The other day I talked to a friend who I hadn’t seen for quite a while. She told me that she had been prescribed Seroquel for sleep problems about a year ago. But when she started to read about it a couple months ago she got really nervous that it was causing her long term health complications and she stopped taking it – cold turkey – without tapering. She said she had been feeling increasingly irritable lately with huge mood swings and significant problem sleeping. She was worried that she might have some underlying mental health issues that needed to be addressed and she had made an appointment with a psychiatrist.
We talked for a while and I suggested that she could easily be still going through withdrawal symptoms from going cold turkey off seroquel. Though few doctors would suggest this, I pointed to an enormous amount of anecdotal information from people who had been through the same problem. I also warned her to be very careful in her conversation with the doctor as they often will prescribe another psychiatric drug, or perhaps a couple. She may be given a preliminary diagnosis of bipolar II, and be prescribed a mood stabilizer or an antipsychotic. Or she may be offered benzodiazapenes or a z-drug like ambien for sleep issues.
I wondered about our conversation afterwards and thought about the countless amount of people who don’t tolerate their psychiatric meds and quit cold turkey. This common experience often leads to horrendous withdrawal symptoms that are easily mistaken for underlying “mental illness”. This can lead to new diagnoses, increased dosages and polypharmacy. And then people get really stuck. It is challenging to taper off of one drug but tapering off multiple drugs are an extreme test for most people.
Cold turkey off psychiatric drugs can seem enormously tantalizing for some people who are completely fed up with the side effects of their medications. Perhaps they are tired of feeling tired. They sleep much of the day away. Or they have lost sexual desire, gained weight, developed diabetes, can’t think properly and are easily confused with poor memory. The simplest solution seemingly would be to throw away the pills. But invariably within a short period of time, raging withdrawal symptoms will emerge such as panic attacks, sleeplessness, derealization, somatic pain, brain zaps and perhaps suicidal feelings.
When we as peers, friends and therapists recommend very slow tapers, it is out of respect for the enormous power of these drugs. We have seen the immense suffering that people go through who try to rip off the bandaid and find themselves with a worse wound. Tapering is not a science but there are some general guideposts. Drop incrementally by very small amounts, no more than 10 percent. Give yourself time to adjust to the new dosage, at least 2 to 4 weeks.
Self care through this process is deeply important. Like any illness, the body needs plenty of rest and good nourishment. I really can’t stress this enough. Good nourishment can help reduce the symptoms of withdrawal. My general rule is to avoid foods and beverages that tax the nervous system such as alcohol, caffeine, sugar and processed foods while encouraging eating a whole foods diet where meals are cooked from scratch. By taking any additional burden off of the body and strengthening the body through whole foods, the nervous system has the ability to manage the major changes taking place.
Sometimes the deepest gift of this process is the one of learning to slow down. Quick fix drugs have not cured emotional distress. And quick cold turkey tapers have not removed the burden of the great changes in biochemistry brought on by the drugs. The only way “out” is to surrender and move very slowly. The gift is in learning how to rest, how to cook nourishing meals, how to take long baths and how to breathe deeply. In our societal rush for greater efficiency and greater speed, we have chosen a type of medicine that promises quick answers to complex problems. When we get injured in that process, the true healing comes when we slow our pace and begin paying attention to the smallest detail. How does that small taper make me feel? How does that food change my mood? What can I cook that will nourish me the best? What is the quality of my breath right now?
Through slowing down and paying attention during a psychiatric drug taper we learn what our body really needs to heal. We learn strength, patience, perseverance, and ultimately we learn greater self-love. And that can be a great gift even in the midst of great pain.
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.
Thank you for pointing these issues out, Jonathan. I had the adverse withdrawal symptoms of brain zaps, odd dreams, and odd sexual side effects from a “safe smoking cessation med” / actual dangerous antidepressant misdiagnosed as “bipolar.” The first neuroleptic given resulted in a “Foul up” confession in my medical records (I had no family or personal history of “mental illness,” except a grandmother who was briefly made ungodly sick by an old neuroleptic – she was psychic, but only psychotic when drugged). We left that psychiatrist, because he wanted to double the amount of the neuroleptic that made me psychotic within two weeks, and went to a neurologist.
He spent three and a half years creating anticholinergic intoxication poisoning with drug cocktails to cover up the misdiagnosis and “Foul up” (and the “bad fix” on my broken bone and medical evidence of the sexual abuse of my child, the misdiagnosing therapist’s goal).
Thankfully, some decent doctors and nurses handed over my family’s medical records and I escaped the apparently all too typical psychiatric lunacy fest. But not without last ditch HIPPA-made-possible malpractice cover up attempts (due to withdrawal induced super sensitivity manic psychosis / a sleep walking / talking problem one night) by the monster, Dr. V R Kuchipudi, and his Advocate Good Samaritan hospital psychiatric partner in crime, Dr. Humaira Saiyed. Read about this now FBI arrested Chicago doctor:
“Oh what a tangled web we weave, when first we practice to deceive.” What an enormous mockery the psycho / pharmaceutical industries have made of the mainstream medical industry. Shame on an industry that defames and tortures other human beings for unethical and greed inspired reasons, especially after hypocritically promising to “first, and foremost, do no harm.”
