Dying for a cure

Over the following months I gradually and systematically dropped one drug at a time; a painstaking and at times gruelling process. The antidepressant was by far the most difficult of all the medications to cease - for days following each tiny reduction I would suffer vivid nightmares, intense irritability, and almost intolerable nausea and dizziness - and it took nine months in total to do so.

Improvement in my mental state was evident with the cessation of the very first drug. Small but undeniable changes at first; I could read a magazine, sleep through the night, engage with my daughter. Once medication free, I had fully regained my sanity. My psychiatrist was thrilled thinking he’d finally got the treatment right. I of course now knew it was the treatment that had made me a mental patient. I set out to research just how such a disaster could have occurred.

Logic told me that my experience could not be just an isolated case, an aberration. After all, there were evidently enough similar examples in Britain to have prompted a documentary. Surely then there were others in this country enduring a similar hell?

I soon came across examples of clinical research dating back to the early 90s documenting several researchers’ suspicions that SSRIs could actually cause agitation, a worsening of depression, personality changes, and induce suicidal thoughts and actions; the very things to strike me early on in treatment.

In the light of such research, why was it that my doctors had not suspected the medication as a possible cause of my sudden deterioration? Why did they add more and more medications rather than stop them and reassess my condition?

When given that very first antidepressant, I’d been told it would take two to three weeks for it to take effect. So when my condition began to significantly worsen at around a week into treatment, neither I nor, seemingly, anyone else thought to implicate the medication; it hadn’t yet taken effect.

What I was to discover was alarming. Though it does indeed take two to three weeks for SSRIs to have their desired antidepressant effect, they actually begin to take action in the system almost right away, achieving maximum elevation of serotonin within 24 - 48 hours. So just because there would be no antidepressant effect for those two or three weeks, did not mean there would be no effect at all.

It is now recognised that the most likely time for a patient to react adversely to an SSRI is in the first few weeks of treatment, upon cessation of the drug, or after an increase or decrease in dosage.

Further confusing the situation, and enabling the medication to evade suspicion, was our belief in the popular explanation that depression results from a chemical imbalance in the brain. This had been drummed into me since the very beginning. I had now learnt that this “explanation” is in fact nothing other than speculation; born in the 50s, still unproven 50 years hence.

Belief I had such an imbalance gave a plausible explanation for my uncharacteristic behaviour - I had a physical illness due to a situation beyond my control. Searching for answers further to that it seemed, would be as futile as doing so for leukemia or a tumour.

I now understood why it was that I hadn’t suspected the medication, why my family hadn’t suspected the medication, but it still didn’t explain why things hadn’t been more obvious to the doctors involved.

In the past few years, thousands of adverse drug reaction reports have prompted regulators to officially warn that SSRIs are associated with panic attacks, agitation, mania, worsening of depression, and inducement of suicidal behaviour - just as suspected by the researchers of the early 90s. But in the years between this early research and the warnings of today, has been a flood of information talking up the benefits of these drugs; information regarding their potential harms has struggled to surface.