에피소드 60: Dr. Josef Witt-Doerring

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into depressed people because we're boosting these these neurotransmitters you know where we're where you know these people they have um uh deficiency in the neurotransmitters and and we're boosting them well um it's a reasonable hypothesis um but the issue with that is that there's also a competing hypothesis and that is that the drugs and that is that there's no actual problems in the brains of the people but the drug effect is simply masking um masking the symptoms that the person is having now that's a much less sexy idea you know and it's actually a lot harder to sell because intuitively people people don't like the idea of taking a drug to paper over a problem to mask a problem because it feels wrong it feels like you know we're not really getting to the root cause and and it's also sort of linked in with ideas about you know maybe taking non-prescription drugs things like alcohol you know when you worry about well you know i don't want to do this to escape problems you know i also know that if people take these these uh you know use this a lot they can develop a dependence and they need to use more and more and so when you think about the drugs out of this drug centered model um um people are a lot more concerned about taking them but if you tell someone well you know there's probably a genetic problem wrong with you and this drug is going to go into your mind like a magic bullet and fix the issue it can seem a lot more justifiable it's like well i'm not papering over my you know my symptoms i'm not hiding them or masking them i'm fixing a medical problem now um ivan you mentioned joanna's paper just a moment ago um and i think that was a big boom right i mean that kind of exploded in 20 whatever two three years ago yeah yeah and so this was a really big deal at the time you know a group of researchers led by joanna mong uh brief and uh out at university king's college london they essentially did a review of every single study out there that had looked at um serotonin in depression and so um looking for correlations you know in in these depressed patients when we bring them in if we if we draw um the central spinal fluid you know out and we look at the metabolites of serotonin you know are they are they lower you know they never found it you know they would do autopsies of the brains of people who had a lot of depression and they would look for the concentration of you know serotonin receptors on the neurons absolutely no difference and then they also touched on really high-tech brain imaging studies things called functional mris where you can

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look at different you can look at structures in the brain and you can also look at the way um uh the the brain sort of uh the physiology of the brain changes and then they got all these people with depression and they got normal people and they could not find any reliable differences between them now um so what this means is that there is no underlying chemical problem that we're seeing in in people with people who have depression at least not one that we can test for maybe we haven't found it yet but but the idea that we are fixing uh well-known problems with these drugs is is false um this doesn't mean that there can't be things out there like temperament you know we we know that temperament is kind of genetic but it's not this easily understood thing where it derives from this one thing in the brain it's it's likely polygenic meaning it's made up of multiple different genes um but that's not a disease you know this is just normal human variation that you get some people who are more nervous and some people who are more extroverted um yes and so like me having an opening to a podcast when i'm nervous yeah yeah yeah and that's and that's just normal human variation i mean some people are taller some people are shorter you know some people are more athletic and and less and all of these different things have survival advantages and they're completely normal um and so what this you know this paper by joanna moncrief um it really brought to the fore at least for humans that when we are using these drugs we are not fixing broken brains we are papering over anxiety and depression with a drug now um and that and that made a lot of people very uncomfortable to hear that but it's the truth and and that's why that paper was such a big deal and and so to some to my like follow-up question to this is like if if the science was always that shaky why did pharma psychiatry and media and pharma and everything why did they kept pushing it so aggressively because like i mean they had to have a little bit of an idea that that's not quite the case or did they or how how why why it became such a mainstream it's just like oh yeah you should you go to the doctor and within five minutes with a list conversation i will tell you before before you answer maybe like i remember myself way back in the 90s when i first came to the states from europe and i broke with my girlfriend and at that time i had two young graduates from you know from school psychiatrists and and and i still remember the girl looking at her boyfriend is like we should we should put him on something

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and then they both look at me and i'm like what are you guys talking about and i can only imagine if at that moment i i was to accept that which way my life would go from there on how little i knew and how much i would have trusted doctors right but how how come that um it's pushed so aggressively to everybody that it's hard to argue well see a lot a lot of this comes down to um um commercial forces right and so anyone you know i mean most doctors have known for a long time essentially you know depression you know why do people get depressed well you know it could be due to life circumstances or it could be due to maybe things we don't understand and and so i think we've always had this idea that there was this interface between maybe your temperament and just the the natural variations between people and then also um uh stresses in one's life but what the drug companies wanted to do was they wanted to downplay the um the life hardship you know when life hardship leads to depression and anxiety they want to downplay that because that's not what their product fixes um they wanted to paint depression and anxiety as as more biological than it was because that's what they had the solution to do and when you have a group of powerful companies who have billions of dollars of uh marketing spend um and in the us they they they used it on television you know there yes there are old ads from you know the the 2000s where there's this bouncing zoloft blob and it says in the in the black and white you're going into these big nice beautiful colors and you're happy again yeah i remember exactly it's yeah yeah and it says you know if you're suffering from depression you may you may have a chemical imbalance that's going to be fixed by these drugs now i think for most people it's understandable that you know a drug company is going to play shenanigans and they're going to market things in a way that increases the the amount of sales but the thing that most people don't realize is that the medical community especially the leading academics have been corrupted by the pharmaceutical industry most people think doctors get corrupted because uh sales reps for the drug companies they they come in and they bring them sandwiches and and because the sales rep is sexy it's it's meant to convince the doctor i'm sure that plays a part but as someone who used to work in drug companies let me tell you how the real corruption happens the fastest way to to excel in your career as an academic psychiatrist now these are the people

