[Clough]

Hi, All!

If a person has been prescribed an anti-depressant or anti-anxiety medication, does that mean that they have to stay on the medication or be medicated on some other kind of drug for life? Might it also depend on the type of medication and the specific reason for which the person was given the prescription in the first place.

Over ten years ago, I was prescribed Paxil. Taking it helped a lot with my anxiety being less. After a number of years, I was really feeling pretty good and decided to wean myself off it. For a number of years after that, I was doing fine and didn't have to rely on some drug to keep me from being anxious.

Now, because of certain things that have happened in my life, I find that I need something to help with my feeling less anxious again.

My questions are the simple ones that I asked in the first paragraph here.

Thanks!

[J_9]

Some people do have to be on for life, for others they need to be on while lifestyle changes are being made. There is no hard and fast rule here.

Many people think that they are "cured" once they are on the meds for a while. Then they wean off, only to find out that they are having the same problems once again, as it seems you are.

It's possible you may need the meds to get over the "hump" again.

[Clough]

Thanks for such a thorough, informative and professional answer, J_9! I couldn't have had a more professional, experienced response!

Thanks!

[J_9]

Clough, there are many kinds of anxiety disorders... General Anxiety Disorders (GAD), Social Anxiety Disorders (SAD), Situational Anxiety Disorders (SAD again), and many more. There are also many different kinds of depression.

First we have to differentiate between anxiety and depression. Once we get the answer to this... for this answer we will use anxiety as an example for now, we have to determine what kind of anxiety the patient is suffering. Now, to make it rather simple, we will use situational anxiety. This is usually a short term disorder and a proper medication is prescribed for a short time until the patient is out of that situation, or learns how to deal with the situation. An example... I went back to school after 20+ years. I had always worked, or been a housewife. When I went back I was a mother, full time student and full time employee. Talk about anxiety!! So I was prescribed Celexa which I took until I was able to balance work, motherhood and school. Once that was accomplished then I was weaned off the medication.

Now, we have depression. Depression can also be situational (post partum for example, which is also a chemical imbalance). However, it could be a chemical imbalance. Unfortunately, there are no tests to determine which chemical is not in perfect balance. We can test for liver functions, we can test for cholesterol, but we cannot test for serotonin imbalances for example. This is where medication becomes tricky. So we have to try a cornucopia of different medications, or combinations therein. This can become like finding a needle in a haystack so to speak. Once the correct medication is found, we have to adjust dosages to get the proper chemical to the proper level. This can be tricky as well because sometimes, over the years, the medication levels need to be adjusted. Then other times we become almost immune to the med and have to begin at the starting line again finding the right med and the right dosage.

Now, we have non-compliance with medications. This happens when many people reach the therapeutic level of medication and "believe" that they are "cured" of their anxiety or depression because they are now asymptomatic, when in all actuality the chemical imbalance is in perfect balance. So, then, people stop taking their medications. Dependent upon how long the medication was taken, what hormone/chemical was imbalanced, it can take a while before the depression/anxiety symptoms reappear.

Back to our example of situational anxiety... The sufferer may be "cured" of their anxiety, only to have a new situation arise where the medication, or a different med, is again needed to get over that "hump."

I could go on with this discussion all night, but I'm sure you get the gist of what I am trying to communicate here. I may work in labor and delivery and love it, but my passion is psychiatry and the unknown... how the brain works and functions... why people do what they do, primarily the mentally disturbed/psychotic/schizophrenic population and forensic psychiatry. One day I may go back to school for that, but for now I'm happy giving the gift of life.

[Fr_Chuck]

I went though a period of my life, death of a spouse, son arrested and in jail and more. My doctor with prescription drugs made my life a much better place. But after I got my life in order, there was no need.

No two cases are ever the same

[Clough]

Thank you again, for such a professional and thorough response, J_9!

Yes, Fr_Chuck. No two cases would seem to be the same...

Thanks!

[jetcitygurl]

Psychiatrists have a formula for this that goes something like this: For the first episode of a serious about of depression or anxiety, person should stay with meds for a minimum of a year. After a second or third instance this increases to two years, etc. It actually takes a surprisingly large number of "relapses" before someone would advise these medications for life. That said, I have been on and off Zoloft for years and believe in my case staying on a very low dose (25mg) when life is "normal" and a more therapeutic dose (50 mg) when life is especially challenging is a good formula. For concerns about sexual or other side effects, some recommend another medication called Wellbutrin with varied success. Hope that helps. I am no psychiatrist but after years of being on Zoloft, I consulted with one and found it incredibly helpful and highly recommend it if your insurance and/or financial circumstances permit. Good luck.