The subject of antidepressants pops up quite regularly on these boards, and is often the subject of light squabbling and controversy.

While I'm quite certain this post will end up like wind in the trees, just a couple quick notes regarding antidepressants to keep perspective;

First, Dr. Harley's position on the effect of Depression in a Marriage -



There are several articles and radio shows, in addition, which Dr. Harley recommends antidepressants in the short-term for marital recovery from an affair or otherwise.

Note; "short-term," when using antidepressants would mean several months, or a few years. Antidepressants require several weeks to reach effective levels.


So - what if the spouse is a recovering addict? I have no knowledge of Dr. Harley excluding addicts from antidepressant therapy. Addiction and depression have correlations, with something of a chicken-and-egg debate. I would welcome any citations on this from Dr. Harley himself, but until that time, I will rely on the official position of Alcoholics Anonymous on use of antidepressants by recovering addicts;


page 6 here


That being said - such therapies are a personal decision, and should be made between a poster and their physician. Misinforming a poster about this approach is a disservice, especially when done so based on personal belief or creed, and with poorly supported claims and assumptions.

HHH, as a 28 year AA member, I can attest to the fact that MEMBERS of AA tell each other to avoid ADs. The reason is because addicts have a history of abusing pills. This advice wrongly assumes that ADs are in the same category as other narcotics. They are not.

I would also like to mention that Dr. Harley often recommends Wellbutrin because it does not have the side effects of hampering sexual desire.

Thanks for an excellent post.

One of the main reasons for admission to acute psychiatric units is people with mood/behavioral/emotional disorders who have stopped their medication for one reason or another. Often times, this results from an attempted suicide. In other cases, it may be acute depression, and the event may have been preventable with previous treatment.

These things can be avoided by reducing misinformation and not discouraging people to make informed decisions with their healthcare providers.

Wellbutrin is also not addictive.

Medications which are addictive and/or carry the probability of abuse are typically Class III controlled substances.

I have encountered no antidepressants which are even a Class IV controlled substance.

SSRIs and SNRIs can have withdrawal symptoms if they are stopped suddenly, which is why the patient education on these medication include the instruction "do not stop this medication suddenly."

This, however, has to do with how they work in the body and brain, and not with addiction.

I'm one of those people that doesn't care for AD's unless absolutely necessary.

Although Dr. Harley likes short term use in most cases, I prefer to ask, what have people tried prior to using AD drugs?

There are many alternatives.
I prefer natural treatments for depression.

Like Melody, I've been a member of AA & NA for years. (just celebrated 30 years of recovery) I've never told anyone that was using AD's to stop. As a matter of fact, coming off of AD's without medical assistance can lead to severe anxiety and in some cases suicide.
I have told almost everyone in recovery to stay off of them if they were never on them prior to recovery. I've always suggested alternatives for this second group.

Look, I've got a real problem with quoting AA and their position regarding alcoholism and AD's. Nowhere do they suggest their position should be taken in regard to recovering Drug Addicts. It's a book for alcoholics.
Also, starting AD's after recovering from addiction is not the same animal as already being on AD's while entering into recovery. The two differences must be clearly understood and acknowledged to avoid confusion when discussing the issues.

Presenting Welbutrin as non-addictive is not necessarily true either. 20% of those in trial studies felt they recognized this drug as an amphetamine (in other words, addictive). Because it's that low of a percentage they can label it as non-addictive. So mis-leading.... 80% of society can drink without becoming alcoholics too... Advertising, marketing, spin control....
Aside from its many side effects, its still a drug that alters the brain chemistry. And that makes it extremely dangerous for anyone recovering from a drug abuse/addiction.

The same can be said for all other AD's too!

Again, IMNSHO, telling a recovering drug abuser/addict to start on AD's after recovering from an addiction is dangerous and IMO, except in rare cases, un-necessary.

In surviving infidelity, many BS's have been abused in such cruel ways and for extended periods of time that temporary use of AD's is a common solution for evening out the severe emotional swings. I do support their use in these cases. Just not all cases.
FWIW, Many BS's survived and recovered with the use of natural alternatives....

... and then the rest of the story. Of the participants, 10% recognized a placebo as an amphetamine. In contrast to amphetamine and methylphenidate, there was no feeling of "liking the drug" and no desire to take it again. A comparison of bupropion SR (150 mg) and caffeine (178 mg) indicated that caffeine may have higher abuse liability since it resulted in more reports of pleasant feelings and a "high" than did bupropion.

Sample size of... 5

http://www.ncbi.nlm.nih.gov/pubmed/9526144


The position of NA on medications for mental health issues;


pg 20, and more on 21 here


It is not dissimilar from the AA stance.


And, from "Dual Recovery Anonymous"


http://www.draonline.org/medications.html


I'm not saying that I'm against alternative interventions. But, I am against improperly informing people on pharmacological interventions based on claims of "advertising, marketing, and spin control" - especially when the founder of this site supports no such claims... and I actually DEAL WITH THESE MEDICATONS ON A DAILY BASIS.

I'm sold on what works. Period.

Thanks for starting this thread, HHH...

I had never taken AD's before, and at first resisted the idea. However, I had never dealt with anything like the emotional roller coaster, so decided to follow Dr. Harley's advice. My doctor was very supportive of Dr. Harley' s advice.

