Tag Archives: depression

No One Is Immune… Woody’s Story Could Be Yours

By Kim Witczak
My life used to look very different back in 2003 than it does today. I was married to my best friend, had a successful career in advertising and was planning to have a family. However, all that changed with one phone call. On August 6, 2003, I became a widow. Woody, my husband of almost 10 years, was found hanging from the rafters of our garage. He was dead at age 37.

Woody wasn’t depressed, nor did he have a history of depression or any other mental illness.

Woody was outgoing, gregarious, smart and had a huge personality. He had just started his dream job as vice president of sales at a start-up company 2 months prior and started having trouble sleeping, which is not uncommon for entrepreneurs. So Woody went to see his family doctor, whom he trusted implicitly, and was given samples of the antidepressant Zoloft for insomnia. His doctor said Zoloft (sertraline) would take the edge off and help Woody sleep. Five weeks later, he was dead.

The 3-week Pfizer-supplied sample pack that Woody came home with doubled the dose from 25 to 50 mg after week 1. No cautionary warning was given to him or me about the need to be closely monitored when first going on the drug or dosage changes. In fact, I was out of the country on business for the first 3 weeks he was on the drug.

Shortly before he died, I found Woody curled up in the fetal position on the kitchen floor

Within days, Woody experienced many side effects, like profuse night sweats, diarrhea and worsened insomnia. He also experienced others, like akathisia (restlessness and an inability to stand still) that were known to Pfizer but not to Woody, his doctor or his family. Shortly before he died, I found Woody curled up in the fetal position on the kitchen floor, holding his head like a vice, crying, “Help me, help me. I don’t know what is happening to me. I am losing my mind. It’s like my head is outside my body looking in.”

We calmed him down and he called his doctor, who said you need to give it 4 to 6 weeks for the drug to kick in. Woody lasted another week.

From the beginning, Woody’s death made no sense to anyone who knew him. Everywhere I turned, all the so-called experts and suicide support groups were telling me Woody must have been depressed. But in the deepest part of me, I knew something didn’t add up.

Why would a guy who loved life take his own life? Woody went from not being able to sleep to experiencing head outside of body, horrific nightmares and extreme crying fits. So we started digging into the only thing that made Woody change during this extremely short period of time. Zoloft.

We Never Questioned the Drug

Woody and I never once questioned the drug. Why would we? Zoloft is FDA approved, samples were given by his doctor, and was advertised and sold as safe and effective. Ironically, the day Woody was found our local newspaper ran a front-page story about a study in the UK finding a link between antidepressants and suicide in teens.

The coroner asked if he was taking any prescription drugs – the only drug he was on was Zoloft. She said she needed to take the bottle with her, that it might have something to do with his death.

My journey for the truth has taken me to the FDA, Congress, the courts and the media. Unfortunately, I quickly learned that Woody was not an isolated case or “anecdotal.” Most people have no idea that the FDA held hearings on Prozac and its link to suicide and violence in 1991 – 13 years before the FDA eventually put “black box” warnings on the drugs for children in 2004 and young adults in 2006. It’s unthinkable how many deaths could have been prevented had warnings been put on antidepressants in 1991.

In the legal battle for Woody, we were able to get confidential internal Pfizer and other drug company and FDA documents made public that showed they knew about the risk of suicide, violence and decided NOT to speak of questionable efficacy. But they failed to tell all this to the public. I hand-delivered these documents to the FDA, members of Congress and the media.

It’s hard not to do something when you have seen these documents in black and white with your own eyes AND you have the experience that I have had. These documents speak for themselves. Lives were being destroyed. It was too late for our family. But, if just one family was informed, then Woody’s life and death made a difference.

I can’t believe that, almost 15 years after Woody’s death, we are still having this debate about antidepressants. In some ways, I think the situation has gotten worse. There are a lot of powerful, commercial self-interests to protect in the current mental health model. All of this is going on behind the scenes while the average, everyday person like Woody goes to their doctor and trusts that they are being given a drug that is “safe and effective.”

The Right Way to Get Off Antidepressants

Crissi Estep had been on Cymbalta (duloxetine) a few years when the medication seemed to stop working. At first, it effectively controlled both her fibromyalgia-related nerve pain and her depression, but “any successes I had had with it earlier were gone,” Estep says.

“I was very depressed, even agitated, and felt like I had plateaued,” she added. When Estep shared her concerns with her physician, he added Abilify (aripripazole) to her medication regimen.

Estep soon developed intolerable side effects. Frustrated, she decided to quit taking her antidepressants.

Because she’s a registered nurse, Estep knew that antidepressant medications are usually tapered before they’re discontinued. So, she developed her own tapering schedule: 1 day between doses, then 2, until the medicine was gone.

