For a time, I was fairly pleased with how Effexor and I got along. The protocol for taking Effexor, and other antidepressants, involves slowly inching up the dosage to give the body time to adjust. I noticed numerous side effects that are typical of antidepressant use. I found the side effects irritating, but manageable enough to endure so that I could benefit from the medication.

After several months I reached a plateau with the medication. I didn't want to step up my dosage because I didn't want to compound to the already irksome side effects, and I felt it was appropriate to cease using the medication. About a month and a half after coming to this decision, I started the process of quitting Effexor.

You might be asking "Why Kyle? Why did you wait to quit taking Effexor so long after you decided to stop?" Well I was going to use the rest of this article to share a story about how I once accidentally set fettuccini on fire, but since you asked I'll indulge your curiosity. It's more enlightening than a story of culinary negligence anyway.

To fully explain my circumstances, it's necessary to mention that the version of the medication I took is called Effexor XR. The XR stands for "we made the drug a bit more safe and manageable now," although those slick marketing fellas over at Wyeth Ayerst will probably insist that the XR stands for "X-tended release." Whereas the original preparation of Effexor required multiple doses through the day, the extended release version requires only one daily dose. This makes the regime a bit more convenient to manage although I suspect ulterior motives for this release.

Effexor isn't alone on the extended release bandwagon. Paxil, Wellbutrin, and Celexa are all available in a controlled release preparations. Some antidepressants have long enough half-lives in the body to not necessitate a time release preparation. But antidepressants with very short half-lives are now being recognized as a terrible liability that exacerbates the withdrawal symptoms a patient must endure when quitting. And by withdrawal, I mean discontinuation syndrome. But make no mistake; by discontinuation syndrome, I really mean withdrawal.

Discontinuation syndrome is the blinding caustic light at the end of the tunnel. Discontinuation syndrome is also an important term that distances antidepressants from the word withdrawal and all the pejorative connotation it brings. The companies behind the pharmaceuticals won't exactly be banging down doors to explain the details of discontinuation syndrome or all the withdrawal symptoms that users could possibly encounter. But it's bad business to made roundabout concessions that indicate that patients (customers) are addicted to their product and will face a difficult time if they wish to stop using it.

When one ceases their intake of antidepressants, it is important to lower the dose over time just as slowly as when they got on. Their brain chemistry has become used to the presence of their medication, and more than just serotonin levels are affected by this process. Other neurotransmitters, like acetylcholine, will fall out of balance. Acetylcholine plays important roles in helping to regulate actions in the stomach, bladder, blood vessels, and sweat glands. The drug-bolstered brain chemistry begins to fluxuate as soon as the half-life of the medication has run its course, so extended release medications help alleviate some of the harshness of withdrawal.

In more broad terms, discontinuation syndrome is why people who stop taking antidepressants start to feel nauseous, disoriented, crazy, and like they're receiving electric shocks. The electric shock sensation, dubbed "the zaps," comes as a surprise to those who have never heard of its prevalence and a larger surprise to those experience it the first time. I personally like the term "the zaps" because it help tether the antidepressant experience to funny junkie imagery. Can't you imagine a haunted gaunt man pawing at a door saying "don't hold out on me man, I got the zaps." Discontinuation syndrome may also cause severe vertigo, insomnia, an intense feeling of depersonalization, and visual disturbances, but that's significantly less funny.

I learned about all of this withdrawal business independently of my physician and the informative Effexor brochures I received, and I was fairly nonplussed. I had already learned to be terrified of just missing my daily dose, an experience I've compared to "really horrible drugs" and "wicked shitty dreams." The truth could more likely be found somewhere in the middle, as if one dreamed about smoking horrible drugs. Or if one dreamed about smoking relatively good drugs, but then had to contend with some terrible buzzkill. What I'm trying to say is: the experience was comparable to smoking a bowl of "one-hundred-dollars-a-quarter-reefer" and then having cops knock on your door looking for the bail-jumping retard that lived in the apartment before you did. The whole mess is unpleasant, tense, and there's a slim chance that whatever you do is going to land your ass in lockdown for the night.

