Column: I'm struggling to get off antidepressants and it's not easy

Sept. 6, 2019 5 AM PT

A doctor put me on antidepressants about a decade ago. I’ve spent the last year and a half trying to get off of them.

It’s one of the hardest things I’ve ever done.

Call it an addiction. Call it a dependence. Call it whatever you please. I’m hooked.

After slowly reducing my dosage, I’m now heading into my third week of cold turkey. It’s not a debilitating feeling — I spent months preparing for this moment. But it’s very unpleasant.

Ask my colleagues if I’ve been crankier and more irritable than usual. Ask my editor.

My experience with antidepressants mirrors the struggle many people face in trying to wean themselves from powerful prescription drugs — drugs that can play a positive role in your life until you realize you’re trapped.

“One thing we’ve learned from the opioid epidemic is that many patients believe if a drug has been prescribed by a doctor, it can’t harm you,” said Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University.

“These are strong drugs,” he told me. “They can do a lot of good. They can also do a lot of harm.”

Painkillers, antidepressants, anti-anxiety medications, tranquilizers, stimulants — each can affect users’ bodies so intensely that severe withdrawal symptoms are possible, even likely, if you stop taking them.

Such symptoms include dizziness, fatigue, nausea, mood swings and other conditions that can make daily life miserable. In some cases, suicidal tendencies can occur.

Adam Bisaga, a professor of psychiatry at Columbia University Medical Center, said that “most people aren’t prepared for the changes these drugs can cause to the body.”

“It’s easy to just take a pill every day,” he said. “To come off a drug means you’re going to have to do a lot more work.”

Don’t get me wrong: These drugs aren’t inherently bad. For many, a painkiller or an antidepressant can be the difference between a functional life and a life of unrelenting despair.

“Users themselves must decide about meds’ helpfulness in their own lives,” said David Cohen, a professor of social welfare at UCLA.

I’m not saying what’s right for anyone else.

I am saying, though, that Americans are currently more medicated than at any time in our history.

In 1997, according to Consumer Reports, 2.4 billion prescriptions were written by doctors. By 2016, that number had nearly doubled to 4.5 billion prescriptions.

For the pharmaceutical industry, that means record profits. Worldwide spending on prescription drugs reached $1.2 trillion last year, according to the medical data firm IQVIA. By 2023, global spending on drugs could top $1.5 trillion.

At any given time, about half the country is taking at least one prescription med, according to the Centers for Disease Control and Prevention. Nearly a quarter of the population is taking three or more prescription drugs. About 12% is taking five or more.

The number of opioid prescriptions dispensed by U.S. pharmacies almost tripled from 1991 to 2011, rising to 219 million prescriptions, according to the National Institute on Drug Abuse. By 2017, nearly 58 opioid prescriptions were being written for every 100 Americans, says the CDC.

Meanwhile, roughly 13% of Americans age 12 and over have been prescribed antidepressants, according to the National Center for Health Statistics. That rate has tripled over the last two decades.

In many cases, such treatment is warranted. But not always. Or not forever.

“There are a lot of people getting prescriptions to drugs who shouldn’t be,” said Gail Saltz, a clinical associate professor of psychiatry at New York Presbyterian Hospital.

My adventure in addiction began after I was diagnosed in 2007 with Type 1 diabetes. That’s the genetic kind (it runs in my family) as opposed to the kind typically associated with obesity.

Studies have found that diabetes can more than double your chances of clinical depression. This is due in large part to coping with a chronic disease. It also can be a factor of your body’s natural chemistry becoming imbalanced.

I went through a grieving process for my suddenly kaput pancreas and sought the assistance of a therapist for a few weeks. But it wasn’t depression that drove me to seek help from my endocrinologist. I couldn’t sleep.

I’ve never been a good sleeper. Diabetes turned my nights into minefields, tossing, turning, lying awake for hours.

My endocrinologist wasn’t surprised. Insomnia is common among Type 1s, he said.

He wrote me a prescription for an antidepressant and said this would likely straighten out whatever systemic imbalance was keeping me up at night.

And it did. I started sleeping better within a few weeks. As an added benefit, my wife said I’d become mellower and more pleasant to be around. Like the old ad slogan declared, better living through chemistry.

Then the New York Times went and ruined everything with an extraordinary investigation last year that detailed the agony faced by many people who tried to end their dependence on antidepressants. It’s called “discontinuation syndrome.”

“Patients who try to stop taking the drugs often say they cannot,” the paper found. “About half who wound down their prescriptions rated the withdrawal as severe. Nearly half who tried to quit could not do so because of these symptoms.”

That frightened me. On rare occasions when I forgot to take my daily pill, I would feel groggy and disoriented by early afternoon. I’d feel and hear a whooshing in my head, as if my pulse was pleading for its fix.

What if there was an earthquake or some other disaster and I couldn’t get my pills? What if the withdrawal symptoms were more than I could handle? How would I cope?

Moreover, how much is enough? Yes, I liked sleeping better. Yes, I liked that my wife felt I was more pleasant to be around.

But who was I? Was I me or was I the product of chemical enhancement? If I came off the drug, what would happen?

By this time I had a new endocrinologist. He’d read the same newspaper story and we agreed that antidepressants seemed more troublesome than once thought.

He also said that after years of taking the pills, it’s possible my body had corrected whatever had been out of whack.

Or not. It could be that, as with my life-long dependence on insulin, I’ll just be happier taking antidepressants. We wouldn’t know until I tried.

So we worked out a long-term program of reduced doses, a process known as “tapering.” And now, finally, I’ve reached the point where I’ve stopped taking the med all together.

That was two weeks ago.

At first I felt a bit better. Now I feel worse — sluggish, moody, short-tempered. I’ve even started thinking about going back on antidepressants.

Anything to not feel this way.

Humphreys, the Stanford professor, was sympathetic. “Cold turkey is brutal,” he said.

Coming on Tuesday: How to kick the habit.