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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4645
Experience:  MD Psychiatry
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For a dr. i just read on the internet that antidepressants

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for a dr. i just read on the internet that antidepressants proven to cause long term brain damage...that is extremely distressing for me because i have been on them 10 years....if this is true i may one day feel suicidal and that scares me....i don't feel that now because i read this on the internet and things on the internet aren't always true.what is true?
Submitted: 8 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 8 years ago.
Hi there,

Welcome to Just Answer !

Well, it is good to know the side effects and contraindications of drugs on which you are placed on . and internet has always been one of the resources to gather information from , but all the information that you get from the internet is not always true and some information is furnished to gain reader's attention and is merely subjective .

Although , i would not deny the fact that Anti depressants , may lead to suicidal thoughts , which in fact it is quite surprising to know , as anti depressants are used in depression and suicidal thoughts and ideas are one of the main features of Major depression , so for the user it becomes quite confusing to decide on taking the drug or not taking it.

I would say that , the chances of developing suicidal thoughts by not taking anti depressants for treating the underlying depression, are far greater than chances of suicidal thoughts developing over long course of anti depressant use , plus doctors put the patient on the right dosage , which rules out the occurrence of any such side effects whatsoever .

So , i suggest . although you should be cautious and aware about the pharmacological facts about the anti depressants or any other drug for that matter , but i feel you should stick to the anti depressants for treatment of underlying depression , as the drugs must have been properly chosen by your doctor and all the side effects and contraindications of their usage must have been kept in mind while prescribing , SO , i would suggest you leave aside your apprehension and continue with the use of anti depressants , as they will be the ones which would get you out of your present symptoms.

I wish you best of health.

I hope my answer serves your query according to your satisfaction.

Please press the ACCEPT button , if you are satisfied with the answer, as only then i will be credited for my service.

Customer: replied 8 years ago.
thanks. I worry that they are making me "dumber". I used to have an above average IQ, i went to college but now i feel that from the antidepressants...because i am going back to college so i can't have this....They don't leave any permanent effects on the brain?
Expert:  Dr. Kaushik replied 8 years ago.
Well , i can understand your point of view , as you are concerned about your perfomance in college , and would certainly not want any anti depresssant make you sloppy or less active and attentive in the class . While anti depressants will not have any ill effect on your brain , but i would concede that some anti depressants do make patients a bit sloppy , and sluggish , but this usually happens initially when you start a new anti depressant or you change from one anti depressant to another , however in your case , since you have been placed on anti depresssants since past 10 years, you will tolerate the drugs quite well , and will not have sloppiness .

But, despite of this , if at all , you feel sleepy or sloppy in the class , then you just have to ask your doctor to review the dose of anti depressant or use a new anti depressant . Ideally , one should use anti depressants which are available in extended release forms such as Effexor XR , as these extended release anti depressants are released slowly in your system without causing any drowsiness and also they work round the clock , plus only 1 single daily morning dose is required.

So, just stop being apprehensive about the ill effects on brain due to prolonged anti depressant use , as if that would have been the case then anti depressants would have been banned from use long before . So relax and continue your treatment as prescribed by your doctor.

I hope my answer serves your query according to your satisfaction.

Please press the ACCEPT button if you are satisfied with the answer , as only then will i be credited for my service.

Customer: replied 8 years ago.
But drugs like thorazine are still used and they have known ill effects on the brain and they are not banned...also Seroquel, Risperdal etc.
Expert:  Dr. Kaushik replied 8 years ago.
Hi there,
        Welcome back !

Well, with all honesty let me tell you that ,i have had an opportunity to having provided care and treated many patients with depression , and almost all of them have responded to treatment . One thing , i will agree with you , that you have been placed on anti depressants for a very long time, that is 10 long years , which should not have happened, as generally a patient recovers from depression within 6 months to 2 years , if he has been regular in taking drugs and follow up. So, not only anti depressants , or any other psychotropic drugs , or any other drug for that matter if has been mainained for this long would cause some side effects .

