Thinking about stopping your medication?

People take psychiatric medications for a variety of conditions and for varying lengths of time – sometimes indefinitely. So it is not unusual for some people to consider coming off their medication, especially if they are feeling better or the side effects are making life difficult. 

Ultimately the decision to stop taking psychiatric medication is a personal choice involving a process weighing up the risks and benefits for each individual.

What you need to think about

There are many reasons why you might consider stopping your medication. But first it’s really important to discuss the decision with your doctor who can work with you to create a plan of action that gradually takes you off your medication, or moves you to a non-drug treatment option.

A few things to consider

• People sometimes stop taking their medication when they begin to feel better, but this can result in symptoms returning. In fact, they may be worse than before, potentially making it more difficult and a longer process to achieve recovery again.
  
  
• Remember that medications are not cures – they only treat symptoms. So ask your doctor how long you might expect to take the medication you have been prescribed.
  
  
• If you think your medication isn’t working, remember that it’s quite common for people to try a number of different medications and treatments until they find a combination that works for their symptoms.
  
  
• Understand the benefits of prescribed medications, as well as their potential side effects. Ask your doctor about any concerns you may have – changing the dosage or the time of day you take the medication can help reduce symptoms.
  
  
• Every medicine has its benefits and its risks. Deciding to take medication requires balancing possible benefits against possible side effects. Sometimes, it's hard to know how a medicine will affect you until you try it.

Choosing to come off your medication

If you decide to try coming off your medication, it’s important to approach the process carefully.

Talk to your doctor and people you trust about the pros and cons of stopping your medication. It’s a good idea to know why you are choosing to stop, and how to do this in the safest and most supported way.

It is also important to understand that stopping your medication is not a quick process. For some people it can take months. You need to reduce the dosage gradually wherever possible – the slower you reduce the dose, the greater the chances of preventing a return of symptoms.

Regardless of the type of medication you are taking, the longer you have been taking it, the more your body and brain will have adapted to it. Reducing a drug slowly, allows the brain time to readjust gradually to its original state.

What are the risks of reducing your medication too fast?

If you stop taking medication abruptly, you may experience some of the following effects:

• rapid return of the illness being treated
  
  
• disturbing mental thoughts or images
  
  
• potentially life-threatening seizures
  
  
• antidepressant withdrawal symptoms such as flu symptoms, sleep problems, dizziness, headaches, anxiety, and irritability
  
  
• increased risk of suicide.

More often than not, symptoms usually occur within days of stopping medication, but a relapse of the illness being treated can be delayed for weeks after initially feeling well.

And while it's possible to stop taking medication all at once, with no ill effects, most people are likely to become unwell by doing so. It's impossible to tell in advance who will be effected, so it is advisable to withdraw slowly.

Tips for preparing to stop your medication

• Tell people close to you - Explain to your friends and family what you are planning to do and how this may impact on your mood and emotions. Discuss what your needs may be during this time and how they can help.
  
  
• Prepare an Advance Directive - This is a written document that contains information for others about how you would like to be treated if you have a serious crisis during the withdrawal process. Ensure you give a copy to someone you can trust and also to your doctor or psychiatrist.
  
  
• Get to know your triggers for crisis - Many people get to know what situations they find stressful, and either prepare themselves carefully so as to minimise the stress, or avoid them completely. You may find it helps to keep a diary so that you can spot patterns.
  
  
• Monitor your mood - This can help you to spot subtle changes that might otherwise get overlooked. Also, recording any side effects can help you to remain objective and recognise any less obvious patterns that occur.

Choosing to stay on your medication

Medications often help the most when they're part of an overall treatment program. Your plan may include psychotherapy, peer programs and rehabilitative services to help with problems that medication alone can't treat.

Because mental health treatment is an ongoing commitment, it’s important that you find a doctor or other healthcare provider who makes you feel comfortable. Good care providers don’t just prescribe medication – they listen to your concerns, help you overcome difficulties, and make treatment a collaborative process.

A few things to consider

• Keeping regular appointments with your care provider is important, especially when you first begin treatment. Regular appointments help you and your care provider monitor treatment progress and make adjustments as necessary.
  
  
• It can take time to feel better. Some medications take a few weeks to work. And sometimes a medication's side effects may start before its benefits. You also may have to try more than one medication before you get the right fit, but many people find it's worth persistenting.
  
  
• Although there are effective treatments available for most mental health disorders, these treatments are not ‘cures’. That is, the treatments can help you manage symptoms of the disorder, but some form of ongoing treatment or management is usually necessary so that symptoms remain in check.
  
  
• Being actively involved in your treatment can make a real difference in your recovery. Talking honestly with your doctor is a big part of that process. If you discuss your concerns and learn about your options, you are much more likely to come up with a plan that works well for you and for the life you want to create, whether that include the use of medication to manage your symptoms or other means. 

Remember if you are thinking of coming off your medication it's important to do this in consultation with your doctor. Raise any concerns you have and work out a plan that's agreed upon by both parties. This will maximise your success.

More to read . . .

• SANE Guide to Medication and other Treatments
• Health Direct - Medicines
• Medicines Line (1300 MEDICINE)

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