I came across some comments that Stuart Shipko MD, a practicing psychiatrist, made on a forum and thought discussing what he’s saying could be helpful. Below the excerpt are my thoughts.
There are people who can pretty much stop taking the drugs whenever they want with little or no problem. The percentage of people who stop on their own with little problem is not known, but anecdotal in my practice, this seems pretty common. A lot of patients have tried to taper or stop their drugs and found it to be too uncomfortable, so they continue to take their drugs, despite being clinically asymptomatic. Some unfortunates taper their drugs, go into ‘withdrawal’ and restarting the drug does not improve the situation….
…I used to feel that anyone on the SSRIs or atypical antipsychotics who is no longer symptomatic would be better off stopping the drugs. Now I am not so sure. The problems unleashed when slowly tapering drugs can be severe and difficult or impossible to reverse. Even if patients get past the withdrawal symptoms, within the year these ‘withdrawal’ symptoms may recur – or worse.If ever there was a need for research on a subject, this is the topic. Absent such research, it is easy to recommend against starting the drugs, but for people who are on the drugs for a number of years, it is difficult to compare the risks and benefits of stopping. (see more here)
It’s not always a good idea to come off psychiatric drugs…the push to do it no matter what is irresponsible. I’ve said it before on this blog but I’m not sure people hear it. People tend to read what they want to see I find.
That’s not to say I saw another way for myself…I didn’t…and often there is no other way. People simply get really sick ON the drugs and the only way to get healthy again is to stop them and let the body heal. Most people do recover in time. I still have no regret for having come off the drugs even as seriously crippled as I am. The alternative was not more attractive for me and that remains true. But I do not assume that is the case for many and maybe even most people who have been on many drugs for many years. Really, I generally avoid making assumptions about the needs of other people regardless of how long they’ve been on psych drugs. People have the right to choose. Always.
So, even though we now know these drugs are toxic and dangerous it’s not always a black and white situation when it comes to discontinuation. Scenarios will vary with every individual.
It gets very complicated once people have been on psychiatric drugs for a long time. And to make matters worse there is often nowhere safe to get help when one decides they’d like to make the transition. The fact is even the doctors who know the drugs are dangerous are mostly at a loss to help those of us who’ve become iatrogenically ill in any meaningful way.
So, to put it bluntly, it’s stupid and cruel and hypocritical to make people feel like it’s an obvious decision to come off drugs no matter what. No one is a winner in this game and no one, whether they take drugs or not is superior to anyone else.
If people choose to take the risk of coming off medications I have a page on what I’ve come to call “safer” withdrawal. Withdrawal is inherently risky, but there are things we can do to make it as safe as possible: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up
Many people feel better than ever once they’re freed of the medications without having to get very ill. And for those of us who do get ill, most of us too eventually find that life after recovery is better than ever. That said, while we are ill we often don’t know whether we’ll ever be healthy again and frankly I’m still in that boat and it’s not pretty. Also without the full-time care of my partner I would be destitute and institutionalized. This is no small thing! I am comforted and inspired by many people who’ve gone before me and healed, but I don’t imagine that this is a wise or possible choice for everyone.
One place where I was very explicit about the dangers of forced withdrawal was when I responded to an article about taking people off of benzos as a matter of policy and the inherent risks involved in such an undertaking:
We need to start drugging people less and educating people to the alternatives to medication early on in whatever treatment and care they get to cope with their emotional distress, so this problem of how to manage withdrawal will just go away with the next generation.
People need to be told the truth so that if they choose medications they know what the risks are. None of us who’ve ended up sick were able to make such an informed choice. We in fact were often implicitly, if not explicitly coerced, while being told that not taking medications was in fact much more dangerous. That’s just not true for a very large percentage of folks taking these drugs.
Using medications in crisis is altogether a different thing from long-term maintenance care which is simply not necessary most of the time. We have a highly drugged population on our hands taking neurotoxins for many years at a time and we need to change that. There are many ways to cope with, heal and transform emotional pain without using high risk medications long-term, but right now there are not effective means of teaching people how to avoid medications and learn these other methods.
And for those of us who grew up in the age of pharma and are already long-time users? We need compassion and patience and support, so that we might free ourselves if that makes sense, or, at the very least minimize harm by perhaps taking as little drug as possible. Whatever makes sense for someone after being on drugs for decades and that’s going to be different from person to person.
Of course more than anything much research should be done to help people who’ve been harmed, but that’s not likely to happen any time soon.
More on this subject:
● Some thoughts on stopping psychiatric medications – pros and cons to coming off
Update 2016: It’s become clear to me that whenever it’s possible that it’s helpful for folks who’ve not begun withdrawal and have the time to consider a carefully thought out plan to attempt to bring greater well-being to your body before starting the withdrawal. That means learning how to profoundly nourish your body/mind and spirit prior to beginning a withdrawal. For suggestions on how to go about doing that check the drop-down menus on this blog for ideas. Anything that helps you learn how to live well can be part of your plan. That plan will look different for everyone as we learn to follow our hearts and find our own unique paths in the world. Things to begin considering are diet, exercise and movement, meditation/contemplation etc. Paying attention to all these things as you do them helps too. The body will start letting us know what it needs as we learn to pay attention.
*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. Do not assume your MD will know how to do it either. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems This is why it’s good to educate oneself and find a doctor who is willing to learn with you. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up