The slowness of slow tapers (safer withdrawal from psychiatric medications)

Below I’m sharing an article written by Rhi Griffith for the withdrawal board, Surviving Antidepressants. It is republished here with her permission. 

Certainly this is something anyone with trouble tapering and withdrawing from psychotropics should consider — a very very slow taper. Rarely are people able to have such patience but it can clearly help and often it will be the only way one is successful. To be clear, without further clinical research we can’t ultimately know exactly what goes wrong with tapers when people fall iatrogenically ill — especially relatively slow ones that still go bad (mine took 6 years after all and I’m very physically ill anyway.  The argument could perhaps also be made that I should have doubled the time). Frankly it may or may not have been the pace of withdrawal that was the problem for me. I was, in fact, already sickened by the drugs before I even started the withdrawal and that is not unusual. That said it’s always worth considering and paying attention to what your body wants and needs when you’re doing a taper and certainly far too many people taper too quickly and that is very clear. Rhi says in the piece below:

The greatest disadvantage to getting tapering advice from the Internet is that most people are giving advice based on their personal experience. Since personal experience varies so widely, one person’s advice alone, based on what worked for them, may be absolutely the worst advice for you.

Absolutely true. I would hasten to say the reverse is also true. The greatest advantage of the internet is that if you hang around long enough you see very clearly that many different things work for different people. That in fact there are never two journeys that are alike. In life and in withdrawal both. Find your way. 

The slowness of slow tapers — by Rhi Griffith

I post here on Surviving Antidepressants and (sometimes, not as often) on BenzoBuddies. I’ve spent a lot more time over the past years working on benzo forums other than on this one, though. And one thing I see a lot there, is people who are in a hurry to get off their meds as fast as they can. More dangerously (in my opinion) I see people urging other people to get off as fast as they can.

While I understand the desire to get off these drugs fast, I don’t think there’s enough discussion of the possible benefits of an extremely SLOW taper.

Last week I saw a reference on another forum to a man who, after many attempts and much disability, is doing an extremely slow taper off 25 mg of Valium, expecting it to take him up to 12 years to get off. I felt myself sigh with relief when I read it. I wish I could find him and talk to him. Sometimes I feel so much like the lone voice in the wilderness about this (especially on the benzo boards, less so here).

I’m working my way off five meds after 20 years of polydrugging and med changes. I now expect it will take me about eight years to get off them all, and I also suspect I may need to stay on a small dose of one of them (Lamictal) even longer than that, although, crossing my fingers and knocking on wood, maybe I won’t. I’m not just goofing off or being silly. I’ve been tapering for 28 months now. I’ve seen how my body reacts. I’m basing my estimate on concrete information.

What I’ve seen is that how much these meds affect people, and how hard it is to get off them, is highly variable. My therapist has seen lots of people come off ADs and she says their experiences absolutely run the gamut (from effortless to total hell) even with identical drug histories. (The greatest disadvantage to getting tapering advice from the Internet is that most people are giving advice based on their personal experience. Since personal experience varies so widely, one person’s advice alone, based on what worked for them, may be absolutely the worst advice for you.)

I feel like it’s important to introduce the possibility of multi-year tapers to people who are approaching tapering–especially if they’ve failed previous attempts or have a history of difficult times with med cuts or med changes. It’s no fun to hear, but it’s worth wrapping your mind around. I can’t tell you how many times I’ve heard “taking years to taper off is just unacceptable to me” or the equivalent. So, what, it’s better to stay on a med or meds for the rest of your life, than to spend years tapering off?

And how many stories do we all hear, of people who’ve tried over and over again to get off meds, and have to reinstate, but have never tried an extremely slow taper with long holds? In the long run so many people spend years trying to get off the meds, suffer, are disabled much of that time, end up hospitalized, et cetera, and in the end they don’t save any time at all.

I don’t feel great during this long taper, I have to keep my activities and my life more limited than I want to, but at least I can hold down a job and I have good spells (after holds) and I do have a little bit of a social life. I hate it that my life will be constricted like this for years, but I know that for me the alternative is great suffering and being too disabled even to work or function at all.

And I want doctors to hear about it too. In all the reading I’ve done I’ve only ever heard of a tiny handful of docs telling someone it might take a years to get off a drug. Even Dr. Breggin recommends a pace that would put me in the hospital, and he’s pretty conservative for a doc (I think he says, what, 10% every two weeks?–yeah, if I went that fast you might as well just send me to the ER right now.) **

(editor: Breggin does allow for instances where one must go more slowly, but certainly, that is not underscored much in his writing and I’ve mentioned that elsewhere on this blog as well)

I’m not saying everyone will have to take this long. I think like Alto Strata says elsewhere, it’s a bell curve distribution, and I’m over on the slow end. But I think people need to know that the slow end exists and if their body is telling them that’s where they need to be, they need to know it’s okay and it can be done and they shouldn’t feel like there’s anything wrong with taking it as slow as they need to.

And maybe, if they’ve had a hard time in the past and so far haven’t really considered an extremely slow taper over years, it’s something they should seriously consider.

So there ya go. 🙂

See community comments on this post at The Surviving Antidepressants withdrawal board

More: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up

More by Rhi Griffith on Beyond Meds:

●  Trellis: this is your brain on (psych) drugs

●  GABA/glutamate system and how it might work with benzodiazepines and Lamictal