Antidepressants

When you first went on the fluoxetine, the first time did it take a while to take effect did you find? Or were you told what to expect?
 
I think, I’m trying to remember to be honest I think it did take a little while to kick in certainly at least a week or maybe a couple of weeks before I felt it but yes I seem to remember it kicking in but, you know, in terms of what fluoxetine did for me it in no way comparable to what Vensir did for me I mean that sort of just changed my life.
 
So what fluoxetine did for you in terms of your mood how would you describe that then?
 
I’d describe it as reducing your emotional range I, if you …..on a plus/minus graph when I was really bad I could, I mean the pluses were never really an issue I could be five or six out of ten or seven or eight out of ten, it didn’t really matter and I never really worried about that too much. What was very tough was when you were in the minuses and I could feel a minus 10 and I went through a long period of feeling minus 10 and thinking even when things were going my way that I wasn’t, you know, having a happy day, basically having a happy time. And so I found with fluoxetine what it did was just reduce the emotional range a bit, the happiness thing didn't really wasn’t really affected hugely although I did find a little bit that I wasn’t amazingly unbelievably happy or incredibly enthusiastic about things which I was quite worried about at one stage but I found it didn’t go down to the minus 10 it only ever went down to the sort of minus three or four.
 
Kept you on a level.
 
Kept me on a level, kept me kind of coping with life a bit better, yes.

I’m not sure I actually did realise, there was at no point where I thought ‘Oh I feel better,’ because it was so gradual. It was other people noticed, family and friends would say ‘you seem a bit more relaxed today Stephen,’ or whatever so. And I think I needed them to tell me because I didn’t know. That, I mean that’s one of the things with depression, you don’t know you’ve got it and you deny things, you don’t realise things but it’s other people. But it was only actually when they told me that I was looking better that I realised that they’d knew I’d been ill to start with. Because no one had ever said ...apart from this one friend, no one had ever actually said ‘you’re not right or ‘you seem a bit down today’. But when I actually was getting better they started to say that.

So I had to go back to back to citalopram which is what I’m on now, another SSRI. Whether that does anything or not I don’t know it’s, I know if I, I did try coming off it a year or two ago and I foolishly came straight off it without tapering the dose down as you should and I did get quite a, quite a reaction to that, you know, I did drop quite seriously down in mood and I had to come back on it again.
 
So basically I’m now on antidepressants really as a long term preventative measure so the GP’s that I’ve spoken to have said well if you’re happy to be on them given that you’ve had depression all your life you, and you’ve got a drug now that doesn’t have serious side effects you might as well stay on it and so taking antidepressants is just something I do now.
 
For me it’s a preventative. So I’m not taking it because I am depressed I’m taking it because I’m prone to be depressed and it is, you know, there are numerous studies saying that that if you, people who have chronic lifelong depression are much more prone to it continuing and that by taking antidepressants on an ongoing basis it reduces the chance of that, it reduces the frequency of that happening. Whether that’s true for me I don’t know because I’d have to come off.

Technically it did help because it did, because it was about, it felt like forever but the really sort of down serious point was for probably about three months and then it took at least a year to come back up to a managing level and I was good I stuck on the medication but the things that still troubled me about them where there. I mean I put on about three stone in weight rapidly…
 
I felt because I’m quite a creative person I make art and write poetry and stuff like that and yes they, they lift you off the very bottom where you’re suicidal but they shave off so much of the motivation and the, the for creativity they limit how much joy you can experience in your life. Because you just don’t have it it’s, you can’t feel things in the same way and for me it didn’t, you know, it certainly is the big, big thing for me is that I’ve always had this weighing up between having highs and lows but being able to experience those highs and living in this what I’d sort of call like middle of the road grey area.

The first six weeks was an odd experience, well no the first month, was quite an odd experience and I think my wife was a bit concerned about me.
 
In what way was it an odd experience?
 
I really felt like it was me, you know, like I was acting someone else’s life, it was like watching somebody else. And so I could sit completely still for half an hour and not even, not even know that I’d done it, you know?
 
So would it, is it like a sort of bit spaced out?
 
Yes it’s just like being spaced out yes. Well I’ve never really done drugs but it’s like being- just what you’d imagine it to be, just like you’re somebody else, your movements feel a bit odd I thought, because everyone’s different I’m sure you know it affects people quite differently I could be at work, we can talk about work in a minute if you like.
 
Yes.
 
But I could be at work and I could sit in front of the computer… and I’d be thinking… nothing really, you know, it just come to a halt almost. And a kind of warm feeling in my head and I mean they were the main sort of, I didn’t have any sleep problems, some people report difficulty sleeping I never had even with the depression I never really had sleep problems, I could sleep, probably found I was sleeping a lot well certainly sleeping a lot more with the depression, or nodding off falling asleep, feeling very tired. But with these things they didn’t seem to affect me, just a kind of slowness and you know that kicking in quite a lot. But I don’t get that now, I don’t really remember when it finished but I know after, certainly by about Christmas I was definitely feeling there was a massive change in, already then, in the way that I was dealing with the family, how calm I was.
 
