What I’ve Learned about Tapering Psychiatric Drugs—A Holistic Therapist’s Perspective

About five years into my career in the mental health field, I began to truly realize the depths of corruption involved in the pharmaceutical industry. My eyes were first opened during a clinical psychology internship at a local psychiatric hospital. I saw the revolving door at the hospital with people stabilizing and then returning again a month later, polypharmacy or people being over medicated to the point of being unable to participate in therapy, and people of color being more likely to be forcibly medicated. My supervisors at the time all considered this to be the system functioning properly, but I was aghast and disillusioned at the lack of healing that was happening in an inpatient setting.

My first job after graduate school was another eye-opening experience that almost prompted me to leave the field. I was a research coordinator for an inpatient hospital involved with clinical research trials bringing depression drugs to market. I was completely shocked at what I witnessed in the industry-sponsored research trials. I witnessed the rubber-stamped FDA approval process for experimental drugs that had adverse reactions or no efficacy, yet were still approved after only a three-month follow up study. I saw people being included that did not meet all inclusion criteria and vice versa with the exclusion criteria. I saw data being thrown out that should have been reported. I was sent to trainings in nice locations with all expenses paid to learn how to do the “industry sponsored version” of the scientific method; their version was vastly different than the scientific method I was trained in at university level neuroscience labs.

The discrepancies, deceptions, and greed were hard for me to come to terms with and it inspired me to go into the field of therapy in order to offer holistic alternatives to traditional treatments.  The internal friction within me between what I was taught (or indoctrinated into believing) in graduate school versus what I witnessed in the field encouraged me to learn alternatives to the mainstream psychotherapy treatments.

I went on to study somatic-based therapies, yoga therapy, and holistic nutrition. After opening my private practice, one of my specialties was perinatal mental health, supporting women during pregnancy and postpartum. I witnessed hundreds of women being prescribed Zoloft at their six-week postpartum visit with their OBGYN who were later unable to stop the SSRI for subsequent pregnancies. They would follow their doctor’s advice to stop cold turkey, go into withdrawals, only to be put back on the SSRI and told it was a relapse of depression. I also began to notice developmental differences in the babies of women who had taken an SSRI during their pregnancy.

Another trend I noticed is that people with a diagnosis of PTSD are often over-medicated and none of the prescriptions were actually addressing or healing the trauma. Numbing the emotions and access to traumatic memories is not healing, it is a band-aid approach with many unintended side effects. This created another paradigm shift within my thinking, and I began to offer holistic support for those seeking to taper off of psychotropic drugs.

For the past six years, I have been supporting people in the tapering process, those in acute psychiatric drug withdrawal, and those in protracted withdrawal at an outpatient level. I work in conjunction with holistically minded MDs and NPs who are willing to write prescriptions for hyperbolic tapering. I help people who are tapering to address the underlying traumas that led them to psychiatry in the first place, and teach them somatic-based nervous system regulation, nutrition, and tapering protocols. It has become quite obvious to me that the chemical imbalance theory of depression is false and that it is actually the drugs that cause the chemical imbalance.

It has been inspiring to see more and more awareness growing around psychiatric drug withdrawal and hyperbolic tapering in the last few years. The tides are changing around this once very taboo topic. Thanks to Mark Horowitz and David Taylor for creating the Maudsley Deprescribing Guidelines (antidepressants, benzodiazepines, gabapentinoids, and Z-drugs), which is a very huge win for the tapering and psychiatric drug withdrawal community to have in print! My hope is that in the next five to ten years more and more awareness, protocols, and remedies will become available for those seeking to discontinue psychotropic drugs.

The sad truth is not everyone can taper down to zero with the current knowledge we have today. Akathisia and tardive dyskinesia are facets of the nervous system in withdrawal that can lead many to re-instatement and sometimes to suicide. Dysautonomia can be a common and very debilitating side effect for those who taper too quickly or cold turkey. There are a vast amount of variables that can make or break a person’s experience of tapering off a psychotropic. The person’s age, length of time on the drug, the dose of the drug, kindling experiences due to cold turkey attempts in the past, underlying co-occurring infections (such as Lyme’s disease, Epstein Barr, etc), mold exposures, parasites, difficulties with detox organs and pathways, genetic mutations (such as MTHFR, COMT, NRF2), heavy metals and other toxic burdens, and of course a too fast taper.

Tapering is NOT one-size-fits-all and each taper needs to be carefully planned and these variables taken into consideration. We must take a harm reduction approach to tapering and withdrawal and be very conservative in our understanding of deprescribing. Some people are able to reduce of half the dose and some people end up staying on a low dose to remain functional. It has become very obvious that the last 1-2 mg of a taper is typically the hardest. The body will give subtle warning signs of destabilization and withdrawal prior to full-blown withdrawal, but we must be willing and attuned to reading the cues of the body and not rigidly sticking to a timeline for tapering.

