|
Post by flyingcarpet46 on Dec 25, 2021 7:53:48 GMT
Good piece by James Moore.
|
|
|
Post by Admin on Jan 5, 2022 17:47:21 GMT
When Tapering Antidepressants, is Going Slow Always the Best Strategy? By James Moore -December 23, 2021 www.madinamerica.com/2021/12/tapering-antidepressants-slow-best-strategy/Istart this blog with an apology. There may be people reading who, like myself, look back with frustration and despair that they cannot change the years they spent dependent on antidepressant drugs or the approach they took when stopping. I recently passed my second anniversary of being off mirtazapine, a highly sedating, anti-histamine type drug. As for my progress in that time, all that I can say is that I still have a lot of healing to do. Some people commenting on my continuing difficulties point to how I tapered, particularly my use of tapering strips. However, I believe there is an important factor in difficult withdrawal that needs consideration, and that is exposure time. For those of us, again like me, who cannot turn back the clock, this can be painful to consider and for that reason, I apologise if this note upsets anyone affected. I first became interested in antidepressant withdrawal in 2016. This wasn’t by choice, it was forced on me, like so many others, because I became aware that the person prescribing my drug had no idea how to stop it safely. They only really seemed interested in getting me on and increasing the dosage despite my protestations that I felt worse while taking it. During my withdrawal, I became a willing member of a large group of people voluntarily providing support and encouragement to others navigating the complexities of getting off antidepressant drugs. While the vast majority of support group interaction is invaluable, I became aware of approaches that are potentially less helpful. Since running my discussion group, Let’s Talk Withdrawal, and being involved in many others, I have come to find that there are times when the individual nature of a person’s experience is ignored and they are all given similar advice. I have had people contact me privately to say that they were thrown out of other support groups because they didn’t want to rigorously stick to the “10% of the previous dose” tapering strategy that has achieved almost mythological status in lay communities. Ten percent of the previous dose is a good starting point to reduce symptoms but it isn’t right for everyone. The biggest problem with it is that it leads to very long tapers which increase the person’s exposure time to the agent that might well be causing their difficulties. There is a prevailing view that how you withdraw sets your future circumstances. That may be part of the equation but it is not the be-all and end-all. It is important to say that long-established withdrawal advice sites, including the Inner Compass Initiative and Surviving Antidepressants, do not advocate a fixed approach or a fixed reduction schedule. The advocates and supporters who advise at these sites know the complexities caused by polypharmacy and the need to tailor an approach to each individual. Sadly, the same cannot be said for all withdrawal advice given in online forums. Much of it comes from a good place but some advice is too restrictive and not given in full consideration of a person’s unique circumstances. The 10% per month of the previous dose is a suggestion, not a target. It won’t work for everyone, it will be too slow for some and too fast for others. We need to distinguish ourselves from naïve prescribers by being open to all methods of withdrawal and all speeds. As an example, for someone coming off a 20mg dose of citalopram (Celexa), a “10% of the previous dose per month” strategy will require them to take 29 months, over two years, to reach a 1-milligram jumping-off point. For someone who has been treated for decades, this seems sensible; for someone treated with the drug for a year or two years, the tapering might well double exposure time. People might argue that this additional exposure time is at a lower dose. This is true but, as we have seen from recent work on serotonin occupancy by Dr Mark Horowitz, many SSRI-type drugs retain much of their potency at low dosage levels. For example, looking again at citalopram, this drug will retain more than 40% of its effect at 5mg. On a 10% per month schedule, this point will not be reached until 16 months into the taper. It is difficult to say this without fearing that it may make some feel hopeless but a gradual withdrawal is not a magic bullet in avoiding problems during tapering or protracted problems afterwards. We do not know nearly enough about the many complexities in the withdrawal experience to know what is the right approach. However, by insisting that everyone follows a similar path, we might inadvertently be prolonging the suffering. Although it sounds glib, the right withdrawal rate is one that you find tolerable and one that doesn’t require major life adjustments to cope with. That is going to be different for different people and may also vary during the taper. Many will be willing to tolerate a more uncomfortable withdrawal period if they can limit their overall exposure time. It is very difficult to think of a way that this could be empirically studied as it would be unethical to potentially cause suffering by forcing people to comply with different reduction rates that didn’t meet their needs. The lack of a randomized, placebo-controlled study has been seized on by some psychiatrists as a reason to reject the need for gradual tapering approaches but it is hard to see how this can be studied other than with a large naturalistic, qualitative