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607502 tn?1288247540

Want to stop taking one or more meds - Read this !

We get fairly often a lot of people posting about getting off medications, I have done it myself I think, and too often we get the posts that start out "Have stopped my meds, now what" and go from there.  So it occurs to me that there is a need for a bit of common sense here when it comes to medications.  

First ask yourself why do you want to come off your medication / s ?  Are you feeling worse?  Better?  why do you think this is a good idea now.  Its important to do a reality check when considering this as, well, face it guys we are mentally ill.  We do not always think straight and rational so decisions that can affect your health need consideration.  Are there side effects you do not like?  Things seem to have stopped working?

Second thing to do is speak to your doctor.

Thats important so I'm going to repeat it.  Speak to your Doctor.  Theyre the ones who prescribed and they are the one's who need to know you want off the drug or drugs.  They are also the ones you need to contact about those side effects.  Too often on here I see cases where people have not read the drug information or they have read a web forum instead which is filled with horror stories (if you read about Lithium for example you can get some really good lies and mis-information to make things clouded and thats just one drug among hundreds and thousands) and panic or start blaming drugs for everything but yet have not called their doctors.

Your doctors is your first line contact and they are the ones you must speak to BEFORE stopping drugs.  BEFORE.  This is obvious because some drugs (SSRI's for example) have serious withdrawal issues and need to be tapered off slowly over a period  Some drugs (Some Anti Psychotics) can cause serious problems if stopped suddenly (Including Tardive Dykenisia in some cases) and the list goes on.  You should never stop a drug cold turkey unless you know what might happen and the best person to advise is your doctor.

The next question is What are you replacing this drug with?  Is there a need to replace it?  If its your Mood Stabiliser what are you taking instead?  If the answer is nothing then are you sure you are thinking this through?  These are just a few questions.

One other thing to watch out for is the "Natural Treatment" thinking which says you can replace all psychiatric meds with natural herbs and drugs.  These are not scientifcally proven and in some cases can be very dangerous (St John's Wort in particular) so if you are going off your drugs to take a natural supplement its a REALLY good idea to see your doctor.  

If you can answer these questions and you know what you are doing then you doctor can tell you about the withdrawl symptoms so you can prepare people around you for what is coming and you know how long to wait before starting a new drug.  Its vital that you do this because folks you do not want to be freaking out manic trying to find information on withdrawl from Drug X at 2am in the morning because you are worried about the symptoms you have now developed and if they are serious.

This is your life you are playing with.  Speak to your Doctor First

21 Responses
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607502 tn?1288247540
On usefull information the Black Dog Institute in Australia produces some good stuff and for those looking at drugs they can be REALLY good - you can find a pile of fact sheets here  :  http://www.blackdoginstitute.org.au/factsheets/index.cfm

In particular the one on "What to expect from a mental Health Consultation" is really usefull

Also they have a whole section for GP's which is excellent reading for us  :  http://www.blackdoginstitute.org.au/healthprofessionals/resources/thepsychologicaltoolkit.cfm  

This includes information on Omega 3 and St Johns Wort and most importantly there are 2 sheets - One on Anti Depressant Regimes and one on Mood Stabilisers that list all the common types, common side effects, cautions, monitoring, dosage information, half life and even pregancy and lactation - these are fantastic resources to have and look at as education tools.
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Avatar universal
You know I had printed out a list of a meds used for mood disorders, tonight i will research the pros and cons of each one then what i will do I will narrow it down my self.  Like i stated before I did a journal of all episodes of attacks that i had and life changing events. the journal is my own personal it is not shared, what i will do is go through it and list ever all the symptoms and when they occur since there is a pattern when they happen and will give it to the new pdoc that i find. That way we can work together and find mood stabilizers (that wont put me to sleep, zombie like and have suicidal) that works best for me.

:)
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629641 tn?1368569578
Ok, I admit it, I am guilty for doing this. Not often, but sometimes when I go off the wacky side, like if I'm manic or depressed, I will take myself off meds. When I'm manic, I feel so good, and I feel like I don;t need meds. When I'm depressed, I take myself off cuz I feel they arent' working, and I just give up.

I don't think I would be the only one tho. I can see how it can happen, cuz it happens to me when I'm not thinking straight.

Although I never had told my dr that. My parents usually noticed if I;m off meds or not within a week or 3 lol. Then they go backto monitoring me and watching me take my meds like a 5 years old.

