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Long term use of antidepressants?

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    After finally finding a pharmacy which sells branded bupropion (wellbutrin XL) to the UK I started taking it 2 weeks ago and after a 'rocky' first week, it started working and after being on it for 2 weeks I am seeing my depression completely dissipate. Ironic that the only anti depressant that has ever worked for me is one that's not licensed on the NHS. Anyway, the only thing I have to worry about now is the drug losing its effectiveness in the long term. So I am wondering if it's a better idea to take 'breaks' from it rather than taking it every day. i.e I plan to stop taking it from june to mid september, as that's the summer holidays & I'm at home, and start taking it again 2 weeks before I go back to uni for my final year.

    thanks for any advice.
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    Antidepressants can suffer from a so called "poop out" effect but there doesn't seem to be all that many studies on why or what to do about it.

    I'm not sure how worthwhile it would be to take breaks from it as the effect might be linked to things like worsening depression or just the aging process of the person, in which case taking breaks wouldn't help this.


    From a personal perspective, I've had this problem with antipsychotics; they work for a while then totally stop. I had a year break from the drug in question then took it again and it seems to be working again, so perhaps you could do the same.
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    (Original post by Lewk)
    After finally finding a pharmacy which sells branded bupropion (wellbutrin XL) to the UK I started taking it 2 weeks ago and after a 'rocky' first week, it started working and after being on it for 2 weeks I am seeing my depression completely dissipate. Ironic that the only anti depressant that has ever worked for me is one that's not licensed on the NHS. Anyway, the only thing I have to worry about now is the drug losing its effectiveness in the long term. So I am wondering if it's a better idea to take 'breaks' from it rather than taking it every day. i.e I plan to stop taking it from june to mid september, as that's the summer holidays & I'm at home, and start taking it again 2 weeks before I go back to uni for my final year.

    thanks for any advice.
    It's a bit of a crap shoot. Sometimes when people take a drug for a while, stop because they think they're better and then take it again it doesn't work the second time or doesn't work as well. Conversely, sometimes over time a drug stops working. It's not really possible to know what'll happen.
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    I've been on anti depressants for around 6 months now, and they do 'stop working' but all you need to do is to tell the doctor and they will usually up the dosage that you're on
    But i would advise to not stop taking the tablets, because when i stop taking mine because i have run out and haven't got to get my prescription yet, for the first few days i feel fine and think ah why do i even take them. But when they start to wear off, you feel the difference and it makes me feel like utter crap! So trust me, stay on them, if they stop working as the doctor for a higher dose
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    (Original post by Exopaladin)
    It's a bit of a crap shoot. Sometimes when people take a drug for a while, stop because they think they're better and then take it again it doesn't work the second time or doesn't work as well. Conversely, sometimes over time a drug stops working. It's not really possible to know what'll happen.
    I can imagine it would work differently for psychostimulants (bupropion is classed as a mild one) compared with SSRIs though, I don't reckon the second time round after stopping it, would be much different. It is completely different to most the AD's doctors prescribe.


    (Original post by iEmily)
    I've been on anti depressants for around 6 months now, and they do 'stop working' but all you need to do is to tell the doctor and they will usually up the dosage that you're on
    But i would advise to not stop taking the tablets, because when i stop taking mine because i have run out and haven't got to get my prescription yet, for the first few days i feel fine and think ah why do i even take them. But when they start to wear off, you feel the difference and it makes me feel like utter crap! So trust me, stay on them, if they stop working as the doctor for a higher dose
    Problem is with this, the next dose is 300mg (up from 150mg) which I think will be too stimulating and you can't cut the tablets in half because it is an extended release tablet. I ordered 300mg tablets a week ago when I thought it wasn't working but now the 150mg has started working I regret buying them.
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    (Original post by Lewk)
    I can imagine it would work differently for psychostimulants (bupropion is classed as a mild one) compared with SSRIs though, I don't reckon the second time round after stopping it, would be much different. It is completely different to most the AD's doctors prescribe.
    Unfortunately I've heard of one or two reports of it happening with Wellbutrin too. It can happen with most psych meds for some reason.
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    (Original post by Lewk)
    I can imagine it would work differently for psychostimulants (bupropion is classed as a mild one) compared with SSRIs though, I don't reckon the second time round after stopping it, would be much different. It is completely different to most the AD's doctors prescribe.



    Problem is with this, the next dose is 300mg (up from 150mg) which I think will be too stimulating and you can't cut the tablets in half because it is an extended release tablet. I ordered 300mg tablets a week ago when I thought it wasn't working but now the 150mg has started working I regret buying them.
    is there no way that you can go back to the other 150mg ones?
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    I would strongly advise against rhythmically withdrawing from anti-depressants. You will find that the constant change in neuroactivity that this causes will mostly do more harm than good. I appreciate that tolerance can grow with some drugs, rendering them ineffective at an equal dose, Diazepam for example. Which ends up in 'dose chasing' where you're constantly chasing the therapeutical dose required which can be horrific when it comes to withdrawal.

    In general terms, once the lowest therapeutic dose has been found for the patient, they should persist taking the medication at such dose for a MINIMUM of 6 months, preferably 12 months. At this point if you feel comfortable and ready to attempt withdrawing you should do so as prescribed, if not; then no worries - just continue as you are.

    You'll find that around 68% of patients will be 'cured' (and I use that term very loosely) of depression if they continue their therapeutic dose for 12 months and then withdraw. After which, they will experience no depression for the remainder of their life. This method of treatment is far, far more successful than yo-yo'ing and rhythmically withdrawing after ever 6 months or so.
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    I agree with Rybee it's better to keep taking it for at least 6 months and then if you feel strong enough, start on a minimum maintenance dose for another month or so than yo-yoing throughout the year.
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    Isn't this something you'd better talk to your GP about? Shouldn't they be monitoring the effectiveness of your AD's anyway?


    It doesn't sound like a good idea tbh.
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    NOT a good idea. I once stopped for a week. I felt so happy, free! And then suddenly it came back stronger than ever.

    Ask you GP for advice.

    EDIT: And long-term, my mum has been on anti-depressants for 18 years. They stopped working once, so the doctor just switched them. It'll be fine.
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    Antidepressants are supposed to be a long term drug. If you're put on them, you need to know that you're going to be on them for at least six months, and then another three after to make sure you don't relapse.

    I wouldn't worry about effectiveness for now... if something changes, go to your GP and s/he'll change your dosage. This is the time where there are no right or wrong answers.
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    Has this medication been prescribed, or have you bought it online? If the latter, to be honest you shouldn't be taking it at all. Anti-depressants are strong medications and should only be taken with the supervision of a doctor. The dose should be controlled by them, because they are trained to assess and make those decisions.

    Anti-depressants take up to six weeks to build up in your system fully and start working properly, so coming off it for the summer would not be a good idea, especially because of how difficult they can be to come off.

    I have been on anti-depressants for ten years, although in that time I have been on several. I am now taking Seroxat (amongst other things) and the combination seems to be working well for me (I'm bipolar). But as I have said above, this is for you to discuss with a doctor, not decide for yourself.

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Updated: May 19, 2012
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