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at harvard yale you know ucsf you know the leading institutions out there and internationally as well the fastest way to make a name for yourself as an academic is to work with drug companies now the reason for this is they will let you run their clinical trials they will write publications for you and they will fly you around the world and all of these things will bolster your curriculum vitae and that will allow you to get uh promotions but what this means is is that for very competitive academics who really want to rise to the top of their profession they um they're not going to speak out about the drugs they they are going to actively avoid saying negative things about it because as soon as they start doing that they're they're not going to be supported by the drug companies anymore and so the the the influence and the power of the drug companies has has corrupted academia um and then the final thing the final reason why you don't hear about negative stories about these drugs is that most of you know for for many companies especially big ones and and you'll see this when you watch tv they're running drug ads a huge amount of um profit in in media comes from drug ads and so even them they they are going to be less likely to run any you know to support any negative content about um you know that's that's critical and so it creates this it creates this thing where um you seem like a crazy person if you start saying things like hey these drugs don't fix chemical imbalances they're just masking the problems people go i've never heard of such a thing before you know i've only ever heard the opposite from people um but it's just essentially it's just kind of like how everybody was how everybody was laughing at tom cruise at 2005 right when he he was on that interview it's like there is no chemical deficiency and everybody was like oh that's an anthology guy right and and yeah he's completely right right right yeah yeah so so yeah that's that's just very difficult situation to get out of but then let me so so if and and i don't know if that's even correct but if if depression like in humans let's talk about so we don't talk about aggression in dogs but depression in humans isn't caused by low serotonin do do we what what are the ssris actually doing to people how it's gone yeah yeah so so i mean when we think about the things that make humans depressed and uh i mean we think about um i mean the the main ones that sigmund freud would always talk about he says love and work and i think that's a great way to think about it we are social creatures and so relationships tend to be

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some of the biggest things that make us unhappy um but we also need purpose and so we need to be doing something that we like um and and so those two areas are significant but then when we get outside of those things i i start to worry about you know drug use as well especially overuse of caffeine and nicotine but also things like cannabis i also worry about medical problems that are missed um big things can be dietary issues you know that we have a lot of people with dietary problems um they have problems with insulin because they eat poor foods they um and so your physical health can also lead to feeling unhappy and so those are the main ones that make humans unhappy now so what are the drugs doing well the drugs are disrupting your neurotransmitters and when we're talking about ssri type medications like prozac which i think is the main one that's used uh used in dogs um they are typically inducing uh an effect of emotional blunting um sometimes they're a little energizing and that can lead to aggression but generally the effect is one of emotional blunting and if you're someone who's anxious or you're feeling depressed and you're you're being tormented by a lot of anxious thoughts if you can blunt your emotions you are going to perceive that as therapeutic and that's why many people take the drugs and they willingly take them because they are they they are benefiting from that drug effect yeah and that's where it goes but it's not fixing but it's not fixing the underlying problem and and when we start talking about long-term use that's when we run into problems right that's kind of like the you know how you mentioned the um um i mean freud's idea and and there was this one again like 2024 study that was really cool the i mean just the title itself was amazing like uh um what was it like depression depression difficult lives explain depression better than than than broken brains or something right yeah yeah and and but we are very quick to it's like when you go to a doctor office and when you go to the psychiatrist you're almost very open to just prescribe me the pill fix me with the pill right yeah it is and and i think it's and i think it's because it's become so um commonplace everyone knows someone who's taking these medications now and it seems so normal um and and the other and then one of the reasons why people get doctors uh can put people on these medications so easily is that they lie to them about well they don't lie to them per se but they leave out a lot of the the the the information which people really ought to know before getting on the meds i

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mean and the main one being that these drugs have never been studied you know for for longer than a year in a controlled clinical trial setting and you know when we have 50 of americans on these drugs for over five years you know drugs which clearly cause tolerance and dependence and the effects wear off and you need to take higher and higher doses and they and so they're changing your brain you know your brain is fighting against them to stay in balance um we've never done a clinical trial on these drugs that lasted longer than a year and some people take these drugs for decades um and and so it's you that there's if people knew that they they would know that they're really um they're really in the unknown you know that they that and and from what i see clinically as a psychiatrist here's what happens to people when they take them long term you get some people the drug effect will stay there and it will work for them but then you get some people where it just wears off and they need to go on higher and higher doses to get the same effect then they need to get on more and more medications to to maintain it um and then we have some people who get worse they develop a condition called tardive dysphoria with but it's essentially brain changes that make people that have you know high anxiety low energy uh low and low motivation and they get stuck in this chronically depressed state that's induced by the drug and if we're not even talking just about what the drugs can do to people there's also an opportunity cost about being on these meds you know what if because you went on these medications long term you never experienced the impulses to fix your relationships or to to go and find that job that you should actually be doing you know you need to quit the one that you're doing now but what if it means you neglect a health issue that was making you anxious and that's just festering in the background um i mean if you don't fix these problems at their root they get worse and so i worry about all of the long-term problems um in these with these medications long term and let me tell you this this is the exact same with dogs because before i got on this podcast i did some research i couldn't find a single clinical trial in dogs that went longer than six weeks right um and so and on top of that they were based on surveys when you deep dig a little deeper in those two studies they're based on the owner saying how my dog feels after yeah yeah and we're also told for for as long as i remember that they're safe and effective this

