


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## Guest

Thank you again, Susan... this acts to reinforce what my body has known for years.You are very wise.


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## M&M

Very interesting indeed! Thanks for posting it Susan!


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## KarenP36

This is so disturbing considering I was just given a new prescription for Zoloft today by my primary care physician. I have been on and off antidepressants for ten years now. When I feel I have control of my anxiety and panic attacks I will go off for six months to a year but always end up going back on them. Hypnotherapy did not work for me in the past...What's even scarier is my daughter. The poor thing is 6 and she is on 20 mg of Prozac, 1 mg of Risperdal every day. She has PDD or mild autism. It makes me afraid of what her life will be like if she is already dependent on these drugs at 6? It's all very sad and very terrifying.


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## Guest

Karen.... it isn't as if there are no other ways to treat ailments. Have you explored other altneratives with your healthcare providers? Talk to Susan about this and read the link she has posted. There may not be any significant risk with short-term use or intermittent use of these meds. And your daughter may change as she grows older and she may not always need these meds.I've taken SSRI's for almost 7 years myself. One thing I noticed is that as more time went by, I seemed to require more of the medication. That bothered me. I stopped taking them... went through withdrawal.... but seem to be doing OK now.Don't lose heart over this, just be aware of the potentials and research altneratives along with discussing them with your doctors.


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## Tammyjoy

Artspirit, what type of withdrawl symptoms did you experience and how long did they last?I have been taking 50mg Zoloft for approx. 3 years, not for depression but for PMDD. (severe PMS symptoms) I find that this amount is no longer helping me but am not willing to continue to up my dosage, and now reading this I am even more certain I'd like to go off the drug. I tried last summer and experienced blinding headaches so I went back on them. Any information you could share would be appreciated. TIA


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## trbell

TJoy,Youdefinitely need to talk to your doctor about this. PMDD is one of those things that in some cases can be a media/advertising disgnosis - something the ad agencies came up with to get people to buy a product. The diagnoses you mention need to be made by a qualified person in persontom


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## trbell

sorry if i wandered from the subject of the thread here. It seems me that the question is not one of medication or not butof indingthe right one.tomfor example, in my own case long-term use of SSRI's may have led to making ibs symptoms worse but it might be that another SSRI will fix that but only if i take it for a long period of time.tom


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## Tammyjoy

Tom, thank you for your input. The diagnosis I mentioned was diagnosed by my OB/GYN. He didn't call it PMDD-he referred to it as severe PMS symptoms. He is the doctor who put me on Zoloft. I do plan to discuss going off the drug with him when I see him for my yearly exam.


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## weener

I am sitting here with a stunned look on my face after reading this article. I have been on Zoloft for 8-l/2 years. I started on them in l994 when I came down with a major episode of depression where life wasn't worth living anymore. I took breaks in between usually during the summer and went back on them in the fall. Then my doctor said that in order for the med to be effective you have to take them all the time. Then I had another episode with depression after being off of it for a few months. This time I decided to stay on it. There are days that I wonder if the med is still working, because my thought is after 8-l/2 years wouldn't my body get use to the same dosage, day after day. Then after reading this article what's better having my brain fried or going through another bout of depression. I would like to get off of all my meds, but I'm terrified about going off of the Zoloft. For anyone who has gone through the contemplation of suicide you will know what I mean. I know if I go off of it the doc will probably recommend another one. What do you think?


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## Guest

TJoy.... I used to have severe PMS too. Rather than use antidepressants, the following helped me:Use of topical natural progesterone creamDaily exerciseAvoiding lots of red meat or other animal proteins and fatsEating more complex carbohydratesRelaxation techniquesIt is my understanding that severe PMS is the result of a wide-spread syndrome in this country in particular due to a condition known as "estrogen dominance". It comes about because of a variety of things. Our lifestyles, lack of exercise, eating too much meat and fat and sugar, stress, xenoestrogens in the environment....and a host of other issues.Get this book and read it:"What Your Doctor May Not Tell You About Perimenopause"By Dr. John R. LeeRead it even if you are not at that age yet. It's invaluable. If you opt to try the topical natural progesterone cream, you will need to follow the directions carefully and use it for at least 3 months until your body has a chance to adjust to it. Someone get worse initially, but then improve. My symptoms improved immediately. I also lost 15 pounds the first 3 weeks without doing anything else.Search the Internet for Dr. John R. Lee's site. Or search on natural progesterone and you will see multiple sites popping up that can offer you considerable information on this topic.Good luck


