A Healthcare Provider's Account of Long-Term Antidepressant Use and Withdrawal Injury

I have worked in healthcare since 2011, including more than a decade in critical care nursing and several years as a Nurse Practitioner. I regularly prescribed psychotropic medications. I have been on antidepressants myself for 22 years. I believed these treatments were life-saving. I administered them, prescribed them, and trusted them, never imagining how much of my own life they would quietly take.

At age 14, I was started on Prozac for depression that emerged after my first menses. At the time, I was also drinking, lacked coping skills, was navigating intense peer pressure at a new middle school, and dealing with family stress at home. I was told I would need to remain on this medication for life. Although it seemed to blunt my emotions over the following years, by age 17 I wanted to stop due to severe sexual dysfunction and emotional numbing. Under my psychiatrist's guidance, I was tapered off over the course of one month. Shortly after, I experienced what I was told was "relapse", but the symptoms felt entirely new: crushing depression, intense anxiety, and panic I had never experienced before. I restarted the medication, and these symptoms subsided within 1–2 hours. I found it striking that symptoms resolved so rapidly, when the medication had originally taken about eight weeks to have any effect.

Soon after, I began experiencing shortness of breath and a rapid heart rate, symptoms that were dismissed by my pediatrician and doctors for the next decade. Eighteen years later, I have never regained my prior exercise tolerance and have since been formally diagnosed with severe POTS and dysautonomia. Before all of this, I loved running, cheerleading, swimming, and working out.

In the weeks following my first reinstatement, Prozac seemed to lose its effect. After a dose increase, I developed relentless insomnia and began relying on sleep medication, a dependence that has continued for the past 18 years. Over the following years, I was cycled on and off 15 different psychiatric medications in an attempt to manage the symptoms I was experiencing. Many of these changes involved rapid tapers or abrupt discontinuation. With each switch, my tolerance for medication changes worsened, while relief became harder to find. I began experiencing severe mood swings, dizziness, visual disturbances, gastrointestinal problems, among many other symptoms.

By 2018, desperate for relief from what felt like an endless cycle, I began to wonder whether the medications themselves were contributing to my suffering. Once again, I attempted to taper off over the course of a month, following my psychiatrist's recommendation. I was struck by the same unbearable pain I had experienced at 18, but this time it was far more severe. Within days, I reinstated the medication at the full dose, and my "depression" lifted within about 15 minutes. I was told that just as diabetics need insulin for life, this was no different. I was told what so many others have heard, that I had a "chemical imbalance." I came to believe it. I even wrote my graduate school thesis on the safety of antidepressants in pregnancy, convincing myself that everything would ultimately be okay.

At 32 years old, my husband and I began the process to treat my persistent infertility, which was halting our dream of having a child. After three grueling, emotionally painful years of infertility treatments, I finally became pregnant in March 2023. When I was pregnant, I was instructed to abruptly stop my nightly Trazodone used for sleep, as this "was not habit-forming even when taken nightly." Several days later, I miscarried.

About 48 hours after stopping Trazodone, I began to notice a widespread hypersensitivity to any ingested substance, including my antidepressant at the time, Viibryd. I was unable to restart my Trazodone for sleep due to the hypersensitivity. At the direction of my provider, I was instructed to bridge to Prozac as "this worked for you before." As soon as we started the cross taper, I developed akathisia. I was enveloped in severe terror, compelled to move my body constantly, with an inner urge to crawl out of my skin. I felt as if my brain was being ripped out of my skull and every cell in my body was screaming, with no end in sight. This was misdiagnosed as possible serotonin syndrome and all of the medication was stopped. My nervous system broke. I was struck with vision loss, my GI system completely stopped working, loss of temperature control, widespread neuropathy, and inability to maintain my blood pressure or heart rate. I couldn't stand, sleep, walk, and was in agonizing psychological torture.

At this point I recognized this must be drug withdrawal and reinstated my dose of my Viibryd, hoping it would take away my symptoms in minutes like it did in the past. But it didn't. This was three years ago and I still suffer tremendous symptoms from protracted withdrawals. I suffer from severe adrenaline rushes at night, feeling as if I am being tazed when I am awoken, gut wrenching "chemical" depression, panic, neuropathy, full body tremors, vision loss, cardiac issues, severe gut dysfunction leading to malabsorption and severe vitamin deficiencies, cognitive dysfunction, amnesia, short-term memory loss, hyperstimulation to sound and lights, zero stress tolerance, among approximately 50 other symptoms.

Due to the severity of akathisia and insomnia, I was started on lorazepam and Lunesta, both incredibly addictive. I tapered off of the small dose of lorazepam over 14 months. I am stuck on the SSRI I reinstated 3 years ago, Viibryd. Anytime I try to taper even an extremely small amount I am hit with even worsening withdrawal symptoms. Its absorption is horrific and its bioavailability can go from 80% to 20% based on GI function. I regularly experience acute withdrawals due to the gut dysfunction I ended up with.

I have seen 55 providers since the onset of my illness. Very few are aware of any longstanding injury from antidepressant withdrawal. The healthcare costs of my care are astronomical. As a country, we need to ensure appropriate informed consent is being obtained from patients prior to prescribing of these medications, alerting them to side effects and also to a potential long lasting withdrawal syndromes. More studies regarding long-term safety need to be undertaken. Safer prescribing and deprescribing guidelines need to be adopted by the FDA, by the states' scope of practice laws in prescribing, and by the medical/nursing programs. Not only do we lose so much in this process, but we are turned away and silenced from the system that was designed to help us. With 1 in 6 Americans taking antidepressants, this is a severe public health issue.

I lost my pregnancy, my career, my health, and my financial security. I cannot change what happened to me, but I intend to spend the rest of my life helping ensure it happens to fewer others.