August
2007
|
August
2007
|
Of Like Minds is now Mood! Over 175 articles on: Help support Mood --
Bookstore
|
Starting, switching stopping
meds |
Have
you read these? Essential information
|
|||||||||
|
Living with depression, anxiety or bipolar disorder can mean starting, switching and stopping meds. And that can cause side effects if not done as directed by your doctor. Starting a new medication or discontinuing one is often done in measured increments. Titrating is the word used for gradually increasing or decreasing the dose. If you switch medications, you may titrate off the old drug, while titrating up to the recommended dose of the new, overlapping the two for a time during the transition. If you discontinue a drug too abruptly, your symptoms could worsen and you could suffer side effects, or worse. Starting some drugs without gradually increasing the dose can also cause side effects. Stopping a drug without working with your doctor is a bad idea. Sometimes, a person taking an antidepressant will decide they feel better and no longer need their medication. Sometimes side effects are the reason for stopping. If you want to stop because the medication doesn't seem to be helping, talk it over with your doctor. You may want to give it a little more time. There may be a medication that will work better for you. Or your doctor might want to reconsider your diagnosis. For example, some people whose depression doesn't get better, or gets worse, on antidepressants actually have bipolar disorder and should be treated with different medications.
Antidepressants Some symptoms of antidepressant discontinuation syndrome may be similar to those caused by the depression, such as dull or sad mood, appetite changes, inability to concentrate, sleeping too much or too little, feeling tired. It's helpful to keep
notes on your symptoms so that you and your doctor can determine whether
they are side effects or relapse. Symptoms of a relapse or recurrence
of depression typically occur two weeks or longer after the discontinuation
of the medication and usually become gradually worse. Other symptoms include: dizziness, balance problems, flu-like symptoms, nausea, hallucinations, blurred vision, irritability, tingling or "shocking" sensations, vivid dreams, nervousness and insomnia. The good news is that these symptoms are not life threatening, are usually worse during the first week after stopping the medication, and usually fade within a few days to two weeks; sooner if you resume taking an antidepressant. You are more likely to experience the syndrome the longer you have been taking the antidepressant. All antidepressants have had reports or warnings from their manufacturers of such withdrawal symptoms resulting from discontinuation or tapering, according to the American Academy of Family Physicians, including SSRIs MAOIs, tricyclics, and atypical antidepressants. You are more likely to experience antidepressant discontinuation syndrome, according to an article in the Journal of the American Academy Family Physicians, if you stop taking certain brands. Paroxetine (Paxil), as warned on its patient information sheet, and sertraline (Zoloft) are among these, although you can get symptoms from stopping any antidepressant. In that case, according to a Harvard Health Publications article, some doctors may switch you to a longer-lasting drug, such as fluoxetine (Prozac) and then titrating down to quit. |
"Worse yet, there is an additional danger," says Jim Phelps, M.D. "In some people, particularly those with bipolar disorder already diagnosed, such a sudden stop can actually cause a manic episode. Ironically, antidepressants can induce manic episodes when they are started - but also when stopped, if this is done too quickly. Many mood experts suggest taking four or five months to gradually taper an antidepressant to zero to reduce the risk of withdrawal, or even this antidepressant-discontinuation induced instability."
Transitions between mood stabilizers can be made three different ways, says Phelps:
Stopping some anticonvulsants abruptly can cause seizures in some people. Some research suggests that once discontinued, some of these drugs may be less effective if resumed. Antianxiety medications Generic medications As you can see, it's important to take seriously your doctor's directions about how to take your medications. Don't stop or change dosages on your own. Work closely with your doctor to keep your medications working as effectively and safely as possible.
|
||||||||||
But
whatever the reason you may want to stop, let your doctor give you a schedule
for discontinuing safely and effectively. 
Antidepressant
discontinuation syndrome is not the only risk of stopping an antidepressant
quickly.