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 tiredof 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. Sometimes the process can be quite complicated and I urge you to explore the web site beyond meds and specific forums such as benzobuddies and surviving antidepressants for much more in depth information. I also highly urge you to read The Harm Reduction Guide to Coming Of Psychiatric Drugs.
The process of coming off meds is often a very long one. With 10 percent reductions, the taper can often take upwards of a year or more. At the same time, it can be deeply challenging to find a doctor that supports a taper that is this slow. However, it is really important to try and enlist your doctor in supporting a slow taper. Having a good supportive doctor is very helpful in this process. None of what I am suggesting is medical advice. It is simply pointing to the accumulated wisdom of the many many people who have gone through coming off psychiatric drugs. Please see a doctor before attempting to start a taper.
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.