So,although it is very important for you as a patient and for me as a clinician to acknowledge the fact that you have suffered from impairment of memory which i believe is transient ( temperory) , but right now our focus should be on two very important issues--

1) To prevent further deterioration in your memory as you are in your prime age , would want to make the best of it ,to have successful life ahead . So what we intend to do here is that i would suggest you to continue the appropriate anti depressants for a while , and once you are symptom free , we shall slowly taper the anti depresants and then eventually take you off from them .

2) To achieve symptom free state , where anti depressants are no longer required .

So, i suggest let's move on , and let's get you symptom free followed by withdrawl of your anti depressants .

So, kindly mention me the anti depressants that you are taking ,so that i can suggest some new drugs or modify the present drugs so that we can achieve remission as early as possible. Also since you have been placed on anti depressants for such a long tome and still have not got symptom free , i Believe your depression is anti depressant resistant also known as rEFRACTORY DEPRESSION, IN WHICH CASE , psychiatrists suggest the use of ECT ( electro convulsive therapy ) , no need to be apprehended about it , as it is a very safe treatment if not the safest , which is given under short acting general anaesthesia hence nowadays called as Modified ECT,IS carried out under the guidance of a psychiatrist and anaesthetist , and the patient regains consciousness within 15 -20 minutes , but from my personal experience till date it has been the most effective treatment for major and refractory depression , with least side effects , and this is contrary to what people believe as they are often misguided by ignorant texts and people . So, one option is ECT AS well , which will take care of your symptoms in a few sessions . And Finally , there is a Cognitive Behavioural therapy ( CBT) , which along with the anti depressants , if continued for a few months , will take care of your depresion ,and after which we shall remove all the anti depressants , and keep you only on counseling , that too , not for too long a period .

So, i suggest you think about the suggestions i have made here , as i have kept your concern about loosing your memory to anti depressants well in my perspective , but you have to decide what actually you would want to choose from the options i have provided , also discuss the above mentioned suggestions with your current psychiatrist as well , this will provide you the best treatment option which you shall embark upon , and achieve withdrawl from anti depresants after achieving symptom free state.

I wish you best of health.

I hope my answer serves your query according to your satisfaction.

Please press the ACCEPT button if you are satisfied with the answer , as only then will i be credited for my service.

Customer: replied 8 years ago.
I'm sorry i didn't fully explain I take Zoloft 150mg for OCD not depression that is why it has never gotten better. I have 'pure' obsessional ocd and have never made headway with CBT...everytime i try to get off zoloft i have such intrusive negative thought that they bother me so much i cannot concentrate. One of the intrusive thoughs is that i will get brain damage from taking medications this long. Are you saying i have permanent brain damage or changes that cannot be reversed and have effected my intellect? I was told by many psychiatrists that i could take zoloft this long without ill effeccts because it is indicated for my problem...Would the high dose have damaged me too? Please help i am very very stressed about this
Expert:  Dr. Kaushik replied 8 years ago.

Well, i never mentioned that your brain has been damaged due to prolonged use of anti depressants or it will get damaged in future , kindly read my post again , what i have tried to explain to you is that the poor memory or poor concentration that you may be experiencing is temporary , and may be atributable to your condition and now that you have mentioned that you have been suffering from OCD , now it makes more sense , why your concentration has taken a dip , as your obsessional thoughts overwhelm you all the time , which clouds your mind , due to which your concentration and memory take a back seat , you only tell me that how can one concentrate or memorize things if one is constantly fearing or preoccupied with other thoughts , similar to te way you do , dearCustomer, it is not the anti depressants , but is the uncontrolled OCD , which is responsible for your poor memory .

I never ever mentioned before that anti depressants have caused brain damage , remember i told you that these drugs are FDA approved , and would have got banned , if such was the case.

So, i suggest you need to get your OCD under control , and no, long use of anti depressants have not caused any brain damage and they never will , it is just THE OCD , that is taking a toll on your concentration, memory and valuable time which can be used for meaningfull purposes.

