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Dr. Chris in Ohio
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience:  24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
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For a PHYSICIAN. I am discontinuing zoloft once again becaus

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For a PHYSICIAN. I am discontinuing zoloft once again because i hate it. I will not take psychiatric medications anymore. I have OCD (pure obsessional type - that's where all the obsessions and intrusive thoughts happen in my head and there is no outward compulsion - just rumination inside my head) I worry about brain damage from various things one of them being medication. I think that if i continue down the path of taking psych meds it will not be beneficial for me. I am seeing one of the top ocd therapists named Dr. Steven Phillipson in new york who is a psychologist and has me doing Exposure Response prevention for the pure "o". I have been down to 50mg for a week and i am just going to stop against dr.'s advice. I have lost respect for psychiatry because they cover up an underlying problem. I stold 100mg dilantin from my brother and took that for my ocd! he takes it for seizures and it worked well i convince my doc for that instead. university and zoloft do not mix. this my final stand. I may have OCD but CBT can be equally effective as meds. I would rather die than continue with psych meds that is how strongly i feel about it. I work in the medical field and deal with people with mental problems and in the end when they are 50 years old and after taking drugs for 30 years they are f*ucked (pardon my language but I am so angry). I will not be one of those people. I am 27 and have been on zoloft 10 years on and off.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Chris in Ohio replied 5 years ago.

u2, let me try a different approach.

 

1. Both Dilantin and SSRIs work in the brain and cross the blood brain barrier.

2. Dilantin has more negative side effectives than Prozac or Luvox.

3. So why are you willing to take Dilantin, and you are scared to death of the SSRIs?

 

Your OCD is controlling you to the point whereby you are going stop something that has helped? Nonsense u2!!! I know people who have been on anti-depressants, even the more toxic tri-cyclics for 25 years, and they are fine.

 

If you were taking older anti-psychotic medications, used to treat Schizophrenia, then I would understand your concern about the longterm effects.... those drugs often cause tardive dyskenesia over the course of many years, and that is irreversible, and a very bad permanent side effect.

 

But SSRIs DO NOT CAUSE THIS! I have read that some docs feel that occasion "drug holidays", whereby a person taking a psychotropic medication for longterm use (especially the older anti-psychotics) is periodically taken off the medication for a short period of a couple weeks, and then put back on it can help stop TD from developining.

 

So, to allay your fears, I suggest this. Stick with the Zoloft, or switch to Prozac/Luvox... take for 6 months, then take a 3 week drug holiday, then restart the cycle again. Your only other choice would be to stop it all together, and then let OCD take complete control of your life!

 

I hope this helps. Would appreciate an "accept" for this. I really want to help you, and will be glad to answer one follow up question later today.

 

Good luck.

 

Dr CJH

Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Dr. Chris in Ohio and 3 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
this does help but i have a follow up question. You say that tri cyclics are more toxic ...their effect on serotonin is actually lower with the exception of anafranil (which is why anafranil works in ocd...im' sure you already know this) ..however they effect numerous other transmitters whereas ssri's don't. The reason i would be willign to take dilantin is that it has been around 70 YEARS. We cannot say the same of SSRI"s ...and there have been scientists, engineers dr's etc on dilantin for 50 years and still fully funcional cognitavely. Basically that is a life cycle of a human..that human was on that drug for life and was in the majority of cases unafflicted cognitavely. With SSRI"s the jury is out because peopel have not taken them for what I would call the lenth of a person's life...atleas the productive part. Therefore using logic i cannot conclude the same for SSRI's YET which means i would be more comfortable with dilantin...Numerous websites and dr's by their own admission say that ssri's are a massive psychological experiment where the effects are still not known. That is just where my thinking is coming from.
Can you say that you have seen a scientist, an engineer, a dr., a nurse a teacher on ssri's for 20 years (fda approved prozac in 1987 i believe) and still on top of their game? I don't knwo if this can be said. I need my brain as I am attempting to get into a physician assistant program.
Customer: replied 5 years ago.
sorry one more thing . I believe that my ocd will not reappear because of the intense EP therapy i am doing.
Expert:  Dr. Chris in Ohio replied 5 years ago.