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## Guest

Weener... I have contemplated suicide on more than one occasion so I can truly understand your position. First and foremost, DO NOT go off of your medication if you are in any way feeling suicidal. Rather... discuss alternative options with your physicians and therapists. Some of them may not be open to alternative treatments. You may need to shop around. It may also be that you are going through a difficult time in your life... you may be predisposed to depression... and your current life situation brings it on. Are you also in behavioral health and cognitive therapy counseling????? That is of major importance here.I also have clinical depression but unless my life truly depends on it, I will never again take another SSRI or any other antidepressant except for the low dose of Trazadone that I need for fibromyalgia pain so that I can sleep... NOT because of Susan's post.... but because of my own personal physical experiences with these meds.Do some on-line research of your own related to treatments for depression. There is a wealth of information out there.Tom... can you add anything here? (Tom is a psychologist)Take care, Evie


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## weener

Thank you Arts for your reply. I am not in behavioural therapy or CTC. I saw a therapist about 12 years ago for childhood issues and that helped immensely. I will be seeing my family doctor soon and will discuss the options with her. I think she wants me off of some of the meds I'm on too.


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## Feisty

Weener and Arts,Weener, I agree with Arts as for checking with your Doc before trying to go off the Zoloft. I remember you telling me she had wantd you to start tapering quite a while ago already, right?I know and understand the suicide stuff myself----been there. That was when I decided to cold-turkey all my meds. It was awful. Do not attempt it on your own. I was just so down-right angry about the anti-depressants (and ther were so many that were tried) actually making me more depressed. The last anti-depressant I was on that really "threww me over the edge" was Serzone. I made myself a promise that I would never again take another anti-depressant. (I hope).Arts ---- I'm on 1 mg. of Clonazepam ( anti-anxiety med) to help with sleeping. What is the difference between that and the Trazadone you are taking for sleep? I read your other post----that is so awesome----your dance performance. Is it ballet or another form? AWESOME. Hang in there!!!Thanks.Karen


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## weener

Hi Karen, hope you are doing well. The med that the doc wants me off is the ativan (anti-anxiety). She says that it is very addictive. She's had personal experience with it. Her mother was on it and it took her 3 years to get off of the meds. Remember the doc and I had a bit of a tiff at our first meeting about the ativan. I'm trying to wean myself off of them, but it has been difficult. I won't go off of the Zoloft until I've discussed other alternatives. I'm not suicidal and haven't been for many years. I go through a few bad spells a year (feeling blue) when the fm gets bad, but otherwise I think the antidepressants have helped me with my fm. You know the crazy thing about the ativan is I started taking it just prior to my hysterectomy. The doc prescribed 10 pills to take because I was nervous about the surgery and I took one the night before the surgery and the rest is history.


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## Tammyjoy

Thank you Arts. I'll look into the things you suggested. I hate being dependent on meds and would love to stop taking them.


