The Case Against Antidepressants

[Charliebizz]

This was the basis for the Dr. Mariano low-dose SSRI craze and I do think it can work for this purpose. The SSRI seems to act like an "adaptogen", improving the resistance to stress and normalizing HPA function. However, the benefits are part of a larger package that includes emotional blunting, apathy, increased susceptibility to depression, personality changes, sexual dysfunction / risk of PSSD, weight gain, osteoporosis, and other negative consequences too numerous to list.

Just sign on the dotted line for relief from an overactive HPA axis:
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To play devils advocate. I’ve seen the “almost” all those things happen to people from trt also. i personally feel worse off mentally on trt vs off. Hpa shut down seems to effect is all differently.

 

[FunkOdyssey]

To play devils advocate. I’ve seen the “almost” all those things happen to people from trt also. i personally feel worse off mentally on trt vs off. Hpa shut down seems to effect is all differently.

Fair point. The difference is I (perhaps naively) believe it is possible to administer TRT in such a way that the pitfalls can be largely avoided, whereas I have enough experience to know that is not possible with SSRIs.

 

[Charliebizz]

Fair point. The difference is I (perhaps naively) believe it is possible to administer TRT in such a way that the pitfalls can be largely avoided, whereas I have enough experience to know that is not possible with SSRIs.

You don’t think dosage has a lot to do with it? I think most ssri are overdosed. I actually didn’t see any negative sides at all from 4 years of low dose lexapro. Maybe I have sides now from discontinuing ssri but I stopped 6 months into trt. And It Very well could be issues with the Shut down from trt.

ive seen many people over the years on the forums and groups complain about mild depression, and loss of zest for life. Penile sensitivity and eq issues from trt. However trt without a doubt has major positives in most too that can’t be ignored. I find myself in a really tough spot. Trt give me a better libido, nocturnal erections,better glycemic control and more resilient to working out and working in general. But my mental has been so off. Ive tried so many different protocols. I’ve dabbled in cortisol and thyroid replacement. I just can’t seem to get it right. And my fear is the shut down is the biggest factor in my mental state. The problem is figuring that out

 

[Fortunate]

You don’t think dosage has a lot to do with it? I think most ssri are overdosed. I actually didn’t see any negative sides at all from 4 years of low dose lexapro. Maybe I have sides now from discontinuing ssri but I stopped 6 months into trt. And It Very well could be issues with the Shut down from trt.

ive seen many people over the years on the forums and groups complain about mild depression, and loss of zest for life. Penile sensitivity and eq issues from trt. However trt without a doubt has major positives in most too that can’t be ignored. I find myself in a really tough spot. Trt give me a better libido, nocturnal erections,better glycemic control and more resilient to working out and working in general. But my mental has been so off. Ive tried so many different protocols. I’ve dabbled in cortisol and thyroid replacement. I just can’t seem to get it right. And my fear is the shut down is the biggest factor in my mental state. The problem is figuring that out

@Charliebizz, I feel you. Sometimes I wish I can go back in time and do things differently…

I also sometimes wonder what would happen if I went back to Natesto and just ran that for 6 to 12 months. Would I recover? I don’t know, but after a few weeks of trying this a few different times, I can’t stand feeling tired and worn down. On the other hand, side effects are minimal.

Maybe Natesto coupled with thyroid would do the trick? I don’t know, but it’s not something I’m going to try anytime soon.

Bottom line is, I can relate to your well articulated points.

 

[Charliebizz]

@Charliebizz, I feel you. Sometimes I wish I can go back in time and do things differently…

I also sometimes wonder what would happen if I went back to Natesto and just ran that for 6 to 12 months. Would I recover? I don’t know, but after a few weeks of trying this a few different times, I can’t stand feeling tired and worn down. On the other hand, side effects are minimal.

Maybe Natesto coupled with thyroid would do the trick? I don’t know, but it’s not something I’m going to try anytime soon.

Bottom line is, I can relate to your well articulated points.