But i never did it cuz of the side effects. I just did it cuz my head isn't screwed on right.
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607502 tn?1288247540
The big thing is choice - its informed consumption really and that includes doctors - I always say that if a doctor wont work with you or listen to you then find another doctor.

At the end of the day unmedicated does not work - it can work for years, hell I managed 15, but in the end everyone pays the piper sooner or later with the right combination of factors causing the wrong event - stress builds up, events build up and you get blindsided.

I say and have done this, if a doctor wont work for you then find another - this can be very true of pdoc's who can ride the whole god like expert factor as if it were a surfboard on Oahu - there can be an arrogance factor which leads to "Do what I say and only what I say" thinking in some doctors,older ones especially.  At the end of the day you are paying for their treatment.  If you dont think you are getting value find an alternative treatment.

This can be hard to do in public or medicaid systems but that does not mean you have no options - there are pretty much always options its knowing how to use them and thats where advocacy groups and patients support groups and people like our own ILADVOCATE and his depth of knowledge of the systems come in.  Use the resources around you ok.
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585414 tn?1288941302
I see your point but the best thing is not to be manic or depressed. That's what a mood stabilizer is for. Anti-depressents address depression only and if used in a person diagnosed with bipolar can worsen mania and are only used as adjuncts if there is treatment refractory depression. Anti-psychotics like Seroquel are sometimes used as a mood stabilizers and are sometimes helpful. However, if a person can't tolerate Depakoate or Lithium, Lamictal remains a good option. If not there are the other mood stabilizers I mentioned on that list. I'd say a general psychiatrist would have some knowledge in that area but if one isn't helpful you could obtain a referral to a mood disorders specialist. In the arena of mood stabilizers, there are many options available. Remember only Lithium was developed as a mood stabilizer first. All other medications were used as mood stabilizers off label originally. They come up with new options all the time. By working with a psychiatrist you'll find one that is helpful.
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Avatar universal
the medications i was on was depakote, 200mg, Imitrex, these was mainly for the migraines i have they seem more concern with the migraines because i normally get them on a everyday basis. they are intense too. I was also on Seroquel originally they were 25 mg because my old Pdoc told me to mix them meaning play with the dosage myself. for example if 25mg dont work make it 50, 75, 150 it was up to me. He told me to do this especially if I felt my mania start to rise. He told me to do this anytime of the day. then my dosage went to 200 that was way to strong so i just stopped them.

This new doc that i went to see in late Nov, (the one with the scheduling conflict) prescribe me Paxil but I dont want to take those thats why I wanted to see her earlier because I dont like anything with suicidal thoughts. . I rather be in manic phase then that depressed.  She said i would be closely monitored but how, I only see them once a month. I be lucky to get that.

So I am looking for another hospital or a private doctor I been looking for someone online.