Severe withdrawal symptoms hit about five days after the medication cleared her system. “I genuinely thought I was having a heart attack,” Estep says. “I had chest pains and was shaky and nauseous. When I turned my head, it would swish, like water in a bowl.”

The South Carolina resident was in Maine at the time, camping with her family, “literally googling ERs,” she says, when her husband wondered aloud if her symptoms might be related to the cessation of her medication. Together, they looked up withdrawal symptoms for her antidepressants. Estep was experiencing almost all of them.

Between 2011 and 2014, approximately 1 in 9 Americans reported taking at least one antidepressant medication in the past month. Sixty-eight percent of those people had been on their antidepressant for two years or longer; 25% had been taking anti-depressant medication for 10 years or more. At some point — typically, when they’re feeling better, but sometimes when they are frustrated by side effects — nearly every person who uses an antidepressant considers stopping the medication. But, as Estep learned, stopping antidepressant treatment without medical guidance is risky and can cause uncomfortable side effects, as well as a relapse of depression.

You should also know that the more depressive episodes you have had, the more time you should take to come off of the medication. Harvard Women’s Health Watch says that for those who have had 3 or more such episodes should wait for at least 2 years once symptoms ease to considering weaning off an antidepressant.

Regarding weaning off, it’s important not to taper off to quickly. Time is your friend and you should take things slowly. Coming off too quickly can increase the risk of nasty withdrawal symptoms, and increase the risk of a relapse. It’s not uncommon for some long-time antidepressant users to need a year or more to come off of medication.

The good news is there’s a right way to get off antidepressants.

Set Yourself Up for Success

The best time to go off an antidepressant is when your depression is in remission and life is stable. “Big life transitions, such as a job change, graduating from college, getting married or having a baby, are not a good time,” says Carl Olden, MD, a family physician in Yakima, WA, and a member of the board of directors of the American Academy of Family Physicians.

It’s also a good idea to bolster your support system and boost self-care strategies. “You’ll have the best chances of success if you have a team around you,” says Jane Payne, MD, a psychiatrist in private practice in Portland, OR. Ideally, your team will include the medical professional who prescribes your medication and at least one or two close friends or family members who know about your history of depression.

“Be as forthright as you can with them about what depression was like for you, about how your behavior changed, and let them know you’re going off your medication, so they can be on the lookout for red flags,” Dr. Payne says. Also share with them some successful coping strategies you’ve used in the past (such as journaling, exercise or time in nature), and ask them to encourage and support your self-care efforts as you transition off medication.

With your health care provider, develop a plan. Your provider will want to know how you fare on days or weekends when you forget to take your antidepressant. That information will help your provider plan an appropriate quitting schedule. And if your antidepressant serves multiple purposes – say, managing nerve pain and depression – your provider may need to prescribe another medication to keep your health under control.

Don’t let your antidepressant prescription lapse. Make sure you have some left, “in case you need to start back up,” Dr. Olden says.

Go Slow

“Any medication that you’ve been on for more than a couple of weeks that works on the central nervous system has initiated changes within the brain to adapt to the presence of that medication,” Dr. Payne says. “If you suddenly take the medication away, the changes are still present without anything to balance them.”

Gradually tapering – decreasing the dose – of the medication over a period of time allows your body to readjust. That’s why clinicians recommend weaning antidepressant medication over a period of weeks — and often for far longer than that.

The length of the weaning period will vary depending on the antidepressant, dosage, duration of treatment and individual response. It may take as little as 5 days, or a month or more to wean completely off an antidepressant.

Follow the weaning schedule recommended by your healthcare provider, and don’t hesitate to report adverse effects.

“If you’re having withdrawal symptoms, find yourself unable to sleep or your mood is really up and down, it might be that you’re coming off too fast,” Dr. Payne says. A more gradual approach could eliminate your symptoms.

Know What to Expect

Some people experience a transient increase in depression-related symptoms, such as difficulty sleeping, anxiety and agitation, while coming off their medication. Other adverse symptoms may include constipation, diarrhea, dizziness and nausea.

In most cases, these symptoms will subside within a few weeks. “This is why it really helps to be in contact with a doctor who has a sense of your baseline, who can tell the difference between a rough patch and things going south,” Dr. Payne says. When in doubt, call your physician, who can help you determine if you need medical treatment.

If your depressive symptoms re-emerge after you’ve stopped the antidepressant, you may need to restart the medication – and that’s OK. “There are some folks who are better served by staying on antidepressants,” Dr. Olden says.

Estep restarted her antidepressant while still on vacation. After she returned home, she spoke to her doctor and “did a very slow wean” that was “pretty uneventful,” she says. One month later, she was off her antidepressant.

The FDA Has It Wrong on Kratom: How the Herb is Helping People Like Me

By Andrew Turner
Some may ask who are the consumers of kratom, an herb used to treat pain, depression and anxiety that has been the subject of controversy lately in the news. It’s complicated.