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## Guest

The most important thing here is that we all support each other in good faith. Having known what deep clinical life-altering depression is like... I can relate to everyone here on this thread and on this board.Feisty.... The medicine you are taking, I believe, is related to the anti-anxiety meds such as Xanax and Valium perhaps. (If I am wrong... Please could Tom or Susan or someone correct me here). Trazadone is a type of antidepressant. The dose I take is not a therapeutic dose by any means. By that, I mean... I am not taking it to control depression. I am controlling my depression with behavior modification, exercise, be-good-to-myself therapy and practicing NOT interpreting every incoming stimulus as negative. It's the side effects of the Trazadone that allow me to sleep and to get the kind of sleep that I need to fight the pain of fibromyalgia. So the difference in the drugs is that they are in different classes of medications and they are designed to treat different things. What you are taking, Feisty... is designed to treat anxiety. I don't know enough about this med to know whether or not it is indicated for long-term or short-term anxiety. Some anxiety meds can be addictive. Antidepressants are not addictive in the same sense... yes... you go through withdrawl... but it only lasts a few weeks... and then you are OK. Thanx for asking about my dance... it's modern dance... creative.. interpretive..... we dance in our bare feet... and it is very fluid and beautiful like ballet... but we don't dance on our toes. Our moves come from the earth and from our hearts with all movement emanating from the torso into the extremities. In other words.. ... while technique training is necessary... the spirit of the dance comes from our hearts... from within..... and this mode of exericise is enormously therapeutic for me. Considering all the ailments that I have, it's amazing that I can do this at all since I only began dancing like this slightly less than 3 years ago at the tender age of 46







TJoy, Weener & Feisty.... always check with your doctors before making any changes in your medications. Going off of antidepressant meds or antianxiety meds needs to be a gradual process and needs to be monitored by your physicians/therapists.And be aware that there is much that we can do for ourselves.... It doesn't come easily or quickly ... but with the right therapist... it will happen. I see mine tomorrow for the first time in 2 months. Pat is the "parent" that I never had. And even though at times she steps on my toes to the point that I sob in her presence and in her arms...... she never misses an opportunity to support me, compliment me and encourage me at the incredible self-awareness that I am developing. And this self-awareness is what makes it possible for me to be antidepressant-free (except for the sleep stuff which I take for the fibromyalgia pain).If I were to cite any one thing as being responsible for my cultivating the ability to now exist without antidepressants.... there is absolutely no doubt in my mind that the major driving force is the CONFIDENCE that I have developed. CONFIDENCE is the whole key. And the key to finding that confidence... is in perspective..... ........ and Tom... you would know that better than anyone. Where the heck are you anyway? Get your butt in here and post. We need you here


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## Guest

I just wanted to add one other very important element to the above discussion:ANGER RECOGNITION AND MANAGEMENT EQUALS.....CHANGES IN PERCEPTION OF INCOMING STIMULI EQUALS.......DEVELOPMENT OF CONFIDENCE/SELF-ESTEEM EQUALS.......TRIUMPH OVER DEPRESSION/ANXIETYThink about that one... and then think about getting the following books: No, I am not plugging these to make money for anyone. My therapist and her husband who have their own clinic wrote these and some other books that are invaluable in the fight against depression:"Letting Go Of Anger"By Pat and Ron Potter-EfronNew Harbinger Publications, Inc.and"Letting Go Of Shame"By Pat and Ron Potter-EfronHazelden Information & Educational ServicesThese two components: Anger and Shame.... are responsible for most of the depression and anxiety in this world.Good Luck to everyone.... and if anyone wants to engage in private email... Mine is available on the above legend. Just click on the envelope.  Evie


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## *Luna*

I liked those statements, ArtSpirit







Someone asked about withdrawal from Zoloft... My experience with going from 50mg to 25mg was a week-long, bad headache. I felt dizzy and lightheaded and my head hurt for a full week, maybe a little longer. Ended up being so dizzy at one point that I could do nothing but lay on the floor for a while. Things were spinning too much for me to even sit.I tapered from 50 to 25...took 50 one night, 25 the next, 50, 50, 25, 50, 50, 25, 50, 25, 50, 25, 25, 50, 25 etc....something like that. I THOUGHT I tapered enough, but I got the withdrawal. I also felt nauseated during this time, and lots of nausea when I first started taking the med. I had some nausea and lightheadedness before that bad week, but the drug stays in your system for about 3 weeks...and it was around week 3 through 4 when I felt terrible.Now I would like to go off the Zoloft completely, for various reasons. But I also started taking it around the time my IBS got a little better, and I kind of hate to go off it if it is helping. I really hate to go through withdrawl, then have to adjust to that or another med again. I can't lose all that time to feeling crappy.I can't wait for Lotronex to available again. Then I can definitely go off the Zoloft. Not sure if I will before then or not...I'm very tempted to try. My dr. supports whatever decision I make.


