tips on how to quit taking crazy meds
Medicated For Your Protection
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Lots of people hit this site wanting to know how to stop taking their crazy meds. That’s understandable. There are many good reasons to stop taking the meds. There are also many bad reasons to stop taking them. I’ll try to help you sort out the good from the bad reasons. But if you do have good reasons, you have to quit taking the medications safely. Sudden or rapid discontinuation can lead to many problems. This guide is help you work with your doctor to decide if it’s a good idea or not to stop taking a drug, and, if so, work out a good discontinuation schedule for the med.
Some good reasons to quit taking psychiatric / neurological medications
- Really nasty side effects (adverse reactions) such as
- Severe allergic reactions.
- Especially fast-spreading, itchy rashes accompanied with a fever.
- Fainting (syncope) or otherwise losing consciousness.
- Blood dyscrasias, which is fancy doctor talk for way too many or too few white or red blood cells, or some other weird problem with your blood. Lots of meds, crazy and otherwise, call for regular blood tests to look for this sort of thing.
- Inexplicable bruises all over the place, especially lots of little bruises in clusters that look sort of like a big rash.
- The whites of your eyes turning yellow and/or your skin looking waxy and yellowish. Along with all the bruising this is a symptom of jaundice.
- Your hair falling out in clumps, and not just thinning.
- Seizures if you’re not epileptic or your epilepsy was under control. Otherwise you and your doctor can figure out if the med in question had anything to do with it.
- Irregular heartbeats and similar problems (cardiac dysrhythmia/arrhythmia).
- Of course you could have actually gotten better.
- Medication is supposed to be a short-term thing for most people with conditions in the panic-anxiety spectrum (OCD, GAD, PTSD, SAnD/Social phobia, agoraphobia).
- Meds are also supposed to be short-term for most people with depression disorders. The catch is, as they’re no better than a placebo for anyone who doesn’t have the severest forms of depression, it’s difficult to tell if that’s actually the case for people who really needed to take meds in the first place.
- In theory bipolar disorder goes into remission and one can consider being med-free. In practice I wouldn’t be so sure. For each study that shows it’s OK to stop taking your meds if you’re completely symptom-free for a long enough time, there’s one published in the same journal showing that’s it’s not such a good idea.
- And what answer do you get when you study over two hundred people for 15-20 years each? “Don’t stop taking your meds if you still have any symptoms, your symptoms have been gone for just a couple of days, or your symptoms go away and come back on a regular basis.”
- You’d think that would be obvious, but it’s not.
- Then there’s the kindling model as applied to bipolar disorder, which is an incredibly complicated and somewhat controversial topic.
- As far as this topic is concerned, if you’ve had frequent and severe bipolar mood swings for a long time1, regardless of being on meds or not, you’re screwed and are looking at taking meds (preferably lithium and/or one or more AEDs) for the rest of your life. Or until they come up with something better.
Bad reasons to stop taking your medication(s):
- Side effects that are more annoying than dangerous. Especially those that usually go away. Even if “usually” is often qualified with “eventually.”
- You’ve felt better for all of three days. Or thirty.
- You feel really good.
- You feel really, really good.
- You’ve never felt so good in your entire life and are finally ready to write that screenplay that’s been rolling around in your head while taking that hiking trip across Europe you’ve been wanting to do since you were in high school…
- This is probably a manic reaction and should be listed as a reason to call your doctor immediately because you need to stop taking this med, and start taking another one right away.
- You, your friends, your family, and society in general consider taking medication for a mental illness and/or neurological condition is a sign of weakness.
- Tom Cruise says you shouldn’t be taking meds because the ghosts of tortured space aliens channeled by L. Ron Hubbard told him so.
- Yet another TV show had an episode about how medication is always bad and it’s better to solve your problems without it, no matter what your problems are.