We can be anyone. We are your neighbor, the veteran in the supermarket, your college professor and even your best friend. There’s a lot of misconceptions about kratom, how it’s used to treat certain ailments and its potential for addiction.

Some incorrectly assume that anyone taking kratom must have been a drug addict before. The reality is most people are taking kratom to supplement their health.

For me, this path to kratom came after trying a number of conventional health options. For many years, I was prescribed a multitude of medications to address all sorts of service-related injuries and illnesses. When my doctors diagnosed me with a rare movement disorder called Meige Syndrome and tried to treat it with limited options, I lost several years of my life due to disability.

For many like me, trapped in a no-win situation with a severe physical or mental disability, you accept that conventional science has not funded research on many rare diseases and you seek other solutions. The path that I was on was not sustainable and too often has led many veterans like myself to take their own lives. I was fortunate that, again, I found an educated doctor, someone who had seen the signs before. My doctor realized that the medications that I was on at the time were doing very little for me — they were not providing me a good quality of life and may have actually been causing more harm than good.

My doctor took me off the medications that weren’t helping and suggested that I “just look into some natural options that will provide you some quality of life. That may be all we can do in your situation.”

Watch Andrew Turner on CBS This Morning, 4/3/2018

Strangely, in my search some 3 years ago, I kept reading people talking about kratom, a plant with medicinal benefits, including relief from pain, depression and anxiety.

I spent many nights reading about this and every time I would read more the only thing I could think was this must be snake oil. I couldn’t imagine some simple plant I’ve never heard of from Southeast Asia could help me in such a phenomenal way. But then I read studies that support the medical use of this incredible herb. (Here’s a review that came out in December that looked at 57 studies of kratom).

The first time I took kratom I can’t say I experienced anything — its effect is subtle. So I was initially still convinced it was nothing but snake oil and I had been duped. But because I had so few options and conventional medication did not help, I stuck with it.

It was a few weeks after I had tried several types of kratom (both in a tincture form and in a ground raw leaf form) when I started to notice something was different. It had an incredibly calming effect, I was sleeping better and my overall well being had changed dramatically. Now 3 years later, I start my day with a cup of kratom tea. I prefer it cold with plenty of lemon or lime juice and just a bit of raw honey.

Now this is not a treatment nor a cure for my physical and mental disabilities. To be able to claim that, substantial sums of money would have to be invested by the pharmaceutical industry so that kratom could undergo clinical trials. I understand my experience may have caused interesting changes to my health, but it may not work for someone else.

FDA Commissioner Scott Gottlieb has said publicly that what I’ve experienced is impossible. I’ve learned that I’ll just accept what he has to say and at the same time I will enjoy my kratom tea. My life has changed so much that I’ve even been able to dedicate myself to almost full-time advocacy work on behalf of kratom.

Now you may ask, “What happens if you stop taking kratom?” and for me, over time I would lose a lot of the ground that I have gained. On a daily basis I have to then fight for my right to have some quality in my life. The one question I have for anyone who supports a ban of plants like kratom or marijuana or dandelions is: Do you feel people deserve to have quality of life or not?

Everyone deserves the right to make decisions about their quality of life. Sometimes to achieve that means allowing things that others are uncomfortable with. Maybe someday folks like Gottlieb will sit down with a kratom consumer like me and say, “You don’t deserve to enjoy the same quality of life I do” and at that point better understand that what is OK for me but not be for thee.

For now I will continue to wake up each day and start with my kratom tea and fight to #KeepKratomLegal for as many days as I have left on this planet. Kratom isn’t perfect. I know that, but it’s perfectly good for what I need. For several years now, I and others have had to fight almost daily to protect our quality of life. That’s a fight worth being in and one that I always say isn’t over no matter what the FDA says.

Is Kratom Really As Dangerous As the FDA Makes It Out to Be?

America is in the midst of one of the worst epidemics in its history over opioids, which may be one of the reasons the FDA recently issued a warning that kratom, a plant-based supplement often used for pain, is potentially addictive since it has opioid-like qualities.

Kratom has also been used by some people to treat withdrawal from opioids. However, the agency stated that there is “no reliable evidence” to support this and “significant safety issues exist.” The FDA also said it has received reports of 44 deaths related to kratom use. However, as a recent Reason.com blog pointed out, in many of these cases, other substances were found along with kratom in the systems of the deceased, making it difficult to prove kratom was the cause of death.

In one of those deaths, a 22-year-old man had a cocktail of drugs in his system that included the antidepressant Prozac (fluoxetine), antipsychotics Seroquel (quetiapine) and Zyprexa (olanzapine), Lyrica (pregabalin), which is used for nerve pain, and several benzodiazepines (tranquilizers) – in addition to kratom. Also, as Jacob Sullum argued in another Reason.com blog, more people have died from prescription and over-the-counter pain relievers than kratom.

