There is a great article in the NY Times Magazine about quitting anti-depressants. Here is the nuts:
What was happening was this: When I started taking Effexor, the drug began inhibiting my brain cells’ process of reabsorbing “excess” serotonin — that is, the serotonin that had gone unused in sending signals across the synapses from one neuron to another. This was the purpose of taking the drug — to increase the amount of serotonin my cells had to work with and therefore, in theory, enable me to cope with my stress and depression. I say “in theory” because even 20 years since the introduction of drugs like these, every researcher with whom I spoke was cautious about presuming a direct relationship between increased serotonin levels in neural synapses and a decrease in depression. First, no one has ever measured the amount of serotonin in the synapses between anyone’s brain cells. No one knows what constitutes a low, high or even standard level. Second, for reasons unknown, only a little better than half the people treated with antidepressants respond to them. Third, studies have shown that placebos have only a slightly lesser rate of effectiveness than the drugs. Fourth, serotonin levels are affected by many things — exercise, light, sleep, diet and even time of day. And finally, serotonin has so much influence on chemistry and functions in so many places in the body and brain relating to mood, sleep, sexual desire, appetite and body temperature that to say that it acts in any one particular way is impossible.
I avoid drugs as much as possible. During my recent dark days, no matter how bad I had it, I didn’t go for the drugs, legal or otherwise. Isn’t the third item striking?
Exercise, diet and social interaction are probably as good as drugs when it comes to serotonin uptake suppression.
In 1996, nearly a decade after the introduction of Prozac, its manufacturer, Eli Lilly, sponsored a research symposium to address the increasing number of reports of patients who had difficult symptoms after going off their antidepressants. By then it had become clear that drug-company estimates that at most a few percent of those who took antidepressants would have a hard time getting off were far too low. Jerrold Rosenbaum and Maurizio Fava, researchers at Massachusetts General Hospital, found that among people getting off antidepressants, anywhere from 20 percent to 80 percent (depending on the drug) suffered what was being called antidepressant withdrawal (but which, after the symposium, was renamed “discontinuation syndrome”).
I think they should have called it the “Serotonin shuffle”. At least they get some alliteration that way.