Zoloft defense -- shot down

Okies. Gotta keep this quick, because I know pages will be on my desk shortly. Just felt the need to comment on two things.

1. A 15-year-old boy from Charleston, S.C., has been sentenced to 30 years in prison for killing his grandparents when he was 12. It's a horrific crime, and I don't want to lessen the blow that two people were murdered here. The twist is that the boy, Christopher Pittman, was taking the antidepressant Zoloft at the time of the murders.

A lot has come to light lately about the safety of antidepressants in children. (Between that at the snafu with Vioxx/Bextra/Celebrex, I know the drugmakers must be reworking their resumes right now.) I am not going to bring up the conflicting studies that say SRIs are safe or unsafe in kids -- mainly because I don't have time to look up the data right now. But I do want to tell you a little bit my encounter with the little blue pill Zoloft -- and how I spent months recovering from it.

I started taking Zoloft right before my 20th birthday. Most people who read this blog (read: people who know me) know the circumstances of that summer, so I'm not going to rehash. But I approached my primary care physician with the classic symptoms of depression and generalized anxiety: feeling sad, crying a lot, irregular sleep habits, weight changes. I was put on a fairly low dose of Zoloft, along with BuSpar, which I was supposed to increase over a period of weeks. The BuSpar was out of the picture rather quickly -- it made me quite sick (incidentally, the BuSpar symptoms largely mirror the discontinuation symptoms of SSRIs, like my current one, Effexor).

I was off the BuSpar before the Zoloft even had a chance to kick in -- do you realize those SRIs take several weeks to reach full efficacy? I didn't really realize the Zoloft had started to effect me until a couple of months after my treatment started, when people started to tell me I was acting like my "old self" again. (Quoted, because I really don't remember myself before the depression and anxiety kicked in.) Okay, so I was under treatment. I thought things were going to change.

And they did. But not in the way I'd hoped.

First it was the dreams -- and this is something that has followed me throughout my treatment options (Zoloft, BuSpar, Celexa, Klonopin, Effexor XR -- and I think I'm leaving one out in the middle, maybe?). My dreams become so vivid that they're practically lucid. (Yes, I know the difference.) They aren't always bad or good, but they are usually very strange. And they stick with me for a long time, even though I've long since stopped keeping a formal dream journal. The dreams caused my sleep habits to change, to get worse. And that exacerbated the anxiety that I was already feeling.

After a few months -- eight, I believe -- I decided to wean myself off the Zoloft. Remember, this was my first SRI, so I didn't realize how difficult it would be to wean. Now I've never taken heroin. But if the Zoloft discontinuation was anything like that of heroin, I can understand why methadone clinics stay in business. The dreams got worse. The anxiety got worse. Sleep was unheard of. I do believe the discontinuation was worse than the depression and anxiety before I ever started the Zoloft. And the problem was that it lasted for months. I was at the end of my rope.

So, to tie this back into to Mr. Christopher Pittman: I didn't kill anybody while I was on Zoloft. But the scary thing is that I didn't notice myself changing until other people pointed it out to me. Here was a drug that was changing me -- and it was even doing horrible things to my mind -- and I was so blind to it that it took an outsider to say, "Hey. What's up with you?"

2. I've written enough already, but I want to bring this message back up to the present day. I've gone through five classes of anxiety/depression treatment. The depression is bearable; the anxiety is not. On March 3, I visit a psychiatrist to see if a combination of therapies can help me work through this. It's a scary thing, although I've been put at ease by a friend named Tyler who happens to be a psychiatrist himself.

Right now, I'm on 300 mg of Effexor XR, and Klonopin for when the Effexor doesn't seem to be enough. The Effexor is ... unique (is that the word I'm looking for?) in that I've been able to tolerate it for almost two years now in increasing doses. But as it lessens my anxiety, I get worse in other ways. I can't sleep unless I take a sleeping pill. The gnawing anxiety makes me feel violent -- mainly towards myself -- although I have assured Paul I am sane enough to not doing anything stupid like suicide or self-mutilation. As an interesting side note, did you realize that the higher a person's IQ, the less predisposed he is to commit suicide? My IQ is somewhere between 150-155, so maybe I'm smart enough to keep myself from myself. :-)

Anyway, the effects are horrible, and the discontinuation is worse. If I'm an hour or two late taking my pill, I'm so dizzy and sick I can't get out of bed. Other Effexor patients call them "brain shocks," and they are well-documented in psych journals (although they use a much more technical term). I'm afraid in a few years, drugs like Effexor will suffer the same fate as Vioxx/Bextra/Celebrex, in that the FDA will admit a snafu in allowing it to reach the market, because there are plenty of people out there just like me who wonder if the treatment is worse than the disease itself.

I'm taking a poetry workshop online (don't ask why -- I've been writing poetry for years, and I've never taken a class before). One good effect though is that it makes me write every day. I used to write only when I felt so burdened that I knew the resulting poetry/prose would be laden with emotion. Now I realize it doesn't have to be such a heart-wrenching thing. If I can see the beauty in the mundane, that's good too ... and if I have a body of work I've created, I can choose the gems from it, instead of expecting them all to be top-quality.

So I thought I'd share what I wrote last night about going to the psychiatrist. As I drove into the driveway last night, on an unseasonably warm February evening, I felt prompted to talk about my psychiatry appointment -- and the way it scares me a little bit.


(As of yet untitled) <-- Hey, I just wrote it last night! Cut me some slack!
Tufts of May green
Sprout between the winter brown,
Fleeting visions of light
In long-neglected shadows and corners.
Only two weeks now until Someone Qualified
Sizes me up like the season's first crabapples,
Wondering how I weathered
that unexpected frost,
Judging whether I would make a fine jam
Or have been infested by worms.
And I long for the vestiges of winter
To hold on longer --
To bundle me like a crocus bulb
Until I know my time has come.
I wanted to linger in my flowerbed
Between the punctual day lilies
And the hearty jonquils,
Near the crepe myrtle who weeps
Beautful fragrant blooms deep into fall.
But already the lawn is whispering spring,
Teasing with hints of color
And calling for new life to burst from the ground.
And I wonder how long
I can bury myself
Deny a flower will grow
From this dusty hard shell of me,
And pretend I'm not hiding
From the rain and the sun.