Thanks for the info
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585414 tn?1288941302
Well what medications were you on? Maybe you could find another that was more tolerable. Here's a complete list:
http://www.psycheducation.org/depression/meds/moodstabilizers.htm
As for changing psychiatrists I'd say that is a definite. If you can only afford a clinic than you could change to another one but if coverage options permit a private psychiatrist that's a much better option and if you have concerns about coverage options then I suggest as I do to people your local independent living center:
http://www.ilru.org/html/publications/directory/index.html
Some clinics see people for 5 minutes and just give them a prescription. And its not always the right one at the right dose. A person needs a full consultation with a psychiatrist and a talk therapist as well. You are probably willing to give the idea of medication a second chance but perhaps my ideas would be helpful to get better treatment as well.
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585414 tn?1288941302
Well its a matter of seeing the forest for the trees. I have experienced the long term side effects of antipsychotics but I would never tell anyone not to take them. I think the issue stems from the past when they were used as behavioral control and the public still associates them with that. Regardless as I've said the anti-psychiatry crowd should focus their energy into new anti-psychotics in development that have a far safer long term side effect profile and I've signed up to their sites to tell them that but they never really responded. They are grasping at straws. Some people's psychiatrists don't tell them anything. Sad but true. I think the package insert on the medications or the medication websites themselves are reliable and tell you the exact incidences of what happenned in studies with exact percentages. And every medication including asprin causes a number of fatalities. Its the common ones to be looking for. And there are people with anxiety disorder who panic at the thought of taking medication entirely and are looking for things that won't happen. I do believe factual information presented in a non confrontational manner is the best way to approach that. I've spoken to mental health consumers in person about my disability and how to watch for it (as I've said Clozaril is an option should it occur) and they took it very seriously but never stated or acted like they would discontinue treatment although people on the internet who are anti-psychiatry misuse my disability to make that claim. And they never discuss how it should be treated when it occurs so they don't have the best interest of people like me in mind.
  And as for medications, I note they never speak about Stephen's Johnson syndrome from Lamictal. That's a one in a thousand chance. I took Lamictal and I know someone who got that and they needed a liver transplant. However, I would still take Lamictal (I couldn't tolerate it for other reasons) and I do suggest it to other people as an option.  Everyone who takes it knows to speak to your doctor at the first instance of a rash. I had that happen and it was just psoriasis. I was in a panic about it but better I knew that not just in case it had been the other. When the public thinks of anti-psychotics and Lithium they are focusing on an outdated mode of thinking like "One Flew Over the Cuckoo's Nest" and that movie/book is filled with stereotypes in itself and reflects the abuses of the mental health system of a long gone generation. They are the same people who say Prozac are "happy pills" instead of a treatment for depression. But when I see the public being misinformed in any manner I do try to address that and have.
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Avatar universal
I am guilty,  I am one of the ones that stop taking medications without talking to my doctor first. I stopped taking for one of how they was making me feel physically and emotionally. Now the type of doctor that I had back then was he wasnt the type to really listen to you he would just hand out drugs just because he could. He would never give a full evaluation of you but on documents he would say he did. He would give a child medication if the child ask for it. The medications that was given to me one of them put me to sleep for 16 hours straight would wake up for 2 feeling like a zombie and then go back to sleep. I missed school on a number of occasions and so did my son( for a week) and thats not good. I am in college and is almost finish. I have problems concentrating now so the meds did not help. Another medication that was giving to me I experienced memory loss with it. The only thing that refered me to my missing days is I was writing in a journal and i happened to read my last post in it and thats how i know what i did those missing days. Now I tried to switch that doc but they told me not. The supervisors told me to give him a chance and also because they was short staff.
Now I put the blame on myself also because of the fact I was not able to share everything with my Pdoc because I was not connecting with him. And if I dont connect with you I am not going to tell you certain things. Plus he wasnt like he was really going to listen anyway. Now the social worker that I talked to is the best, If he was able to prescibe me meds then it would be all good because unlike this p doc he seems to know what he is doing.

Now another reason I am skeptical to take meds now is my career choices. I wanted to do the careers I picked for a long time now so it is kind of bugging me when I hear I might not be able to do them because the stress my cause me erupt or something. But i cant see myself doing anything else.  I havent taken any meds since september 08. The things that seem to be keeping me in line is My Son, family, you guys :), writing my thoughts down and talking to my social worker. My anger and my bipolar seems to be under control so far without meds. But I may need to change the hospital that I was being seen at because they seem to be so unorganized. Now I went back there because I wanted to take your advice to see if there are proper meds for me. But everytime I go there, there was a system problem or schedule conflicts they apologize to me for that. But I am researching now to get the proper care that I might need. :)

SORRY FOR THE LONG POST!!!
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Avatar universal
wow!  I never knew you were an albino sloth!!!

Joking aside, that's a particularly good point to have made monkeyc.

:-)
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607502 tn?1288247540
Another thing to avoid is what a Time Magazine article recently referred to as google medicating or sympomoogling which is web surfing looking for symptoms of drugs and reading the long lists of of symptoms and side effects and thinking they are common or in fact true.

The trap with this is that you read a post on a web forum by someone who says "Drug X destroyed my [Insert body part or organ] and its evil" or "Drug Y caused me to [insert symptom, side effect or strange behaviour]" followed by 10 people with horror stories - this is VERY common with psychiatric drugs and it seems Seroquel, Lithium and Depakote seem to be the big winner in this stakes.

What you need to realise is that we have no way of knowing about these people, their cases, illnesses, treatment, drugs, personal habits or anything else so their information is at best part of a big picture - its not gospel.

So when it comes to information on your drugs the places to go are your doctors, the pharmacist, the FDA or country regulatory body and then maybe some reputable internet sites.

You can never trust the veracity of what is written on the internet - you don't even know anything about most people - I say I am a 37 year old guy from australia but I might be a 12 year old albino tree sloth from El Salvador for all anyone knows.  Which is kind of why I tell people to see their doctors.

Now where did i Put those leaves?
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607502 tn?1288247540
True that actually, my psychiatrist has told me he always hates it when patients start feeling really good and stable for a period of time because a good percentage invariably want to stop taking the medications that made them that way in the first place.

