A Hard Pill to Swallow: Rx Drugs – The Stigma and Why We Fight Them
Who Really Needs Them?
Let me be VERY clear – we are discussing LEGAL medication that has been prescribed TO YOU by a medical doctor of some kind. This post has nothing to do with the pill your friend gave you on a bad day, alcohol, or illegal substances. We can talk about those later – for now, let’s stick to the legal shit. On a personal level I can tell you I have tried just about every medication out there, both FDA approved and off-label medications. My longest used medication was an SNRI called Venlafaxine (Effexor). I am currently taking no medications now, to be honest this has everything to do with my life getting better. My life is now stable enough that I am ok with being off my medications – well that and I’m currently knocked up. I’ve been off of my meds for two years and have beat the odds by doing remarkably well. Some of these medications are meant to be used for a short time, meaning that they are just supposed to help until you get to a point where your own coping skills can help. Other medications are meant to be taken, daily, for life. This doesn’t mean that you aren’t able to deal, it doesn’t mean you are weak, it doesn’t mean anything other than you require a pill to help you out. Stop looking at medication as a crutch, a sign of weakness, a sign that you can’t handle shit, or anything negative. A lot of these views and opinions on medication come from the generations before ours that viewed the need for meds as something negative. Stop feeding into the stigma and just own that shit. So what you take a pill? Diabetics take insulin and PTSD folks take a pill, there’s no difference. Get. Over. It.
FDA Approved versus Off-Label Medications
The Food and Drug Administration (FDA), which has say so over just about everything you put in your face-hole, has approved selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) as PTSD treatment drugs. Other drugs like serotonin-norepinephrine reuptake inhibitors (SNRI) and anti-anxiety are used “Off-label” meaning that they can treat symptoms specific to you and your version of PTSD but aren’t approved by the FDA for your particular diagnosis. Just because a drug is approved by the FDA for a specific diagnosis doesn’t mean that it’s the drug that will help you, nor does using an off-label medication mean that it is wrong. Different strokes for different folks. I did best on a SNRI along with taking as needed or p.r.n. (coming from the Latin “pro re nata” meaning when necessary) anti-anxiety medications like clonazepam (Klonopin) or diazepam (Valium). Maybe you are taking an SSRI and are doing great, maybe you take a couple of pills a day, maybe you just take medication as needed. What ever is working, just do that. Don’t focus on labels or what is the hot new drug on the market unless you are feeling like your symptoms are not being helped by your current medication(s). Talk with your doctor and make sure that you are on the right drugs for what you feel you need help with. Do research, ask questions, and make sure that you are doing what’s best for you.
Types of Medications
The two most common types of medication prescribed by physicians are SSRIs and SNRIs. So here’s the dry and boring information…
SSRIs ease depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters. SSRIs also may be used to treat conditions other than depression, such as anxiety disorders. SSRIs include: Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), Sertraline (Zoloft), and Vilazodone (Viibryd). All SSRIs work in a similar way and generally can cause similar side effects, though some people may not experience any. Many side effects may go away after the first few weeks of treatment, while others may lead you and your doctor to try a different drug. If you can’t tolerate one SSRI, you may be able to tolerate a different one, as SSRIs differ in chemical makeup. Possible side effects of SSRIs may include, among others: Drowsiness, nausea, dry mouth, insomnia, diarrhea, nervousness, agitation or restlessness, dizziness, sexual problems, such as reduced sexual desire or difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction), headache, and blurred vision. Taking your medication with food may reduce the risk of nausea. Also, as long as your medication doesn’t keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime. Which antidepressant is best for you depends on a number of issues, such as your symptoms and any other health conditions you may have. Ask your doctor and pharmacist about the most common possible side effects for your specific SSRI and read the patient medication guide that comes with the prescription.
SNRIs ease depression by impacting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, SNRIs work by ultimately effecting changes in brain chemistry and communication in brain nerve cell circuitry known to regulate mood, to help relieve depression. SNRIs block the reabsorption (reuptake) of the neurotransmitters serotonin and norepinephrine in the brain. SNRIs include: Desvenlafaxine (Pristiq, Khedezla), Duloxetine (Cymbalta) ― also approved to treat anxiety and certain types of chronic pain, Levomilnacipran (Fetzima), and Venlafaxine (Effexor XR) ― also approved to treat anxiety and panic disorder. All SNRIs work in a similar way and generally can cause similar side effects, though some people may not experience any side effects. Side effects are usually mild and go away after the first few weeks of treatment. Taking your medication with food may reduce nausea. If you can’t tolerate one SNRI, you may be able to tolerate a different one, as each SNRI varies in chemical makeup. The most common possible side effects of SNRIs include: Nausea, dry mouth, dizziness, headache, and excessive sweating. Other possible side effects may include: Tiredness, constipation, insomnia, changes in sexual function, such as reduced sexual desire, difficulty reaching orgasm or the inability to maintain an erection (erectile dysfunction), and loss of appetite. Typically the benefits of antidepressants outweigh the possible side effects. Which antidepressant is best for you depends on a number of issues, such as your symptoms and any other health conditions you may have. Ask your doctor and pharmacist about the most common possible side effects for your specific SNRI and read the patient medication guide that comes with the prescription.
Do What You Have To Do…
Stop worrying about other shit and take care of yourself. If you need to take a pill, take a pill. If you need to go talk to someone, do that. Get the help you need, not only for yourself but for those around you. For the family and friends that surround us and don’t have and/or don’t understand PTSD, this isn’t easy for them either. Speak up and take care of yourself. It should also be noted I am NOT a medical doctor, so these are simply opinions and you should do your own research and talk with your own doctor before starting or stopping any medications.