How Slow is “Slow” When It Comes to Tapering Off Psychiatric Medications?

Submitted by ICI Staff on April 7, 2018.
descending staircase with a red carpet

It’s common to hear about the importance of tapering off a psychiatric drug slowly in order to improve one’s chances that the process will go smoothly and successfully. But what, exactly, does “slow” mean? If you’re not sure of the answer, you are far from alone. There is a general lack of medical research into risk-reducing taper protocols. Doctors are typically taught in medical school how to put people on psychiatric medications, not how to bring them off in a way that minimizes chances of setting off withdrawal problems. Many people—professionals, patients, and family members alike—end up making assumptions about what “slow” medication tapering means: cutting a dose in half for a week and then stopping? Taking a dose every other day for a few weeks and then stopping? Cutting by a quarter each month for four months and then stopping?

Because of the huge void of information on risk-reducing psychiatric drug taper rates, they don’t realize that coming off psychiatric drugs over a few weeks or months is actually far from slow—and that for this reason, it is incredibly risky and possibly even dangerous to one’s physical health and mental, cognitive, and emotional well-being.

So, where does one find a reliable explanation for how slow “slow” medication tapering actually is? Many people believe that the most informed answers lie not in the offices of mental health professionals and medical doctors but rather among ordinary people who’ve undergone psychiatric drug withdrawal themselves and learned from their successes and mistakes along the way.

Through gathering our personal experiences together, thousands of us around the world in this “layperson withdrawal community” have discovered a taper rate “sweet spot” that seems to allow for a more manageable, smooth withdrawal experience. Eager to find out what that sweet spot is? Head over to Inner Compass Initiative’s "Psychiatric Drug Taper Rates: A Review and Discussion” for a detailed breakdown.

Comments

Mersenne Tue, 08/14/2018 - 15:06

Nine years ago, I went on Cipralex (an antidepressant), quickly followed by Zoplicone (a sleeping pill), and then the psych ward. Yes, I got worse on the drugs, not better. Before I met with the first hospital psychiatrist, I hoped that someone would see the Cipralex didn't work for me and help me withdraw. Oh no! Instead, I was put on Lamotragine (a mood stabilizer) a small dose of Seroquel (an antipsychotic used in small doses for depression), and, finally Ativan. After 15 months of drugs, and once again on a short stay in the psych ward, I hit bottom and really just wanted to die. I felt like a zombie and couldn't function. That night I had a dream, which was a big event. I hadn't dreamt since going on the drugs. The dream was about an eagle carrying me up out of the mud. I decided to rise above and look at my situation through eagle eyes.

I had gained 50 pounds on the drug cocktail, despite working out at the gym for 10 hours a week and walking everywhere. My pulse went from 55 to below 40. My blood pressure rose. My right hand developed a slight tremor. It was time to quit the drugs. Since my psychiatrist wouldn't discuss the drug effects with me, I fired him and found a therapist. I didn't tell her about my withdrawal because I didn't want to implicate her morally/professionally. Oddly, everyone thought I was "getting better" when in fact I was just getting off the drugs.

I took 5 months to get off the drugs, tapering down slowly except for the Ativan, which I quit cold turkey at the start. The Seroquel was next to go, then the Lamotragine. Finally, I was down to a stub of Cipralex and a little piece of Zoplicone. I forgot to take these small doses one day and had a reaction, feeling so suicidal I ended up in the psych ward again. I lied my way out of that situation, saying I'd quit the drugs three months earlier. In fact, I had a weekend of sleepless withdrawal.

I can't speak for other people, but it seems to me that 5 months isn't long enough! I didn't go back on the drugs only because I'd cold-turkeyed the final bit of withdrawal in the psych ward and didn't want to renew my prescription. On the other hand, no question, getting off the drugs saved my life. Oh, and my hand tremor disappeared and physically I'm back to normal, after much hard work.