How to Avoid Relapse and Injury While Tapering

“Relapse rates are higher for patients who stop their antidepressants, mood stabilizers or antipsychotics abruptly or rapidly compared to those who stopped them more slowly. For example, patients tapered off antidepressants rapidly had higher relapse rates than those tapered more gradually. The findings are supported by more modern studies that find relapse rates are lower in people who taper of a variety of psychiatric drugs more slowly.” The Maudsley Deprescribing Guidelines by Mark Horowitz and David Taylor

Dear friend,

Many people experience adverse effects or toxicity on psychiatric medications and desperately want to top. Others may prefer not to rely medications long term despite the presence of minimal unwanted or adverse effects.

Often deprescribing and safe tapering is not well supported in the conventional system. People end up stopping medications abruptly on their own or they’re guided by clinicians to taper very quickly resulting in unpleasant and alarming withdrawal effects.

Withdrawal effects are very common for all class of psychiatric drugs, 

“about 50% of patients who stop antidepressants will experience withdrawal effects, and 32-42% of people taking benzodiazepines will be unable to stop their drugs because of withdrawal effects.”

Some of these withdrawal symptoms include dizziness, headache, nausea, irritability, anxiety, agitation, tremors, panic attacks, sleep disturbances/insomnia, low mood, fatigue, delirium, suicidal ideation, and seizures.

Medically supervised gradual tapering is key to avoiding injury.

Tapering cannot be approached lightly because there’s great risk for harm, relapse, and going into severe withdrawal.

These risks are determined by multiple factors including how long the person has been on medications, the withdrawal symptoms associated with specific med, and person’s past history with psychoactive drugs use (illicit and prescribed) and resulting brain sensitivities and vulnerabilities.

It’s essential to work with medical professionals who can accurately assess these risk factors in order to design an appropriate tapering schedule.

The best way to avoid withdrawal is to taper slowly.

Many people are rushed and desperate to get off of psychiatric drugs quickly especially if they are experiencing unwanted and or adverse effects. The distress that comes with being on medications that are causing harmful effects is very real. The desire to taper off psychiatric drugs is also understandable when the risks and harmful effects outweigh benefits.

Clients need to be validated about their bodies feedback and subjective and objective experiences of distress and harm. They also require support in the process of evaluation of risks and benefits, as well as deprescribing and safe tapering.

That said, this needs to be a collaborative decision between prescriber and patient.

Please do not reduce or stop psychiatric drugs without consulting with your prescriber.

Unless of course there’s a through assessment, evaluation, and agreement by your support team that the next right step is tapering. Once this decision is made then there needs to be a design of a proper tapering schedule.

The general principle and guideline for tapering off of psychiatric drugs is reduction of 5-10% every 30 days. High risk clients will need to start at the lower end.

As well, depending on the withdrawal symptoms that appear with initial reduction, the rate of taper may need to be further adjusted. Some clients may need to start at lower than 5 % tapering rate depending on their history and sensitivities.

Every person is different in their response to tapering.

Some individuals will experience no withdrawal symptoms, others mild to moderate symptoms and a percentage will experience alarming and fatal symptoms. There’s also no way of knowing which camp a person belongs to, although there’s some clues if there’s history of past tapering attempts or even reactions to psychiatric drugs.

Therefore it is crucial to proceed with caution.

The most appropriate path to safe tapering is slow, gradual, and patient led. The client’s body feedback need to be closely tracked and monitored for withdrawal symptoms. As well to determine a rate of taper that is comfortable and doesn’t create unnecessary stress, harm or further injury.

Ideally people will be able to continue activities of daily living, work, school or home commitments while tapering. If done correctly this need not be a process that will disrupt their functioning and daily life.

In some high risk situation, it maybe necessary to lighten the burden of responsibility in order to taper safely. However, in most situation tapering can be done while a person continues to live their life and function well.

Again, part of the reason for gradual tapering.

It allows a person to go through a process that will protect their brain from injury and prevents them from experiencing unpleasant or harmful withdrawal symptoms and minimize the risk of relapse.

The greatest risk of not tapering psychiatric drugs slowly and gradually is protracted withdrawal symptoms. These are very complicated distressing symptoms that arise from injury caused by improper tapering. They can last for weeks, months, and even years.

I will cover protracted withdrawal symptoms in a future email. For now it’s important to recognize that rushing through tapering process has a huge potential to backfire.

It’s a risk not worth taking.

If you or someone you know is struggling with psychiatric drug harm/injury or withdrawal please share this article with them.

Safe tapering practices are not well understood or practiced in conventional psychiatry. Often people are told to taper very quickly and are not informed about the risk of withdrawal symptoms.

Many times withdrawal symptoms are often misdiagnosed as relapse of original illness or onset of a new illness.

Part of how people end up with a litany of psychiatric diagnosis and multiple drugs.

Feel free to leave me your questions, comments, and feedback below. Thank you for taking the time to visit here.

Until next time, we continue in solidarity. 

Neseret Bemient, BScN
Holistic Mental Health Coach 
Website: Return to Wholeness Healing Services
YouTube: www.youtube.com/@NeseretBemient
Twitter(X): Neseret Bemient (@JourneyofHope4U)

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