Yes u2 I can. I worked for 5 years with a psychiatrist (who is now 72 or so), who started on Doxepin (strong effect on both N & S) in the the 1960's, and has been on it, except for short infrequent remissions for over 40 years. He actually switched from being an general surgeon and went into psychiatry due to his personal issues with depression.

 

I see him on occassion. He is as sharp as ever, and aside from the minor side effect of dry mouth, he is just fine. And remember, the tri-cyclics are much more toxic than SSRIs. So please.... stay on your SSRI, but perhaps take a couple weeks off from it every six months. Many years from now, you will remember this discussion when you are doing fine, and wonder why you were so worried!

 

Good luck u2!

 

Dr CJH

Customer: replied 5 years ago.
Thanks, but what about the Exposure prevention therapy without medication it can be effective right?
Expert:  Dr. Chris in Ohio replied 5 years ago.

It (the EPT) is an adjunct u2. The therapy and the meds together are your best bet!

 

Dr CJH

Customer: replied 5 years ago.
can i aks this one other question. I will provide bonus.
This dr. that you know that took doxepine for 40years was it at a high dose was it at a dose that you would consider equivalent to high doses of zoloft or another antidepressant that would effectively treat ocd. becasue can't we say that luvox or zoloft is ok at 25 mg long term but at 200mg whichit takes to treat my ocd well is different. It is like drinking 1 beer a day is ok but drinking 8 times that per day is not ok....i dunno the whole thing is scary to me...I need my brain to be sharp for years to come but at the same time i am only fooling myself..i can't live without moderate to high doeses of ssri's....it seems like a shitty future ...take a drug you are possibly screwed and don't take it you feel like suicide...but you want to be smart...you want to continue a higher education...can you give me another example of someone with ocd who took anafranil since it's introduction at high doses (1980) and still is a scientist/engineer or something like that please. to ease my worry.
Expert:  Dr. Chris in Ohio replied 5 years ago.
u2,

I believe the Doc was on 150 mg. at bedtime. He told me that not only did it help him stay depression free, but he needed it for sleep.

The dosage range for Doxepin is up to 300 mg. per day. So his dosage is right in the middle.

u2, please chill and don't worry!. Your mind is not going to be harmed. SSRIs have now been around for over 20 years, and there is not one reported case that I am aware of, where somebody has developed dementia from their use!

Hang in there. You will be fine!

Dr CJH
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Dr. Chris in Ohio and 3 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
well then why are there so many people on the internet that claim they have been brain damaged by ssri's and other psych meds...they are walking zombies they claim with no brian left even after getting off the drugs.????
Customer: replied 5 years ago.
I just wanted to put foreward some evidence I have that ssri's can damage the brains of people. READ this http://en.wikipedia.org/wiki/PSSD

while wikipedia is not a trusted source...they do have references to journals to back up their claims

Post SSRI sexual dysfunction is real and in some people persists indefinately after the ssri is stopped...it is believed to be linked to permanent changes in the brain. So it begs the question if it can do this what other permanent changes can happen? So when reading something like this how is someone who has ocd (and specifically worries about brain damage supposed to carry on with a normal life)
Expert:  Dr. Chris in Ohio replied 5 years ago.

u2,

 

Sexual dysfunction from SSRIs is thought to be caused by hormonal changes, not anatomical brain changes. Wikepedia, while it is a handy resource for simple questions, it has no business having this kind of technical/medical info on it.

 

The first anti-depressants were MAO inhibitors. They came out in the 1950's. There was a chap on here yesterday who said he had been on 90 mg. of Nardil for over 40 years. His post was very clear and to the point, and MAO inhibitors are much more toxic than SSRIs. Obviously long term use of very toxic antidepressant medication had not hurt him.

 

So, do as I suggested. Take a week or two off from your SSRI every three months or so.... this "drug holiday" will certainly give your brain a chance to "recover', if in fact there was any building damage to begin with.

 

Hang in there.