study that does not impose tapering strategies. I’ve known people who have been forced to take five years to come off a drug and thoughts of the speed of their taper and whether they have got it wrong occupies every given moment. Maybe that person would be better off reducing more quickly and getting to a stable position faster. I took 2.5 years to come off and, against the conventional wisdom, I speeded up as I got to the smaller dosages. Was that the right thing to do? Who knows? I will certainly never know because I can’t repeat the experiment a different way. Though I can’t prove it, I don’t believe that my continuing problems are a result of either the way I tapered or the time I took. I believe it is a direct consequence of spending seven years and eight months, including tapering, on a dependence-forming drug. At the time of my withdrawal, I was lucky to have the support of a helpful and much-respected psychotherapist. He tried very hard to motivate me to go quicker but my confidence failed me. The reason it failed was that I had been influenced to accept that the slower you go, the better you will feel and the less chance there is of long-term difficulties. Looking back now, my adviser was completely right. I suspect now that I could have come off in a year or less and been exactly where I am now but with 18 months less exposure time. Going through withdrawal yourself only qualifies you in your own experience, it doesn’t tell you a great deal about other experiences. If you find yourself in a support group that forces you to engage only in a certain way, then find another, more open, more welcoming group. There is tremendous work going on in the lay community and I stress that these rigid approaches are the exception rather than the rule but we need to best support the person withdrawing by delivering their needs, not our preferences. Another issue that those participating in support or discussion groups will often see is people arriving on the maximum dose of an antidepressant, having sometimes been labelled “treatment-resistant” because they didn’t respond any better as the dosage got higher. When a group of psychiatric researchers studied what they called ‘optimal’ antidepressant doses, they found that in the seven drugs they selected (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, venlafaxine and mirtazapine) “the lower range of the licensed dose achieves the optimal balance between efficacy, tolerability, and acceptability in the acute treatment of major depression.” Put simply, the long-standing recommendation by the American Psychiatric Association to “titrate up to the maximum tolerated dose” has been called into question by psychiatry’s research. As Peter Groot, developer of tapering strips, often reminds us, our approach to dosage when prescribing antidepressants is so limited as to be almost laughable. The standard dosages available for people are the equivalent of going to a shoe shop and being told “you can have any shoe you like but we only have them in size 5 or size 12”. Told this, we would rightly laugh at the limited choice and go elsewhere. Unfortunately, where antidepressants are concerned, there is nowhere else we can go. A 120-kilogram man will end up on the same dosage as a 60-kilogram woman with little to no account taken of their physiology. There may well be some prescribers who do take account of physiology in their prescribing but they are the exception rather than the norm. An athlete will end up on the same dosage as someone inactive, a pensioner will end up on the same dosage as someone in their twenties. Far from “precision medicine”, these standard dosages have been arrived at by looking at group averages in short-term trials. You might be lucky and fit neatly into one of these “dosage boxes”, but you are just as likely to be taking more than you need for a response. Many of you will have pets and will have taken them to the vet where you might get a prescription. Often you will find that the dosage is in milligrams per kilogram of body weight. Can we do that for our pets but not for us? The need for variable dosages and variable tapering strategies has never been more important. The number of prescriptions for antidepressants is rising fast; more people each day are being put onto drugs that they might have difficulty getting off. We are compounding the problems people have in tapering both by prescribing for too long without review and rapidly increasing dosages to the maximum suggested level seemingly based on guesswork. Then when the person finally realizes the limitations of the advice that they have been given, they are often side-lined by their prescriber or labelled “treatment-resistant” and left to fend for themselves. Thanks to the efforts of many professionals, activists, advocates and those who have experience, we are starting to make progress in responding to the challenge of getting off antidepressants. However, to make sure we help the many, we need a nuanced, flexible and open approach to helping people off the drugs. For some people, coming off in two years might turn out to be as problematic as getting off in two weeks. We are all learning as we go, but in contrast to mainstream psychiatry, we need to avoid a fixed view of the methods and timescales that people might choose to put their antidepressants behind them. *** Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own. James Moore www.letstalkwithdrawal.comJames has personal experience of psychiatric drug withdrawal and is a keen advocate for greater awareness of the need to taper safely. He hosts and produces the Let's Talk Withdrawal and Mad in America podcasts.