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been like one of the major slogans like don't worry just we will play with the dogs or we can switch to a different medication but ultimately we know what we're doing and and it will be safe you will be okay but as you mentioned all this like there is incredible side effects and at least in the dog training arena uh when i when i when i try to work with a very difficult problem dog that's been already for three years i mean dog's life is 15 years max let's say three years a young dog on fluoxetine for three years gabapentin trazodon and some other cbd so like just and without any outcome so finally everybody gives up and it's like let's euthanize it it's nothing it's working we cannot change anything and when i look at the dog there is there is just nobody it's just this emotional blunting like clearly like with dog is very easy you can talk nicely for a second and they start wagging their tail or they show you some excitement something and there is nothing and from everything that i've listened and to you particularly because you're one of the really specialists in the arena of tapering the meds but with dogs it's very difficult and there is nobody that can really tell us how at least yet um but so the the only easy thing i guess with the dogs is as dangerous as it is is that with a human you can they can get close to being off of the medication and then things go very bad and they jump back in because they start to feel as you're explaining it very well i actually let you explain this but uh with the dogs the way we you know it took me typically it takes me about three to four months just for the dog to start to get a little bit excited about anything being like even when you tell them hey don't be a bad boy or hey you're such a good boy and you get the same kind of dull look from the dog and there is nothing to work with um and and um it clearly just prevents in my opinion for dog behavior modification actual success because the dog just doesn't care like he's like i'm i don't care kind of attitude which makes it very difficult to encourage or discourage any behaviors and and get anywhere with it but um i it was very nice the how how it gets so complicated how how people think some psychiatrists argue that it's yeah it's not addictive it's very easy to you know leave it alone and but it's actually that's not the case can you can you tell a little bit about how difficult it is and what happens usually why people get back in it so yeah so um coming off psychiatric meds especially the antidepressants for humans um can be really

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challenging so um there's a huge variation in what people experience coming off these meds i i talk to some people and they you know they've been on the meds for you know three four years they can come off in two months no problem they go back to their life um in fact i actually think that's the majority of people um but there are some people that when they try and come off uh for reasons we don't understand their brains are just not very elastic they they don't they they have a very hard time adapting to the drug being removed and then they can develop really severe withdrawal problems and and sometimes these can go on for years uh it's a condition called protracted withdrawal and um it can it can make the person very unwell um it's it's not it's not the most common outcome but it can happen and because of that i mean that's what i do now i find these people who are having a really hard time coming off the drugs and then i do these very gradual slow tapers to help them come off you know typically after they've failed to come off um quickly levin do you have any difficulty getting the you're getting the dogs off medications when you take over their care yeah that's what i was kind of trying to say that um i i don't it's not difficult because um um um i know of trainers that will just just cold turkey kind of do it i know that that's not correct so i do take time um but again i'm trying to do it on my own to some to some extent i don't see like what i see is i gradually start to see the dog becoming just reacting to normal life better like even even if there is a let's say a sudden noise in a bush and they're like they acknowledge it and and they start to you know just have much more normal reaction to to to everything not necessarily being happy or or being angry but they like the emotions are kind of coming back again yeah so it's very difficult to say um what happens with the dog because we i mean no no way to measure and the only thing we're left no way to talk to them we're left with their body language and how they go in everyday life what they do um so from typically and again it's not everybody some dogs are you you don't see this dramatic difference in behavior and mood but the the dogs that i work with the really difficult dogs that end up working coming here they're just very um flat and and so they're like they're so flat i don't even know if that's even a good description to to describe it this way but to where you don't really see like if it gets worse what more it can be besides they they cannot just go in a corner and start crying um but they just don't get

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excited in a good or a bad way they're just very it's like okay yeah you're petting me or yeah you're telling me and and and that makes it very hard to to read them the interesting thing is that the whole uh um that the way the medications are coming into the dog world it's really based on the human experience in psychiatry and it's basically kind of copied into the dog world the idea that it would do the same thing but it's became such a common problem that um and that the to me the most dangerous thing right now is that these medications are not not that they are just overly prescribed but they are so easily prescribed by anybody like like any i feel that that any veterinarian doctor a dog will come to the office and the owner will say my dog is too rambunctious and he's charging other dogs on the street and chances are they may walk away with an ssri prescription because the and that's i'm speculating here but because the animal veterinarian behavior is which they get some uh uh extra school of course and they get educated on the medication but the all the education is exactly taken from from human psychiatry and so my my assumption is that if if they're using it then they can use it and you can i mean you can get a prescription like i i know that i can go to any dog veterinarian with my dog and then convince them they're very easy and on top of that i will go online on there is like this dog website that sell medications and stuff and tomorrow i have it and off we go on medication it's really really sad and the sad part is that the majority of the dogs and i'm talking the majority of the dogs like i remember one of your i don't know was that a podcast but you you had some really good presentation at one place where you had a big circle and you put a percentage and you were talking how there is this five percent of people that really need it and everybody else yeah there is a whole other ways of alternatives and it's just harmful to do and that's kind of where we are with the dogs yeah yeah a lot of these dogs haven't really been given the opportunity to to to find a non-drug ways of um of of coping and and instead of doing that you're putting them on drugs that flatten their emotions and you know and the same thing happens with humans a lot of the people that i speak to at the taper clinic they'll come to me and they'll say i just i just want to feel like myself again you know yes i don't really feel bad emotions but i don't really feel good emotions either i i have pretty low motivation you know i'm not that excited about anything or doing things like i used to be

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i feel like i'm just um you know um sort of like you know passive you know just just living but not really alive and and they hate that feeling and and i guess i mean it saddens me to think yeah and i mean it saddens me to think that you know you have this lovely dog um and um um um you know it's having some separation anxiety or that or there's some issue going on and then you know the way we do it the way we treat that is by blunting them and i i think you might have said this ivan because i've been on your social media it's like if you know if you left a child alone in a house for like 12 hours you know and the and the kid and the child became unhappy would you would you drug that child you know but that's that's you know that's essentially what i feel like a lot of people do to dogs yeah yeah and even yeah i mean dogs bite each other dogs can be aggressive to each other but because a dog is aggressive to another dog or dogs it doesn't necessarily mean that there is a chemical imbalance and that the ssri will do something to resolve that problem so the dog actually can change its perception towards other dogs because of uh and and of course the the proponents of the medications they will very quickly here correct me and say well it's not the medication only it's in uh conjunction with some behavior modification plan but my argument is that the behavior modification plan gets kind of stalled because you have nobody to work with because the dog doesn't just doesn't care if they do something right or wrong yeah and this is one of the things that i that i worry about with with humans as well with um because they all they often say you know you know drugs and antidepressants are the best combination and i guess you know maybe for some people that's true if if they're so depressed they couldn't even do the therapy without you know getting a little nudge from a drug but i mean we're essentially talking about a drug that is going to affect your mood and your personality you know and how you respond to things happening to you on a daily basis and if you blunt that you're also going to have a lot less material to work with in fact a lot of the people that that i you know when i'm pulling them off medications if they've been on them for decades they tell me it's it's like they were their maturation was stalled you know if they got on the drugs as a teenager they're they're learning to regulate their emotions for the first time you know in their 40s you know when i'm when i'm pulling them off and everything is coming back to them you

