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  • Safety Notice: This section on Psychiatric Drugs/Medications enables people to share their personal experiences of using such drugs/medications. Always seek the advice of your doctor, psychiatrist or other qualified health professional before making any changes to your medications or with any questions you may have regarding drugs/medications. In considering coming off psychiatric drugs it is very important that you are aware that most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them. Withdrawal from psychiatric drugs should only be done carefully under experienced clinical supervision.

Harm reduction & safely withdrawing from medications

cpuusage

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I know that there is a 'Warning sticky thread' at the top of this section. But I feel it may be helpful to have a resource thread on this subject? Maybe this could be made into a sticky?

This is a very good Harm Reduction Guide that can be printed off - Harm Reduction Guide To Coming Off Psychiatric Drugs & Withdrawal | The Icarus Project or here - Harm Reduction Guide to Coming Off Psychiatric Drugs and Withdrawal | Will Hall, MA, DiplPW

& associated Video - Coming Off Psychiatric Drugs: A Harm Reduction Approach to Medication Withdrawal | Will Hall - YouTube

For more information on psychiatric medications and withdrawal, go to Beyond Meds, Harm Reduction Guide to Coming Off Psychiatric Drugs and Withdrawal | Will Hall, MA, DiplPW, Mad In America | History, Science and Psychiatry, Coming Off Psychiatric Medication - Home, Peter Lehmann Publishing Berlin: Homepage, http://www.theicarusproject.net/comingoffmeds, and Journal of Psychiatric Mental Health Nursing http://bit.ly/wbUA6A.
 
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cpuusage

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WARNING

[Active Links in above web address/original article]

WARNING

This is a very old post. A more recent post that speaks about difficulties in withdrawal that might also be helpful is: Some thoughts on stopping psychiatric medications

Brief note to my readers — why I’m not available for correspondence.

New video: Coming Off Psychiatric Drugs: A Harm Reduction Approach | Will Hall

Just want to add a warning to this blog. So that it will be at the top of the page.

Withdrawing from psych meds is potentially DANGEROUS. (see this post too: Some thoughts on stopping psychiatric medications – things to think about before deciding if you should discontinue your medications)

Way back when I started my blog I understood withdrawal was risky. I linked to a paper by Joanna Moncrieff that makes plain as day the dangers. I said it was a scary paper and withdrawing is scary.

But it doesn’t have to be. If you do it right and if you’re lucky both. But people should be scared, if only to do it right so that they minimize reasons to be scared.

I am very very sick and I for the most part I followed the rules of psychiatric withdrawal—what few there are.

I did follow the 10% or less rule. Cuts of 10% of current dose no more than every two weeks. One drug at a time. That can still be way too fast. Especially if one has a long and complicated history.

I cringe at the thought of all the fly-by comments left by random readers, many of whom I never heard from again, blithely saying how they were coming off of multiple drugs in a matter of days, weeks or a couple of months….

Why did we never hear from them again? I hate to say it but it’s likely they failed. Short of people who have been on drugs for a short time, coming off drugs is potentially dangerous and should be done with great caution and conservatism.

I have learned the hard way. I’m extremely ill. My endochronological system is shot and I have some awful sort of withdrawal syndrome. I am debilitated in a way I wish on no one ever. This physical illness is seen again and again on both benzo and antidepressant withdrawal forums. The other drugs there are not big communities of people coming off of them, so it’s harder to know how common it is with the mood stabilizers and neuroleptics, but given information we can glean from smaller pools of anecdotes it can happen with those drugs too.

Doctors do not understand this phenomena. We must get support from one another and help educate our doctors.

At this point I trust a doctor who tells me she doesn’t know if she can help me a whole lot more than one who thinks they know what is going on. The most helpful professionals in my life have been learning about this with me. And those who thought they could help have all hurt me. And I see this again and again in the groups too. Doctors can be our greatest allies but finding one that is humble enough to learn with us is tricky.

Coming off of drugs is dangerous. It could make you crazy, or like with me, it can be physically disabling.

This site offers valuable insights and resources for withdrawal, but do yourself a favor and really get into the conservative tone of it. Don’t hurt yourself. Especially just because you’ve heard a few stories of people doing it stupidly and surviving it.

And call me a fanatic, it’s been suggested many times, but eating right, nutrition, spirituality, movement and meditation or some combination of similar self-care, will get you through. Don’t even try withdrawing if you aren’t going to support your body through these means. Your body has been ravaged by the drugs and needs special care.

