I am NOT A DOCTOR. THIS IS NOT MEDICAL ADVICE. If you want medical advice, talk to your doctor, who, unlike me, can't be thrown in jail for dispensing advice that might be perceived as "medical."
(I am a mere human being, not a godlike being, and this is just my own experience and my own opinions. From doing a LOT of reading of hundreds of peoples' stories, and talking to many dozens of people one on one, and having a strong academic background in biology and the basic sciences, and a personal history of long interest and reading about the complex behavior of chaotic physical and chemical systems like, say, bodies, and brains.)(But not, certainly not, from ever having gone to medical school. So this is NOT MEDICAL ADVICE. SEE A DOCTOR FOR MEDICAL ADVICE.)
(Health care providers, after you read this page please read this.)
If you're taking a psychotropic medication or medications, DO NOT TRY TO QUIT SUDDENLY. Do not go "cold turkey." Abrupt stopping of psychiatric medications can be dangerous, possibly leading to seizure or worse--even the drug manufacturers agree. (If you have a medical reason to need to quit abruptly, discuss that with your medical provider.)
Don't be alarmed. Most people come out just fine. But please be careful so you can make sure you're one of the ones who come out fine.
Rule Number One in getting off psychotropic drugs is: TAPER. (Preferably slowly.)
Here is a slow taper that is recommended on some Internet forums:
Reduce by 2-10% of your current dose. Wait two or three weeks. If you are feeling stable and good, reduce again by the same percentage.
If you're not feeling stable and good, wait until you are.
Adjust the rate of taper--how long you wait between cuts (days to months), and how much you cut (1-10% is usually suggested), as you go, according to your symptoms.
If it takes a year or more, well, that's how long it takes.
(It's going to take me five.)
**********Warnings and caveats********
1. Symptoms don't always hit right away. Cuts can add up faster than your brain can catch up with them. If you find you did okay with cuts for a while but your symptoms seem to be getting worse now--well, that does happen to people. When it happens to me, I stop and take a break. (A friend of mine calls that "sideways tapering.") It gives my brain time to make the slow changes and adjustments that are needed.
2. Seems like lots of folks say that their tapers get harder as the doses get smaller. If it happens to you, don’t doubt yourself. Just slow down. It takes as long as it takes.
All of this is very individual. It depends on your genes, the meds you’ve been taking, your age, social situation, all kinds of stuff. This is definitely not a one size fits all kind of situation. So pay attention to what your body is telling you because you are the best expert about yourself.
And finally but important: If you are having a toxic reaction to the drugs you are taking, you may need to taper off more quickly. Discuss this with your healthcare provider if that's your situation.
(Check out the "resources" section at the very bottom of the page.)
Not everyone agrees about doing such slow tapers. (Here's one opinion about that.)
It looks to me like people who:
- have been on multiple psych meds
- have been taking psych meds for more than a year or two
- have a past history of being switched from one medication to another suddenly, or a past history of cold turkey
- were first started on psych meds before the brain reaches its adult state at around 23-27 years old
... are especially vulnerable, when it comes to tapering. For people in these categories, it seems like tapering is trickier.
The thing is, you have to forget what you think you know about how pills work. It's not like aspirin, where you have a headache and you take the pill and the headache goes away; and then after the aspirin leaves your system it's gone. These pills don't work like that. (In fact they mostly don't work at all, but that's another story.)
These pills actually cause your brain to change its structure and chemistry over time, in ways that are not quickly reversed.
When you mess with the chemistry of the brain, the brain reacts by remodeling itself.
This takes time. Your cells have to actually grow, and some of them have to die and be removed and others have to be born and grow from scratch. Brain cells don’t grow fast like skin or hair. They grow very slowly.
And reversing this process--growing a new brain, which is what you have to do when you quit psychotropic medication--is also very slow.
*********from benzo withdrawal forum*********
Here is something that I posted on an Internet forum:
"When you take drugs that change your neurotransmitters, which benzos do (and so do antidepressants and other psych drugs)--your brain doesn't like it. Brain chemistry is indescribably complicated, much more complicated than any piece of machinery ever created by humans. Everything affects everything else and it all feeds back on everything else. You can't mess with one thing without affecting everything. So our brains don't like it when suddenly even just one neurotransmitter is screwed up. Because that screws up everything else. (And most of these meds also affect hormones, which also work as neurotransmitters, by the way.)
So our brains adapt, or try to. They destroy some cells and grow new ones. They eliminate receptors and grow and install some other new ones. They turn some genes off and turn other genes on. They try very hard to re-establish a normal balance as best they can. This is a diffic ult and imperfect process and produces a certain amount of havoc and chaos, but the brain does the best it can, and gradually it reshapes itself. It reshapes itself around the new chemistry that the drug has caused.
This isn't a simple, subtle thing; it involves concrete, complex chemical and physical changes.
I like to use the analogy of a plant on a trellis. The trellis is the new chemistry caused by the introduction of the drug, and the plant is your brain. (Although brains are way more complex than a single plant, more like the level of complexity of an entire jungle. But I digress.)