My mind always goes back to thyroid for me also. Low body temps, cold intolerance, dry skin, etc… but I really still think it has something to do with cortisol for me but just don’t know how to fix that.

 

[Fortunate]

My mind always goes back to thyroid for me also. Low body temps, cold intolerance, dry skin, etc… but I really still think it has something to do with cortisol for me but just don’t know how to fix that.

You supplemented thyroid? I did it briefly based on Dr. recommendations. Wouldn’t rule out trying it again, but not sure what I think about it. What was your experience?

 

[Charliebizz]

You supplemented thyroid? I did it briefly based on Dr. recommendations. Wouldn’t rule out trying it again, but not sure what I think about it. What was your experience?

i trialed t3 years ago with dr crisler. Wasn’t a great experienc. had this weird low grade dizzy feeling l, pressure in my ears And anxiety. Then a few years ago I trialed armour didn’t really feel much. got up to 1.5 grains and started to get wicked headaches. So I ditched It. Then I did a real short trial with t4 (Not long enough) got In my head about it and bailed. It’s hard for me to commit cause my thyroid numbers are pretty good. And trt actually made them better. I know numbers aren’t end all be all. But even though some people say taking thyroid is safer and easier since then t. I just don’t know if that’s true. most people I know in my life that are on thyroid hate it and always messing around with it.

 

[Systemlord]

@FunkOdyssey whats your take away from these study. Might be better ones. But these 2 are talking about the possibility of restoring hpa. That I think is my biggest problem and one of the reasons I tried ssri with trt.

Pharmacological Treatment of Anxiety Disorders: The Role of the HPA Axis

Implication of the hypothalamic–pituitary–adrenal axis in the physiopathology of depression

Hpa shut down seems to effect is all differently.

I have heard some guys say they can't get erections when LH is suppressed, the moment they stop TRT things are quite different.

The majority of men don't have problems, it's the outliers who do have issues.

 

[Charliebizz]

I have heard some guys say they can't get erections when LH is suppressed, the moment they stop TRT things are quite different.

The majority of men don't have problems, it's the outliers who do have issues.

Agreed. Thats The most frustrating part for me is I get great libido and erections with higher doses. But feel worse physically and mentally.

I do think cream would have worked for me but possible the sky high dht ends up problematic. I’m usually great the first 3-4 days in cream then I start to feel fatigue abd get angry Easy. Also depressed moods.

 

[Hyrulewarrior1978]

Agreed. Thats The most frustrating part for me is I get great libido and erections with higher doses. But feel worse physically and mentally.

I do think cream would have worked for me but possible the sky high dht ends up problematic. I’m usually great the first 3-4 days in cream then I start to feel fatigue abd get angry Easy. Also depressed moods.

Why did you stop the lexapro if it was working for you?

 

[Charliebizz]

Why did you stop the lexapro if it was working for you?

I was always worried about long term side effects of ssri. I was also bing some lingering energy issues and harder to lose weight. it’s really hard to put my finger on the cause of my current problems. They all started somewhere around the time I got off ssri. But I also was on trt only 6 months. Would it have happened anyway even if I stayed on ssri not sure. Is it trt? are my levels too high for me? Is it the shut down? is it all unrelated ? Who really knows

 

[Charliebizz]

Antidepressant use and risk of adverse outcomes: population-based cohort study | BJPsych Open | Cambridge Core

Antidepressant use and risk of adverse outcomes: population-based cohort study - Volume 8 Issue 5

www.cambridge.org

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Seems to me that study is full of holes. One statement for example “Moreover, it was not possible to distinguish between the effects of antidepressants and depression itself. Our fully adjusted model at 10-year follow-up” few other statements I could quote.

they also never mention dose. dosage matter in many medications, when it comes to short and long term side effects. Do you guys think dosage matters at all? I know personally I had no side effects that I was aware of on low dose lexapro. High dose paxil I had major weight gain. And trouble reaching orgasm.

the point I’m trying to make is I think ssri might be over dosed. I could be off base because I’m not sure how much “reuptake” is blocked based off dosage. But could it be something similar to how people encounter side effects when they take too much testosterone?