And lastly, take note. I did not do this in days or weeks. I was not reckless by any stretch of the term. I was on six drugs and I’ve been at it almost six years. Most of you are on much less. So take as much time as you need and stay functional.

Some thoughts on stopping psychiatric medications – things to think about before deciding if you should discontinue your medications

Note: In the end it took me somewhat over six years to complete my withdrawal. It’s now 7 months later. I’m getting better, but it’s at a glacial pace. We do recover, in time and not everyone gets sick like this by a long shot, though it’s by no means unusual in the withdrawal forums to see this either.

Some of the folks I’ve met in the withdrawal forums,some of whom were just as ill as I am now have shared their triumphant stories of well-being and recovery here.

For information on the safest methods to withdraw from psychiatric drugs see here.

Tool box for coping with psychiatric drug withdrawal syndromes (and some chronic pain and/or illness too.)
 
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Rose19602

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You can access a web-site called : www.surviving anti-depressants.org through the toolbox link above.

I found this site very useful and dysautonomia - which is described there - relates to the symptoms I experienced on withdrawl. This was described at the time as neurocardiogenic syncope / vasovagal syncope and autonomic dysfunction. With the correct medical advice at the time I probably would have made a much quicker recovery. Instead I am being treated for health anxiety and depression....

x
 
T

Topcat

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Are there any articles detailing what withdrawal symptoms exist, and what could be confused for symptoms, or missed as a symptom.
Thanks.
 
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Are there any articles detailing what withdrawal symptoms exist, and what could be confused for symptoms, or missed as a symptom.
Thanks.
Have you tried some web searches? (1st Result - Withdrawal From Antidepressants: Symptoms, Causes, Treatments )

It's a very difficult & complex question. & there are not a great deal of people exploring & researching these areas, it's really only quite a few professionals & service users. Peter Breggin is good - Psychiatric Drug Facts with Dr. Peter Breggin - HOME

& I recommended his book before - Psychiatric Drug Withdrawal A Guide for Prescriber's, Therapists, Patients and their Families - Psychiatric Drug Facts with Dr. Peter Breggin - Psychiatric Drug Withdrawal

Also - Coming Off Psychiatric Drugs: Successful Withdrawal from Neuroleptics, Antidepressants, Lithium, Carbamazepine and Tranquillizers by Peter Lehmann

Also some of the work by Joseph Glenmullen (although I haven't read it) - The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and "Addiction" - & Coming Off Antidepressants: Successful Use and Safe Withdrawal. [Amazon]

& Coming Off Tranquillizers and Antidepressants - by Malcolm Lader

But try some Google/U-Tube searches for 'withdrawal from antidepressants' - comes up with a lot of results.

People are highly individual - we're all effected by a myriad of factors that impact overall health & experience (environmental & personal; stress & trauma, family dynamics, life history, experiences, our physiology, psychology, & overall health etc) . It's very hard to say what is an underlying condition & what is withdrawal effects - & also there are many different opinions & perspectives on it all. But there are a lot of peoples personal experiences & stories - especially on the forum that 'ME' has linked you to (& other places/Blogs etc like it). There are also a lot of ways & approaches of addressing & dealing with things. There is the information out there. I feel it's best to explore - start somewhere & build up a knowledge base. Maybe start by reading the 'Harm Reduction Guide'? Or the 'Beyond Meds' Blog.

For me; I feel that 'we' don't fully know with all these areas - 'we' don't really understand the workings of the brain/consciousness & drug interactions & withdrawal. Different people have found different things useful. I think that the best general advice is to find as much stability, support & healthy ways of dealing with everything as much as possible; get as personally informed as possible, look after yourself as best as possible, & if you feel it is wise to then try a very gradual & gentle withdrawal.

It's not the be all & end all, or something to beat yourself up over. Medications have a place & can be useful, some people are satisfied & feel very helped with psychiatry & medications - & others not so - & for some people maybe medications are very necessary. Some people can stop successfully & easily - & others can't. For whatever the reasons, I accept currently having to take a medication. It's an area that needs a lot of very careful consideration.

Maybe people are used to a very simplistic one size/quick fix approach to it all - 'your depressed; so take these anti-depressants - job sorted' - However the actual realities & areas this all goes into isn't simple. Mental health/the mind/brain/consciousness, psychiatry, psycho-pharmacology, alternative/holistic healing, etc - we're not dealing with simple areas - there aren't really simplistic answers.
 