Actually I’ve looked at some since, I looked at some forums on line where people have thinking about going on treatment or have just started. And I didn’t want to feel any worse and it did make me feel this in this odd place but it didn’t last long and I just thought I’ve got to do this, you know, I’ve got to. And the doctor had kind of underlined this to me that, he said you may not you may just find that you’re fine but he had said that it may make you feel a little bit odd at first. So I was primed and now all these months on I just think thank goodness I carried on, you know, and I really glad I persevered with it really, you know, I wouldn’t want to be in that place now.

They started me on some Seroxat which I found gave me terrible side effects, I felt a lot worse and really quite mad after I started taking it. I persevered with it and it was okay up to a point, I felt very controlled, you know, like my emotions were you know if someone said oh you’ve won the lottery I’d go ‘oh right’, you know, and if someone said, you know, someone you cared about died, I’d go ‘oh dear’, you know there was no kind of... I didn’t feel I was able to experience a full array of emotions but I felt numb but not depressed anymore.
 
Everything I was feeling was amplified initially during the period when I first started talking those particular tablets until it then tailed off then it turns off, the side effects turn off to just feeling numb. And also really, really dry mouth, horrible taste in my mouth and insomnia couldn’t sleep, you know, racing thoughts and the anxiety was significantly worse.
 
I was much better after coming off them for a number of years until things got very bad, I was, everything in my life was rubbish really my relationships were awful my health was bad because I was probably drinking too much and partying too hard and I hated my job but I didn’t know what to do about it so everything was a bit rubbish. So I went to the GP and explained and said point blank ‘I’m not going to go on Seroxat again but can you help me?’ and I was prescribed sertraline, Lustral as it was then and immediately felt better, I didn’t have, a few side effects there was kind of a slightly clenchy mouth and clenchy jaw if anything I felt slightly euphoric for a couple of days and given that I was fearful that I would feel worse before I felt better that was kind of quite pleasant really and I felt like my normal self a better version of my normal self immediately.

The doctor said to me, "How are you?" and I just burst into tears and said, "I hate it, I hate kids, I can't stand it, I can't do it anymore." And he said, "Ah take these tablets," basically [laughs] and started me; had a little discussion and started me on fluoxetine, twenty milligrams to start with and I thought ok, fair enough, it's enough just to get me out the dip and pick me up a little bit. Didn't notice any initial side effects. I had one panic attack which I'd never had before and that was, that was a bit odd but nothing else from that. Initially they kept me awake a bit and I had got very vivid dreams, very, very vivid dreams. So sometimes I didn't know if they were real or not. I had to sit back and think about my dreams and look for something in them that was random, like an elephant or something to work out, "No that was dream," and I stayed on that, I think it took about two months and I felt much better and my husband at the time said, "This is you, you're back to your old self, for Christmas."
 
I felt much, much better. And then I think I had to go; keep going back to the doctor for checks and I was on them for about six months to eight months till the summer, this is over Christmas ....and he said, "Start coming off them in the summer because the weather's better and you might feel a bit better which I did gradually and that was OK but then I got to the September/October and then started dipping again and I ignored it and it got worse and worse and it took two months for me to phone the doctor and make an appointment and he put me straight back on fluoxetine. And from then I've just sort of every time I've tried to come off one I've been OK for a while and then I've dipped again.
 
I was getting concerned, I started a… I moved and went to a different doctor who tried various different medications.
 
Because I didn't think the Prozac was working, I felt very angry a lot of the time on it, not as depressed but very angry. So I think I tried the Seroxat next which didn't seem to make much difference but again six months and then came off it. I went to see the community psychiatric nurse, it was the first time, when I'd moved up here because my doctor's had decided, "Oh you've had enough of these pills, you need to be off them now. Go and see them, talk to them, you'll be fine." So what was initially supposed to be a six week session turned into six months and I managed to come off the antidepressants again and was off them for two years which I thought was great and I was doing really well and then it hit again.

I think it was 1990, yeah 1990, I first went onto Prozac and actually that was probably the best move they’d made because the increase in energy was much, much more noticeable. It created a much better sort of, the apathy lessened the, the lethargy lessened, that kind of reduced, and I didn’t really have too many side effects at all from Prozac.
 
Did you have any?
 
I think the only thing I can remember at the time was occasionally fidgety but I didn’t, apart from that I didn’t experience anything else at all with Prozac. And I continued on that with the continued with the antipsychotic and the Prozac together for the next maybe about five, five or six years I stayed on that. I think in the midst of that there was, sometimes you kind of think that the antidepressants maybe don’t last they don't have a longevity to them, you take them for a few years and the kind of effects start to, to wear off so. While being on Prozac I was also given paroxetine but that was a complete nightmare.
 
It wasn’t very pleasant at all, it is not a pleasant drug.
 
Tell me about that.
 
Yeah I started to, again the, I lost all, I lost all interest, it took away my level of creativity, it took away any interest I had in things that I felt like, not that I was constantly bored but the fact that I felt bored but I wasn’t interested in doing anything anyway and I think I also lost kind of any ability to communicate in any kind of meaningful way, I felt very flat, you know, flattened by a tyre.
 
Took away your motivation?
 
Yeah motivation, thought processes, cognitive functioning that kind of thing was pretty, quite horrible. I didn’t actually stay on that medication for very long at all before coming off that and actually I was really quite glad to see the back of that.