So is kratom really as dangerous as the FDA makes it out to be?

It’s hard to say. But it may be harder to get your hands on kratom. The FDA has already blocked importation of the substance. And in 2016, the Drug Enforcement Agency (DEA) ruled to classify kratom as a Schedule 1 drug, putting it in the same class as marijuana, LSD and heroin as substances with no currently accepted medical use and a high potential for abuse. The DEA backpedaled a bit later in the year following outcry from the public. However, the FDA’s warning could make it more likely for kratom’s Schedule 1 designation to go through.

To me, it seems the FDA is making a bit of a rash decision. Although the FDA says it conducted its own medical analysis of kratom, there is a lot of existing research supporting kratom as effective for conditions such as PTSD and depression. Did they consider this before issuing a warning?

Much like the FDA’s and DEA’s position on marijuana, it seems that decisions are being made based on incomplete examinations of the positives and negatives of herbal substances. The FDA and DEA owe it to patients who use kratom and find benefit from it to conduct a more thorough investigation before deeming it unsafe for public consumption.

Quick Hits: Antidepressants and Ovarian Cancer, Limiting Opioid Scripts & More

Antidepressants are not linked to ovarian cancer, according to a new study. Although there have been a few studies over the years showing a link between certain classes of antidepressants and the development of tumors, researchers from Shengjing Hospital of China Medical University are suggesting otherwise. The research team thoroughly analyzed data from observational studies that examined the connection between antidepressant use and cancer from 1984 to 2017. The results from this large-scale review indicated that there is not a significant association between antidepressant use and the risk of ovarian cancer, which is contrary to initial findings. Posted February 5, 2018. Via British Journal of Clinical Pharmacology.

Opioid prescriptions for Medicare enrollees would be limited to 7 days under a request from the Centers for Medicare & Medicaid Services. The agency has also proposed that patients who are considered “potentiators” of opioid misuse and opioid-related adverse events be closely monitored, especially those who take Neurontin (gabapentin) and Lyrica (pregabalin). According to the agency, there has been a significant increase in gabapentin use to treat pain. Via CMS. Posted February 2, 2018.

Senate Democrats want the FDA to reject a new alternative cigarette that will be marketed as less risky. Ten Democrats sent a signed letter requesting that the FDA to reject Philip Morris’ risk application for its new iQOS smoking device. The letter was sent after most of the FDA’s scientific advisory panel reported mixed findings on the new product. According to the advisory panel, the tobacco company did not prove whether its new “heat not burn” cigarette reduced harm compared to tobacco cigarettes. However, the advisory panel concluded that iQOS exposes users to lower levels of harmful chemicals. The senators also referenced the Family Smoking Prevention and Tobacco Control Act, noting that modified risk tobacco products must significantly reduce harm and benefit the health of the population. Posted February 7, 2018. Via The Hill.

Young People on Antidepressants at Increased Risk of Developing Type 2 Diabetes

Researchers from the University of Maryland examined the medical claims of nearly 120,000 patients between the ages of 5 and 20 years old who were using antidepressants. The team compared incident cases of diabetes among the young patients using antidepressants — patients who didn’t discontinue the medications for more than 90 days during the study period — with those in former patients.

Researchers found that the risk for type 2 diabetes was nearly twice as high among current users of certain types of antidepressants, they reported in JAMA. The antidepressants included selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine) and Zoloft (sertraline), and serotonin norepinephrine reuptake inhibitors (SNRIs) such as Effexor (venlafaxine) and Cymbalta (duloxetine). They added that the risk increased the longer one was on an antidepressant and the higher the daily dose.

Researchers also noted that for adolescents on older types of antidepressants for long periods of time, there was no increased diabetes risk.

Asthma Drug Singulair Causes Nightmares, Depression in Children and Adults

Dutch researchers have confirmed that the asthma drug Singulair (montelukast) has serious side effects, including depression, nightmares and even sleepwalking in some children and adults.

Their study, published in Pharmacology Research & Perspectives, is a meta-analysis of data from both the Netherlands Pharmacovigilance Center Lareb and the WHO Global database, VigiBase. The researchers found that while depression is the most reported side effect, nightmares and aggression were the most reported for children using the drug.

Interestingly, the researchers suggest that because asthma itself is known to cause depression among children, the use of Singulair may have lifted the depression. According to the authors, “a reason for the higher incidence of agitation in children can be that children have more energy because their symptoms of asthma and/or allergic rhinitis are being tempered by montelukast and parents may interpret this as abnormal behavior or aggression (de Vries and van Hunsel 2016).”

The study data reaffirms the 2009 decision by the FDA that depression, suicidal ideation and other neuropsychiatric symptoms must be listed among potential side effects included in the medication packaging. In addition, the Dutch researchers advise that doctors should talk to patients specifically about these potential side effects.