My doctor and I chose PRISTIQ when I asked her about AD's. She said it is a new drug which seemed to have less side effects in her patients, and took effect more quickly (than the usual 10 days to 2 weeks.) The down side is that the drug is considerably more expensive than other AD's.

I was on it for 7 months, then began to wean myself off, as my doc outlined. For me, there were none of the side effects reported. No loss of libido, no weight gain, no nausea, no dizziness.

The only side effect I did notice (which I haven't seen reported anywhere) was canker sores on my tongue. I had one, sometimes two canker sores at all times. The location travelled around the circumference of my tongue. They were no more painful than usual canker sores (which I normally might get one a year.)

The drug worked well to "even out" my moods during early days after discovery.

Pristiq (Desvenlafaxine) is an SNRI (Seratonin-norepinephrine reuptake inhibitor.)

HHH,

I know you work with these meds every day.

I work with addicts. I have watched some relapse due to uneducated and uninformed doctors that prescribe meds that have adverse effects, the most common being AD's. I'll never forget the day I took a fellow addict down from a noose. It wasn't his family doctors fault that this man abused the drugs he was prescribed. He never shared the fact he was a recovering addict. The doctor offered him AD's and the addict did what the doctor thought was best. Today he's dead..... That's why ALL the commercials share the side effects of these medications, one of the side effects being suicide. (sample size of 1)

Did you know that it's estimated that well over half of those now on AD's have never been evaluated by a mental health professional? Marketing, advertising and spin control have had a great impact on these numbers. Over 11 billion dollars a year is spent on these AD's..... Along with many deaths and law suits we never hear anything about. (ie. my comment on spin control)

Is America really that depressed, or just that uniformed about the alternatives.
11 billion dollars spent in the US..... when there are only 313 million people in the US. Think about those numbers..... To me that's staggering.
Or maybe we just don't understand that there is a time and a season for everything under the sun. And sometimes we will feel depression.

I'm sold on what works too... Period!
And Exercise along with diet often work for many medical conditions where prescription meds are also prescribed for relief. It frequently just comes down to what's easier, and often meds are used by uninformed and uneducated patients, in spite of the side effects that exist in these meds. They trust the doctor instead of being their own advocates.

I'm sure you'd agree that diet and exercise can bring most cases of mild depression under control.

You see, I'm not talking about major depression or psychiatric disorders that requires AD's or other drugs. But even in these cases, alternatives such as cognitive behavioral therapy is having better successes than AD's in treating many of these disorders. But regretfully, health insurance doesn't cover the expenses involved in these less invasive alternatives, but will cover the drugs.... it's all about economics rather than what's best..... go figure...

Just as there are different degrees of diabetes, some which can be controlled with diet and exercise, like my MIL's, and some, like my nephews require insulin. The problem for my MIL though, like so many others, is it was easier for her to just do insulin instead of diet and exercise, so she did. Her doctors allowed this because, regretfully they are worried about law suits. I don't blame them, but its terribly sad that medicine is being practiced based not on the Hippocratic oath, but based on the risk analysis of law firms across America.

Regretfully, addicts typically behave much like my MIL. They search out and rely on easier, softer ways to deal with medical issues like minor depression when other alternatives are available.

You and I may not agree when it comes to addictive personalities and AD's, as I will always prefer alternatives first, but that's OK.... We can both post our opinions!

Eeeek!


And the cankers weren't a "stop taking this medication if" side effect?


Thanks for sharing.

We aren't really talking about minor depression, though. We are talking about acute and/or chronic SEVERE depression. What we typically see here would be acute, but a few cases of chronic depression may pop up.


Would herbals and/or vitamin supplements, along with diet, exercise, and discipline help here? Sure!

However, someone in the grips of a severe depression isn't likely to get that implemented. It's one of the hallmarks of severe depression.

And in those cases, not only will these strategies be less likely to be implemented, but treating the underlying cause - a marriage in shambles - is likely to be less effective.


THAT is the point.


Not big pharma conspiracies, or self-advocacy. Not our personal opinions about western medicine. Not opinions, facts, or figures on depression in America.

Hmmm. Very interesting. I am on WB have a wound on the back of my throat and canker sores. I just figured it was stress or possibly my hypothyroid issue. On recent labs my T3/T4 levels did come out low. The sores do coincide with increasing WB dosage.

I tried natural AD methods also but my Dr. wanted to supplement with WB. Especially considering extenuating family circumstances that may take time to resolve and the possible benefit of WL which my body fights.

Make sure you are consulting your doc on these issues!

Well heck, maybe we should seek to change the welcome page on the forum intro to....

AD's are us! You're not only a BS, you're now suffering from acute and/or chronic SEVERE depression because of this betrayal.



There have been many, many BS's recover and flourish here on MB, without the assistance of the almighty AD's.... They approached the grief process naturally.

Grief is a normal and natural response to the loss of someone, using drugs to avoid these feelings is one of the underlying causes of addiction to begin with....

So...

If you do a search here, you'll discover that this topic has been beaten on again and again and it's led to too many warnings as a result.
as a matter of fact, here's an oldie; link

I'm respectfully bowing out of this discussion from here.....

I'm sorry that we won't agree on this issue.
Regardless, I still have a high regard for your advice on these forums.