Going Off Medications

Dear Kayla,

Not many people are aware that I have successfully managed to go off psychiatric medications. When people do find that out, they urge me for advice or suggestions. I actually do not have that many suggestions. But I wanted to tell you the little I have learned.

My last psychiatrist realized I was over-medicated. He took me off some psychiatric meds within months or a year or so after I started seeing him (I forget the exact time frame). At the time, I did not realize how unusual this treatment was. I have since learned that most doctors will insist their patients remain on medicines regardless of what the patient wants. I did not personally encounter that situation, and I am not sure how to advise people about it. I apologize for that.

After a while my psychiatrist decided to take me off my primary antidepressant. I knew it was not the right time - I despised the place I was working at the time - but I was too meek to speak up. That was a considerable mistake. I grew increasingly miserable and ended up going back on a higher dose of the antidepressant than I was originally taking.

In theory, the doctor was supposed to wait a year after that before trying to take me off medicines again. Eight months after that failed first attempt I was in a much better job, feeling better about myself, and essentially told my psychiatrist, "Take me off these things now." He agreed on the condition that we go slowly. I think (it was about five years ago and I don't remember all the details perfectly) we started at a dose of 300 mg and reduced it by 75 mg each month. When we first started cutting the doses it would take a day or two for my body to adjust and then I would be hit with depressive symptoms. I would need to withdraw from activities as much as possible and figure out ways to cope. After a few days both my body and my mind would start to adjust and I would be able to function more fully. Usually after a month I would be more than ready to reduce the dose again.

One time I asked to postpone our scheduled dose-reduction because I was dealing with considerable external stress and knew that I could not deal with both issues at once (the changes while reducing the dose and the external crisis). That proved to be a very wise decision. After two weeks I was able to continue going off the medication. I think if I had tried to keep the schedule I would have relapsed.

After a few months I started being able to anticipate and plan for dose-reduction problems ahead of time. After that it grew much easier.

My antidepressant was the most difficult medicine to stop taking. There are a few lessons I can give you from my story: (1) Do not attempt to stop taking medicines unless you are reasonably satisfied with your present life. I think waiting a year - the psychiatric recommendation - is excessive, but you need to be fairly happy with what you are doing and what you are feeling at the present time (2) Go slowly and give your mind and your body time to adjust (3) Don't hesitate to postpone reducing the dose if your life circumstances change and/or you have a crisis. Going off medicines is difficult enough. If you add outside stress it can be overwhelming.

I hope this is helpful.