The Right to Be Informed: On the Importance of Understanding Psychiatric Drug Dependence, Tolerance, and Withdrawal Prior to Starting a Taper
Navigating psychiatric drug withdrawal can be a grueling, terrifying, and even hope-draining process — especially when you’re feeling unsure of what, exactly, is happening to you. When I came off my “med regimen” of lithium, Lamictal, Abilify, Effexor, and Ativan back in 2010, I was lucky enough to have access to a lot of support from my family — but none of us had access to a solid understanding of how these drugs had been affecting my brain and body and what this could mean for me mentally, emotionally, and physically were I to come off them. In fact, to my recollection, I wasn’t even aware that psychiatric drug withdrawal was a “real thing” — let alone know what it might look and feel like, or how long it might last for.
In part, my lack of awareness was due to what was likely my Harvard-trained psychopharmacologist’s own ignorance on the matter. (There is a glaring lack of clinical research into psychiatric drug withdrawal, and often the reality of withdrawal is not even acknowledged or is outright denied in the medical and mental health systems.) In part it was due to the absence of easy-to-find, accessible resources on psychiatric drugs funded by sources other than the pharmaceutical and mental health industries. (Often, the first hits that show up on internet searches about psychopharmaceuticals come from sources that stand to gain profit and power from their widespread use.) In part it was due to how deeply I trusted in and relied upon my “treatment team”, whom I saw as experts over me, my mind, my suffering, and my life. (As a good, compliant psychiatric patient, I never once thought that it might benefit me to question, challenge, or do further digging into what I was being told — after all, they were the trained professionals, not me!) And in part, it was due to the impatience I felt in response to a question I’d become consumed by earlier that year — Who would you be off your meds, Laura? — and the growing sense of urgency I felt in needing to find an answer.
The more I grappled with this question, the more determined I became to get these drugs out of my bloodstream. My next steps seemed simple and logical to me at the time: If I want to find out who I am off psychiatric drugs as quickly as possible, all I need to do is stop them as quickly as possible. What else is there to consider?
Unfortunately, there was much else to consider — and ignorance, in my case, turned out to be far from bliss. After finally (and, might I add, reluctantly and unhappily) agreeing to my request that he bring me off my medications, my psychopharmacologist told me that it would take five months to wean off my antidepressant, two mood stabilizers, benzodiazepine, and antipsychotic. I was wholly disappointed and unsatisfied with this proposed plan, thinking at the time that five months was an absurdly long taper timeline. I — and I’m assuming he — had not a shred of understanding that the truth of the matter was actually quite the opposite: coming off five psychiatric drugs in five months was in fact incredibly fast — essentially “cold turkey” — and thus highly risky and even possibly dangerous to my well-being, especially given that I'd been on medications for well over a decade.
And indeed, immediately after starting to withdraw, I was sucked into a vortex of mental, emotional, cognitive, physical, and spiritual agony that would take me years to move through — but I'll save the details of that story for future blog posts. (In the meantime, if you’d like to learn more about what a slow, risk-reducing taper rate actually looks like according to the anecdotal wisdom of the layperson withdrawal community, you can read Psychiatric Drug Taper Rates: A Review and Discussion.)
Getting Informed About the Effects of Psychiatric Drugs
Had I had access to reliable information, resources, and support, I would have likely taken a whole different approach to planning my taper off psychiatric drugs that would have likely felt far more manageable and much less agonizing. The first critical piece of information that I’d needed? I lacked a straightforward and honest understanding of how psychiatric drugs had been affecting my brain and body. This would have been essential information to have if I was to truly understand why five months was such a fast taper, and why it would have made so much more sense from a biochemical perspective to come off medications incredibly carefully and slowly.
We’ve created The Withdrawal Project’s Primer on Psychiatric Drug Dependence, Tolerance, and Withdrawal to help people access this very information. It provides a simple breakdown of how psychiatric drugs actually act on the central nervous system, what kinds of effects they can have on the brain and body, and what can happen when one decides to come off them — especially too quickly.
Many of us in the layperson withdrawal community have found that having a clear understanding of this issues allows one to much more carefully and thoughtfully plan out a psychiatric drug taper that is more likely to minimize risk and optimizes chances of success. Speaking for myself, I may very well have made the decision to taper off in a much slower fashion had I read the Primer prior to agreeing to a five-month withdrawal plan — not in spite of my desire to figure out who I might truly be off psychiatric drugs as quickly as possible, but specifically because of it.