|
|
|
Post by Admin on Mar 11, 2022 13:39:55 GMT
CONFERENCE – Reykjavik, Iceland WITHDRAWAL FROM PSYCHIATRIC DRUGS Friday 6th & Saturday 7th May 2022 Online If you’d like to attend the conference, please register your interest by email at info@iipdw.org and we will keep you updated with our plans. This is the first conference of the International Institute for Psychiatric Drug Withdrawal, and will bring together international experts in the field, and leaders from many different countries. The three themes underpinning the conference are safe withdrawal from psychiatric medication, alternatives to psychiatric medication, and the need to question the dominance of medication in mental health care. Due to the ongoing coronavirus pandemic, the conference will be online. The main speakers have been confirmed: iipdw.org/
|
|
|
Post by Admin on Apr 20, 2022 10:14:05 GMT
Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults NICE guideline [NG215]Published: 20 April 2022 www.nice.org.uk/guidance/NG215
|
|
|
Post by Admin on May 16, 2022 23:54:16 GMT
auto-immune illness, chronic illness, withdrawal illness (how it’s all linked for me) beyondmeds.com/2021/05/20/auto-immune-illness-chronic-illness-withdrawal-illness-how-its-all-linked-for-me/I learned “auto-immune” meant my system was in over-drive all the time because it was fighting real infections. Western medicine says that auto-immune means the body is hurting itself. For me this was untrue. My body was fighting and waiting for me to start cooperating. Infections that are locked up in biofilm don’t show up on labs. It does not make them any less real. They become much more dangerous because the medical system denies their existence and tells many people with “unexplained” chronic issues that they are delusional. Shameful. Biofilm encased infections can vary from completely harmless/contained to raging insanity. Pharma in my instance (and the ensuing withdrawal illness) created outrageous opportunistic infections. Stuff in biofilm is, in general, anti-biotic resistant hence chronicity of all sorts can develop. I’ve never regretted giving up on getting diagnosed. What I’ve learned as an undiagnosed chronically ill person (auto-immune & “lyme disease”… View original post 575 more words
|
|
|
Post by Admin on Jul 22, 2022 13:29:40 GMT
A Method for Tapering Antipsychotic Treatment That May Minimize the Risk of Relapse Mark Abie Horowitz, Sameer Jauhar, Sridhar Natesan, Robin M Murray, David Taylor Schizophrenia Bulletin, Volume 47, Issue 4, July 2021, Pages 1116–1129, doi.org/10.1093/schbul/sbab017Published: 23 March 2021 academic.oup.com/schizophreniabulletin/article/47/4/1116/6178746Abstract The process of stopping antipsychotics may be causally related to relapse, potentially linked to neuroadaptations that persist after cessation, including dopaminergic hypersensitivity. Therefore, the risk of relapse on cessation of antipsychotics may be minimized by more gradual tapering. There is converging evidence that suggests that adaptations to antipsychotic exposure can persist for months or years after stopping the medication—from animal studies, observation of tardive dyskinesia in patients, and the clustering of relapses in this time period after the cessation of antipsychotics. Furthermore, PET imaging demonstrates a hyperbolic relationship between doses of antipsychotic and D2 receptor blockade. We, therefore, suggest that when antipsychotics are reduced, it should be done gradually (over months or years) and in a hyperbolic manner (to reduce D2 blockade “evenly”): ie, reducing by one quarter (or one half) of the most recent dose of antipsychotic, equivalent approximately to a reduction of 5 (or 10) percentage points of its D2 blockade, sequentially (so that reductions become smaller and smaller in size as total dose decreases), at intervals of 3–6 months, titrated to individual tolerance. Some patients may prefer to taper at 10% or less of their most recent dose each month. This process might allow underlying adaptations time to resolve, possibly reducing the risk of relapse on discontinuation. Final doses before complete cessation may need to be as small as 1/40th a therapeutic dose to prevent a large decrease in D2 blockade when stopped. This proposal should be tested in randomized controlled trials. discontinuation, withdrawal, schizophrenia, D2 occupancy, hyperbolic, dopaminergic hypersensitivity
|
|
|
Post by Admin on Nov 5, 2022 21:20:46 GMT
