Medication Tapering/Withdrawal

In an interview with MIA, Dr. Horowitz discusses his recent article on why tapering off antidepressants can take months or even years.

Nobody told me what it would be like when I first stopped taking antidepressants. The worst is definitely over, but I’m still experiencing some lingering side effects. When the hyper-arousal to sights and sounds kicks in and my head starts buzzing, I’ve learned some ways to cope.

After long-term use, most people are going to have serious symptoms when stopping SSRIs. Many people are going to have transient, mild to moderate difficulty and some are going to end up falling down the akathisia rabbit hole. That is a long, difficult drop.

In the first systematic review of withdrawal problems that patients experience when trying to get off SSRI antidepressant medications, researchers found that withdrawing from SSRIs was comparable to trying to quit addictive benzodiazepines.

A variety of scenarios of social and economic collapse have gone through many of our minds since Election Day. Insurance companies and pharmaceutical companies want to keep people on drugs, but what if there was no government subsidy for those who can’t pay?

Researchers from the City College of New York and Columbia University published a study this month testing the hypothesis that people diagnosed with schizophrenia treated long-term with antipsychotic drugs have worse outcomes than patients with no exposure to these drugs. They concluded that there is not a sufficient evidence base for the standard practice of long-term use of antipsychotic medications.

A new update to the NICE guideline for depression suggests providers discuss long-term, severe antidepressant withdrawal symptoms.

Rock climber, author, and MIA Blogger Matt Samet discusses his experience becoming addicted to, and subsequently coming off of, benzodiazepines.

Revealing the false information provided about psychiatry should cause any thinking person, patient, thought-leader or politician to wonder: “how many otherwise normal or potentially curable people over the last half century of psych drug propaganda have actually been mis-labeled as mentally ill (and then mis-treated) and sent down the convoluted path of therapeutic misadventures – heading toward oblivion?”

My study, in which I slowly withdrew people from prescribed antipsychotics and antidepressants, found that it is possible to decrease both spending on psychiatric drugs and patients' chronic exposure to them. In general, the drug-reduction process was well-tolerated and well-accepted among those treated.

Effects of discontinuing SSRIs and SNRIs reported on an online forum indicate significant and long-lasting withdrawal symptoms.

An analysis of medical records in the UK reveals that the use of certain antidepressants for depression is linked to a heightened risk for mania and bipolar disorder. The research, published this week in BMJ Open, found the strongest effect for serotonin reuptake inhibitors (SSRIs) and the antidepressant venlafaxine.

It was the first time in my Klonopin journey it occurred to me the problem might not be inherent in me. The problem might actually be the Klonopin. Convinced my very life was at stake, I made the firm decision to get off the stuff once and for all.

My doctor insisted that my symptoms could not be associated with withdrawal – they had to be symptoms of an underlying condition. I have since learned from legitimate sources that protracted withdrawal syndrome from benzodiazepines can intensify long before it abates, with some symptoms lasting for years.

A new study by Peter Groot and Jim van Os has found that tapering strips help people successfully discontinue antidepressant medications.

A new special issue brings together articles exploring the harmful effects of simultaneous multiple medication use.

In a couple of weeks, I may see some of you at the MIA Film Festival. I am honored to be on a panel called “Re-Thinking Psychiatry” with two esteemed colleagues. In advance of the festival, I decided to write about what has been most central in my own “re-thinking”: my basic understanding of psychosis - when a person does not share consensual reality. It has been a fundamental re-think: how do we define it? how do we understand it? when do we intervene? how do we intervene?

Healing mental health issues through correct supplements as well as nutrition is, I believe, the final factor for me in my journey. This is possibly what was missing in my first attempt at coming off, and why my brain and body couldn’t handle the extreme anxiety I felt in December 2013. I am ensuring that as I prepare to taper off the Lexapro in 2015, my brain and body are being supported in every way possible.

It is hard to believe that a year has gone past since I posted Playing the Odds: Antidepressant Withdrawal and the Problem of Informed Consent. The feedback I received underscored the more controversial aspects of SSRI toxicity.  Common themes concerned the abrupt onset of new symptoms 3 to 12 months after stopping the drug, reinstatement of the drug failing to help withdrawal related symptoms, the possibility that withdrawal-related symptoms can persist indefinitely and concerns about using benzodiazepines to help with tardive akathisia.

In a major study, published yesterday in JAMA Pediatrics, the use of SSRI antidepressants during pregnancy was found to increase the risk of autism spectrum disorder (ASD) by 87-percent. Previous studies reveal that more than 13-percent of women currently use SSRI antidepressants during pregnancy.

Medically-induced harm—affecting tens of millions of people worldwide—has taken the field decades to take seriously.

Mixed-Methods study explores the experiences of antipsychotic discontinuation among service users.

Psych meds can not only put weight on regardless of how you otherwise care for yourself, they also tend to make people feel gravely lethargic and vaguely sick all the time. I could not exercise as I had before. Could not. It doesn't matter how much mental health professionals try to tell us that if we just exercised we'd be okay in the face of neurotoxic drugs that cause weight gain, because the fact is the drugs impede that capacity. This is not widely appreciated or understood and people on psych meds are again traumatized and made to feel guilty for something that is truly outside of their control as long as they are taking these medications.

Language is important. And when language dictates specific treatment protocols, it should be used with extreme scrutiny. Using the wrong words can put vulnerable people at risk—not only to their sense of self-worth, their sense of self-knowledge, and they way they are treated, but also to their health.

For a long time I have felt that there just isn’t a good enough and long enough study on the pros and cons of long-term antipsychotic treatment versus reduction and discontinuation in people who have psychotic disorders, including those who are classified as having schizophrenia. Moreover, there are increasing reasons to be worried about the effects of long-term treatment with antipsychotics. I put this case to the UK’s National Institute of Health Research recently, and proposed that they fund a trial to assess the long-term outcomes of a gradual programme of antipsychotic reduction compared with standard ‘maintenance treatment.’ The NIHR agreed that this was an important issue, and that a new trial was urgently needed. The RADAR (Research into Antipsychotic Discontinuation And Reduction) study officially started in January 2016.