Looking at ourselves and the world through the lens of the 21st century.

Saturday, August 6, 2022

To Medicate or Not to Medicate: A Crisis of Conscience


This week on the
podcast, Amber shared with us her history of suffering from migraines, as well as her desire to manage them holistically, without the use of prescription medications. I have many of the same sentiments about medications and usually forgo the use of Tylenol, NSAIDs, or other pain relievers whenever I can. I’d much prefer to sleep off a headache than to keep working and hope that some kind of pill will make it go away. Likewise, for an upset stomach, mild indigestion, bowel irregularities, the common cold, or any other slight discomfort. I just don’t like putting chemicals that have names I can’t pronounce into my body. I didn’t even take multi-vitamins.


Then I developed breast cancer and diabetes and I suddenly found myself staring at a regime of 20-30 pills a day of vitamins, supplements, and prescription drugs to fight off a host of ills, side-effects of the treatments, and side-effects of the side-effects. It can be overwhelming.


One of the medications I found myself on was a selective serotonin-reuptake inhibitor (SSRI) commonly known as Effexor (venlafaxine). It’s an antidepressant, but was originally prescribed to help with my post-menopausal hot flashes that were exacerbated by the nonsteroidal aromatase inhibitor, Arimidex (anastrozole), that I was taking for the breast cancer. After just a couple of weeks of taking the SSRI, I suddenly realized I was not as depressed as I had been. It was like a little black cloud had lifted off my head, and I could finally see and feel the sun. I was so grateful.


Fast-forward six years, and I am still taking that SSRI, even though I finished my 5-year round of the cancer meds back in January. In fact, the antidepressant helped me so much that I had begun to fear the doctors would take it away once my cancer treatment was finished. Then January rolled around, I went off the cancer meds, my children went back to their respective homes after the holidays were over, I had gained back some of my hard-fought weight loss, and our dear friend Koy passed away. I felt a little bit of the depression returning and mentioned it to my doctor. She promptly doubled my dose.


I’m not sure when I first noticed the issues, but I started experiencing heart palpitations (skipped beats, extra hard beats, irregular rhythms, and even rapid pulse rate). They started coming more often, then every day, and finally I was having them most of the time. They left me exhausted, struggling to breathe (even though there was no constriction), and more than a little bit freaked out. I went back to my doctor, and she sent me to a cardiologist, who performed a nuclear stress test and then fitted me with a heart monitor I had to wear 24/7 for 30 days. My sister died in a hospital after open-heart surgery at the age of 50 due to a failed heart valve. My dad had died 9 months prior due to COPD and a host of complications from a previous heart attack. You can imagine the horrors spinning around in my head.



I’m not sure how long it took, but I eventually came to the realization that my heart palpitations had started around the time of the increased dosage of the antidepressant, and that the symptoms I was experiencing were actually anxiety attacks brought on by stress, and sometimes by nothing at all. I asked my doctor, and she agreed I could cut the dose in half, which meant going back to the original dosage that had worked so well for me. Within a week, the worst of the palpitations were nothing but a memory, and I was left with only the pre-ventricular contractions (PVCs) that I’ve had all my life. I was feeling like myself again.


I’ve known many other people who’ve had negative reactions to antidepressants, particularly the SSRI Prozac. In some people, it has caused mania, and withdrawal from it can be very tricky and drawn out because the rebound effect can cause extreme reactions in otherwise normal, healthy people. It’s one reason why I worry whenever someone tells me they are on Prozac instead of one of the milder SSRIs. So, after a lengthy phone conversation with a family member who often advocates against medication for mental upset, I received in the mail Anatomy of an Epidemic: Magic Bullets, Psychiatric Drus, and the Astonishing Rise of Mental Illness in America by Robert Whitaker.


I’m not ashamed to admit that when I opened that package, I was skeptical. Even though just six years earlier, I had been one of those people who didn’t want to take medications, I am also a believer that sometimes medications are the only option (like for my cancer and diabetes). Still, I look at medications as a short-term treatment most of the time. I feel like it is a tool you use to fix something that is broken, and then, when it’s fixed, you put the tool away and move on. I didn’t really want to read this book, but I respect my family member enough to listen to what she had to say (she’s a smart cookie!), and I figured that going into it with that healthy dose of skepticism might help me find some flaws in Whitaker’s theories. Sure enough, they did, but I also discovered that some of what he was saying was alarmingly plausible – that mental health incidents might be transitory and treatable with good psychotherapy, and that the medications we are using to treat things like schizophrenia, bipolar disorder, and depression might be the very thing that is making us more depressed. That the drugs doctors prescribe to treat neuroses are causing Americans to become trapped in a cycle of worsening episodes, hospitalizations, and increasing dosages.



Right now, I am only about a third of the way through this book, but it already has me rethinking some of my medications (all of my medications!) and wondering whether I should make some changes in my life. I’m no longer reading it as a skeptic, but rather, looking at it with fresh eyes, wondering what horrible truths might be revealed in the next chapter. I’m not saying I’m ready to give up my antidepressant, but it is definitely worth a thorough discussion with both my therapist and my primary care physician. I’ll share more about it here on the blog when I finish it.


What about you? Do you depend on neuroleptic mood stabilizers? Have you ever tried to wean yourself off them? How did it make you feel? I’d love to discuss it with you further over on the MMC Chat group, or in the comments below.


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