 

[Hyrulewarrior1978]

I know FunkOdyssey was going to comment on this one from other thread. Enjoy.

Our RCT Fetish: How the “Gold Standard” for Research Has Led to A Societal Delusion About the Merits of Antidepressants

While RCTs show that antidepressants provide a statistically significant benefit, there is a large pool of evidence that tells of harm done

www.madinamerica.com

So are you still taking Lexi after reading all the horror stories? Lol. Imo the ssris are pretty harmless.

 

[Hyrulewarrior1978]

Why would you LoL? What do you find humorous?

I just thought that you might stop the lexapro after reading the stories. Hopefully you can see past the bullshit that’s out there.

 

[Hyrulewarrior1978]

Glad you got it figured out. I hope one day to reach that level of enlightenment. Thanks for the hope.

No worries man you do you. Given the choice between klonopin and lexapro I think you made the right choice.

 

[Tn198989]

What’s funny is back in my early 20s I had crippling anxiety. And paxil legitimately cured my issues. I was on it for 2 years. Highest dose. I gained so much weight. I had a little delayed ejaculation. But libido was still great. I actually quit it cold turkey, didn’t know any better. And I never looked back. Had no side effects and anxiety was gone. I’m not sure if it actually did anything or the Placebo made me realize the panic wasn’t going to kill me and was able to not over think it.

then in my mid 30s I jumped on low dose lexapro. I used it because dr Mariano said it could help people with cortisol issues tolerate trt. I stayed on it for 4 years. i was only on 2.5 mg. Didn’t have any side effects. i Was mmostly off trt those 4 years. But when I finally committed to trt 6 months in I started to get some emotional flatness and thought maybe it was ssri. I got off the lexapro and had pretty annoying withdrawal. A lot of brain zaps and some depression. Took about 3 months for the acute symptoms to get better. Then slowly over the last year I’ve become more and more depressed on trt alone. Trt is great for my libido, nocturnal erections,glycemic control. But my moods and way of thinking about life are just off. I’ve been toying with the idea of going on low dose Prozac for some time. I even started it for a week and then bailed again. I’ve read a lot of the things @FunkOdyssey has posted and looked into them myself for years. part of the reason I got off them.

im not sure what to do but I have been absolutely miserable lately. I have admittedly Been messing with my trt way too much. And that does mess with my mental state. But I almost feel stuck like I need a reset. I’m not sure if I got here from the 4 year ssri use And withdrawal. Or the trt it self. I been off the ssri for little over 2 years. And on trt for same time.

sorry if my grammar and punctuation is off. Kids are screaming in the back round driving me nuts lol.

I am in somewhat same situation at the moment. I stopped prozac

What’s funny is back in my early 20s I had crippling anxiety. And paxil legitimately cured my issues. I was on it for 2 years. Highest dose. I gained so much weight. I had a little delayed ejaculation. But libido was still great. I actually quit it cold turkey, didn’t know any better. And I never looked back. Had no side effects and anxiety was gone. I’m not sure if it actually did anything or the Placebo made me realize the panic wasn’t going to kill me and was able to not over think it.

then in my mid 30s I jumped on low dose lexapro. I used it because dr Mariano said it could help people with cortisol issues tolerate trt. I stayed on it for 4 years. i was only on 2.5 mg. Didn’t have any side effects. i Was mmostly off trt those 4 years. But when I finally committed to trt 6 months in I started to get some emotional flatness and thought maybe it was ssri. I got off the lexapro and had pretty annoying withdrawal. A lot of brain zaps and some depression. Took about 3 months for the acute symptoms to get better. Then slowly over the last year I’ve become more and more depressed on trt alone. Trt is great for my libido, nocturnal erections,glycemic control. But my moods and way of thinking about life are just off. I’ve been toying with the idea of going on low dose Prozac for some time. I even started it for a week and then bailed again. I’ve read a lot of the things @FunkOdyssey has posted and looked into them myself for years. part of the reason I got off them.

im not sure what to do but I have been absolutely miserable lately. I have admittedly Been messing with my trt way too much. And that does mess with my mental state. But I almost feel stuck like I need a reset. I’m not sure if I got here from the 4 year ssri use And withdrawal. Or the trt it self. I been off the ssri for little over 2 years. And on trt for same time.

sorry if my grammar and punctuation is off. Kids are screaming in the back round driving me nuts lol.

