Given that I’ve had a rough time in the last week with depression, it probably seems strange for me to quit taking my anti-depressant medication. Let me explain…
[NOTE: It can be dangerous to suddenly stop taking any medication. There can be unpredictable and serious side-effects. Always consult your doctor before changing your medication.]
For several years now (on and off), I’ve been taking an SSRI (Selective Serotonin Reuptake Inhibitor) called Fluoxetine. It’s also known by the brand name, Prozac.
I feel that Fluoxetine has really helped me. It’s not an exaggeration to say that I may well have killed myself without it. It’s reduced some of the symptoms of depression.
I think of Fluoxetine as giving me a kind of force field against strong emotions. I’m often quite a sensitive person – little things can produce large emotional reactions in me. I put this down to difficulties in childhood stemming from having an alcoholic mother.
Fluoxetine basically makes everyday life easier. In essence, little things bother me less.
There are plenty of times where it can be really helpful to experience less emotion. Some people find it helps them deal with a stressful work environment, for example.
Dealing with life
However, I’m often left with a nagging feeling that Fluoxetine prevents me from experiencing the full spectrum of life. Positive emotions are numbed as well as negative ones.
With 12 Steps fellowships, there’s a focus on “life on life’s terms”. One of the reasons addicts might use drugs is a desire to escape reality… and I can definitely relate to that. I’ve realised that my SSRI medication is cushioning me from being able to deal with life on life’s terms.
I want to build my mental and emotional resilience and toughness. I believe I have the tools and support systems in place to do that now, so I don’t need to depend on SSRIs.
I’m much better at using mindfulness to counter unhelpful thoughts. And I’ve got more of a social support system, thanks to the 12 Steps fellowship.
I’m very familiar with CBT and REBT, which are both great tools for tackling depression.
I also know that if I maintain my physical health through the golden triangle of a good sleep routine, healthy food and exercise, that makes a huge difference to my mental health.
Another reason for stopping Fluoxetine is that it often becomes less effective over several months and years, meaning patients need to increase their dose in order to obtain the same benefit. Our bodies are quite clever at achieving homeostasis – in other words, adjusting to changes we make. Sometimes this includes our long-term medications.
Until a few weeks ago, I was on the maximum possible dose for Fluoxetine in the UK. So, if my depression worsened, there was no way for me to increase my dose again.
But I know from past experience that if I have a few months off Fluoxetine, my brain seems to “reset”. That means if I get badly depressed again, I can start Fluoxetine on the minimum possible dose.
Not my first time
Generally speaking, it’s advised to “wean off” SSRIs, in other words: reduce the dose very gradually. This minimises any unpleasant withdrawal effects. Cold-turkeying like I’m doing can be quite risky.
However, I have cold-turkeyed Fluoxetine twice before, meaning I know what to expect. Fortunately it has one of the longest half-lives of any anti-depressant, meaning it takes weeks to fully leave your body. This means that even if you stop taking it suddenly, your body and brain still have a relatively long time to adjust.
Other anti-depressant medications have much shorter half-lives, meaning that withdrawal effects can be much more severe and potentially dangerous.
I’ve stopped taking Fluoxetine several times in the last few years, usually for the same reasons. But I’m fully prepared to start taking it again if I get seriously depressed.
There’s no point in being medication-free if I can’t handle day-to-day life, or if I constantly want to kill myself.
One slightly weird withdrawal effect I get is “brain zaps”. These are hard to describe unless you’ve had them yourself, but it feels like a very quick, mild electric shock. I wonder if this has something to do with varying levels of neurotransmitters in the brain as it adjusts. It’s not painful and it’s not entirely unpleasant… just a bit weird.
Another withdrawal effect is that I’ll experience emotions more strongly. That means I’m more likely to randomly burst into tears for no apparent reason. That’s fairly likely to happen at least once in the next few weeks.
This happened once before to me – during an interview! I think my tears were a big part of the reason why I didn’t get the position. Crying made me seem emotionally unstable, which was a big issue for this particular role.
So be warned if you’re thinking of reducing your own anti-depressant meds! Make sure you know what you’re letting yourself in for!
Hopefully this explains all the ins and outs of why I’ve stopped taking Fluoxetine. Again, I have no problems restarting it again at some point in the future (in consultation with my doctor), if it seems like depression is getting the better of me and my other tools aren’t sufficient.
However I’m cautiously optimistic that now I’ll be able to stop taking anti-depressants permanently. Wish me luck!