Get Off SSRI Drugs and Overcome Depression Naturally



by Jeffrey Dach MD





A Young Woman with Depression and PMS Gets Off SSRI Drugs, and Reclaims Her Life, a Case Report



T hirty Two old Debbie came into my office on November 7, along with her Dad, complaining of severe PMS, painful periods with irregular cycles for which birth control pills had been tried and discontinued because of side effects.







Debbie is so depressed that she spends much of her time alone in her room. She is on two different antidepressants, Zoloft 200 mg/day and Wellbutrin 300 mg/day prescribed by her psychiatrist. She has been unable to sleep for many years without Ambien, a prescription sleep drug. Her Fast Food Diet diet from McDonald's, Wendy’s and Taco Bell, and lack of exercise has left her overweight. She takes no nutritional supplements. Her physical exam shows dilated pupils, dry skin, and brittle thin nails. Her reflexes, although hyperactive, are delayed (230 msec).



Header Image: Dilated Pupils, a common finding on SSRI Drugs.





Laboratory Studies

Debbie’s labs showed a low Vitamin B-12 level of 304 (normal above 400), and an extremely low Vitamin D level of 14 (deficiency is below 20). Her thyroid labs were low with a TSH of 4.0 (normal less than 2.5), and a free T3 of 270 (normal 230-420). (

17

). Her luteal phase progesterone level was low as well.

Deciding to Get OFF the SSRI's

I explained to Debbie, that her insomnia, dilated pupils and hyperactive reflexes were du e to the SSRI antidepressant drugs which are over-stimulating her nervous system. When I suggested that she taper off the SSRI drugs, she and her dad breathed a sigh of relief, and said "that was the main reason they came to see me, to get off the drugs."



I suggested that Debbie and her Dad go back to her psychiatrist and ask the doctor to work with them in getting off the drugs by providing a tapering schedule.















Later, I learned that her psychiatrist was in general agreement, yet was dragging his feet and refused to provide the tapering schedule for Debbie to get off the SSRI drugs. After waiting a few weeks realizing we were just wasting time, I finally went ahead and called into her pharmacy the authorization to reduce her SSRI dosage in half every week until the dosage was small enough to stop altogether. Tapering is required because the SSRI drugs are chemically addictive and can produce withdrawal effects.









5-HTP for Sleep, acts as an Antidepressant

For sleep during the SSRI tapering period, I recommended 5-HTP capsules which increases serotonin naturally with no side effects.(

20

) She was encouraged to stop the prescription sleep drugs (Ambien).



I explained to Debbie that low Vitamin B-12, low Vitamin D and low thyroid function could all be possible causes of depression.







John R Lee MD, Pioneered Use of Progesterone

Natural Progesterone for PMS





The PMS and painful periods were treated with natural progesterone capsules, 50 mg twice a day for the last two weeks of her cycle (days 14-28). The night-time progesterone had the added benefit of helping her sleep.



Debbie was started on natural thyroid half grain daily, high quality multivitamin, B12, vitamin D, and iodine supplementation, stopped the fast food, and began going out more for daily activities.



By December 3, Debbie had tapered down to Zoloft 50 mg per day and Wellbutrin 100 mg per day. She says, "I am feeling good in general. I have a lot of energy. I am out of my room more. I am basically in a good mood, and sleeping about 4 hours a night."



By mid December, Debbie was off the SSRI drugs and off the sleeping pills.









A Dramatic Improvement



By January 28, 2008, Dad calls in and says , "Debbie is doing so much better. She has more energy and is sleeping well. The difference is between Night and Day."



That same day, Debbie calls in and says, "I feel a lot better. My energy is pretty good. I am back to work at my mother-in-law’s business at the sales counter. I am sleeping good at night 6 ½ to 7 hours. My mood is stable, pretty much happy. More normal than before. I’m not snappy, and not in my room as much. I am getting out and doing stuff."



Regarding her last menstrual cycle, Debbie remarked "This time, no cramps, no PMS, no mood swings. The progesterone capsules are definitely helping, I have never had a period without pain before. It was awesome to have no pain. Now, I can do normal stuff. Before, when I had my menstrual period, I would be in bed for 7 days because of the pain.”





Adverse Side Effects of SSRI drugs

Adverse side effects of SSRI antidepressants include akathesia, a form of agitation which drives people to commit suicide, sexual dysfunction (impotence), tremor, involuntary body and facial movements, tardive dyskinesia, and hyperactive reflexes indicating a hyperactive nervous system. The SSRI induced loss of sexual function may be irreversible even after discontinuation of the drug. (

1

)



In many studies, SSRI efficacy was no better than placebo raising questions about SSRI efficacy. It is astonishing that today, SSRI antidepressants are the standard mainstream medical treatment for PMS (Pre-Menstrual Syndrome). In addition, BCP's, birth control pills are frequenty given as treatment for PMS, irregular periods, or any female complaint for that matter (relating to cycles). Natural, bioidentical Progesterone is a far better and more effective alternative for PMS.

Broda Barnes

found irregular cycles frequently responded to natural thyroid in spite of "normal" thyroid labs.



SSRI drugs for PMS - The Wrong Way

A Practice Which Should Be Abandoned

SSRI antidepressants may have some justifiable uses as a temporary treatment in the severly depressed. However, the widespread usage of SSRI antidepressants for PMS and Menopause should be abandoned.



Women on SSRI antidepressants for PMS, or menopausal symptoms should be encouraged to taper off the SSRI drugs (under a physician’s supervision). The correct diagnostic workup includes hormone levels, thyroid panel, vitamin D and B12 levels. Treatment with natural bio-identical progesterone, natural thyroid and vitamin supplementation is more effective with fewer side effects than the current mainstream use of SSRI antidepressants or BCP's (birth control pills).





A Successful Outcome

The case of Debbie Depressed illustrates a successful outcome treating depression and PMS with progesterone, natural thyroid, vitamins D and B12, and by modifying diet and lifestyle. It is very gratifying to see Debbie make such a dramatic recovery after discontinuing the SSRI drugs.





References for Causes of Depression:

Low vitamin B12 levels are associated with depression. (

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)(

3

)(

4

) (

5

)



Low Vitamin D levels are associated with depression.(

6

) (

7

) (

8

) (

9

)



Low thyroid function is also associated with depression. (

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) (

11

) (

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)









Lastly, bioidentical progesterone has been widely used as an effective treatment for PMS (Pre-Menstrual Syndrome). (

13

) (

14

) (

18

)(

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)



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Jeffrey Dach MD

7450 Griffin Rd Suite 180/190

Davie, FL 33314



Phone: 954-792-4663

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References

By January 28, 2008, Dad calls in and says , "Debbie is doing so much better. She has more energy and is sleeping well. The difference is between Night and Day." That same day, Debbie calls in and says, "I feel a lot better. My energy is pretty good. I am back to work at my mother-in-law’s business at the sales counter. I am sleeping good at night 6 ½ to 7 hours. My mood is stable, pretty much happy. More normal than before. I’m not snappy, and not in my room as much. I am getting out and doing stuff." Regarding her last menstrual cycle, Debbie remarked "This time, no cramps, no PMS, no mood swings. The progesterone capsules are definitely helping, I have never had a period without pain before. It was awesome to have no pain. Now, I can do normal stuff. Before, when I had my menstrual period, I would be in bed for 7 days because of the pain.”