Of course missing a dose could always be counteracted by taking the next scheduled dose. When weaning off the medication, there is no such luck. Because the dose must be stepped down if the patient wishes to get off, the only way out is through. My personal timeframe for quitting Effexor would last three weeks, though it should be noted that my normal dose was only half of what the average Effexor user is taking daily. I informed my doctor of my plans, and waited for a convenient three week window in which I wouldn't be traveling or otherwise burdened with any particular responsibility (a rare occurrence in my jet-set playboy lifestyle).

The cessation process was pretty cut and dry. I would lower the dose and feel repercussions the day after. While I did experience the zaps, I never found them to be all that similar to being shocked. Every time I changed where my eyes focused, I felt like my entire brain would have to painfully re-calibrate my spatial coordinates. It was three weeks filled with only driving when necessary, a little bit of vomit, and a lot of sitting quietly trying not to look at anything. After several days the withdrawal symptoms would lessen and become tolerable, just in time for my dosage to lower again and start the nauseous cycle again for the next week.

Was it bad? Certainly. Was it unbearable? Not by a long stretch. It was like having a flu without the fever, or a hangover without the thrill of getting drunk and finding creative places to urinate when the bathroom was occupied. But it is my personal experience and it obviously can't be expected to play out the same way for each and every person. The sad reality is that some people believe they will never be able to quit. And that some people are so dissatisfied with their experience, that restitution must be sought out in a court of law.

It's not my place to argue one way or another about the usefulness or necessity of antidepressants. I understand that there are plenty of people out there who could not tolerate life without the assistance these medications offer. Just as many people find the antidepressant experience comes at a price of too many obtrusive side effects. In regards to my own personal experience; I certainly don't regret deciding to pursue the antidepressant avenue. I'm here today with the motivation to write this spectacular retrospective spectacle, and that's the most I can ask for. But I'm obviously left with grievances to air out.

My beef (and this is a large beef I'm sharing with thousands of others at a very large table, feel free to pull up a chair) is that the pharmaceutical companies behind antidepressants are only presenting the bare minimum on discontinuation syndrome and the addiction that leads to it. Full disclosure is not on their agenda, and who could blame them. They are businesses and their objective is to make and market products for consumers. In response, subcultures of current and ex-users have sprung up to start tossing around scary terms like "class action lawsuit" and "fucking pissed".

The Effexor website points out that The World Health Organization has ranked depression as the fourth greatest public health problem. Certainly we should trust The World Health Organization's objective ranking, and respect their statement because depression is a serious problem. The Effexor website fails to mention that The World Health Organization also compiles a list of reported adverse reactions to medication that come in from sixty countries. Effexor is ranked number two, behind Paxil.

In Britain, a class action lawsuit has been mounted against GlaxoSmithKline for purposefully failing to inform doctors and patients about the addiction and eventual withdrawal from their antidepressant Seroxat (although the lawsuit was filed in the state of California). Seroxat overtook Prozac to become the most prescribed antidepressant in Britain. Here in the U.S. Seroxat is sold under the name Paxil. GlaxoSmithKline has stalwartly insisted that their product does not cause addictions, only to concede the point this past year and admit the contrary.

The pharmaceutical companies are showing a modicum of responsibility. They have, after all, introduced their extended release formulas. Wyeth-Ayerst has been sending vague letters to doctors that advise against the prescription of Effexor to children, although they are not releasing the research findings they've based this advisement on.* And the names behind the antidepressants will most likely continue taking judicious steps out of the way of legal responsibility while trying to redress the negative image their medications have acquired. Depression is a serious ailment that deserves effective treatment. Unfortunately antidepressants have become mired in a growing bog of bad press, bad public relations, and—let's face it—bad names. I take something called Effexor I want to be imbued with superpowers, not laid up for 3 weeks while trying quit.