Do I still need my antidepressant medication after all these years?

I’m not going to answer that question for you.

I can’t, because I don’t know you.

My intention is not to encourage you or someone you know to quit taking your antidepressant medication. My intention is to share with you how we have done this in our clinic and give you information so you can explore options for yourself with the help of your healthcare provider. Please understand that this information only applies to those who have been prescribed an antidepressant for non-serious, non-life-threatening conditions. LISTEN TO ME!  DON’T QUIT TAKING YOUR ANTIDEPRESSANT MEDICATIONS UNTIL YOU’VE TALKED WITH YOUR DOCTOR AND HAVE COME UP WITH A PLAN!

When I use the term “antidepressant medication” I am referring specifically to Selective Serotonin Reuptake Inhibitors or SSRI’s. The reason I am picking on this class of medications today is that they have been hideously over-prescribed since the 1980’s. In 1998 about 6% of people in the US were taking antidepressant meds and in 2016, we’re right around 15%. This is astounding and by 2020 we could be at 20%. That’s 1 in 5 people taking meds because they can’t cope with the myriad of symptoms that accompany brain-based disorders. I see many people in my clinic who take SSRI’s for legitimate reasons, but I also see others who can’t figure out what their diagnosis is or why they were prescribed antidepressants in the first place.

There are legitimate reasons for taking SSRI’s including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), sexual dysfunction, major depressive disorder, dysthymia, PTSD, postpartum depression, or symptoms associated with PMS. People end up taking SSRI’s for all sorts of reasons often legitimate, but there are many, many people who have been prescribed antidepressant medications who no longer need them, but can’t discontinue their use because of the terrible side effects from withdrawal.

Why would you want to quit taking antidepressant?

That’s a question every individual needs to answer for themselves. Most people wouldn’t choose to take an antidepressant because of the side effects, but in case you need to be reminded here is a short list: fatigue, dry mouth, diarrhea or constipation, nausea and vomiting, agitation, insomnia, weight loss, weight gain, increased sweating, decreased sexual desire, drowsiness, headaches, poor clotting ability, muscle spasms, fever, shaking, rapid heartbeat, and premature ejaculation.

Many people who take antidepressants describe the feeling of being “flat”. The emotional highs and lows are removed and they feel kind of stuck-in-the-middle, emotionally. I had one person tell me years ago before I became a doctor that her antidepressant made her feel like she was “wearing a giant condom.” So why do people put up with these side-effects? They do so for two reasons:

1. The medication helped them in a crisis and the way they feel now is much better in comparison to before they started;
2. The withdrawal symptoms are so bad that they can’t bear the thought of experiencing them again.

Number one above is an understandable and legitimate reason not to quit taking the medication, especially if the prescription accompanied a formal diagnosis. With that said, some people can quit taking SSRI’s even if they have a formal diagnosis. The second reason isn’t very helpful and the patient needs to better understand what “the plan” is. Taking medication because you have a condition that will never change or improve is justified. But taking medication because of the terrible withdrawal symptoms is not justified in any way – especially if there is a way they can quit without withdrawal symptoms.

The truth is, most people don’t know that you can quit taking SSRI’s without experiencing terrible side effects. Yes, that’s right, we do this all the time in our clinic! Keep in mind, I prescribe SSRI’s regularly, but I only prescribe them if they are needed immediately or we’ve tried alternatives that haven’t worked. I can count on one hand the number of people whom I’ve prescribed SSRI’s for  because alternatives didn’t work. I digress a little bit here but I want people to know that the alternative therapies work well and in most cases patients don’t need to take SSRI’s if they get to the root cause of the problem.

What I really want to share with you today is that if you take SSRI’s and have talked with your healthcare provider about discontinuing the medication, there is a way to do so, safely and effectively. I will share with you how we’ve done this but I don’t want to encourage anyone to try this on their own. I want to restate this again,  I am not providing treatment advice for anyone here, I’m just sharing what we do in our clinic.

