Antidepressants Becoming a Bigger Problem for Patients and the Recovery Industry is Going to Have to Help Solve It

Antidepressants Becoming a Bigger Problem for Patients and the Recovery Industry is Going to Have to Help Solve It

Millions of patients taking antidepressants (selective serotonin reuptake inhibitors, or SSRIs) experience terrible side effects when they try to cut down or stop taking them altogether, says a report from Britain's elite All Party Parliamentary Group for Prescribed Drug Dependence (APPG).

The problem in the UK, says the report, is twofold:

  1. When the time comes to stop taking the medication, the "discontinuation effects" can be severe, persisting for weeks or months - for some, serious enough to be classified as disabling.
  2. Patients are seldom advised in advance that withdrawal might be serious. In fact, they're usually informed that discontinuation effects will be mild and last maybe a week or two, three at the most.

Although the majority of SSRI patients do not suffer unmanageable symptoms, a much larger percentage than generally acknowledged are hit pretty hard, and for longer than expected.

The APPG survey found that fully half of UK patients experienced very uncomfortable and disturbing discontinuation effects, and for longer than they were advised. And fully 30 percent say they were unable to work indefinitely due to the severity of their withdrawal symptoms.

SSRI discontinuation effects seem to increase for most patients with the length of time on the drugs. Originally intended as a short-term solution for depression, SSRIs are becoming a long-term, even life-long, solution for increasing numbers of patients, and not just in the UK.

It's happening in America too

Getting off antidepressants, for many people, is more of a problem than many have realized until recently. It's so difficult, and is so widespread, that the New York Times devoted a large and detailed feature article to the subject recently.

'Many People Taking Antidepressants Discover They Cannot Quit' examines the effects that America's skyrocketing increase in antidepressant prescriptions is having on patients. It's a disturbing picture of desperate people trying to get off SSRIs - countless thousands of them, with little or no success.

Roughly 15.5 million American adults are still taking antidepressants after two years, the Times said, doubling since 2010 and tripling since 2000. And 25 million Americans have been on SSRIs for at least five years.

According to the CDC, roughly 11 percent of Americans of all ages have recently taken SSRIs. From less than one in 50 people 30 years ago, today one in every 9 Americans is taking an antidepressant on a regular basis.

The use of antidepressants also increases with age. Nearly 19 percent of adults 65 years and older are taking SSRIs. Back in the 1990s, only 3 percent of older adults were taking antidepressants.

In the SSRI class, the most-used include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac), vilazodone (Viibryd), and sertraline (Zoloft).

A newer drug related to SSRIs is duloxetine (Cymbalta, Irenka), which is in widespread use. But duloxetine is not an SSRI, it's an SNRI, a "selective norepinephrine and serotonin reuptake inhibitor." It's prescribed not only for depression, but also to relieve the pain of fibromyalgia, and the symptoms of neuropathy.

The drug companies, prescribers and patients all say that SNRIs are even more difficult than SSRIs to discontinue.

The unprecedented increase in antidepressant use threatens a future avalanche of people suffering serious problems with SSRI discontinuation effects and needing help.

Who is going to provide it?

More and more drugs

As we know, America and much of the developed world has something of a love affair going with psychoactive drugs, whether legal and prescribed or purchased from a shady figure on the street. There seems to be a pill we can take for almost anything that pains, worries or just annoys us. And we're taking them in ever-increasing numbers.

On one hand, we already have the worrisome opioid epidemic, about which much is being said and written about every day. Overdose deaths from drugs of all sorts, including but not limited to opioids, claimed well over 70,000 lives a year ago, says the CDC. (Just as a point of comparison, that number is roughly the same as the number of deaths caused by last year's deadly influenza season.)

Antidepressants are already a part of the picture for the recovery industry, however small that part may be now. However, antidepressants appear to be looming large on the horizon, and perhaps could become a much greater problem than anyone now realizes. In that regard, the recovery industry will certainly be asked to help deal with it, if and when it arrives.

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