 

Dr CJH

 

 

Customer: replied 5 years ago.
thanks friend. out of curiosity hwo did people cope prior to 50 years ago...? i mean surely there was mental illness. How did they go to university and succeed...did they just pull themselves up by their bootstraps? are we so weak now taht we need meds?
Expert:  Dr. Chris in Ohio replied 5 years ago.

u2,

 

The MAOs are actually used to treat depression and OCD. There are dietary restrictions on them, plus tons of other side effects. Virtually every person I work with in psychiatry (MD, RN, MSW, etc.....), if the truth be known, has been on an antidepressant at one time or another.

 

Quit blaming yourself and beating yourself over the head! Thousands, if not millions of people live with their OCD, and survive, and you will too!

 

Dr. CJH

Customer: replied 5 years ago.
ok i understand but you can say taht there are still high funcitoning people out there that have been on prozac 20 years or more (laywers, dr. etc)?
Expert:  Dr. Chris in Ohio replied 5 years ago.

u2,

 

Prozac came out in 1988 or so, so I really don't know anybody who has been on that particular drug for 20 years, but I do know people who have been on "much harsher" antidepressants than any SSRI for many more years than 20, and they are fine.

 

In my humble opinion, there is more danger taking Insulin (some people take it their entire lives) than SSRIs, so please just go with the flow, or you will only be hurting yourself.

 

Would appreciate some positive comments, and whatever $$ you may wish. Understand that "experts" split their earnings with the operators of this website, so $30 is really only $15.

 

Good luck.

 

Dr. CJH

 

Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Dr. Chris in Ohio and 3 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
when you say harsher antidepressants you may be right in that they have greater effects on other transmitters. but the only other antidepressants out there besides the ssri's that has a powerful effect on serotonin is anafranil which is why it was used for ocd because as you said ocd requires higher than normmal increases in serotonin relative to depression. So isn't true that while the other drugs hit more transmitters we don't know the consequences of hitting serotonin so hard and increasing it so much because the old ssri's didn't have the same powerful effect on serotonin...they effected a slew of other ones though...do you know what i am saying. am i not playing russian roulette with my brain because never before (tca era) have levels of serotonin increased so much...internet chat rooms are full of people claiming that sssri's damaged their memory long term...if people haven't beenon them that long how do we know this is not true...how bout someone who has been on ssri 15 years and is still smart as hell and university educated do u know any of those?

thanks , Derek
Expert:  Dr. Chris in Ohio replied 5 years ago.

Some of the TCAs like Elavil and Tofranil have a stronger effect on serotonin than other TCAs (Norpramin effects only N) , but not as strong as the SSRIs. I can't say I know anybody who has been on an SSRI that long, but I know many current patients have been on them for many years, and are fine.

 

Derek, chat rooms and forums are full of lots of doom and gloomers. Google any medication, and I guarantee there will be people who have had bad reactions from it.

 

Again, periodic drug holidays are the best solution if you remain concerned.

 

Good luck.

 

Dr. CJH

 

 



Edited by Dr. Chris in Ohio on 6/6/2009 at 12:49 PM
Customer: replied 5 years ago.
could i use elavil to treat ocd?
Customer: replied 5 years ago.
or what about clomipramine is that the gold standard tried and true and you know peopel on that for 25 years?
Expert:  Dr. Chris in Ohio replied 5 years ago.

No, because those people switched to the much safer Prozac and Luvox when the SSRIs came out!

 

Elavil is not a good med for OCD. Has to be strictly a drug that works with serotonin.

 

Dr CJH

 

 

Customer: replied 5 years ago.
thanks. can you please explain how someone like me who is faced with taking these drugs long term and needs to have the smarts to finish school. I am thinking of becoming a physician assistant. how can i go through my days knowing that we DON"T know what happens when you raise serotonin to these levels for many years....I already feel my memory is negatively impacted for having been on zoloft since i was 16 and a half years old.. i am now 27. i can't have the future i want without my full faculties and since people have only been on ssri's not even 20 years we cannot say they are safe because people don't normally take a high dose like me for so long because most people don't have ocd they have depression . so you tell me about someone who has ocd and took drugs that enhanced serotonin to the degree it is doing to me for 15 years and could still do a phD.??
Customer: replied 5 years ago.
I think i might try Nardil ...sounds good it has been around so long

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