discontinuation syndrome

The perils of the pills

Vincent van Gogh's 1890 painting At Eternity's Gate

Vincent van Gogh's 1890 painting At Eternity's Gate

As part of my ongoing discussion about depression I am going to explain in cold facts why warm fuzzy soft focus ads do nothing in understanding depression.

Don’t get me wrong, John Kirwan is doing a great job but he still doesn’t want to scare the horses on what I believe is a fraud and mass poisoning by professionals in dosing people with depression with drugs.

The simple, plain and unadulterated fact about anti-depressants for me is that not one single one I have been experimented with has worked and some, particularly venlafaxine, have actually contributed more pain than any relief. This isn’t necessarily the doctors fault, because this is all one great experiment that unwilling participants commit themselves to without any idea as to the outcome or the consequences of pouring a chemical cocktail into your body.

When you first go down with depression, or perhaps, reach the magic threshold under the Diagnostic and Statistical Manual of Mental Disorders then your doctor will use what s/he has been trained to use which is drugs. the first lolly almost without exception is Prozac. When that doesn’t do anything, then they usually try Citalopram or Paroxetine, then after trying all those and still feeling like Vincent Van Gogh in his famous painting At Eternity’s Gate (left/above). That painting covers exactly show you feel. you can see the despair in every brush stroke.

Yet doctors, bless them, just aren’t trained in how to actually help you. If you happen to have a insurance policy for income protection, like from life leechers like Fidelity Life, thn you are really screwed. You are now trapped in a spiral of hurt you have no control over.

You see, in order to make a claim you have to be sick. You are sick, but that is not the problem, the problem is that now you have to get well, and not by your definition, or any other definition except that of the insurance company. Plus you have to get well in their time-frame or you are in for some serious poisoning at the hands of paid lackeys of the insurance company.

The problem starts because the insurance company and the doctor and indeed society in general puts the cart before the horse. You sit a test, you are depressed, you make a claim, you sit more tests and then the claim is accepted.  A course of medical experimentation treatment is agreed upon and off you go on the chemical train-wreck.

Six months later and your doctor will be pretty sure by now that the first course of drugs hasn’t done a thing. The insurance company knows for sure that you aren’t yet well because they are still paying and that is the worst thing ever in their minds. They don’t give a flying fuck bout you or your health and it is about now that they write you a letter demanding a review by “their” psychologists and psychiatrists. I say “their” because that is exactly what I mean. Almost their entire practices are funded by insurance companies. In Auckland the insurance company favourites are Dr. Anthony Asteraidis and Ralf Schnabel, one is South African and has a handshake like a wet tissue from a peep show and the other is a German and all the medical experimentation nightmares that conjures up. they sit you down for a 40 min session. It should be 60 minutes, but they need 20 minutes of the hour they are billing the insurance company to write a report that is more about covering their arse than helping you. Dr Anthony Asteraidis, at this point for me, recommended I go onto Lithium, for no reason whatsoever other than it couldn’t really hurt could it. this despite me showing none of the symptoms for which Lithium is a treatment. Of course I resisted. But this is all part of the trap from the insurance company. You see they will now say that you aren’t trying hard enough to get well, so demand a change of medication.

Now you have to go through withdrawal from one and substitute that poison for another. then gradually increase dosage until it too becomes apparent that this drug doesn’t work either. Now repeat this several times. By now you will have realised that your life has become a chemically imposed treadmill, slowly but surely wearing you down. Just to increase your stress levels though, you will discover that the insurance company has put a private investigator on your tail. he isn’t that smart because he gets caught, then they write a letter and say it is all part of the process. that’s about the only true thing, the process, that is the insurance companies process to get you off claim, well or not. And you have to do what they say or like Pavlov’s Dogs you cop a flogging from them. This will include cutting your claim off, just to see how you react, interviews private investigators and the like. Not once will they offer to pay for a psychologist. Not once did they ever.