And I hear you on the Laing era psychs - that attitude was discredited years ago along with pure Freudian and Jungian psychology but it still seems to be around - the other side of the psychiatrist coin is the sedate and manage method which is very very prevalent in the older generations - 55-60 plus - of psychiatrists who came up through the profession using drugs like Clorazine, Haldol and the like and who equate 'sedation' with treatment for mental illness (a common thing once if you remember the old way of treating schizophrenics was to bomb them the hell out and insitutuionalize where possible.

If you see a psychiatrist mixing 5 or 6 meds in smaller doses then its almost childs play to guess the age of them and you know that the word sedate comes into their vocabulary - mixing multiple cocktails below theraputic dose may be useful in rare cases but ask why if your doctor wants to do it.

Always ask why?  why do I need this drug?  What will it do for me?  What are the side effects?

These psychs do not help, they actually contribute to the myths and bad feeling peole have towards the profession - thankfully they are becoming rarer but they have been replaced it seems, based on reading Im doing and seeing, with a younger generation dependant of scatter gun prescribing and quick fix thinking - this is equally worrying - I see some people in the circles i move in who have been on 4 or more Mood Stabilisers and or AD drugs in a year as their doctors move them around .  It takes time for a drug like that to work so flicking people around unless there are side effects is another sign for concern because it stinks to me of not knowing what they are doing.

Medical treatment is a partnership.  We need to be able to work with our doctors and understanding the medication options is a good idea and making sure they are working and telling people when there is a problem.
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585414 tn?1288941302
Well I would add to that from my conversations with a relative who is a doctor and my psychopharmocologist as well. From what they said to me the vast majority of hospitalizations are for people who discontinue medications. And unfortunately when someone is an elated or grandiose state from when they are manic they feel that their "reccomendations" supercede psychiatry and basically all known medical science and common sense as well. Obviously, if someone doesn't have a psychiatric disability and signed up to tell people to go medication then its a misuse of the site. But if they do have a psychiatric disability, it can be a symptom in itself. However, if they aren't telling other people to go off medication but saying they did it themselves and "feel fine" the important thing to do is not just to tell them to go back (which is essential) and make sure to reach them at that point (because they are likely hypomanic and if they continue at that rate, soon they will spiral into full blown mania) but to ask them why.
  We've all probably are guilty of stopping or lowering a medication because of side effects without asking our psychiatrist once in our lives. In having done that before recovery I can clearly explain to people why it was the wrong thing to do but the websites that discuss medication options give them some ideas to speak with their psychiatrist about. Its not just something you take to "stay out of the hospital". Its important and beneficial and for your recovery. As for following your psychiatrist's instructions its essential and sometimes they may agree about a particular medication. My neurologist had no problem with me going off the Tizanidine (which controlled both dystonic spasms and worked as a mood stabilizer, the Tenex has replaced it in both regards, they are alpha blockers like Clonidine which due to their side effects are used for mood stabilization but far from first line mood stabilizers) because it caused suicidal ideations but in discontinuing it all at once I had abnormal heart rhythms. That was a terrifying experience and that was last summer. I should have followed the titration schedule exactly.
  The only thing I can say on the part of psychiatrists is that they should be responsive to people's needs and calls during an emergency during titration and have a good working knowledge of available medications. And sadly there are still a few working psychiatrists in the profession from the R.D. Laing/Thomas Szasz era who believe people "don't need medication" one of whom is well known and people are fond of quoting as a "source" even though what he says is blatant misinformation. The essential thing is a good consumer/provider relationship. If someone is afraid to tell their psychiatrist how they are doing it may be their own paranoia or it may be just that they got off to a bad start with that psychiatrist or it may be that what they say is ignored. Regardless, here as in the outside world I hear the person out no matter how irrational they are as telling them that is obvious but it won't work until they realize it for themselves and surprisingly that's not as hard as you think. Off site I've encouraged people I knew to seek help and they didn't know they had a problem for a good part of their lives and were very thankful after.
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Avatar universal
Yes this is a good post especially with the number of people who have come on here recently saying they have come off meds or a trying to stay medicine free.

The Welcome Post already states quite clearly that nobody should come off their medication, unfortunately as the saying goes "you can lead a horse to water but you can't make it drink", is true with posts.  People often don't read previous posts whether they be sticky or otherwise.  A list of related dicussions shows up below the thread but I wonder how many people click on those either!?

Anyway what I'm really saying is Thank you to monkeyc for such a great post and that for those of us that have read it we can certainly lead the "horses" to it when they post about their non medication in the future :-).  I shall make a note of the link for future use.