So, the solution is to get your present drug Zoloft ( sertraline ) dosage reviewed , zoloft is an SSRI , your body might have become resistant to it over a long period of time , so you can turn to a different class of drugs which even today is cnsidered the first line medication of OCD , and that is Clomipramine , which is TRICYCLIC aNTI DEPRESSANT , AND ALONG WITH IT YOU MAY ADD Risperidone low dose . Both these drugs dosages need to be discussed with your current doctor , and i am sure this combination will work for you , as it has worked for my patients . Also , if you can give CBT ,one MORE TRY , IT WILL BE JUST GREAT and will be considered a positive step. Believe it or not CBT , does have a good positive result in cases of OCD.

i KNOW,you have endured a lot of stresess due to your condition , but i feel if you consider the treatment regime that i have mentioned here and discuss wth your doctor and decide to get start on it , i feel you will benefit , and your cognition will improve , and again please do not jump to hasty conclusion as no brain damage has been caused here , it is a temporary phase , which will get sorted once your OCD features are taken care of.

I hope this answer clears your doubts.

Please press the ACCEPT button if you are satisfied with the answer, only then will i be credited for my service.

Customer: replied 8 years ago.
thanks very much for the answer that does help reduce my fear greatly. I just had one last thing to point say they wouldn't allow drugs that cause brain come they still allow haldol, clorazine and other ones that cause tardive dyskinesia...that is brain damage isn't it...for the schizophrenics?
Customer: replied 8 years ago.
thanks very much for the answer that does help reduce my fear greatly. I just had one last thing to point say they wouldn't allow drugs that cause brain come they still allow haldol, clorazine and other ones that cause tardive dyskinesia...that is brain damage isn't it...for the schizophrenics? also what about post ssri sexual dysfunction doesn't that show that the striatum or some part of the brain is permanently damaged if people are still having sexual problems after discontinuing ssri's? couldn't we then conclude that there may be other parts of the brain that are damaged permanently?
Expert:  Dr. Kaushik replied 8 years ago.
lt;p>Well, you are right to some extent , but i must say this is a very controversial topic , as older typical anti psychotics such as Haldol and the newer ssri anti depressants , although cause Extrapyramidal side effects( EPS) such as tardive dyskinesia and sexual dysfnction due to the latter group of drugs , but most of the time THESE SIDE EFFECTS ARE REVERSED . after discontinuation of these drugs , in very few cases they are seen to persist throughout life, so you see on a very low proportion of side effects ,along with higher proportion of success rate to treat psychoses and depression , these druugs are still considered as the mainstay , and please take into note that till date there has not been a clear documented evidence of either of the drug groups causing brain damage , and as far side effects are concerned, you only tell me , is there any drug in this world that does not have side effect ,i believe the answer is no.</p><p> </p><p>So, relax and do not dwell on it further .</p><p> </p><p>Regards...</p>
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 8 years ago.
there really is no chance of PERMANENT effects from zoloft...i mean if i was to go off zoloft even after years and brain would recover fully? as fare as the latest research shows? Do the old antidepressants like Clomipramine which has been around since 1980...does it have as strong serotonergic effects as 200mg zoloft...and have people been on it for 30 years for ocd at a high dose where there is a lot of reuptake blockage of serotonin and still highly intelligent with functional capable of university and enginerring math etc...can you give examples
Customer: replied 8 years ago.
Hello thanks. are you able to answer the last question i pushed accept for the others
Expert:  Dr. Kaushik replied 8 years ago.
Thank you !

Well, Clomipramine is a Tricyclic Anti depressant , which till date is considered as the drug of choice for OCD , and unlike zoloft which is an SSRI anti depressant , does not act by blocking serotonin reuptake , and hence is less likely to result in high serotonin levels which may be achieved after prolonged use of SSRI anti depressants , which can lead to serotonin syndrome , but rest assured both zoloft and clomipramine do not cause permanent brain damage the way you presume , yes there may be some side effects here and there , but that is there with any drug , why single out anti depressants .

But, i will still profess that CLOMIPRAMINE IS THE FIRST LINE DRUG FOR OCD , however , Zoloft , paxil , prozac and other SSRI s are nowadays readily used for OCD and they too deliver fine results , but the psychiatry textbooks still maintain clomipramine to be no. 1 for OCD.

I hope i am able to clear your doubts . Take care ..

Please feel free to contact for any further assistance. As this is a follow up answer , so not need to press the accept button.

Warm Regards..

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