Antidepressants make some people feel better. I wasn’t one of them – for 30 years I struggled with the debilitating side effects of SSRIs. When I complained to my doctors, they piled on more drugs, prescribing 17 of the 25 top-selling psychiatric drugs which eventually led to my being declared totally disabled.
After I quit antidepressants in 2015, I gradually returned to normal and discovered that when the drug companies’ initial trial results were reanalyzed by the FDA, the efficacy rate dropped from over 90 percent to just 50 percent. For all those years, I only had an even chance of getting any better.
Maybe I would have gotten off antidepressants sooner if I had been able to more clearly tell my doctors what the drugs were doing to me. That’s why I’ve come up with some practical suggestions for keeping track of your reactions to the drugs and effectively communicating them to your doctor so that, together, you can decide what’s best for you.
Efficacy Rate Reduced to a Coin Toss
When SSRI (selective serotonin re-uptake inhibitor) antidepressants were first introduced in the late 1980s, the drug companies touted an overall efficacy rate of 94%, which made the new antidepressants sound like a wonder drug.
This purported high efficacy rate eventually propelled antidepressants to the second most prescribed class of medications in the U.S. (National Institutes of Health, 2018). According to the CDC (2017), 12.7% of adults have taken an antidepressant in the last month, and one quarter of them have been on antidepressants for 10 years or more.
However, the drug companies’ initial trial results were incomplete. In 2008, the FDA re-analyzed the trial results and found that almost one-third of them had been withheld. When the missing data were factored in, the efficacy rate dropped from 94% to 51% (NEJM, 2008).
I didn’t know my chances of getting better had been reduced to a coin toss. As the effects of the antidepressants overtook my entire being, I felt alone in my suffering and had no idea I was only one of millions who might be going through the same thing.
More than thirty years after they were introduced, there’s scant research about their adverse effects. But, a New Zealand study (NIH, NCBI, 2016) reported some disturbing findings: One-third of the respondents, who had taken antidepressants from 3 – 15 years,
experienced moderate-to-severe depression, and more than half reported ten (10) adverse effects.
Doctors Perpetuate the Myth
Based on the 94% efficacy rate myth, my doctors kept me on antidepressants for thirty years. When my antidepressant wasn’t “working,” they either increased the dose of the one I was on or switched me to a new one. They didn’t know that the drugs were causing the overwhelming anxiety and suicidal depression they saw in me every time I walked through the door.
Quitting antidepressants never came into the discussion. They told me that if I stopped taking the drugs, my symptoms would “rebound” which in my mind meant going back to the way I felt after being attacked twice in four months in my Boston apartment. I certainly didn’t want that, so they kept writing prescriptions and referring me to therapists to “work through my issues.”
The overload of serotonin in my brain caused cognitive decline and made it impossible for me to process information: I couldn’t understand what people were saying, and I couldn’t get my words out. Nowhere was this more evident than in my doctor’s office. I couldn’t piece together what I had just been told about the drugs she was prescribing, and I could only tell her in vague terms how I was doing. Maybe if I’d had a more systematic way of communicating with my doctor, I would have been able to decide to quit antidepressants sooner.
Communicate Better with Your Doctor
Take a “Buddy” to Your Doctor’s Appointments
I didn’t know what had changed me from being an articulate, accomplished marketing executive into someone who dissolved into tears every day. But, the fierce independence that had guided me through life was still entrenched in my psyche – I didn’t ask anyone for help.
Every time I walked out of a doctor’s appointment, my brain was swirling with disconnected bits of information. I couldn’t piece together what I had just been told and kept thinking I wasn’t trying hard enough.
I didn’t know how bad I was, but the people around me could see it. I’ve heard from friends and family members of people who are suffering the debilitating effects of antidepressants who say that the drugs have turned their loved ones into totally different people.
Taking a buddy (a family member or friend) to your doctor’s appointments can give you perspective on what’s going on. Your buddy can ask questions, make note of your doctor’s responses and help you keep track of your prescriptions (what and when). Most importantly, you’ll be able to talk through things outside the doctor’s office.
Keep Track of Your Responses to the Drugs
In my muddled state, making sense of the information I found on the internet was frustrating, if not impossible. Ask your doctor for printed information about the drug(s) you’re taking and provide your doctor with a detailed account of how you are responding to the drugs.
Self Assessment Chart
Write down how you’re doing by preparing a Self Assessment Chart using a T-scale format:
- On a blank sheet, put your name, the name of the drug and dose at the top and draw a line down the center of the page;
- Write PROS at the top of left-hand column and CONS at the top of the right-hand column. Here is a sample.
Your entries should include both emotional and physical descriptions and will serve as talking points with your doctor.
Keep a Journal
You can amplify the notes you made in your Self Assessment Chart by keeping a journal. Describing your reactions to the drugs in real-life context can help your doctor see how the meds are affecting you.
One of my CONS was “anxiety,” but a one-word entry didn’t tell my doctor how it manifested itself. I was in a constant state of fight or flight – every time I came home from being out in the world, I was ashamed of how I had acted and reacted. Referring to my journal in doctors’ appointments helped me explain how overwhelming anxiety ruled my days.
While writing in my journal helped me focus on what was happening in the moment, looking back over my entries helped me realize how diminished I had become. What I couldn’t do was convince my doctor that everything she saw in me was caused by the antidepressants.
Keep an RX Calendar
I was declared totally disabled twenty-seven years after I took my first antidepressant. Receiving the official notification, signed by a judge, rocked my world – I felt my life was over at age 66.
But, it also forced me to try to take some small control over what was happening to me. I started keeping a dedicated RX Calendar making a note each day of the name and dose of the medication I was taking.
To get started, I ran off a copy of the current month and noted the drug and dose at the top. I kept it handy and made an entry every day. I used it in my doctor’s office when I invariably got tongue tied.
It was particularly helpful when I was having a bad reaction to a new drug. On the phone, I was able to tell my doctor at a glance when I switched and how long I had been on it, so that she could decide what to do next.