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know it's it's not like they've really taken gains or taken a lot of gains from while they're on the drugs it just kind of flattened things so they never really got to have that um experience of having to work through difficult emotions and and and deal with that that's really part of the normal process of maturing uh and then so we get it all when when we pull them off the drugs yeah the so i i just thought of something else like with the dogs there i mean of course there is quite a few different ways people would do and there is different dog training camps of course and but the way i and and some dog trainers will approach problems with dogs i mean the first thing you want to do is try to get close to the dog try to make that dog like you so you create some reports so you have some trust so you can start to get somewhere but the dog has to kind of be able at least to see it if not actively search for it at least to be able to recognize it and so we would try to get a dog to play because play is one of the i mean i'm sure with humans is the same thing i mean when you play you show very good intention and and especially when you like to play and you activate your body and the whole good chemicals start to interact in your brain it's a bit and and then you present a certain situation and so on so you have play and you have food you can use treats as rewards but from what i know and playfulness is something that kind of gets also quieted down loss of appetite is another side effect of of so on top of having the kind of emotional blunting you have a dog also that i cannot reach and say hey dude let's play i have a ball and he's like yeah okay so what and and it's almost like my hands are tied until i can go through the whole process of taking the dog off and starting to see that dog as i said at least starting to react to the world around it being well what is that woofs or oh somebody's coming oh it's a it's not a friend but you see a brain that's actively uh responding to to the outside environment um i i really don't understand why i mean what would be the the approach when when you have this emotional blunting or motivation loss you know like i i don't know how do you approach to get somebody excited to look forward to life again in that state of mind so i mean that's a really good question i mean for some people it will be just removing the medication because it is it's impacting their ability to be connected with the world you know some of the humans when i ask them can you describe they're having a lot of side effects to the meds i'll say

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can you describe what it feels like um to be you and then they say it's like i'm watching my life through a television you know i'm not feeling the emotional responses to things when i hear my favorite song come on i don't get prickles down the back of my neck you know because it reminds me of my youth when i hug my child or my spouse it's harder to feel those feelings of of of connection i mean it it it actually just is it i mean it is the effect of the drug that is that is lunting the emotions or also it can create increase irritability and and you know it can kind of go to a different extreme as well in some cases right or so this is the thing that's that's that's going to be challenging um because dogs can't say that they're not feeling well on the drug you know that it's it's it's really hard to know so with antidepressants um um many people i mean they may or may not be aware of that that they have this thing called a boxed warning now a boxed warning is the highest warning a drug regulator can give for a medication it means that when you you get the drug it has this big black box on the front of it and it says um you know and it says what the risk is now for the antidepressants it's that the drugs may make you more suicidal um and and this is crazy people people will think this sounds crazy but this is this is real when they've done clinical trials and they look at the rate of suicidal behavior in people under age 25 there are more suicide attempts in the groups of people who get the drug compared to the groups who get placebos yeah so you know let that sink in for a second you know taking an antidepressant will make you more likely to have uh you know a suicidal behavior than taking a placebo yet we use these drugs in people under age 25 all the time you know it astounds me why why we do that um now the reason these drugs can make people suicidal is that they can cause paradoxical effects and so when i say paradoxical i mean uh it's like a random effect that just happens to someone because they have the genetic susceptibility and the example i usually like to use to explain this to people in a relatable way is you could have 10 people sitting around smoking smoking smoking a joint nine of them are giggling and they're having a you know they're laughing they they feel relaxed and you get one person who becomes paranoid um now what that's what happens with antidepressants as well you you know majority of people are feeling emotionally numb which is the intended effect of the drug but you can get one person

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who starts to feel more depressed or even more aggressive um and um and if and if that's already an unhappy person and they start to have this paradoxical reaction where they feel even worse that can push them into a suicide attempt um i know you were talking i mean dogs recently about the the mass shootings too which is another crazy yeah yeah yeah let me let me let me link yes and so i mean for me i don't know how suicidal behavior might turn up in a dog i imagine it could be self-injurious behavior maybe they start to to bite their their paws or their arms or they they start to do something like that but also um you know what we've seen in humans and this is in the drug labels i mean the it it has you know aggression hostility you know all of these things are already in there they've they've been observed to be these these idiot these um paradoxical reactions and and when um and and and these side effects have led some humans to do terrible things like mass murder um you know um you know people strangling their family members um you know you know killing their whole families and then turning the weapons on themselves these have gone to uh courts of law where juries and judges have heard all of the the evidence about you know what that person was like right before they got on the drug you know how their behavior drastically changed and you know and then and then usually how their behavior got better when they removed the drug they juries have heard these these these stories and you know based on what we know about the drugs and the side effects they have um um um they have let people off who have essentially you know harmed other people uh during these things they've also um uh allowed people to sue companies you know one man got six million dollars out of smith klein beecham uh after he after a side effect resulted in the death of multiple family members by his father-in-law this is a guy gentleman called donald shell and so we do know that these drugs can make some people unexpectedly aggressive and you know ivan when i was preparing for this i was looking at you know one of those two studies that you had mentioned and in one of the studies they have a doubling of um aggressive behavior you know the the dogs who got the drug the the the prozac uh aggression as a side effect was seen in 12 of them compared to 6 of them who didn't get it now um and so i mean that would just be another thing that people would need to be aware of um before putting their their their animals on these medications if you start to see you know