2 weeks ago I stopped prozac after tapering for months. About 5-6 days later I got a panic attack for no reason at all during some routine work. After that panic attack I was more anxious than I have ever been in years. I went to a new doc that seemed knowledgeable and agreed that if it affects libido or cause Ed then keep looking.

So he suggested an older medication amitripyline 10mg which is the lowest dose. Unfortunately after taking it my already low diastolic blood pressure dropped below 50 (my normal is around 65-70) so after speaking with him, he suggested trazodone as it doesn't cause libido or Ed issues. I am on the 4th day of 75mg trazodone and I ve been sleeping for like 12-14 hours a day since I started it. Hopefully this side effect will go away once I get used to the medication.

Anyway I still have withdrawals from prozac so he said that I can try trintellix 5mg in the morning. Bad advice though cause my libido dropped again and don't know which to blame.

You have to realise that taking prozac for like 2 months, will do nothing for you. You probably need to be on medication for the rest of your life. SSRIs don't cure the underlying cause, they just cover it.

Like you, I need to be on medication for life . If you feel like shit then these two could work for you(trazodone or trintellix). But again, only after speaking with your doctor first.

About what to blame for your mental state I think you know the answer.

There is a reason you were on a ssri's in the past.
I mean trt can cause issues itself but feeling that bad would require severe hormone deficiencies and/or changes.

There are people who are sensitive to even the slightest change in protocol but with your history I would bet my money that's it's the same cause that made you take antidepressants in the first place

 

[Fortunate]

I am in somewhat same situation at the moment. I stopped prozac


2 weeks ago I stopped prozac after tapering for months. About 5-6 days later I got a panic attack for no reason at all during some routine work. After that panic attack I was more anxious than I have ever been in years. I went to a new doc that seemed knowledgeable and agreed that if it affects libido or cause Ed then keep looking.

So he suggested an older medication amitripyline 10mg which is the lowest dose. Unfortunately after taking it my already low diastolic blood pressure dropped below 50 (my normal is around 65-70) so after speaking with him, he suggested trazodone as it doesn't cause libido or Ed issues. I am on the 4th day of 75mg trazodone and I ve been sleeping for like 12-14 hours a day since I started it. Hopefully this side effect will go away once I get used to the medication.

Anyway I still have withdrawals from prozac so he said that I can try trintellix 5mg in the morning. Bad advice though cause my libido dropped again and don't know which to blame.

You have to realise that taking prozac for like 2 months, will do nothing for you. You probably need to be on medication for the rest of your life. SSRIs don't cure the underlying cause, they just cover it.

Like you, I need to be on medication for life . If you feel like shit then these two could work for you(trazodone or trintellix). But again, only after speaking with your doctor first.

About what to blame for your mental state I think you know the answer.

There is a reason you were on a ssri's in the past.
I mean trt can cause issues itself but feeling that bad would require severe hormone deficiencies and/or changes.

There are people who are sensitive to even the slightest change in protocol but with your history I would bet my money that's it's the same cause that made you take antidepressants in the first place

Well said. I think that a healthy hormone milieu might be a prerequisite for feeling content, but it’s not the only factor. Having hormones out of whack can affect you emotionally (we all can attest to that); but, fixing hormones (whatever that means), is no guarantee for happiness. This is part of the reason why I applaud @readalot for exploring ways to better himself by looking beyond TRT.

It’s easy to get tunnel vision with TRT (guilty as charged here).

