tendency
Explorer
Hi - I'm wondering whether anyone in this community has tried taking an SSRI, for instance lexapro, for 4-6 months each year and then stopping for the remainder?
Has anyone managed to cycle an SSRI successfully?
- Thread starter tendency
- Start date
lessthanhalf
Explorer
why? Either the mood holds steady while on treatment and then worsens once you stop, in which case you're better off continuing it ? or it holds steady when treatment ends, in which case you don't need to cycle it or start over ? Or is this seasonal affective disorder that doesn't answer to bright light therapy?
TheEngineer
Explorer
Consider how freely physicians prescribe these—like candy. Makes me question the reason.
The approach seems to be: dull the feelings, never address what's actually causing the issue. And they'll tell you your brain is defective, but luckily there's a medication for it.
This isn't an attack on you, but I've witnessed the impact antidepressants had on people I care about.
A person very dear to me got prescribed antidepressants after breaking his ankle. Now, after two suicide attempts, he's stuck in an endless loop of trying different shit to see what works.
The medical system is pure evil.
I'm begging you, steer clear of this no matter what.
The approach seems to be: dull the feelings, never address what's actually causing the issue. And they'll tell you your brain is defective, but luckily there's a medication for it.
This isn't an attack on you, but I've witnessed the impact antidepressants had on people I care about.
A person very dear to me got prescribed antidepressants after breaking his ankle. Now, after two suicide attempts, he's stuck in an endless loop of trying different shit to see what works.
The medical system is pure evil.
I'm begging you, steer clear of this no matter what.
lessthanhalf
Explorer
Antidepressants leave a lot to be desired as medications, and frequently they fail to help, yet in most cases nothing better is on offer. Talking treatments, CBT in particular, deliver comparable results, except many individuals lack the means to obtain them.
Across more than 40 years I have gone through numerous serious depressive episodes and at one time or another have used almost every antidepressant in existence. They are far from ideal, still they frequently do help and at times they save lives.
The healthcare apparatus definitely contains problems, but portraying it as malevolent bears little resemblance to how it actually functions. On this forum, roughly every 2nd or 3rd member has probably had their life preserved at some stage thanks to contemporary medical treatment. Receiving antibiotics for pneumonia rather than succumbing to it is in no sense malevolent.
What happened to your friend is something I regret, however attributing the whole of it to a single first antidepressant script seems to leave out the greater part of what really occurred.
Across more than 40 years I have gone through numerous serious depressive episodes and at one time or another have used almost every antidepressant in existence. They are far from ideal, still they frequently do help and at times they save lives.
The healthcare apparatus definitely contains problems, but portraying it as malevolent bears little resemblance to how it actually functions. On this forum, roughly every 2nd or 3rd member has probably had their life preserved at some stage thanks to contemporary medical treatment. Receiving antibiotics for pneumonia rather than succumbing to it is in no sense malevolent.
What happened to your friend is something I regret, however attributing the whole of it to a single first antidepressant script seems to leave out the greater part of what really occurred.
Mr. Blonde
Explorer
Trazodone was prescribed to me. It went straight into the garbage.
Fostradamus
Explorer
What possible reason is there to cycle an SSRI? I'm speaking as a person who is right now tapering down from the highest dose of one, and I can tell you it is not a good time. You end up with what people call 'brain zaps' — it's like a strange electrical jolt hitting your head out of nowhere. Like lessthanhalf said, either SSRIs are something you need or they aren't. In my view, playing around with them by cycling is a pretty stupid idea.
TheEngineer
Explorer
It isn't that. While constructing a deck, a guy who took pleasure in physical work and loved laboring like a horse fell from it. His ankle suffered a compound fracture.
When he barely hinted at feeling "depressed" about being stuck at home, antidepressants were immediately handed to him. That outrageous move made his condition worse. A different cocktail was then given to him. Then yet another. And after that, one more, and at this point he's caught in an endless "Let's throw this shit at the wall too see if it sticks."
X-Rays, MRI's, Blood Analysis, and so on -- am I thankful for those? Without a doubt, yes.
As for pill pushers who embody laziness and hold zero regard for what their patients actually need, do I believe a special spot in hell's pits waits for them? You bet your ass.
Everyone has a right to their own opinion. It makes me glad that you found comfort through other medications that did the job for you. Still, I hold my ground. There's a reason this is an industry that prints money.
tendency
Explorer
Yeah, this is about SAD. For me, SSRIs are a great fit — barely any side effects and they help a lot. Usually they kick in fast too, often within 2-3 days. I've moved back to a region of the US where my SAD is clinically severe, so I've been thinking about starting lexapro again.
I realize these meds often get criticized, but for a certain % of people they're extremely effective and can be life savers. My worry is what long term use might do.