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a typical aggressive behavior or violence um these are potential side effects of the drugs right yeah it's a very very difficult um it's a really difficult situation we we are in in the dog world especially like a like some some veterinarians or especially the veterinary animal behaviorists you know because they they have gone through the school they they know how they're supposed to know how the medication work but but but everything they say is not how the medication work and they get very angry when somebody says well there is this emotional bluntness or or lack of motivation or numbness they they hate it when somebody says that and and very quickly it just doesn't make sense how can one medication the same pill work for anxiety for fear for aggression for ocd for sure it does something collectively to all these problems yeah but it doesn't really addresses them in any reasonable way directly it's not like you you have a a cough and you've got a cough syrup and then i don't know you have a headache and you get some i i don't know if that analogy is even better than than what we're talking about but one serotonin it's a it's a great it's a great analogy and we use them in the same way in humans we will give ssris to people with depressed mood to people with anxiety to people who have ptsd and and and trauma uh we give it to women who have um uncomfortable periods and and are irritable around their periods because the drug doesn't work in any specific way it is it's a chemical blanket it you know they wipe out emotions i mean so anything that's that that generally tends to make people anxious and and and irritable it can it just turns the volume down on the on the on your emotions good and bad ones it's just like cranking a knob down and it'll work for many different things but not in any specific way the tapering or tapering like what would you think would be a proper way to deal with this with a dog like would you have a slightest idea how that would depending on let's say let's say a dog has been for two years on flox it in 10 or 10 milligrams or something and it's about 50 kilos i mean 50 pounds yeah yeah what kind of protocol would be a reasonable because and the reason i'm asking you is because i will let me back up some something here because i do have a no i'm smiling because this is like this is like the greatest question that i've ever been asked before to start talking about antidepressant tapering with dogs i love it i love it it's it's it's great because no because it's

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it's a real real question um i also i run a school for dog trainers i teach people how to train dogs and and then we have like a monthly meeting with the graduate students and there was a time when out of curiosity i was like guys how how often do you get because they deal with problem dogs that's why they come for training so naturally the question was look how often you get dogs that are on ssris and everybody every month has at least one dog on medication the youngest one can be six months old which is like ridiculous to even say that it has a problem it's just a little puppy that doesn't know who he is then my next question is when you talk to the owners have they ever been told that there will be a process of getting away from the medication not one not one single dog zero and and that's why how how do we learn how to do this if if we decide to yeah so yeah this is this is a great question um um and so what i would what i would say the most important thing would be is to try and get a sense of the dog's baseline behavior before you taper because you're going to be looking out for withdrawal signs and and so what do we notice in humans you know humans will start to to become more anxious um and you know they they might have a hard time sleeping um they can look dizzy as well um and and sometimes they have like brain zaps although that's really hard to to notice if you're it's going to be hard to notice if the dog's having brain zaps maybe you'll notice some twitches or some or some ticks um and this is just assuming that the physiology of the dog will will behave in a similar way to to to the human when when you're taking it off um so as i mentioned before i mean most people um can come off these these medications i would say in a couple of months and so um that's honestly that's that's way too fast for what i do but i i talk to a lot of people and and you know oh and then they can come off pretty quickly the most important thing that you need to be aware of is that if the so if the person starts to look like they're becoming very uncomfortable you slow down the taper and so that might be the same with the dog if when you're removing the medication you you notice the dog is very irritable um maybe very on edge you might want to just wait you might want to wait two weeks um or or just until the dog looks like it's settled down a bit more and then keep on dropping the dose um i'm gonna have to rely on you and your community to sort of educate the world on how to how to do this do this well you know whether it's something that can be done in a

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couple of months or maybe it takes six months maybe for most dogs it's you know it's pretty quick maybe for a select few it takes longer but the the golden rule is is to if the dog looks very uncomfortable put put it back on the last dose where it was comfortable where it was comfortable and then the next time drop it by a smaller fraction in humans we drop the dose every two to two to four weeks generally no no no sooner than every two weeks it might be different from dogs we're gonna have to we'll have to comment i have to get people to comment below this video on youtube or wherever it is to start to start sharing their experience of weaning their animals off ssris and and and how it went we'll have to crowdsource this one yeah yeah i'm sure we will get these responses for sure it's it's very uh every time i have talked about it it it brings a lot of interest and and definitely you know what else we do um especially because they again they're typically not as playful not as excited about anything so in some tricky way we kind of force them to get to start the body to get active so we would like maybe do a light treadmill or a little bike rides and just start increase to to get some conditioning and get some just physical exercises to where the dog starts to like i find that they as they're doing that they start to act a little more normal and even then as they come out they're like really going into a rest because they're simply tired not because they don't care anymore and and and that seems to be really helping as far as um kind of like a kick in the butt to like hey do something like let's let's move let's let's do something together there was a you know how i came up with this was uh because there was some again i don't know it seems like it's becoming really which i'm very happy just very very much the conversation is real and it's out there for humans right now and and more and more people are becoming aware that it's it's not quite as it's presented for so many years and but there was like a couple of other studies that kind of prompt me into this how how they they were comparing exercise with ssri and and like running and ssri and and it was a very um i i actually i don't know if i have them here but it was very very interesting to see that the results of physical activity really made a very uh uh big improvement on mental health bigger improvement than the ssris um there is one uh it's called the exercises trans diagnostic intervention for improving mental health and it's another umbrella review of things and uh um what was the other one there is like two of them