 

[Charliebizz]

I am in somewhat same situation at the moment. I stopped prozac


2 weeks ago I stopped prozac after tapering for months. About 5-6 days later I got a panic attack for no reason at all during some routine work. After that panic attack I was more anxious than I have ever been in years. I went to a new doc that seemed knowledgeable and agreed that if it affects libido or cause Ed then keep looking.

So he suggested an older medication amitripyline 10mg which is the lowest dose. Unfortunately after taking it my already low diastolic blood pressure dropped below 50 (my normal is around 65-70) so after speaking with him, he suggested trazodone as it doesn't cause libido or Ed issues. I am on the 4th day of 75mg trazodone and I ve been sleeping for like 12-14 hours a day since I started it. Hopefully this side effect will go away once I get used to the medication.

Anyway I still have withdrawals from prozac so he said that I can try trintellix 5mg in the morning. Bad advice though cause my libido dropped again and don't know which to blame.

You have to realise that taking prozac for like 2 months, will do nothing for you. You probably need to be on medication for the rest of your life. SSRIs don't cure the underlying cause, they just cover it.

Like you, I need to be on medication for life . If you feel like shit then these two could work for you(trazodone or trintellix). But again, only after speaking with your doctor first.

About what to blame for your mental state I think you know the answer.

There is a reason you were on a ssri's in the past.
I mean trt can cause issues itself but feeling that bad would require severe hormone deficiencies and/or changes.

There are people who are sensitive to even the slightest change in protocol but with your history I would bet my money that's it's the same cause that made you take antidepressants in the first place

I didn’t take ssri ever for depression. And I only took it for 2 years back in the early 2000s for anxiety. I tried low dose ssri for cortisol issues. A dr back in the day on the forums swore it could help guys with lower cortisol levels. to some degree it did for me.

seems the cause of my depression As of late is when ever my trt dose is too high. Or too frequent. I’m feeling much better in that department on 2x a week at a lower dose. Only issue with that is I lose some of the benefits. Like my fantastic libido, spontaneous erections And better flaccid hang

 

[Fortunate]

Ok, I know you have all been on the edge of your seats for an update (lmfao) so here it is.

TRT disclosure:
I am on 80 mg/week TC/TP blend (4:1) - 40 mg twice weekly + 400 IU twice weekly hCG. Anything above that and my Hct will get up above 50.

Doc prescribed benzo and escitalopram 10 mg daily last month. Tried the benzo for a few days and thought ok that is what drug addicts feel like, cool. Then promptly stopped. Tried the 10 mg daily escitalopram for a few days and headaches so dropped to 5 mg daily for last 4 weeks based in part from recommendation of our beloved resident AD SME @FunkOdyssey .

So after 4 weeks the panic/anxiety/heart racing outside of gym is gone. Gone. Libido is also gone. In fact everything is gone. Even trying to suffer through daily mental crucifixions during workouts I still showed up every day. Now zero motivation to workout but I can deal with that. Still very minor anxiety when I push workout but night and day difference in the gym experience.

On work side... no care. SSRIs (my anecdotal n=1) seem really effective at blunting any and all professional motivation. And blunt interpersonal motivation. Thank goodness never tried these in the old days. In summary, the SSRI really did a bang up job on the panic/anxiety/heart racing and left me more depressed and less motivated (bonus). Grateful it have me some relief on the panic.

Confirmed everything @FunkOdyssey shared. Should be out on a street corner with my cardboard box duplex by the end of year. Peace!!

Now to practice those CBT skills and use the power of the brain to will my intentions to reality. Whoosh!!

I’m sorry, man. Wish I could help.

 

[Fortunate]

Thanks for the kind words. In the end the only person who can help you is you with this stuff (and the Doc with the Rx pad evidently haha). I appreciate it Brother. I have not forgot about your request just been a little sidetracked.

Will follow up with you. Have a nice weekend.

Don’t sweat it, my man. I have more data that may be useful. But, at this time, I just don’t think injections and me get along. For the time being, moving away from them.