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## Guest

Hi Luna.... why was Lotronex ever removed from the market anyway? I don't know much about it, I just know from this board that it apparently helped a lot of people. I don't know what kind of med it is or what its mechanism is, so maybe you could share that with me?I had flu-like symptoms for a few weeks when I tapered off of both Zoloft and Celexa. I didn't mind because I had strong motivation (both rendered me anorgasmic.... and I know this sounds pretty extreme, but I'd almost rather be dead than be anorgasmic... and I am doing very well without the SSRI's in my life. Intimacy with my husband is probably the biggest healer in my life). He also has IBS as well as epilepsy and is sexually dysfunctional to boot. We go through a helluva lot together to get what we want from each other.... but by golly... we get it.... and it's great!! And THAT, in my opinion, is far better than any drug.I'm getting off the topic again... so time to move on.....


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## *Luna*

There is lots of info on Lotronex in the 5HT3 (Lotronex) forum.Basically, Lotronex is an SSRI in the gut. It acts on a specific receptor in the gut and was a miracle drug for many people with IBS-D, including me. The difference was so incredibly amazing!! I had an almost normal digestive system while on it, and moderate to severe IBS-D without it.Some women who were taking Lotronex had bad side effects and a few died, so the group Public Citizen campaigned for it to be withdrawn. Now, I know that sounds scary, but the people who had problems with it were people that should have never been taking it in the first place. Some dr's misprescribed it for patients with ANY type of IBS. So some people ended up with bad constipation and bowel impaction. The side effects people got, I can't help but wonder how they could ignore the patient info and what their body was telling them until it got so bad they needed to be hospitalized. I should stop before I say too much more. I am pretty bitter that people like me could not take the medicine that changed our quality of life so much for the better because of it being misprescribed or people ignoring medical directives. For instance, if you got constipated, you were supposed to reduce your dosage or stop the drug. A lot of people on here found the regular dosage was too strong for them. It was just perfect for my bad D, thought. It is coming back with a recommended dosage of half what it was before. Hopefully that will help me enough, or I will be able to take more if needed.


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## Guest

Thanx for the explanation, Luna. I can see where drug with that kind of mechanism might cause some significant problems if mis-prescribed.


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## *Luna*

I forgot to specifically mention that Lotronex was intended only for women with diarrhea-predominant IBS. People who alternate or are C-type were never supposed to be on it in the first place.


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## celticlady

Yikes!







Is Effexor(and also trazadone) on the "bad" list???I need to know!Artspirit-you are right re the "medical magic" of an orgasm







I do self-help stuff like self-hypnosis,etc.but I sometimes get the feeling that some people think that some of us who currently HAVE to be on anti-depressant medication are somehow not "strong" enough. Not to offend anyone,but this attitude can be kinda"holier than thou",and could be percieved as hurtful to those who really need to be on SOMETHING. My spinal problems(probs with 7 discs,possibly more)are currently severe enough to also require a low dose of narcotics.I have noted a negative attitude from some of my relatives,like I am somehow a "junkie" or just not strong enough to get thru with plain tylenol....







I see a therapist,I do theuraputic pool exercise, and daily back exercises,and did do home traction before the neck surg,and when I get some more cash will go back for massage and acupuncture,but right now I am 7 weeks post-op from a spinal surgery(discectomy with a fusion and placement of a titanium cage )and I am having flare-up of some of the other discs,today cannot use left hand to drive,and can barely type this,having to lay flat in bed on ice most of the day.Thank goodness my hubby is helping me out.Thanks again for the interesting post-keep 'em coming!!!


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## ncottle

What is an SSRI Drug? Please explain. I also find that taking a 5 mg. tablet of Valium helps my pain of Fibromyalgia, and also relaxes me enough to get to sleep. I take no more than two a day. Please share your comments. Thanks.


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## Susan Purry

ncottle, the beginning of the article explains what SSRI stands for, what they do, and lists a few of the different antidepressants which are SSRIs.


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