I sought the extra help because I realised that the drugs weren’t going to work. I paid for it, I went every week, then dropped to a fortnight because I couldn’t afford it, then monthly because my claim was delayed, postponed, lost or simply cut off.

After a while though the insurance company insists that you start taking more serious drugs. They don’t say it openly, but when they send you letters, lots of letters, with the implied threat of cessation underlined and in bold then  you get the picture. The doctors all concur that you have a Major Depressive Disorder, and you do. What they fail to tell you is that all their treatment, plus the tickle ups from the insurance company is why you still have it. but their answer is more powerful drugs. Even better, not for you, but for someone, is that these more powerful drugs aren’t funded by Pharmac, welcome to real wealth distribution by chemical torture.

When I was left to my own devices and with good work from my psychologist I was getting well. The long hours in the gym have helped me way more than any drug but psychology and gym doesn’t count to an insurance company. For them trying means trying more chemicals. Along comes a drug regime change, a tickle up, a cessation of  claim and right back down into the painting you go. This where the combination of chemical torture and mathematics starts to bite you. you see what no-one tells you is that depression is cumulative. the maths gets you in the end. the insurance company knows this, and this is why they try like hell to get you off claim well before a year is out. Once you go past a year, the maths mounts, once you go past two or three serious depressive episodes the maths mounts, for them financially, and for you mentally. For them only the money matters, your health is of no consequence to them.

So because you have now had two or three depressive episodes they define you as having a major depressive illness. You do. they put you there. Basically the maths goes like this. If you have one major depressive episode (longer than the median of 23 weeks) then you have a 50% chance of having another in your lifetime. If you do have another episode then you now have a 75% chance of having still another major depressive episode, and after the third the maths is 99%. Got that. Three major depressive episodes and get used to life with major depression. The maths and the research says you will never be rid of the black dog as long as you shall live.

Once you work out the math, you also work out that drugs aren’t going to work, but by this time you are on Venlafaxine or something similar.

These are the side effects of Venlafaxine (The ones I have I’ll note for you. This is highly personal but I think people really should know what these drugs do without the soft soaping. This is real, this is my life, has been my life for 6 years. I’m not hiding it, I’m using it for your education, and I’m not excusing anything either, this is just what it is.)

NOTE: The percentage of occurrences for each side effect listed comes from clinical trial data provided by Wyeth Pharmaceuticals Inc. The percentages indicate the percentage of people that experienced the side effect in clinical trials.

  • Headache (34%) YES
  • Nausea (21-35%) YES
  • Insomnia (15-23%) YES
  • Sexual dysfunction (14-34%) YES
  • Dry mouth (12-16%) YES
  • Dizziness (11-20%) YES
  • Sweating (10-14%) YES
  • Decreased appetite (8-20%)
  • Abnormal ejaculation (8-16%) YES
  • Hypertension (4-5%)
  • Vivid/abnormal dreams (3-7%) YES
  • Akathisia (agitation) (3-4%) YES
  • Decreased libido (3-9%) YES
  • Increased yawning (3-5%) YES
  • Apathy YES
  • Constipation
  • Ongoing irritable bowel syndrome
  • Fatigue YES
  • Vertigo YES
  • Orthostatic hypotension (postural drop in blood pressure)
  • Impulsive actions YES
  • Electric shock-like sensations also called “brain zapsYES
  • Increased anxiety at the start of treatment
  • Memory loss YES
  • Restless legs syndrome YES

Less common to rare side effects

Note ‘Rare’ adverse effects occur in fewer than 1 in 1000 patients.