Anders Sørensen – Tackling Psychiatric Drug Withdrawal Through Research and in Practice "Coming off psychiatric drugs is more than withdrawal and chemistry, it involves other strategies." By James Moore -November 5, 2022 www.madinamerica.com/2022/11/anders-sorensen-tackling-psychiatric-drug-withdrawal-research-practice/On the Mad in America podcast this week we are sharing a special interview that’s being done as part of World Tapering Day. World Tapering Day is being held on the 4th, 5th, and 6th of November 2022 and it aims to raise global awareness of the need to safely taper psychotropic drugs. It has been organized by people with personal experience of the severe difficulties that can arise when stopping antidepressants, antipsychotics, or benzodiazepines. If you would like to find out more or participate, you can visit the website WorldTaperingDay.org where you can sign up for a range of free-to-view webinars. Our guest today is Anders Sørenson. Anders is a Danish clinical psychologist with a special interest in psychiatric drug withdrawal. He has undertaken research which assesses the state of guidance on psychiatric drug withdrawal. He has also paid close attention to tapering methods with the aim of identifying approaches which might make withdrawal more tolerable for people. In addition to his research work, Anders utilizes psychotherapy in his private practice when helping people to come off the drugs and we’ll get to talk about some of that in this interview. The transcript below has been edited for length and clarity. Listen to the audio of the interview here.
|
|
|
Post by Admin on Nov 5, 2022 21:35:59 GMT
|
|
|
Post by Admin on Dec 22, 2022 22:23:48 GMT
OUR AIMS Support research and practice-based knowledge that will facilitate safe reduction of and withdrawal from psychiatric drugs. Contribute to evidence-based practices for reduction of and withdrawal from psychiatric drugs, and facilitate their inclusion in general practice guidelines. Support the human right to informed choice with regard to psychiatric drugs. Promote practices that help families, friends, and practitioners support safe reduction of and withdrawal from psychiatric drugs, and take into account relational and social aspects essential to this process. IIPDW is committed as an organization to pursuing and embodying the values of social justice. As part of our work to support, research, and educate about psychiatric drug withdrawal, we see it as integral to uphold the values of anti-racism, gender equity, and support of civil rights for people who identify as LGBTQ+. iipdw.org/
|
|
|
Post by Admin on May 2, 2023 16:52:40 GMT
Global survey leads to new recommendations for deprescribing psychiatric drugs By Samantha Lilley -17/04/20230122 www.madintheuk.com/2023/04/deprescribing-antidepressant-psychiatric-drugs/New recommendations for deprescribing and tapering antidepressants, benzodiazepines, z-drugs, gabapentinoids, and opioids have been made based on input from service users and a global survey. These recommendations were recently published in the scientific journal PLOS ONE by a team of authors from the United Kingdom, including Ruth E. Cooper, Michael Ashman, Jo Lomani, Joanna Moncrieff, Anne Guy, James Davies, Nicola Morant, and Mark Horowitz. The authors not only documented the current state of deprescribing and tapering but also aimed to identify factors that contribute to successful outcomes for service users who go through the deprescribing and tapering process. “In the UK, a recent Public Health England (PHE) Report identified the scale of the prescribing of drugs that can cause dependence and withdrawal as a significant public health issue. It found that one in four adults in England were prescribed at least one prescription of a benzodiazepine, z-drug, gabapentinoid, opioid or antidepressant in 2017–2018,” the authors write. “In the USA, it is estimated that 10.4% of people are using benzodiazepines, and benzodiazepine-related deaths have risen, which has generated concern. The US Food and Drug Administration (FDA) updated a boxed warning for benzodiazepine medications to add information about the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions…In Norway, due to dissatisfaction with aspects of mental healthcare, including high rates of prescribing of psychiatric medication, service user groups successfully campaigned for the introduction (from 2015) of medication-free mental health services into