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that that that that did this with um and but basically and and you have to tell me more about this but i'm assuming that it's in some way you're forcing yourself to go out and do something for yourself than just sitting and saying how bad you feel or is there something more happening i think um yeah i think it's i think it's both things um and so we so we do know that exercise is a very good antidepressant for for some for some people not everyone now the people that i see it work really well for are the people who are sedentary you know they don't move they sit behind their computer all the time they're they're not active um and human beings we're designed to move i mean we're designed to be out in the sun you know with you know with the vitamin d effects and the fresh air we're meant to be moving our bodies and if you just sit behind your computer all day and drink you know three cups of coffee and you never see the sun you feel bad um and and that's why when we do these these these clinical trial when we do these studies we always find that uh exercise um really makes people feel a lot better um and and yes it's a distraction but i think physiologically being outside in the sun moving your body like your biology is designed to is a great way of regulating your mood and getting energy out and that's the same for dogs i mean but before you go and put your dog on an ssri i mean some there's different dogs out there but some dogs oh man they're they're they're bred to move all they need to that's all they need yeah that's that's where it gets frustrating because uh that that's what that's the one of the frustrating things is when it's like my dog is okay i'm really kind of really butchering this it's not quite like that but it's it's like my dog is really active so it's a problem for me and you you can not it's just wrong to say that and and label it now as a some problem that the dog has to almost like the with the kids with the htnd and things like this right it's like well it's the kid is active like sign them up for some martial arts or whatever let them do something to you know well i think i mean a lot of people they're not really you know they they just get a dog um and i don't know maybe they have to move for work and they used to have a yard and now they don't have a yard and they're in a you know in an apartment and their job is busy you know their job is very busy or they have a child and all of a sudden they can't meet the needs of that animal anymore um and and i mean that's that's that's that's really sad and then it's

1:01:17

very complicated because um what do you do you know you have to i guess you have to find a family for the dog that is better able to meet its needs right yeah it's it's uh with the dogs it's almost and it may be with some humans it's the same but it's like a convenience thing to some great extent just to yeah let's just calm things down um they have um if the dogs are not the dogs if the humans are they sometimes really on on their own realizing that the drug that the drug actually makes them feel better like because in in the dog as i was opening the the podcast like all the dogs that i have worked with that were on ssri they like got way better and some just improved 100 percent after they were removed now having said that there is always in the back of my mind i'm like but there's gotta be that dog that really needs to be on and that dog that comes to mind is just a dog that really we just need to really keep it in that blunt flat state of mind because it is the safest for the dog it is the even emotionally it's probably the better option than any other option but i don't find it like how how how does it really even compare with the human brain and the human emotion because dogs emotions are you know they're they're not quite i mean they do have similar emotion but they are not quite uh you know we are humans we have very different level like in in dogs you know you have affect arousal and and you know it's much more basic and how do we like do you think that there are dogs that have to be on or are they humans that have to be on and why are they have to be on so yeah so let's i i um so i have no problems with with with people deciding that they want to be on the medications and so you know generally what i like to see is if when when a person is unhappy that you really try and find out why um and the major buckets are you know relationships purpose um and then also you know stopping any substances that are making them sick and then also looking for medical problems or nutritional problems or problems with their food if if you have done all of those things and the person is still suffering a lot i think with a very clean conscience you can go ahead and and and and and say well you know we've tried everything you're exercising you're eating well you know we we can't really explain where this is coming from and we want you to have a good quality of life and so we're going to you know if and then we explain the risks to the person you know we you know this is the evidence base you know these are these are the risks do you feel comfortable with them

1:04:51

and if they say yes then i think that's completely valid you know you've done a good job you've tried everything you could if it's not working with a clean conscience i think it's fine to use the medications um and i mean another thing that that comes to my mind when i think about uh dogs is is the very real possibility that the behavior could lead to the dog being euthanized or to the dog being rehomed or something like that and and and so i actually start thinking about children with autism or um parents with dementia because because sometimes that's what we're looking at with families that are caring for these for these people um and it's the same for them you you know you want to make them as healthy as possible you want to do everything you can but but sometimes especially with um adults who have dementia who are just getting worse the most humane thing you can do might be putting them on an antipsychotic medication or or some antidepressants because it allows you to control their behavior better it allows them to stay in the home with you longer um if and if that means that your your grandparent or your parent can stay with you and you can look after them and you don't have to send them to a nursing home these aren't easy decisions to make i mean these are ones that are very complicated and you know they're challenging but there's never a right answer it's never you know it's it's it's never right or wrong to use a medication you look at the individual circumstances for the person you try everything you can and if if that's just the way it needs to be then um then then that's okay yeah yeah it reminds me this sometimes not sometimes very often in in like the dog shelters the where where you know people will just drop off a dog for whatever reason and it is quite common to put the dogs on any ssris and tracodone and gabapentin for that kind of reasons but the problem with that is that they are if the dog stays for five months there and he's on the medication and then he comes out and he really didn't have to be on medication the only main reason that it's on medication is because it's just wants to get out and run but there is nobody to take him out to run with and they're just losing their mind and starting to do things so let's quiet it down and it's a it's a difficult situation i can see how for the moment this is beneficial but then aren't we creating more problems when that dog is not at the end of its life but actually now needs to come out and needs to deal with the world and needs to become somebody's pet