When considering whether or not to stop taking SSRI’s you need a clear understanding of the diagnosis given and what will happen if the medication is discontinued. I talk with my patients about their health history and I try to fully understand how they ended up on meds so I know if they are a good candidate for tapering the drug. The following is an example of my thought process when I’m trying to determine if a taper is appropriate:

1. Why was the drug prescribed?
2. Is the medication the correct choice for the patient?
3. How long have they been taking the medication?
4. Are they taking other prescriptions or supplements?
5. Is the medication working for the intended purpose?
6. Does the patient want to quit taking the SSRI’s?
7. Can they safely do so without causing risk to themselves or others?
8. Have they previously tried to quit taking SSRI’s? If so, what happened and why didn’t it work for them?
9. What are the other potential underlying causes of their conditions?
10. Did their practitioner rule out hormone imbalance and hormone metabolism disorders, genetic predispositions such as MTHFR or COMT defects, neurochemical imbalance, nutritional deficiencies, gut dysfunction, suboptimal liver function, ongoing or past history of trauma, chronic infections, or substance use?
11. What therapies has the patient tried that worked for them?

These are some questions that I ask but there are others to consider when dealing with specific patients.

Let’s move forward  and say that I have a good understanding of what’s going on and we want to try an alternative therapy.  What do I use? Let me preface this by saying that as a practitioner, I must offer the “Standard of Care” prior to prescribing alternative treatments for my patients.  The “Standard of Care” is what is agreed upon by modern medicine in the United States to be preferred treatment for specific conditions backed by some sort of scientific evidence. For what we’re talking about today, SSRI’s are first line therapies in the Standard of Care and I must legally recommend them. When the patient has expressed their desire to quit a medication, I respectfully agree to help them discover which alternative is right for them.

When I consider the questions above and we’ve ruled out all potential causes of their symptoms and a patient wants to discontinued their use of an SSRI, I recommend that they take a balanced amino acid based dietary supplement. About 8 years ago, I developed my own product because I saw an opportunity in the marketplace for a viable alternative treatment to SSRI’s and to help people understand that they can safely discontinue the use of antidepressant medications with the assistance of their healthcare provider. The product is called EQ. It contains a balanced, formula that provides starter material for the serotonin, dopamine and norepinephrine systems in the brain. Put simply, this is what we do.  

1. Week one – The patient takes their prescribed amount of their SSRI. In addition, they take 4 capsules twice daily at 12-1pm and 4-5 pm. If they experience worsening anxiety, or intolerable nausea they call me right away and we usually have them cut their dose of EQ in half for a week so they will take (two capsules twice daily and increase to three capsules twice daily the following week and then back up to 4 capsules twice a day.
2. Week two – The patient reduces their dose of antidepressants by 25% and increases EQ dosing to 4 caps three times a day. They do this by adding an AM dose of EQ at 9 am.
3. Week three – We have the patient taper the SSRI to 50% of the original dose and continue taking EQ 4 caps three times daily.
4. Week four – We have the patient reduce the dose of the SSRI to 25% of the original dose and they continue taking the EQ as they did in week three.
5. Week 5 up to week 8-12 – we have the patient continue taking three doses of EQ per day and when they feel like they can quit taking EQ they are free to try.

Some patients end up taking EQ long term, but many discontinue its use altogether or they take it in cycles for a few months at a time when they feel they need it.

For those who are able to quit taking SSRI’s, those who have been slaves to their medication for years are suddenly able to experience a full spectrum of emotions, and feel great at the same time is a wonderful and rewarding experience. Now, it may take twice as long for people to taper their SSRI’s and some people will need to continue taking their medication indefinitely. A small percentage of people truly need to take antidepressants to feel good and I am a firm supporter of this therapy when it is appropriate.

Again, I do not want you to think that I endorse or encourage anyone to quit taking SSRI’s. It can be life-threatening to do so especially without the help of a healthcare provider. But I do want others to know that it is possible and very rewarding for the patient when done correctly.

After taking Equilibrate, I’ve decreased my usage of Imitrex intake to anywhere between 5-9 a month, and when I get migraines, they are not nearly as severe.

B.H. / Toledo, OH

After taking EQ for the past 2 months, I've experience no unusual side effects. I've been feeling less irritated, more alert and have more energy during the day. I'm also sleeping better!

W.L. / San Deigo, CA

I’ve been taking antidepressants for years and I never thought I’d be able to get off of them.With the Equilibrate I’m free of the anti-depressant med and feeling great!

P.W. / Portland, OR