national policy.” As websites like SurvivingAntidepressants.org grow in popularity, the need for shared-decision making in the prescribing and deprescribing process between patients and their practitioners grows, too. However, barriers on the prescribers’ end can create friction that may leave service users feeling disempowered and unheard. Thus, the UK-based authors crafted a research question designed to document the current state of deprescribing practices and to draft recommendations to improve them: “In deprescribing services, what are the common practices to support patients to withdraw from prescribed medicines of dependence?” To answer this question, the study’s authors surveyed 13 deprescribing services across various countries, including 8 in the UK, 1 in the USA, 1 in Norway, 1 in Italy, 1 in Sweden, and 1 in Denmark. Each of the included deprescribing services had to meet the following criteria: 1) the service was specifically designed to support patients withdrawing from prescribed psychotropic medications, and 2) at least one staff member could conduct interviews in English. A researcher with lived experience conducted structured interviews, and the study lasted only three months. The qualitative analysis of the structured interviews was performed using a rapid qualitative analytical framework. Most of the service users at the deprescribing centres were prescribed various psychotropic medications, with four centres targeting a specific combination of z-drugs, benzodiazepines, antidepressants, and antipsychotics. The interviews revealed the difficulties and complexities of tapering and discontinuing psychotropic drugs. For example: “It’s maybe hard to start a benzodiazepine taper if you haven’t got somewhere to live or money struggles.” “People still are very much told that they need, for instance, antidepressants because there is some imbalance in their brain. . .and then I typically used to say that the imbalance theory is very much of a myth which actually has not been possible to. . .validate.” “…if I’ve got a client who’s struggling, which I do quite often, I’ll ask them [peer volunteers] if they’ll join us in a Zoom session to give their experience, people want to hear it from the horse’s mouth, as it were, rather than some professional, it can sort of motivate them to make changes. . ..it works really well.” After coding, the results revealed that the most efficacious way to discontinue psychotropic drugs was to taper the medication slowly with patient preference and lived experience as the driver of the taper. The author’s direct recommendations for services are: Drugs should be tapered gradually using hyperbolic strategies. “This means that the steps by which the dose is lowered are made smaller and smaller as the dose decreases, for example, reducing the medication by 10% of the prior dose.” Tapering should be individualized, flexible, and use shared decision-making. Psychosocial support should be provided to patients during and, if required, after withdrawal. Lived experience should be integrated at all levels: people with lived experience of successfully and unsuccessfully withdrawing from prescribed drugs of dependence must be involved in the conception, development, and running of services. The broader context of a patient’s life should be taken into account. Dedicated deprescribing services for prescribed medications of dependence are necessary. The authors end their recommendations by substantiating their qualitative findings with quantitative findings: “Tapering medications gradually and slower at lower dosages is in line with the existing limited evidence and guidance on withdrawal strategies for a range of medications, including antidepressants, benzodiazepines, antipsychotics, opioids, and z-drugs. A systematic review found one trial demonstrated a 6-fold increased chance of stopping benzodiazepines for gradual dose reduction compared with routine care.” **** Cooper RE, Ashman M, Lomani J, Moncrieff J, Guy A, Davies J, et al. (2023) “Stabilise-reduce, stabilise-reduce”: A survey of the common practices of deprescribing services and recommendations for future services. PLoS ONE 18(3): e0282988. doi.org/10.1371/journal. pone.0282988 (Link) Editor’s Note: Part of MITUK’s core mission is to present a scientific critique of the existing paradigm of care. Each week we will be republishing Mad in America’s latest blog on the evidence supporting the need for radical change.
