Planning your withdrawal, things to think about
The following things are important to think about in the reducing of
medication process: The rate of reducing medication, the alternative
ways of managing mood, thoughts and behaviour and recruiting social
support for the 'coming off' / reducing process.
How quickly do I reduce my medication?
We suggest you always reduce one medication at a time. Reduce your
medication gradually as a general rule. This is because research seems
to suggest less withdrawal difficulties if one reduces one's medication
gradually. The French Canadian Psychiatric Medication Reducing project
('Taking Back Control' ) has been running now for eight years. They
suggest 10 percent reductions. If you have been on a medication for
just a few months medication can be reduced at a minimum rate of one
week, as long as withdrawal difficulties have subsided. Someone who has
been on medication for a number of years is suggested to take more time
with the withdrawal process taking for example 12 months to attempt the
10 percent reductions.
What alternative ways can I develop to manage my mood and thinking?
It is important to develop different ways to deal with difficult
thoughts and feelings that may come up. Examples of strategies people
have found helpful are, Relaxation, Meditation, Yoga, Tai Chi, Massage,
Reflexology, Herbal Medicine, Bach Flower remedies, Homeopathy,
Acupuncture, Eating more healthily, Creative expression (e.g. Art,
Painting, Drawing, Drama, Poetry, Music, Dance, Singing) Spending time
in nature, Walking, Gardening, Sport, Gym, Circuit training, Swimming.
The psychological problems that the medication may have been prescribed
to address may also resurface. So it is important to deal with these,
prior to during and after the withdrawal process. Journalling, talking
with friends, support groups, counselling or therapy are all good ways
to understand and process suppressed emotions and make sense of
difficult thoughts and behaviours.
Who can I recruit to support me in this medication reduction process?
It is important to have some supportive people around you for this time
Health professionals who are anxious about the reduction process may
need persuading that this is a venture they should support you with.
Take time to collect evidence (e.g. about harmful health effects of
being on the medication long term) and explain the reasons for wanting
to try a reduction programme. You can try involving a supportive
friend, relative or advocate in negotiations with the health
professionals working with you. In Hebden Bridge, West Yorkshire,
England we have set up a 'coming off psychiatric medication' support
group. If you would like advice on ways of setting up such groups
contact the us via this web-site.
Choosing to come off psychiatric medications should be your decision
and your decision alone. Once you have come to this decision it is
essential that you plan how you will come off, who can support you in
this, anticipate and have a back-up plan should you run into obstacles
and be aware of other resources that could help you in this process.
After all, you are taking responsibility for the outcome of the withdrawal.
To help you plan your withdrawal we suggest you think about and try to
answer the following questions or discuss these with someone you trust
or someone who can support you as you withdraw from your medication(s).
It may also be worth considering;
- Why did you start taking the medication(s)?
- How do /you/ understand your distress at the time?
- Are the reasons for your distress still present?
- What did you expect the medication(s) to do?
Were they effective / meet your expectations? If not, why not?
- What were the attitudes/reactions of people around you to taking the
- How long have you been taking your medication?
- Have you ever tried to come off/reduce your medication(s) before? If so
how did it go? How did you go about it previously?
- Why are you taking your medication(s) today?
- Can you imagine life without medication(s)?
- Do you have any fears or concerns about coming off your medication(s)?
If so what are they?
- What are your experiences of taking the medication(s)? (You may want to
use the headings; mind, body, relationships with others,
difficulties(e.g. voices) recreation/work etc.)
- How's your sleep? What's normal for you at the moment?
- Diet- what do you normally eat and how much?
- What do you do for fun? How often, when, with others?
- Relationships that are important to you?
- Social activities (work, family, hobbies, friendships)
- Home environment
- How is your physical health at the moment? (may be easy to think about
strengths and weaknesses)
- How is your mental health at the moment? (may be easy to think about
strengths and weaknesses)
Once you have had chance to think about these things and you have
decided that you still want to come off your psychiatric medication(s)
it may be worth considering keeping a diary commenting on the above to
keep a record for yourself of how well the process is going. By keeping
a record it will help you hopefully to identify early for yourself if
you may be getting into trouble or may need to consider the rate at
which you are reducing or just stop reducing for a while.
It is not surprising to assume that when you start to reduce your
medication some of the problems/experiences you had which led to you
initially starting the drugs may re-surface. What would you do if this
happens? Who could you turn to for support? Are there any other
alternative therapies you could try to alleviate the distress?