1:07:54

yes yeah you're definitely creating you're making things easier for the person who runs the kennel but making things more complicated for the dog and the next owner when they're going to have to deal with a dog that's developed a physical dependency to a medication and has to go through withdrawal yeah and i know sometimes there is just no it's a it's very difficult because the the most of the animal shelters are always packed and and eventually some dogs are just starting to being from the front row to the back side to the back side to the back side and eventually nobody ever even knows that they are there and they're on medication and ultimately if it's a no kill shelter they if they can manage it they they manage it somehow or otherwise it's euthanasia that's an that's a an option with dogs that we have the euthanasia but also very frustrating because that happens sometimes very prematurely it's not it's like like we can say well we tried this kind of training it didn't work we put it on medication it didn't work and and the medication really is the final has the final say it's like okay it's been on whatever sri and it doesn't work so it must be um it's kind of contradicting because it like what exactly didn't work like the dog just had to come out and and have somebody that show some interaction teaches that right from wrong and give some outlets to to do something with it but when that's not happening then they become very difficult to adopt but they are also very difficult when they come out and well here is your dog your new dog but he comes with a chemical imbalance do you still want him and and some people will actually take the dog simply because they they will feel bad and they want to save that dog but most of the people will like no i i just want a dog to have fun and play with i don't want a dog that has chemical imbalance in its brain yeah and i also imagine it could be very um it might be very confusing for the person who adopts the dog because some people may say i i actually want a very docile dog i want one that's kind of you know doesn't you know is is very mellow and if you go and adopt a dog from a shelter who's on ssris and um you know it's it's very mellow it's very calm and you say oh this is a good fit for me and then you bring it home and you take it off the medications and then it's real personality comes out and all of a sudden it's like i want you to interact with me i want you to take me out i want to move my body i mean that's also um i mean that could also be very confusing for

1:11:33

for an owner yeah yeah very very much um hmm like we with humans where like if things are progressing the way they are and and the more awareness comes which which is really like i feel like it's in the last few years is really just picked up some really really crazy good momentum but if not ssri what what uh what the future looks like for psychiatry how do you i mean because there are problems um how how would how do you see it moving forward so what i would love to see is it's not that we get rid of any of the medications is that at least for the humans the doctors really emphasize getting to the root cause of why people are unhappy and being honest with them you know and helping them do that you know i would love to see us help people more with their relationships with their work with their physical health and you know and and and set realistic expectations and say listen this could take you a couple decades to figure out you know you have to cultivate these things in your life you know good relationships work that you love you know these aren't shortcuts there is natural pain along the way and to set those expectations you know i'd love to see us get people on on on you know to stop using so much caffeine and nicotine and cannabis to to clear up their minds and then also to to eat good food and to move their body every day i mean if we can do that i i think the the amount of people who need these medications will go down a lot the the meds aren't really the problem the problem is is how we talk to people about them as if you know the reason they need them is a brain illness and the drug fixes the brain illness and the drug is safe and effective even though it's never been studied longer than you know longer than a year and it leads to all of these problems down down the road i mean we're if we could just help people with the things that actually underlie the depression and not lie to them about what the drugs are doing we'd be in a much better place and i and i hope we could do that for the dogs as well you know that it will translate that that level of thinking can translate over into the the animal world i think it will because again i mean if that's that's how the sris came to the dog industry so i would assume that that's how it's gonna go um what is the the whole like when when i had the the conversation yesterday um with with dr orion um you know like like is there a way to measure serotonin level in the brain and to say well clearly by now we know that's low or or or higher like the levels are are not really necessarily a factor but how do we measure

1:14:46

serotonin in the brain so we've we've been doing this in humans for decades you you stick a needle into the space between the vertebrae um in the lower back and you get it into the um um um into the to to where the spinal cord is and then you suck up uh cerebral spinal fluid this is the fluid that is kind of going around your brain it's what the brain kind of floats in and what the spinal cord floats in you you suck up that fluid and then you look for um serotonin or the metabolites for serotonin and and we've been doing this in humans for a very long time and trying to correlate it with different moods and and that's why we know and that's what joanna moncrief uh found was that there was no correlation between the neurotransmitters and the people who were depressed compared to the people who were not depressed who had the levels strong it's there there is there is it has nothing to do with low or high uh neurotransmitters it's not that simple how many types of depression i don't want to get like too crazy on this but i as as you were saying you get fired from work or you break up with your girlfriend or your football team loses sure you can get upset and get upset and that upset can lead into more kind of into depression but but there is some can you genetically be really predisposition and just just come out and and don't have motivation and just i think it's i think that's very unlikely um personally um in almost all of the people that i've that i've met who have been depressed over the last 10 years and you know kind of longer it's very hard to find someone who who doesn't have a reason why why they're unhappy i think depression and anxiety is it's mostly uh due to life hardship right and then medical problems or substance use now there are some people who are just more nervous and that's their temperament generally they tend to have more depression because when bad things happen in their life because they're more emotional and they feel things stronger they they will be more likely to be depressed this is women as well women women experience depression at a higher rate than men they they're much more emotionally attuned and emotionally sensitive than men and so they're more likely to develop depression and so i mean your question is is it still possible that there is someone out there and they come out and and they and they're just depressed you know and there's nothing right there's there's nothing out there it's it's always a possibility um because there you have to be humble and know that there are some things that we may not know about

1:17:53

you know the human brain and and we're still learning things and so i think it's a possibility but i i reckon it's you know 99 of the people with depression or anxiety interactions and 999 yeah yeah it's it's it's due to life and and problems i think that's the the the the extraordinarily rare case that that it's completely a brain problem it's a very very crazy thing that the the worst is that it's very young sometimes dogs just don't have any reason to be on the medication our own medication because maybe some behaviors kind of as we were talking earlier is too too difficult for the owners to deal with and but then there is the you can have a training or you can give up on the dog or you can put it on medication and everybody can make their own choices i guess um but hopefully people when they listen to this uh it like one of the main things is to to bring the awareness that you bring to people that it's not it's not just like a vitamin c it does affect and and if you decide to give it to your dogs ask the questions talk to the vets and if the vet cannot explain it to you then you need to find a vet that can actually tell you how what can possibly happen you know because typically what they will tell you like it's very standardized it's like okay well we're going to put the dog on medication it may lose its appetite for a week or two and we're gonna see if we need to go a little higher on the dose or lower it or switch the medication but that's the extent of of it's like when you as a veterinarian you're relying on the owner to tell you well how are things how is your dog and typically when you're like i've had i had clients with dogs that again been for quite some time like let's say two years on medication and i i remember this one woman she was like i know this is not working but it's kind of it makes the owner feel good that they're doing something about it even though that's something maybe puts the brakes to to really make a big change in the dog but they're going through the right channels to the veterinarian to the prescription and every day the dog gets its pill and and they they feel good about it so i don't know and that's one of the dangers of using the medications in humans as well there's there's a sense of well i'm doing what the experts are telling me you know i'm you know i'm looking after my mental health where your depression or your anxiety is so much more than than taking a pill you know you you know there's so many things like i mentioned you know cultivating relationships and work that you love looking after your health