|
|
|
Post by Admin on May 2, 2023 23:44:47 GMT
|
|
|
Post by Admin on May 16, 2023 22:13:37 GMT
Ready to Quit Antidepressants? New Approach Helps Avoid Dreaded Withdrawal Symptoms www.madinamerica.com/2023/05/ready-to-quit-antidepressants-new-approach-helps-avoid-dreaded-withdrawal-symptoms/From Toronto Star: “A growing number of people are choosing [an] antidepressant exit route [known] as a ‘hyperbolic tapering’ protocol, a new way of thinking about SSRI de-prescribing, which takes into consideration ‘serotonin transporter occupancy’: essentially, how the drug actually works in the brain. One of the most ardent champions of hyperbolic tapering is Dr. Mark Horowitz, a training psychiatrist and clinical research fellow in psychiatry at North East London NHS Foundation Trust, who studies the neurobiology of depression and how antidepressants work. ‘The key thing is that doubling the dose doesn’t double the effect,’ said Horowitz, while pointing to a graph with a hyperbolic (sharp) curve that shows how the brain reacts to an increased dosage of an SSRI. ‘It goes up very steeply at low doses and it flattens out at higher doses.’ Horowitz explained, ‘When there’s not much drug around, every extra milligram has a big effect because all of the receptors are open.’ Since increased doses don’t have a linear effect, it makes sense that decreased doses don’t either. Horowitz said that a two-milligram dose can have half the effect of a 40-mg dose, as opposed to the one-20th you might expect. ‘If you step down from 20 to 10 milligrams, which is half the dose, there’s a small effect on the brain that people can usually handle,’ said Horowitz. ‘Going from 10 to five is a bigger effect and people often find a bit of trouble with it. But when they go from five milligrams to zero, it’s like jumping off a cliff after walking down a steep hill.’ Horowitz runs a psychotropic drug de-prescribing clinic in the U.K. He said that his email inbox was full of messages from people in North America asking him for help in designing a hyperbolic tapering protocol, since the guidelines here are still largely linear.” Ready to quit antidepressants? A surprising new approach promises to avoid the dreaded withdrawal symptoms The symptoms —emotional blunting, apathy, sexual dysfunction — often lead people back to the medication they’re trying to kick. www.madinamerica.com/2023/05/ready-to-quit-antidepressants-new-approach-helps-avoid-dreaded-withdrawal-symptoms/
|
|
|
Post by Admin on Oct 21, 2023 9:33:32 GMT
|
|
|
Post by Admin on Dec 1, 2023 11:29:06 GMT
The Drug Taper Paradox By E. Kent Winward -November 30, 2023 www.madinamerica.com/2023/11/drug-taper-paradox/My wife J.A. was on the couch in the living room crying and writhing in agony. It was the late summer or early fall of 2014 and I had no idea what to do. I called her then-psychiatrist and explained that I was worried for her safety. “How many clonazepam do you have?” he asked me. J.A. had been taking a 1 mg tablet of the benzodiazepine every night at bedtime for sleep. I checked and told the doctor that the prescription had recently been filled so the bottle was almost full. “Give her 8 mg,” he said. “Is that safe?” I asked. “Yes, it will calm her down and then we need to get her an appointment soon, so we can adjust medications.” I gave J.A. eight pills as per her doctor’s directive and told her they would help. And in that moment, the pills did help. She calmed down and eventually fell asleep. The eventual adjustment in medication was to prescribe J.A. dissolvable clonazepam tablets that she was to take PRN (pro re nata, Latin for “as needed”) whenever the anxiety or emotional turmoil became too great. Soon the little silver foil packets of clonazepam were stashed around the house, in the car, and in J.A.’s purse. For a while, I even carried a couple with me in case she needed them. At that point, we still did not know that the daily emotional upheaval was drug-induced akathisia. Clonazepam continued to be used as a calming agent throughout her withdrawal from the “atypical antipsychotic” Latuda in 2016. As J.A. and I have mentioned in earlier articles, the impact of that withdrawal was devastating. Clonazepam was used extensively; at its height, J.A. was taking up to 4-5 mg per day. Now, more than nine years after I first gave her that 8 mg dose, we are still tapering from clonazepam. We recently dropped the current daily dosage from 0.34 mg per day to 0.31 mg per day. Every time J.A. drops, we can’t help but brace for the numerous withdrawal effects that range from mild, to moderate, to severe. The taper process is incredibly slow and incredibly counterintuitive—just as she begins to feel better from the last dose drop, we know it’s time to do it all over again. This paradox is at the heart of psychiatric medications. Intense emotional distress is counteracted by a pill, so an immediate crisis is averted, but all of the underlying factors that initiated the crisis remain. So another pill soon needs to be taken. And then another pill is taken. The entire process becomes a slow-moving downward spiral until the medications have you so far down in a hole it can feel impossible to climb out. The process of withdrawing from these drugs is a slow climb out of that steep hole. A concerned family member or friend can only observe the process from the outside. When J.A. was in crisis in 2014, I reached out for help and the help I was offered came in the form of eight pills. The pills averted the crisis but did nothing to address the underlying cause of J.A.’s distress. In hindsight, I know her distress was caused