Also, light therapy barely touches my symptoms.
retarequired
Explorer
I realize this is unlikely, but has bupropion been something you've tried? It's more amenable to cycling and it also has approval for treating SAD.
tendency
Explorer
Hmm, I appreciate the idea — bupropion is something I'll consider. My history has generally been that serotonin-boosting medications work better for my SAD, so wellbutrin gives me some hesitation. Still, it's worth mulling over..
GTS97
Explorer
Wtf? No. SSRI/SNRIs don't function that way. For many of them — possibly every one — you won't see any effect until you've taken them steadily for 4-8 weeks.
These aren't PRN drugs, they aren't "take it when you feel like you need it" drugs, and they aren't "take it occasionally for fun" drugs.
What an annoying post.
These aren't PRN drugs, they aren't "take it when you feel like you need it" drugs, and they aren't "take it occasionally for fun" drugs.
What an annoying post.
lessthanhalf
Explorer
According to the original poster, it helps him across that timeframe. If it's effective and isn't creating issues, is there really any cause for worry?
True, they usually need more time than that to kick in, but the direct chemical action happens almost immediately, and why mood improvement takes 2-8 weeks remains unexplained even after decades of studies attempting to solve it. Plenty of hypotheses exist, yet nothing conclusive.
Seasonal affective disorder is a recognized condition, and I don't believe medicating it counts as merely for enjoyment, since it can be just as debilitating as any other form of depression. I haven't looked into SAD myself, but my guess is that if I did, I'd discover that prescribing antidepressants during the pertinent months is probably a standard treatment.
True, they usually need more time than that to kick in, but the direct chemical action happens almost immediately, and why mood improvement takes 2-8 weeks remains unexplained even after decades of studies attempting to solve it. Plenty of hypotheses exist, yet nothing conclusive.
Seasonal affective disorder is a recognized condition, and I don't believe medicating it counts as merely for enjoyment, since it can be just as debilitating as any other form of depression. I haven't looked into SAD myself, but my guess is that if I did, I'd discover that prescribing antidepressants during the pertinent months is probably a standard treatment.
samIam
Explorer
Yeah, I've done it, and honestly it isn't the kind of thing you cycle. With these, you're either taking them or you're not. I stopped that and switched to breath work, which has helped me a lot.
cheaperseeker
Explorer
The original poster only wanted information on a topic they hadn't yet had an opportunity to study. At minimum, they're making an effort to learn now.
When someone asks something, either provide an answer or don't. Being dismissive isn't necessary.
A great aspect of this community is that people here don't respond to questions with that kind of attitude.
Dogmandu
Explorer
Switching SSRIs on and off isn't a recommended approach in medicine, and doctors won't endorse it. That said, if you've decided to stop, a slow, step-by-step reduction might be possible.
lessthanhalf
Explorer
It looks like most people replying missed the section where the original poster gives his reason: it is for seasonal affective disorder, and it helps him. I cannot see any problem with discontinuing it during the months when it is not required.
birdwhacker
Explorer
My advice: stay with prozac unless you have confirmed that Prozac is ineffective for you. Its half life is long, and tolerance is generally good. Cycling it should be feasible.
A lot of medications work better when taken in a thoughtful pattern of this kind, rather than following the standard prescription approach. Take Lamictal: the dose is raised right away to levels that aren't safe, and then you're expected to simply... remain on it? Indefinitely? Despite the fact that it begins harming people after 4 or 5 years? Why increase to 400mg instead of staying at the initial 25 and 50mg doses.
The reason is that medicine as a whole tends to be doctrinaire. That serves well for surgical procedures. Or antibiotics. But it doesn't serve well for mental health.
5byfive
Explorer
Plenty of takes here—some solid, some poor, and a few that could put you at risk. Honestly, this question belongs in a different setting. The right move is to bring it up with a psychologist or a psychiatric NP. Many primary care physicians wander far beyond their training when it comes to psychiatric medication, and although I wouldn't call it catastrophic when they hand out a low-dose antidepressant every now and then, they're frequently practicing well outside what they're qualified to do. So if it's questionable for most physicians, an online message board is hardly the ideal source of guidance (though it can be useful for figuring out which questions you ought to ask).
With that said, speaking as a licensed mental health clinician (not a physician), I've rarely encountered people who cycle on and off SSRIs, which likely isn't a wise approach, but a subset of individuals with SAD will drop their dosage during the off season to cut down on side effects (frequently related to libido). Before you change anything, please raise this with a psychiatrist or NP.
tendency
Explorer
Yeah, that's fair. Actually, the suggestion came from my therapist, who mentioned a handful of their other patients are doing something along those lines .. still, I tend to be skeptical and like to hear what others think - appreciate it!
Having taken antidepressants for a long stretch of years, cycling them is something I myself simply couldn't picture doing. Even skipping 1 day brings on terrible withdrawal for me (search for "brain zaps"). That said, if your dose is lower and you only require them at particular times of year, I can't think of a reason it would cause a problem! The main thing is to be careful when your dose is higher or you're on more than 1 SSRI.