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Patients Describe Challenges in Discontinuing Psychiatric Medications

     

Many people prescribed psychiatric medications for mental health conditions stop taking their medication; some research suggests that more than 70 percent of patients stop taking psychiatric medication.

A group of researchers in California wanted to better understand why and how patients stop and what happens when they do. They surveyed a sample of 250 U.S. adults who recently had a goal of stopping one or two psychiatric medications they had been on for at least nine months. The study looked at the experience of stopping medication, it did not look at the long-term outcomes.

discontinuing-medications

Study participants had been taking psychiatric medication for a diagnosis of depression, bipolar disorder or schizophrenia or other psychotic disorder. Most had been taking medication for many years, 70 percent had been taking medication for more than nine years.

The top reason for wanting to stop taking medication, cited by three-quarters of study participants, was because they were concerned about the long-term side effects of the medications. Other top reasons included wanting to know themselves without medication, having learned about alternative approaches, feeling better without medication and finding the drug was not useful or not working anymore.

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People used different approaches to stopping medication. About one-third discontinued gradually over six months or more; about one-third stopped over one to six months. About one-third stopped in less than a month, and half of those did so immediately (“cold turkey”).

For many the process of stopping as physically and emotionally challenging. Even with the more gradual discontinuation, most people reported significant withdrawal symptoms. The top withdrawal reactions mentioned were changes in sleep, psychological effects (such as increased anxiety), difficulty with emotions, sadness/tearfulness, fatigue, flu-like symptoms and memory/concentration problems. Although most people reported some type of withdrawal effects, more than 80 percent of those who stopped medication were satisfied with their decision to discontinue.

The study respondents noted several self-care approaches they found helpful during the process of stopping medication, including:

  • Self-education (books, Internet research)
  • Being outdoors
  • Getting sleep
  • Expressing feelings
  • Being with pets or animals
  • Physical exercise

They also identified a variety of sources of helpful social support, including friends, family and Internet support groups for people discontinuing medication.

About half described the process of discontinuation as a collaborative decision with their prescriber and just under half (45 percent) said their prescriber was helpful in the discontinuation process. About a quarter of respondents didn’t tell or stopped seeing their prescriber and 16 percent stopped against their prescriber’s advice.

APA President Anita Everett, M.D., says people should “be aware of potential effects of stopping medications, such as flu-like symptoms or uncomfortable feelings of anxiousness or irritability.” Everett adds, “while it may be tempting to just stop taking a medication, I encourage people work with their psychiatrists to stop medication gradually.”

Reference

Ostros, L, et al. Discontinuing Psychiatric Medications: A Survey of Long-Term Users. Psychiatric Services in Advance. 2017

     

AnxietyDissociative DisordersBipolar DisordersSleep DisordersDepressionHoarding DisorderOCDPersonality DisordersSomatic Symptom DisorderSchizophreniaPostpartum depressionAddiction

 

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