Is Withdrawal from Antidepressants Worse than Depression?

Is Withdrawal from Antidepressants Worse than Depression?

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This post was originally published on October 14, 2015.

There’s been plenty of controversy surrounding antidepressants over the years. Disturbing side effects like suicidal contemplation, especially in young people, have raised plenty of eyebrows, as have the not-so-pleasant symptoms of withdrawal from antidepressants like Effexor and Paxil. In a recent article for VICE, writer James Evans details specifically the horrors of trying to withdraw from Cymbalta.

Bad PR

On top of detailing the nightmare he experienced when trying to wean off the drug, which includes “brain zaps” that feel like electric shocks, irritability, anxiety and—to some degree—insanity, Evans describes the emotional and mental numbness he experienced when taking it. He was plagued with persistent fogginess and the feeling that his head was disconnected from his body, neither of which are an improvement from depression to begin with.

Sadly for Evans, his solution to deal with the brain fog initially wasn’t to get off the drug, but rather to drink a lot of coffee and snort blow. I guess you can’t blame him—he was just 17 at the time, and his doctor shoved the prescription for Cymbalta at him when he asked how he should handle the unexpected death of his best friend.

Ultimately, he ended up drinking on top of the antidepressant, the blow and the coffee and apparently he didn’t like this cocktail. So he decided enough was enough and went off the stuff. His withdrawal from the antidepressant was a process. After tapering down from 60mg a day to 20mg, he finally had to drop down to nothing.

Here’s how Evans described his withdrawal once he stopped taking any Cymbalta:

“It became hard not to doubt myself when everything got under my skin,” he writes. “Mundane daily tasks completely unraveled me. All of my anxious traits took over. I couldn’t decide what to eat, what to wear, what to do with my time when I wasn’t working. I could never sleep and when I did, I would wake up erratically, sweating and panicked. I lost weight and considered moving back home.”

Big Bad Pharma

Evans mentions an FDA report on Cymbalta withdrawal that was released in 2009. In it, withdrawal from the drug is actually referred to as “Cymbalta Discontinuation Syndrome,” and the FDA states that the withdrawal symptoms are “more severe and much more widespread than acknowledged by Eli-Lilly,” that “sales representatives and marketing materials do not adequately inform physicians about the likelihood and severity of discontinuation syndrome” and that “Eli-Lilly has not developed a clinically-proven protocol for safely discontinuing Cymbalta.”

Ouch.

The worst part about all of this is that Eli-Lilly allegedly covered up the severity of the withdrawals. A 2005 study by The Journal of Affective Disorders showed serious withdrawal symptoms were experienced by more than 44 percent of people who go cold turkey off Cymbalta, but the warnings released by Eli-Lilly state this only happens in about one percent of patients. According to Evans, he approached the company for comment on this discrepancy, but they blew him off.

Evans sums up his personal essay with a bit about how we shouldn’t throw pills at our problems and how he is happy and fulfilled and normal now that he’s off the drugs. But did he ever have a need to take them in the first place?

Who’s to Blame?

It’s not Evans’s fault that his doctor shoved an antidepressant into his face, given he was neither mentally ill nor clinically depressed at the time, but rather going through a spell of mourning. Still, for those of us who had a much harder time keeping ourselves alive and well (and out of the local psych ward) when not on an antidepressant, the last little bit of Evans’s essay is just a touch insensitive and borders on ignorant.

Yes, the side effects of medication can suck and the withdrawals can be awful, and Eli-Lilly probably needs to either discontinue Cymbalta or fix it so people don’t experience these extreme withdrawals. Still, all psychotropic meds have powerful side effects, and many have unpleasant withdrawals. However, for those with severe and debilitating mental illnesses like schizophrenia and bipolar disorder, these withdrawals are sometimes the lesser of two evils.

I’m living proof of it.

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1 Comment

  1. The research done by Irving Kirsch and others has shown that antidepressants as a class of drugs has essentially the same therapeutic effect as a placebo. He has a book out that systematically reviews this research, “The Emperor’s New Drugs.” There are also several articles by him on the subject, here are two. One has the same title, The Emperor’s New Drugs,” which was published in 2006: http://alphachoices.com/repository/assets/pdf/EmperorsNewDrugs.pdf; the second was just published in July 2015: “Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences”: http://www.contemporaryclinicaltrials.com/article/S1551-7144%2815%2930003-3/pdf. His coauthor there, Joanna Moncrieff is a British psychiatrist with several of her own publications on the same topic. She has written several books, including “The Myth of the Chemical Cure.” Try her website: http://joannamoncrieff.com/

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About Author

Tracy Chabala is a freelance writer for many publications including the LA Times, LA Weekly, Smashd, VICE and Salon. She writes mostly about food, technology and culture, in addition to addiction and mental health. She holds a Master's in Professional Writing from USC and is finishing up her novel.