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You must work with your doctor, both to figure out if you should be discontinuing the drug and how to quit. We try to provide information on how to discontinue a med, based on information like the half-life of a drug. But it’s your doctor who has experience with taking people off of meds, and you and the people around you have to monitor for the return of any symptoms.
Even if you’re replacing one med with another you have to be on the lookout for symptoms coming back. You’ll want to keep some kind of diary, a blog, something to keep track of how you feel every day. At some point if it starts to suck, then you know you’ve lowered your dosage too far. But, hey, maybe you can get along at a lower dosage. It’s not quitting, but it’s probably better than taking more than you needed.
The most important thing to remember is this - your symptoms have gone away BECAUSE THE MEDS ARE WORKING! It’s not necessarily because you’ve been cured. There is no cure for a lot of these disorders. For many of us the meds are a life sentence and you just have to accept that.
While each med will have a unique, or nearly unique discontinuation schedule, classes of medications have similar effects to be aware of when you stop taking them. Especially if you’re discontinuing too rapidly2.
- Anticonvulsants/antiepileptic drugs (AEDs). With gradual discontinuation the worst most people experience is a headache, slight dizziness, confusion and sensitivity to sound and/or light. In other words, the symptoms of what AEDs treat: migraines and simple partial seizures. Discontinue too quickly, or stop a high dosage suddenly, and you risk seizures, even if you’re not epileptic.
- SSRIs and SNRIs are notorious for their discontinuation syndromes.
- Abrupt discontinuation of high doses of benzodiazepines can lead to seizures in addition to dysphoria, insomnia, muscle cramps, vomiting and sweating.
- The discontinuation of antipsychotics (APs), especially atypical antipsychotics (AAPs), has been likened to taking small amounts of psychedelic drugs. Whether that is a good or bad thing is up to individual experience. Others get rebound symptoms for a day or two, sometimes longer and that’s about it.
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Unless there is at least one of:
- A specific protocol on how to discontinue a drug in the PI sheet.
- The drug has a generally accepted discontinuation plan, such as Lamictal’s “decrease the dosage at the same rate you increased it.”
- Your doctor told you something other than, “just stop taking it” without giving you a prescription/samples of a med that works in a very similar fashion (e.g. swapping one SSRI or SNRI for another).
You may have to come up with your own plan on how to stop taking a med, formally known as a discontinuation schedule.
We have a rule of thumb on how to stop taking most psych meds that is the basis for a lot of the discontinuation schedules we’ve written up:
Decrease the dosage by the standard titration amount (whatever the PI sheet tells you to increase the dosage by when you start taking it) by the average time it takes to clear from your system. We have clearance time listed for all of our meds, but in case we don’t, or you’re taking a med that we haven’t written up, multiply the half-life by five and round up to the nearest day.3 You should find that in the pharmacology section of the drug’s full prescribing information - the PI sheet. Unfortunately the half-life isn’t known, or firmly established for all medications. If there is no half-life, look for something called “steady state” and use that as the clearance time. Otherwise ask your doctor again and, if you have no other choice, use one week as the clearance time.
For example: with most SSRIs it works out to reducing your dosage by 10–20mg a day every five to six days.
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2 If you have to stop taking a med because of a severe allergic reaction or equally important reason you're just shit out of luck about a gradual discontinuation. While allergic reactions almost always happen at the very beginning of treatment, every now and then it happens after somebody's been taking a med for years.
3 The half-life times five is known as "plasma clearance," and is based on Julien's calculations from A Primer of Drug Action. It is the generally accepted estimate of how long it takes a med to be eliminated from the system of someone with a normal metabolism.
How to Discontinue / Withdraw from Psychiatric Drugs by Jerod Poore is copyright © 2011 Jerod Poore
|Last modified on Wednesday, 18 March, 2015 at 13:14:56 by JerodPoore||Page Author: Jerod Poore||Date created: 26 May 2011|
All drug names are the trademarks of someone else. Look on the appropriate PI sheets or ask Google who the owners are. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.