As so many of us seem to be in agreement about such a worrying trend it is possible to create a health page about this which is a permanent "fixture".

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607502 tn?1288247540
Adel I think we have established you need a new doctor more than once now :)

To refine I guess there is an addendum to this which Adel has just really made a good point which needs to be noted down (thanks for that BTW as I had missed it)

If the reason you want to change meds is your doctor is not listening to you or not doing the job for you then change doctors FIRST.  Its going to be easier to see a new doctor when you are on medication than off them and a lot of doctors have limited patience with seeing a new patient who is unmedicated or refuses to take advice or meds - they have limited time and lots of patients and most just do not want to work with someone who is not interested in working with them.

If you dont like your doctor find a new one, you are paying for him or her.
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539549 tn?1315981662
be very careful
My only advice is to have a friend or family member stay with you to make sure your alright. I'm saying this because I have tried getting off my meds before and it royally screwed me up.
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574118 tn?1305135284
>>Second thing to do is speak to your doctor
I had a different experience. it's my doctor who said since you are Ok now we can stp the meds. I was happy of course. I bet i am the only case of this sort. I was OCD and was on 1mg risperidone, 2mg stelazin and 25mg anafranil. I was doing fine. But the stupid guy felt i would be happier if i stop them. Sure he was a shoemaker before reverting to medicine. So I withdrew from the stelazine, then risperodone without any problem in a couple of weeks and was left with the AD only. The guy agreed on this. and here i was psychotic and felt many crazy things, then all of a sudden the mania began. of course i rushed back to the risperidone and stelazine and stopped the AD but fell into serious depression. I came out of it by the AD again but of course kept the AP's. But it was too late now I became dysphorically manic on this combo and i added the seroquel and stayed like this since then. strange the OCD seems to disappear.

Monkeyc post is very clear and a good article that Bulldozer can refer to for new pts, i.e. it should be archived somewhere
adel
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585414 tn?1288941302
Yes I agree with that totally but as for one thing you said I'll just point out one fact since you brought it up. Tardive dyskinesia if it emerges when withdrawing an antipsychotic is because its masked. Raising the dose of the antipsychotic won't make it go away. It will just mask it again. All medical sites will confirm that. If anyone experiences that they should speak to their psychiatrist immediately and their psychiatrist will have them see a neurologist and if its diagnosed change them to Clozaril. The main issue with discontinuing antipsychotics is that you will of course become psychotic. But not right away. In 1993 when I was misled by this anti-psychiatry group to go off medication, when I stopped an antipsychotic and 1800 mg. Lithium cold turkey (!) it wasn't until two weeks later that I became fully psychotic. First I was hypomanic and I thought "I feel so much better" then fully manic and then incredibly psychotic. Rather not post what I did but the results were I had to go to the psychiatric hospital. One class of medications to be extra careful of is benzodiazepenes. I had permission in 1998 to go off Klonopin but I went ahead of the schedule my psychiatrist gave me to taper off it and I had full blown withdrawal symptoms. Its physically dangerous.
  And right now although I identify as "recovered" it doesn't mean "cured". I've never said that anywhere. Since recovery I've never altered treatment but one day I visited my mother's house and forgot to bring the glycine. I became as psychotic as I ever was and we hurried home to get it. It was a scary experience but it reminded me of something to tell other people. Just because you feel better doesn't mean your symptoms went away. They are in treatment. If someone has epilepsy they will need anti-seizure medications for life. And if they stop them it could be dangerous. People know that. But the same is true for psychiatric medications as well. And with discontinuation of treatment good judgment goes away as well. And the rest is downhill.
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561706 tn?1333947274
Monkeyc's provided some very good questions to ask yourself If you're considering quitting meds or treatment.  I hate reading posts where people report they've gone off without a docs consult.  

Psych meds usually take a few weeks to begin to show effectivness and I think many people don't want to wait.
So continue to post here if it helps, but always talk to your doctor when you're having problems.
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Avatar universal
oops I hit enter.

I can't imagine going off my meds,  I have such mood swings that I haven't had more then a day that I feel "normal".  My pdoc mentioned that I haven't been longer then a week without some level of depression. So to me these drugs are a life line to say the least. Even in my hypomanic phases, I know something is wrong. I think it's just better to keep tabs on oneself like you said, and if you don't feel a med is working, see your pdoc then do a possible switch, going it alone not only can be scary but dangerous!
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Avatar universal
Awesome post Monkey :) Thanks for posting, I couldn't have said it better, you rock!
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