First and foremost, do no harm. Indeed.
Doubling neuroleptics, drug cocktails, heavy withdrawals from psych meds, anticholinergic poisoning, smoking cessation drugs that lead to manic states… How is this “no harm”?
“quick answers to complex problems” Exactly right. People expect the pill to solve their live problems and end up trapped.
Very good post thank you. I think one group that has suffered from this are children and teenagers who learn to hide their pills or spit out most of the drug laced juice secretly. This can leave them in an ongoing state of withdrawal and lead to all the devastating things you mentioned. It’s a horrible position to be in.
Because they are of course not always successful is what I mean. And they have no way of knowing what is happening to them. It’s very damaging to the emerging sense of identity. Even learning about withdrawal decades later can be a sort of aha moment. So that’s what was going on.
Absolutely. So many people get started on meds and then just stop them, not realizing how that messes with their brain chemistry. How many kids in foster homes cheek their meds? Spit them out? Then suffer from the ping pong effect of going on and off of them? This is therapeutic?
Wise words. The most aggravating is that a lot of people don’t choose to solve their problems with a pill. They are forced into it and have to hide and lie to get off those meds
Some are. Many don’t – they really believe they have a medical problem and pills will take problems away and psychiatrists are not exactly explaining the error in this thinking. When I was being let out from a hospital with a farewell prescription for 3 drugs I remember thinking to myself “I’d rather die that take any of that shit ever again”. But I was fortunate to be there only for a few days and still they managed to abuse and traumatise me and that despite the fact that they drugged me to the point I don’t even remember most of it (including talking to my legal council who didn’t speak any language I can communicate in but unilaterally decided that it isn’t a problem). So I guess if people are kept in hospitals for weeks and months on end they already emerge addicted. That would be my fate if not for my family.
One of the biggest problems with “Assisted Outpatient Treatment” is that civil commitments eventually end. And at that point, folks who have been placed on heavy neuroleptic cocktails may easily say “no more” and quit takingt the drugs cold turkey. They then end up back in the hospital for another trip on the merry go round. You are exactly right- the hospitals get them addicted… and then they suffer the consequences when they quit without tapering.
Its difficult to write too much about careful tapering. I’ve experienced disaster and belief in genuine chemical imbalance with cold turkey withdrawal. There was no information around years ago, and withdrawal syndrome was generally diagnosed as the reappearance of illness. I settled for coming off the most offensive drugs, and then took as long as I liked with the rest, because I knew I’d get there anyway. The main thing for me was not to fall back into the clutches of the system.
So very hard to get out once you are caught. Glad to hear you were able to find your way back…
…and once again drug companies have not done research on how to taper off these drugs successfully…why would they when they want people on them for life! Our FDA and CDC are in bed with the drug companies so we as American and World citizens are not protected from this completely out of control profit motive! We must set limits on Big Business.
One thing I have noticed also is how mental health providers often really don’t know about these discontinuation effects and will create a new diagnosis for the withdrawal symptoms that can take months (even years) to overcome in my experience.
Extensive research into tapering and discontinuation symptoms…now that would be amazing…especially if it was done by an independent body separate from the drug companies.
My son who was diagnosed with psychosis a couple of years ago was put on Olanzapine 2 years ago. His psychiatrist switched him to Invega when he felt like shit all the time. He had a seizure on Invega so she immediately stopped it and put him on Seroquel. I had just found out about Robert Whittaker and his books and I was appalled so when he started Seroquel we were able to stop him at 200mg where he could get to sleep and had no other problems. Psychiatrist was not too pleased but whatever.
After much research we went with the 10% every 2 week model (Breggin) for the most part. When things were going better than expected at the end my son decided to go from 100mg to 0 in 1 week. BAD DECISION. Within a month he relapsed (withdrawal induced rebound) and was back in the hospital.
Since then I have realized that it takes at least 4 weeks for a single 10% taper to take full effect and sometimes up to 6 weeks, at least for my son. Thanks to a couple of posts on beyondmeds.com things started to make sense (http://beyondmeds.com/2012/06/06/slowtaper/ AND http://beyondmeds.com/2013/09/18/listen-to-your-body-taper-plan/).
My son is now on risperdal and the side-effects for him have been minimal that he can tell. Of course we can see his lack of desire, his walk is affected, etc but this drug has a longer half-life than seroquel and he feels it is not as bad as the others so that is good. We are down to 2mg from 3mg and this time we are going 4+ weeks at a time and really focusing on making sure he levels off for at least a week before we move on. It has taken 5 or 6 weeks between every drop of .25mg so far. I believe this will be the key to getting him off successfully.
IMO, 2 weeks may be way too fast for most people. Why not stay on the safe side and really make sure and take your time?