1:21:28

but it gives people a false sense of security that yes they're they're really handling things when when they might not be and you know like i mentioned i i take people off meds who have been on them for two decades and when they come off we're rebuilding their lives you know and teaching them how to process their emotions and and so in some ways it might actually be um slowing things down for them unfortunately right yeah that's that's kind of what i want to yeah that's that's my feeling can you tell me one like i know you like i follow you so much then and i love the the cases when you have uh uh on on youtube i think it is mostly when you talk to do i don't know if all of them are your patients but they're definitely people that have been or are at the moment on sris and how they you know their experiences if you any of your like top three very interesting ones that comes to mind to share with us i think one that's really good for people to listen to is the one it's it's called psychiatrist hurt by drugs he prescribed challenges the whole profession and the thumbnail has a photo of of mark horowitz and it says i got i got really hurt um and that one i think is a great story because it talks about a psychiatrist who everyone assumes you know is meant to know the risks of these medications but he he falls for the same narrative um and and so i think that that's a really interesting one okay i mean some of these some of these stories are really um it can be really quite emotional and sad i mean we have um you know if i think about another one we've got i i feel like there's uh an interview i did with a gentleman called matt marin m-a-r-i-n it's called um surviving akathisia and protracted psych med withdrawal he's just a very likable person he's young he's attractive and he kind of talks about how he got lulled into taking these medications and um um and then how it caused him a whole bunch of problems and let me see if i had one more he asked for three um this is this is very sad yeah yeah the last one would be um benzos killed my husband interview with kelsey krauss um this is a story of a woman who loses her husband because he um he he comes off the medications too quickly and i talk a lot about this on my channel channel it's a it's a condition called protracted withdrawal where some people if they come off their meds too quickly it's they they experience a traumatic brain injury it's almost like they've had a very severe concussion and her this happens to her husband and she fights to to keep him

1:24:35

alive for years um but eventually fails um and and that's a very moving uh moving interview so i think i mean those would be the ones that i really uh think are quite powerful but they're i've to warn people listening to this these are sad stories i mean these these these aren't uplifting stories they're they're very raw and um um and they may make some people feel uncomfortable very cool yeah we're gonna like uh if if anybody i i know uh some of i mean i actually know all of the the the places where people can find you but you can you can direct them to any specific if you would like your website or the youtube channel because i i know that there will be people that actually as much as we are talking about dogs i know that i i even have friends that are on medication or think to be on medication and and the information that you're bringing up it's so valuable that i know that there will be people that will show a lot of interest to this so so so um yeah best place i'm i'm on every single social media platform i can think of like the the main ones and so the the biggest channel is the youtube channel it's dr joseph it's it's spelt in the with in with the german way so j o s e f um and um you can find me on you know instagram tick tock uh x uh under either dr joseph or taper clinic at taper clinic that's t-a-p-e-r uh clinic um that's usually my handle there um and we also have a website it's taperclinic.com and um and we we work in 10 10 of the most populous u.s states uh doing drug tapering for people and so um you can come to our website if you or you maybe you or someone else that you know is interested in potentially doing a drug taper very cool very cool well i think this was again i i am so happy that i was able to to get you because i know how busy you are and and again it's dogs and but hopefully that was interesting to you also just to get your mind off people for a moment um and and hopefully very interested in this i mean i actually think i'm going to do a a dedicated video on dogs and um and prozac i i think because this this got me really interested that would be amazing you will you will definitely have a a big big audience that will want to hear it and uh hopefully for everybody that listened um yeah we're gonna post all the links of course and and and yeah i don't know what would be the closing things to tell you but you know just just don't don't get too comfortable if you're gonna be using or you're using ssris on your dog understand that it's not a necessarily treating directly a problem that the dog has in in some ways it's

1:27:56

more of masking or just just as we were talking um and they are not benign that they're not safe as an effective depending on and if it's okay i'd like to add to that just that that the studies looking at these in dogs they go on for six weeks um and so this is you know when when the vet says you know this is effective for the dog you know dogs live for 15 years you know we we have no idea really what it's going to do in the long term um and these drugs like any other drug that acts on your mind and alters your neurochemistry you know you build tolerance and so you may end up it may stop working for the dog or you may need to go on a higher dose and then the dog has side effects and you know when you go to a higher dose and there could be problems and so it's um yeah you know it's i think there's a lot less certainty than than than well i know that doctors convey and i imagine maybe the vets could be the same oh you know safe and effective we do it all the time you know and then people don't hear yeah for the six weeks you know the study went for well super i am very very grateful and uh if you if you really if that was uh uh if you're gonna end up doing something on dogs that will be absolutely amazing and um yeah thank you so much for for the conversation very very insightful and and i know people will be very happy because this this conversation was really missing in in the dog training community uh we we're always here one side well it was a pleasure it was really nice talking to you ivan i'm i'm so happy you're interested in this topic and you're trying to to spread awareness amongst your community and dog owners out there thank you thank you thank you so much