The information shared below is not medical advice and I am not suggesting anyone stop taking a psychotropic medication without consulting with a healthcare professional. These are tips and suggestions I have seen be helpful, but again not every tool is a good fit for everyone. The suggestions must be tailored to the situation of slow tapering versus active withdrawal or protracted withdrawal states of the nervous system. These suggestions are for educational purposes only. Lifestyle and diet changes are highly recommended for anyone considering tapering or lowering the dose of a psychotropic drug.

BRAIN

• Lowering inflammation in the brain by eliminating inflammatory foods, such as gluten, dairy, sugar, and alcohol.
• Lowering histamine responses by following a low histamine diet.
• Intermittent fasting – Autophagy can be a powerful tool to help the brain detox, but this should be done gently and gradually and is sometimes contraindicated in active withdrawals.
• Ketogenic diet – We think that when ketones enter the brain they partially replace glucose as a source of fuel, which can significantly affect brain function and result in improved stress tolerance and lower levels of depression and anxiety.
• Proper light life – Exposing the eyes to sunlight as the sun is rising every morning is a great way to regulate the nervous system; then exposing the skin and eyes to as sun as possible throughout the day. Blue light from screens is one of the worst things for your nervous system and a proper light life can help balance your hormones as well. Avoid screens after the sun goes down. Blue light blocking apps exist for your computer and phone.
• Vagus nerve balancing – so many people in withdrawal have extreme difficulties with stress tolerance. Gentle ways of balancing the vagus nerve include cold water exposure to the face (place face in large bowl of cold water with ice for 30 seconds OR placing a cold pack on each side of the face). Singing and humming are also great ways.

BODY

• Trace minerals and electrolytes – Pharmaceuticals deplete the body of key trace minerals and electrolytes. Spray and topical forms are my favorite way to boost lost nutrients by bypassing the GI tract.
• Magnesium – Psychotropics deplete magnesium stores in the body and almost always need to be supplemented during a taper. There are at least 10 types of magnesium and very poor-quality supplements on the market. My go to is glycinate.
• Amino acids – I don’t suggest most people add supplements, but instead to always try to get the missing nutrient from foods. Organ meats are a great way to replenish depleted amino acids, vitamins, and minerals, as well as B vitamins which are often not tolerated well during a taper.
• Far infrared saunas – This is a fantastic form of gentle detoxing IF the person is not destabilized and in active withdrawals. Start with the lower temperature and low time and gradually work your way up. ALWAYS replenish minerals and electrolytes after a sauna session.
• Red light therapy – Red light exposure may lower inflammation and help with cellular repair. Many people on psychotropics long term have leaky gut issues, and targeted red light therapy to the abdomen can be a great way to help the gut heal without additional supplementation.
• Grounding – I have found that having people sit directly on the ground for a minimum of 30 minutes a day can have a very regulating impact on the nervous system. The more time spent out in nature, the better for the nervous system.

PSYCHE

• Community – Psychiatric drug withdrawal is a very isolating experience. Most people do not acknowledge or understand how difficult it is to stop taking psychiatric drugs. Often times, well-meaning friends and family say the wrong thing because they are unaware of the challenges in tapering. Laura Delano offers group support to find community around tapering and withdrawal.
• Medical gaslighting – It can be very painful to come to terms with the amount of medical trauma and medical gaslighting that happens from well-meaning doctors and nurses. So many are just uneducated and unaware of the difficulties in psychotropic withdrawal. The medical profession desperately needs training to be able to identify withdrawal and protracted withdrawal, instead of assuming it is a mental illness. A good therapist can help you process and unpack the experience of gaslighting and realizing that the medical system that got you on the drugs has very little knowledge or tools on how to get you off the drugs.
• Trauma healing – It is beneficial to process and address the traumas which led one to psychiatry before and during the taper. Some would argue that you may not be able to fully access the emotions surrounding the trauma while at the full dose of the drug. Stagnant and trapped emotions impede the body’s innate healing capacity. For this reason, body-based and somatic approaches to healing and clearing trauma may help with tapering and withdrawal.
• Spiritual support – Akin to the AA model, I have seen many people cope with the challenges of withdrawal by having spiritual guidance and direction. A belief in God or a higher power can be a grounding experience, as well as finding a spiritual community to gather with in person.

This is a small sampling of techniques that I have seen to be helpful in tapering and withdrawal and not an exhaustive list. It is truly a case-by-case approach to learn the unique needs of each nervous system. Liberation from pharmaceuticals is possible, but it is not an easy journey. I advocate for informed consent and that people be offered the truth when deciding whether or not to medicate, in regards to the challenges of stopping the drugs. The drugs are easy to start but incredibly difficult to stop, which creates a brilliant business model for those fueled by greed.