If you’re feeling tired all the time and struggling with negative thoughts, your doctor may tell you that you’re depressed and offer well-intentioned help in the form of an antidepressant. The dominant medical orthodoxy regards antidepressants as safe and effective for the treatment of major depressive symptoms, under the default assumption that these medications rebalance the serotonin levels in the brain.1 Combine suffering with the promise of a quick fix, and we have an epidemic of prescription-dependent individuals identified with their mental illness labels.
Antidepressants are notoriously habit-forming. If you reach a point of minimal return, or significant side effects, you may want to part ways with your medication, only to encounter weeks of withdrawal symptoms including flu-like symptoms, brain fog, increased agitation, panic attacks, palpitations, and/or hair loss.4 This is when some doctors might tell you that your withdrawal symptoms are proof you must stay on your meds, rather than acknowledge the physiologic dependency these medications induce. Withdrawal can sometimes be a years-long struggle.5
But what do we really know about the withdrawal process? Most of the literature focuses on the indications and benefits of psychotropic drugs, to the neglect of exploration of the process of medication discontinuation. With withdrawal symptoms so understudied, how can we effectively support individuals through medication cessation? Could there even be clinical goals beyond medication initiation or cessation… perhaps inclusive of the reclamation of vitality?
Twelve patients move beyond psychiatry
Published in the peer-reviewed journal Advances in Mind Body Medicine, a recent publication by myself and coauthors Alyssa Siefert, Emily Whitson, Leiah Kirsh and Virginia Sweetan is the first case series of its kind to document the methodology employed in the successful discontinuation of a range of psychotropic medications. The objective was to gain a better understanding of psychotropic drug withdrawal and the use of holistic support interventions to provide long-term mood support.
These 12 patients were split into two groups: A, in which patients came to me for psychotropic medication tapering and B, in which patients were seeking mood support for protracted withdrawal symptoms.
But both groups were treated with individualized regimens over several months, with those in group A slowly reducing weekly psychotropic drug dosages under my supervision and both groups being treated with holistic approaches.
These treatments focused on three several critical concepts:
- Neuroinflammation, mood, and the gut-brain axis
Resolution of neuroinflammation and sending the autonomic nervous system a “signal of safety” is the principal tenet of the approach described. Nutritional optimization contributes to the resolution of blood sugar imbalance, nutrient deficiencies, and antigenic food reactions, with a focus on gluten and dairy which can lead to leaky gut syndrome. Detoxification strategies included coffee enemas, which have been demonstrated to help synthesize glutathione, a potent antioxidant with a critical role in cellular detoxification functions. Lastly, meditation, specifically the Kirtan Kriya yogic meditation practice, helped increase patients’ mindfulness and sustain mental health recovery.
After the initial thirty day protocol, up to four years later, these patients went on to enjoy medication-free status, symptom remission, and a shift in mindset toward the prioritization of self-discovery and self-insight in their lives.
In her follow-up two years after her tapering, patient CO from Case 3 said, “I’m doing really well, actually. I feel more energy, my mind feels more clear, and I am more like my true self than I have been in years! Since cutting gluten years ago and following Dr. Brogan’s protocol I have not had any symptoms of anxiety (ruminative thinking, intrusive thoughts, etc).”
Patient IU of Case 6: “I feel well; knowing that my process is not over, that I’m still learning and changing. Even when times get hard, when some pain that was buried a long time ago in my childhood shows up for no apparent reason, I have many tools now to handle it and I trust that it will go away.”
Proof there is another way
One of this study’s most interesting features is that it focuses not just on weaning patients off the psychotropic drugs, but also on how to sustain remission. Without resolving the root cause of initial symptoms, weaning off medications would be unsustainable. By treating both mood symptoms and comorbid chronic illnesses, the treatments used in this case series demonstrate the benefits of integrating holistic and conventional medicine in psychotropic drug tapering.
It’s studies like these that remind us that symptoms can be a meaningful opportunity to attune to lifestyle changes that lead to optimal health through the resolution of evolutionary mismatch. The protocol outlined in this study represents a self-implemented treatment approach with the capacity to resolve medication dependency, psychiatric labels, and an experience of oneself as “sick” for life, disrupting the allopathic perspective that mental illness is a genetic pathology that results in life-long chronic disease.
With this publication, the medical literature now reflects that radical healing from medication-treated symptoms of ‘mental illness’ is, indeed, possible.
- Castrén, E. Is mood chemistry? Nat Rev Neurosci. 2005 Mar;6(3):241-6. https://www.ncbi.nlm.nih.gov/pubmed/15738959 ↩
- Levine, H. (2018, September 24). Can Your Medications Cause Depression? Consumer Reports. https://www.consumerreports.org/drugs/can-medications-cause-depression/ ↩
- Chouinard, G, & Chouinard, V-A. New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal. Psychother Psychosom 2015;84:63-71. https://www.karger.com/Article/FullText/371865 ↩
- Shelton, R. C. Steps Following Attainment of Remission: Discontinuation of Antidepressant Therapy. Prim Care Companion J Clin Psychiatry. 2001; 3(4): 168–174. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181183/ ↩
- Stockmann, T, Odegbaro, D, Timimi, S, & Moncrieff, J. SSRI and SNRI withdrawal symptoms reported on an internet forum. Int J Risk Saf Med. 2018;29(3-4):175-180. ↩
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.