John Grohol at Psych Central wrote an article about withdrawal from psych meds in response to an email exchange he and I had in which I encouraged him to cover the very serious issues with psychiatric drug withdrawal…well, the conversation has been started but the severity of the problem has simply not been addressed…for example… Continue Reading →
The over-prescribing of potentially dangerous pharmaceuticals is rampant throughout all of medicine, not just psychiatry. I’ve written about anti-acids before, but I’m sharing again since the New York Times has done a feature article. It’s always nice to get a bit of back-up from the mainstream media even if they’re generally late to the party… Continue Reading →
When you reduce or quit a psychiatric drug, you may experience withdrawal symptoms.
Withdrawal symptoms are due to an absence of a medication at a level to which your body has become accustomed. They are an adverse effect of psychiatric drug use. When the level of the drug is reduced, your body notices it and tries to compensate, creating withdrawal symptoms. Withdrawing faster will increase withdrawal symptoms….
We need to keep in mind these are MICE studies. The mice are unable to voice concern about side effects. There is no way to assess their quality of life while they are being treated with the drug and before they are sacrificed to examine their brains.
Below I’m sharing an article written by 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. Rhiannon says in the piece below:
In many ways, withdrawal syndrome is the opposite of adrenal fatigue. — In withdrawal syndrome, the theory is that the brain is sending erratic “fight or flight” signals to the adrenals and the adrenals are obediently responding with adrenaline and cortisol, as they are designed to do. — The normal diurnal cortisol cycle may be exaggerated, as we see when people wake up with panic or anxiety due to the morning cortisol spike. However, there may be waves or surges of cortisol on and off throughout the day, felt as waves of what we call neuro-anxiety, neuro-melancholy, or neuro-panic (they seem to be coming from the body instead of the emotions), as well as other symptoms of autonomic upset such as palpitations, dizziness, and brain zaps or tingling. … [click on title for the rest of the post]
We believe that, for a minority, the risk of severe withdrawal is so great, a very conservative approach to tapering to protect everyone is called for.
Many people seem to be able to taper off psychiatric medications in a couple of weeks or even cold-turkey with minor withdrawal symptoms perhaps for a month or so. Doctors therefore expect everyone can do this. However, it seems a minority suffer severe symptoms for much longer.
It is unknown how large or small this minority is. You may very well be in it. You cannot know how your nervous system will respond to a decrease in medication until you try it.
As the “chemical imbalance” theory wanes, the “neurogenesis” theory justifying antidepressant prescription arises.
The “chemical imbalance” theory spawned countless scholarly and scholarly-seeming articles and books as doctors nodded solemnly over their brilliant biological insights into the brain and emotions. Unfortunately, these insights have been demonstrated to be based on bogus research, wishful thinking, and a bandwagon effect stoked by pharma money.
How embarrassing for psychiatry’s intelligentsia. But there still has to be a rationale for prescribing antidepressants, so they came up with something else.
Now we have the “neurogenesis” hyperbole, with its corollary that would have depression as a degenerative brain disorder. If “chemical imbalance” doesn’t exist, there has to be some fundamental flaw in the brains of people who are unhappy, right?
Antidepressant withdrawal syndrome itself has nothing to do with the mythical imbalance of serotonin, norepinephrine, and dopamine that antidepressants are supposed to treat. It is autonomic damage: Disinhibition of the locus coeruleus and the glutamatergic system, which develops in the context of serotonin receptor downregulation, a recognized consequence of antidepressant use.
For some people, it takes a long time for the serotonin receptors to correct. Without adequate serotonergic participation, other systems take over and establish a dysfunctional homeostasis.
The underlying issue is autonomic destabilization, which can be caused by any psych drug. They all act on the CNS, no matter what their micro-action. The neurotransmitters involved are almost irrelevant except, I believe, when they’re GABA. I’m no benzo expert but I suspect benzo withdrawal causes a different kind of autonomic destabilization because the GABA system lacks the redundancy of the others and when GABA is knocked out, recovery paths are more limited. (My suspicion is that simultaneous withdrawal from benzos and other psych drugs might be the worst.)
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