When you stop taking a benzo or another psychiatric drug, it's like you are removing the trellis. If you yank it out all at once, ouch; the plant is damaged and it collapses and it takes a long time for it to heal itself, and it's not going to be able to function properly for a while. (Hence the problems with c/t.)
If you want to keep that plant functional you have to snip that thing out bit by bit.
At first when you start snipping, the parts of the plant that still have enough support from the trellis will support the parts that you've taken the trellis away from. If you're going slowly enough the plant will start to grow new stems to support itself, even. Ideally if you want the plant to regrow its natural structure, you won't take the trellis away faster than it can grow its own new stems and figure out how to hold itself up. Tricky pacing.
But if you keep going at the same pace day by day and you're going faster than the plant can grow, eventually some branches are going to fall down, although not enough to keep the plant from functioning okay. And if you keep going at the same pace, more branches will fall down and the plant will get looser and have less support but still be basically functioning, so it's easy to not notice that you need to slow down.
But then you run the risk that part of the plant might just collapse.
It feels to me like smaller cuts more often are easier on my brain than big ones less often--as long as I remember that even small cuts can add up. And sometimes it seems like they add up faster than my brain can catch up.
For me, the keys are:
(a) paying very close attention to my symptoms and respecting the healing process;
(b) not expecting to follow some pre-planned schedule, because growth and healing can't be scheduled (there are spurts, and plateaus, and the only way I can tell is by listening to my body)
And (c) going slowly enough that when those first branches start falling off, I haven't already cut so much that the collapse can't be prevented.
Sorry I am using the word "collapse", I know that sounds pretty strong. It's just an analogy and a pretty imperfect one.
But imperfect analogy or not, how our brains respond to drugs and tapers is much more like how plants act than like how machines act. Our brains are wetware, not hardware. Brains and plants come from the same place, from nature. You'll learn more about your brain from going for a walk in the woods (and stopping to watch everything from the soil bacteria to the birds in the treetops) than you will from working on computers.
*********************and more...************(repetitive but this is older stuff I wrote and I haven't pruned it yet...)
Nobody has done any solid research on the process of safely getting off psychiatric drugs. For that matter, nobody has even done any wobbly research on the process of safely getting off psychiatric drugs, that I can find. There's not a lot of R&D cash being invested in getting people off meds--what would be the point? (Peoples' lives matter more than CEO bonuses? excuse me? You must be crazy.)
No matter how certain someone sounds, the fact is there is no solid, neutral, objective information about getting off psychiatric drugs safely.
If you want to taper off your psych meds, you are going to have to learn about this and talk to people and figure out for yourself how you want to go. Hopefully you can find a doctor who has a clue to work with, too, but docs who have a clue about psych med withdrawal seem to be few and far between.
So it's up to you. And I advise everyone to be cautious, but in particular if you have been or are on multiple meds, if you started meds before the age of 25 or so, if you have been on meds for more than a few years, if you have changed meds a number of times, and/or if you have taken high doses of meds, I would recommend you be very conservative with your taper and think in terms of years, not months, to complete it. I suspect (and hope) this may be the best way to give the nervous system enough time to slowly repair and remodel itself.
I could be wrong about this. This is just what I think. You will need to educate yourself and make your own choices. There are no experts who can guarantee you a safe path through this. This journey is up to you.
Resources: (under development, more to come)
Icarus Project's guide to getting off psychiatric drugs : This is an excellent guide to decreasing or getting off psych drugs. My only caveat about this guide is that their taper rate (10% every two weeks) can be too fast for some people. Certainly it would be for me. I recommend starting with a more conservative pace until you see how your body and nervous system are going to respond.
Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications by Peter Breggin, MD and David Cohen, Ph.D--I've just begun reading this book. From what I can tell it offers exactly what the title says--lots of good information about the dangers of psychiatric medications and sound advice for tapering. With my usual caveat that I recommend starting with a slower rate of taper at first. There's also a chapter on getting your children off of psychiatric meds.
Beyond Meds : Gianna's blog is probably the best known "getting off meds" blog on the Internet. And much more--a collection of seven years of writing and commentary from a smart and passionate thinker. This blog has earned a great deal of recognition over the years; Dr. John Grohol of Psych Central links to this page as a recommended resource. (Gianna, unfortunately, is suffering severe disability due to her many years on high doses of psych meds, and the process of getting off of them.)
Internet forums: You will find support, friendship, and wise, experienced volunteers who spend their days and weeks and years helping people taper off drugs. There's an extensive body of knowledge of techniques, based on what has actually worked for people over and over again. You'll also find the usual Internet mix of trolls and attention-seekers and in-fighting, and a certain amount of superstition and dogma. Just remember, it's the Internet, and use your own brain and your own judgment. I recommend paxilprogress and benzowithdrawal, but there are many others.
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker--Okay, sort of cheating here, putting this in as a withdrawal resource; this book won't give you any advice about withdrawing. But it's flawlessly researched and will give you ammunition, if you need it, when people try to convince you that you should keep taking meds.
More resources and links to come!