From Women's Health

Antidepressant prescriptions have doubled in the UK over the decade from 2008-18, according to the latest data. Within this reality is contained another: namely, that the number of people in this country who may attempt to come off the medication at some point has never been higher.

Here, WH Senior Editor Roisín Dervish-O'Kane shares her experiences with this under-discussed issue.

Perhaps it’s a little glib to introduce myself by saying I’m medicated up to my eyeballs, but to borrow the most memorable reality TV maxim of the past 12 months, ‘it is what it is’. I take three capsules daily with a glass of water. They’re usually green and yellow; sometimes they’re the exact blue and white of a Tottenham Hotspur jersey.

Their combined contents add up to 60mg of fluoxetine – more commonly known by its American brand name Prozac – an SSRI (selective serotonin reuptake inhibitor) antidepressant, which is prescribed to treat my dual diagnosis of anxiety and depression.

Last month marked my four-year anniversary taking fluoxetine, the latter two years of which I’ve been on the maximum prescribed dose. While I’ve long resisted the stigmatising rhetoric around antidepressants (I’ll happily take mine at my desk at work), this particular timestamp troubled me.

I am, by all accounts, well and happy. I'm able to challenge myself; to take calculated risks; to enjoy the many textures of what remains of my rapidly dwindling twenties. Anxiety and depression no longer shape my work, social or romantic life in any meaningful way, and yet, I’m still treating them. Truthfully, I feel like a bit of a fraud. Perhaps worse, I feel stuck.

Why? Because while we’ve just parted ways with a decade in which medicating your mind became more acceptable than at any time in living memory, still very little is known about how to come off antidepressants.

I’ve tried before – without success. Given that the number of prescriptions for antidepressants in England has almost doubled in a decade from 36 million to 71 million, many continue to take them for over two years and women are twice as likely to be given them as men, I wonder how many other women like me – swinging kettlebells of a Tuesday morning and sipping a negroni come Thursday – feel the same sense of unease.



'It Felt as if I Had Willingly Dipped My Toe Back into Chaos'

My relationship with fluoxetine blossomed gradually. In the beginning, 30mg helped ensure I was functional enough to pay my rent while struggling with disorientating grief; 40mg helped me deal with the pain of ending a relationship I hated with a person I loved.

Inching up to 50mg helped me return to work after being signed off for five weeks; increasing the dose to 60mg helped me feel as though I was taking action after a night in December 2017 when I felt so unstable, I feared, for the first and only time, that my life wasn’t safe in my own hands.

Six months later, though, I’d reached a different place entirely. I answered my kind, patient, communicative NHS GP’s call in a meeting room at work, having run out from a team brainstorm where my ideas flowed and jokes landed. When asked if I was ready to start reducing my dose, I said I was – and I meant it.

I was to alternate between taking two and three pills each day; a reduction equivalent to 10mg per day because of how long the drug remains active in your system. Secure in the knowledge that this medication isn’t physically addictive, I felt confident about shaving such a small amount off my dose.

One week later, however, getting through the day felt like trying to tightrope walk in a spinning arena with floor-to-ceiling funhouse mirrors. Not only did I experience the nausea I’d prepared for, but also the scooped-out, immobilised feeling of depression and teetering-on-the-edge anxiety I’d spent three years attempting to orient my life away from.

Within days, it felt as though I’d willingly dipped my toe back into chaos. So, just as you would when you step into unexpectedly scalding bath water, I yanked myself back out.



Why is Stopping Antidepressants So Hard?

‘Patients’ experiences tell us that the impact of coming off antidepressants can be severe, to the point where the official guidelines have been criticised for painting a picture of discontinuation symptoms being either rare or minimal,’ says consultant psychiatrist Dr Chi-Chi Obuaya.

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