by drug-induced akathisia from Latuda (among other psychotropic drugs she’d been prescribed). She was on Latuda because after years of taking Abilify, she had developed metabolic syndrome. After the eight-pill clonazepam crisis, the medication adjustment her psychiatrist made was to switch her to the (then) latest and greatest “atypical antipsychotic” (though the more accurate term is ‘neuroleptic’), despite the fact that this class of drugs all work in roughly the same way and cause the same metabolic dysfunction (among other side effects, including akathisia). For a year or so things appeared to improve; the lateral shift to a new neuroleptic seemed to be the right, albeit more expensive, move. Yet, the reprieve from the shift was very temporary as the metabolic syndrome continued and her daily neuroleptic-induced akathisia worsened. In 2015 and into 2016, I was still a believer in the pills and what the doctors said, but I was beginning to have my doubts. The pills seemed to help some things, but then, like clockwork, things would inevitably get worse. The search for the right “balance” of medications was like shining a bright flashlight in a completely empty basement. No matter how hard you searched, it remained empty. At this juncture, although I had doubts about the medications, the medical system and J.A.’s suffering left no room to raise concerns until her neuropsychologist saw that she was suffering from drug-induced akathisia. Prescribed psychotropic drugs are inherently paradoxical. A pill that’s supposed to calm or tranquilize comes with a warning that it can cause increased agitation. A pill prescribed to improve depressive symptoms comes with a warning that ‘worsening depression’ is a side effect. A pill prescribed to prevent suicide comes with a warning that it can cause suicidality. Unfortunately, after observing the paradox of these pills for almost eight years firsthand, the contradictions forced me to see the drugs’ ultimate inefficacy. When you first discover the pills don’t really work as advertised, the urge is to shout how damaging and ineffective the medications are, but that declaration is lost on the very people who need to hear it most. The warning is silenced by the occasional (and temporary) efficacy of the pills, along with the system that prescribes them. The pills do something, and for at least a moment, the pills may help. For those taking these pills, understand that family who may be unsupportive of you getting off of them may only see the positive side of what the medications do. The pills stopped your agony, if only for a moment—something your support person was incapable of doing on their own. If you are the support person, you may be missing the alternate agony the pills are causing your loved one. To successfully navigate these medications, we have to resolve the paradox of why the pills can make those who take them simultaneously better and worse. The Opponent-Process Theory With multiple systems and functions, nothing in the body happens in a vacuum. Everything that happens within our bodies was honed over centuries of evolution to keep the body alive and functioning. Introducing something from the outside, specifically psychotropic drugs, creates unintended and unforeseeable consequences. Optical illusions offer a glimpse into the complexity of these systems through our sense of vision. In 1878, a German physiologist, Ewald Hering, proposed something called “opponent-process theory” to explain color vision. The simple version of his theory is that humans see color because of three competing color systems. The competition between these systems is what creates our ability to see color. The vertically red striped circle shows how the process works. Stare intently at the red striped circle for at least fifteen seconds and then if you shift quickly to the similarly striped circle with only white stripes, you will get an image of a light green striped circle. It is a clear illusion of a green striped circle created by the sudden withdrawal of the red. rest in link.
|
|
|
Post by Admin on Jan 6, 2024 10:51:35 GMT
Withdrawal from Prescribed Psychotropic drugs Edited by Peter Lehmann and Craig Newnes www.egalitarianpublishing.com/books/withdrawal.htmlSynopsis Doctors, including psychiatrists, prescribe antidepressants, neuroleptics (“antipsychotics”), mood stabilizers, tranquillizers and psychostimulants all over the world, and, in most cases, without providing information about the risks of taking them and problems when stopping, for example, adverse effects, tolerance formation, bodily and psychological dependence and withdrawal symptoms. Nor do they tell people about ways to avoid or minimize the risks. In its report to the General Assembly of the United Nations, even the Human Rights Council’s Working Group on Arbitrary Detention demand assistance in withdrawing from prescribed psychotropic drugs for those who want to withdraw. This volume presents a collaboration of users and survivors of psychiatry (ex-patients), professionals, researchers, lawyers, and academics around the world committed to helping people understand the potential harm (including drug dependence) that prescribed psychotropic drugs can cause and how to safely reduce or stop taking them. The chapters include individual accounts of people who discontinued their prescribed psychotropic drugs, information about withdrawal groups, research data (especially about antidepressants and neuroleptics) and a commitment to relatively safe withdrawal that will offer hope to many people; those who want to help and those who want to withdraw.
|
|