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Unfortunately Topcat - I'm not sure that there are any easy answers/solutions to it all. It's very hard to get appropriate acknowledgement, help & support from the system & mainstream, & in a lot of cases I think it does require a lot of work, self knowledge/education, trial & error & perseverance. It also flies in the face of popular culture, the medical establishment to large degree & the psychiatric/pharmacological Industry - they all want to state/enforce - Your ill, you can't resolve it all, you need these tablets. It's hard to go against all that. But the facts are that there are many who do heal & recover medication free; it is possible & can be done - but there are no guarantees.
 
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Rose19602

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TC,
The symptoms I had, which my current psychotherapist said sounded like the symptoms a lot of people had were these. Obviously yours may differ:

Autonomic Nervous System:

Restless legs - quite extreme jerking particularly at rest
Excessive sweating
Hypoglycemia (like a hypo attack - triggered by low blood sugar, shaking, weakness, sweating)
Problems with saliva and tears (production drying up)
Brain sensations (jolts, sensation of freezing/stopping, zaps)
Slow bowel / peristalsis
UTIs / bladder problems
increased bleeding (menstruation related)
Weird speeded up dreams / like a cine camera running through my head
Greasy hair (excessively so)
Knotted muscles in throat and under chin
Jaw clenching involuntarily
Hypotension (low blood pressure)
Syncope (fainting)
Low blood volume
Muscle jerks (like parkinsons)
Nerve damage to my nose
Swollen sinuses when I cry that block my breathing.
Fatigue

Cardiac Symptoms:

Slow or fast heartbeat (mine was slow....told this wasn't possible...as tachycardia is the most frequently reported symptom)
Long QT syndrome / arrythmia
Weak irregular pulse

Psychiatric Symptoms:

Increased anxiety (this is the main one for me)
Feeling of unease / rising panic
Suicidality
Anger
Rages
Volatility
Depression
Oversleeping


I didn't have problems with any of these psych problems before (only mild anxiety/depression in the form of exhaustion / oversleeping / tearfulness.) I have experienced all of these emotions since.

My withdrawl lasted a long time (years) and things went badly wrong, so this is a long list and hopefully will not apply to you, because you will manage withdrawl carefully. If you google dysautonomia many of these symptoms are listed. You should be aware that the symptoms of withdrawl syndromes change over time and wax and wane. I started with rages / anger / volatile emotions, headaches, brain zaps and fatigue and then went into autonomic symptoms and heart symptoms. These changed over time and one symptom would dominate for months then slowly disappear. Some symptoms still appear under stress and during menstruation for some reason 5 years later, and I'm stuck with the heart problems.

Maybe this list explains why I am urging you to be careful. Withdrawl can be risky.

Hope this helps, take care
x
 
R

Rose19602

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For anyone reading this post please be aware that these symptoms were part of a withdrawl syndrome, and came about as a result of 7 years of AD usage (escitalopram 10mg) and what I believe was an inadequate withdrawl period of just 10 weeks.

None of it, as yet, has been medically proven to be down to AD usage or withdrawl. This is my opinion based on my personal circumstances, medical opinion at the time - which was never put in writing or confirmed and personal research.

Doctors in general were very keen to tell me that withdrawl periods are related directly to the half life of the drug (e.g. how long it is in your blood stream for.) This can be hours, days or weeks but certainly never extends to months or years. Current drug research has found a link between the drug I took (escitalopram) and heart health risk, but only at higher doses than I took. They tested it on people who had been on the drug for a short period of time. There is no research on extended use that I know of and escitalopram's efficacy has not been proved to be of use for a longer period than 12 months atm.

I would request that all of you please report any drug effects or withdrawl syndromes you experience to www.RxSK.org.uk or use the yellow card system. In this way a more reliable list of symptoms and experiences will be built up, and people affected by side effects and withdrawl syndromes will then be believed and their experiences validated.

I have been told that my experiences are down to health anxiety....e.g. I imagined them! I must admit there has been significant anxiety about my health over the withdrawl period, but is it really any wonder! I think that there is an unwillingness to find fault with the extent of research into the drug, and a tendency to disbelieve a psychiatric patient.

To my mind, to deny the existance of these symptoms is insulting. I would therefore ask you to please do what you can to improve doctor's knowledge of withdrawl syndromes with a view to improving the testing of drugs and making them safer for us all.

