When it comes to anti-depressants, and in particular Selective Serotonin Re-uptake Inhibitors, one wonders if the doctors that prescribe them have any knowledge about them at all! Through my research I have discovered that doctors seem to know little about what they are prescribing on a daily basis. Let me give you some examples. A doctor once decided to prescribe an anti-depressant for the treatment of insomnia and persistent free-floating anxiety. She told the patient (and I have this from the horse’s mouth) that she would prescribe either Venlafaxine (Effexor) or citalopram (Celexa, Cipramil). When questioned she informed the patient that the side-effect profile and the ease of withdrawal were largely the same with both drugs. As anyone that does a little research can tell you, this is not true. Venlafaxine actually seems to have a much worse side-effect profile than citalopram, and due to its relatively short half life seems to be more difficult to come off (something which is not helped by there apparently not being sufficient low dose options to taper off with). What’s more, it is one of the most difficult anti-depressants to come off over all! It is a disgrace that doctors do not have this information. One wonders if they, after six years of medical school, are instantly blinded by the skilful patter of the pharmaceutical reps, accept their freebie golf trips and lunches and prescribe away. Another patient was told that if they changed the time they took their citalopram from the morning to the evening they would feel less drowsy and spaced-out. In fact there is no clinical reason why this should be the case, as the drugs stays in your system for longer than twenty-four hours. If you are considering taking any SSRI for anxiety or panic or for that matter anything else, it is of prime importance that you do your research, and go to your doctor armed with questions. They can certainly help in your battle to overcome your issues, but you need to understand what you are taking, what is likely to happen, and what your end game is.