Now that is quite a list, and I’m not making it up. This is my life. Doesn’t sound like a wonder drug to you now does it. Well think about how it is from my point of view. Now those are the side effects of being on it, I am now 8 days into being off the evil chemical and the withdrawal side effects are even worse. the worst thing is this scary paragraph:

Venlafaxine may be particularly hazardous to those individuals who are susceptible to both venlafaxine-induced serotonin toxicity (also known as serotonin syndrome) and SSRI discontinuation syndrome. In such cases, individuals who have developed the potentially fatal serotonin toxicity and/or may be at risk of doing so, may find cessation or dose reduction unachievable, placing them at continuing risk. As it is not possible to determine which patients are likely to develop the most severe symptoms of the discontinuation syndrome before cessation or dose reduction is attempted, this dual risk requires that all patients are closely monitored during any increase in dosage (when the patient is most at risk of developing serotonin toxicity) and that such increases are carried out in the smallest incremental steps possible. Additionally, patients who recommence venlafaxine or revert to a higher dosage following a failed attempt to discontinue the drug or reduce dosage are another group with an increased risk of developing serotonin toxicity.

Fantastic drug huh? F*cked if you are on it, or doubly f*cked if you try to come off it.

I am writing this today after having spent 4 hours this afternoon “in the painting”. I have had a full blown DPD episode, complete with hallucinations. This post came about right in the middle of the episode and it wasn’t till I could get up again that I started writing. I am writing this because it lessens the pain. Every word I write takes a little bit away as I type it out. (At this point I have written 1781 words and the pain is still there. I’m sorry but I think people need to know.

For me the drugs don’t work, I suspect that they don’t work for many others, I suspect that their lives are ruined and papered over by the cocktail of drugs. Right now I feel that my live as I knew has been destroyed. The devastation is pretty complete. The money is all gone, and I had a fair bit. The houses are gone, the friendships are gone, the relationships are gone. I find it utterly confusing that despite all of that I can actually still do this, that unfortunately doesn’t pay the bills. Working and suffering through the above are unfortunately unable to intersect. the insurance company, Fidelity Life, however thinks I am “cured”, they think that I am “well”. What they really mean is that they arbitrarily decided I cost them too much and despite all medical evidence to the contrary moved me “off claim”. they can do this knowing that my life and stability is utterly destroyed and that to pursue them will cost me my sanity and any remaining resources I have.

Unfortunately for them they picked the wrong person to screw over. I never give in, I never surrender and I can write and surprisingly lots of people like what I write. they refuse to talk, they ignore letters, well they can play like that, but after wrecking my life they will pay and it will be loss of reputation and ongoing posts like this that they will pay through. If they won’t talk, then I will.

I will fight this illness for as long as it takes, I will not give in, and I will tell the truth so that others may learn. If I had known then what i know now about these evil drugs I would never have taken them, I would have fought harder at the start to run my plan for wellness, based around physical fitness and I for sure would be well now. Drugs, Doctors and Fidelity Life have taken me from one “painting” and put me in another. I sure as hell won’t be solving this like Van Gogh did though.

That said, my GP and my psychologist in conjunction with my psychiatrist have been brilliant, they have always agreed with my plan, but when in the grip of an insurance company that can see only one solution then it is impossible to move ahead. In one sense having Fidelity Life cut me off in contravention of our contract has allowed me to be free to pursue my own path toward wellness. It has taken me 6 months to wean myself down to zero on the drugs, I am now in the home stretch for being drug free. Now I can concentrate on trying to pick up the pieces of the wreckage of the last six years.

Blame is the wrong word, but I can think of no other. State funded, doctor prescribed drugs supposed to heal are the “blame” for my hell of a life. In actual fact the blame is a lack of education that there are other ways.

If you suffer depression, or think you do then seek help, but make sure you explore the alternatives to the chemical cocktails. In the absence of anything else listen to John Kirwan, even if the message is soft-focused and massaged so as not to scare you.

As a postscript….If you notice me posting all sorts of videos to my Facebook wall, that is another of my release mechanisms. I play really sad songs about depression until I’m sick of hearing about it, every video I post leaches the depression away. Don’t despair of me, I’m not going to top myself, and I really, really appreciate the messages of support I get even if it is a “Like” of the post.