Thanks for reading
x
 
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|||ME|||

|||ME|||

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This is one of the most important topics, if not the single most important, for board like this and I'd like to thank cpuusage and MissKitty for their contributions already, this is something very close to my own heart and life. I urge anyone wishing to withdraw from psychiatric drugs who is not undergoing a medical emergency caused by the drug they are on to do a slow and gentle taper. I'll add more about what that means in practice when I get chance. This is not an aspect of your healthcare you want to play with.
 
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|||ME|||

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I've got quite a lot to add here. I hope to be able to edit this post or get mods to do it for me when I've had chance to write a few things I believe will be of use to anyone attempting to withdraw from psychiatric drugs so they are available easily when people come to this thread. Hopefully that doesn't sound too pompous. I've done a lot of looking into this.
 
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|||ME|||

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Again:

Taper by cutting present dose by 10% per month (so 1000-900-810-730mg and so on).

Any problems hold off on reducing further or reinstate last dose (depending on severity), stabilise, cut by lower than 10% in future.

This is by someone who knows an awful lot about this stuff on tapering:

_______________________________

Understanding what TAPERING means.

But prescribers all over the world, including the vast majority of psychiatrists, are actively injuring people by not understanding even the basics of TAPERING.

It’s a lie that withdrawal syndrome is mild and lasts only a few weeks. It can be very severe and last for years. It amounts to iatrogenic neurological dysfunction. The risk of withdrawal syndrome can be reduced by TAPERING.

TAPERING means a gradual, progressive, systematic reduction in dosage. The consensus among peer support sites is that 10% is a rate of dosage reduction that minimizes withdrawal symptoms.

People who are sensitive to dosage reductions may need to taper as slowly as 10% per MONTH, calculated on the last dosage (the amount of decrease gets continually smaller). People who are very sensitive may be able to reduce by only a fraction of a milligram per month or longer.

Does this seem onerous? Psychiatric drugs are tremendously powerful. Read case histories here

If a person does not have the self-discipline to taper at 10%, even reductions of 10% per week are safer than decreases of 25% or more at any interval.

(NEVER skip doses to taper — this is an old wive’s tale going around among doctors. It’s second only to cold turkey in eliciting terrible withdrawal symptoms.)

Cutting up tablets, using liquid preparations, and customized prescriptions from a compounding pharmacy are a few ways you can accomplish gradual tapering.

.... I’ve got hundreds of pages of information about tapering here and symptoms here Journal articles are here

I spend hours every day giving people tips about tapering.

Let’s stop pretending that neuroleptic withdrawal is a black box. There is actually a great deal known about it. There are some big lies — that withdrawal syndrome is trivial and lasts only a few weeks is the biggest ... Many people who believe they’ve relapsed after withdrawal are actually suffering from this ["post-acute withdrawal syndrome"]

Prolonged withdrawal syndrome from psychiatric drugs is largely denied by psychiatry. David Healy is one of the very few authorities who have warned about it.

There is no information about success and failure rates, as you mention above, because proper systematic TAPERING is so infrequent.

... Very few psychiatrists know how to taper. I wish I were exaggerating. This is the only list of such resources that exists and it was incredibly difficult to find them. (If you know of a doctor knowledgeable about tapering, please write me at survivingads at comcast * net)

Here’s what patient advocates need to do to provide a safe avenue off psychiatric drugs: Educate themselves and doctors about TAPERING.
 
|||ME|||

|||ME|||

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Common question on this topic is how to taper by lesser amounts than the tablets/capsules come in ...

Useful links:

Check can be cut, google search for people doing this will usually say.

Using a digital scale to measure doses - Tapering - Surviving Antidepressants

Or (check it's stable in liquid - ask there if in doubt)

How to make a liquid from tablets or capsules - Tapering - Surviving Antidepressants

- Hassle, but not as much hassle as getting ill.

____


Also for general info on tapering

Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants
 
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More words from Altostrata, just to show some sources where the 10% taper schedule is supported:

The 10% taper I suggest, which involves calculations down to the fraction of a milligram, is advised in many sources: The Icarus Project Harm Reduction Guide; Mind UK's Making Sense of Coming Off Psychiatric Drugs; Dr. Peter Breggin's 10% taper method; NHS Advice: Benzodiazepine and z-drug withdrawal - Management; Gianna Kali's Withdrawal 101 on BeyondMeds.com; and most peer support withdrawal forums.
It's a figure which is inconvenient because it's not in the interests of the companies that produce these drugs to provide them in denominations which encourage people to take less when they start, and get off them once they have. They are businesses, their decisions are based on profit!

Safe tapering schedules will involve some way of reducing in smaller increments than the tablets or capsules are produced in.
 
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