Around 1 in 6 adults in the U.S. report taking a psychiatric medication according to data from 2013. That translates into roughly 40 million Americans who have taken at least one psychiatric medication. Those numbers are likely currently even higher given the increases in reported psychiatric disorders in the U.S. While psychiatric medications may be necessary for certain individuals for specific periods of time, they come with an impressive number of side effects, including weight gain, sexual dysfunction, movement disorders, and metabolic syndrome. In addition, there is significant evidence that the longterm use of psychiatric medications can actually lead to chronic disability. One reason for this may be because psychiatric medications do very little to treat the underlying causes of mental illnesses, and the longer the underlying causes go untreated, many times the more severe they become.
For some individuals, psychiatric medications are necessary, but it is always advisable to use the least amount of medications possible, and for the shortest period of time, in order to maximize mental and physical health and minimize side effects. For other individuals, psychiatric medications might not be necessary at all, and other interventions can be more effective, and without unwanted side effects.
In my practice, I encounter many patients who were started on psychiatric medications by a psychiatrist or primary care physician but who have found the medications to be only partially effective or completely ineffective and many times causing intolerable side effects. Quite frequently, I see patients who are on a huge cocktail of medications, which is usually the result of a snowball effect that has happened because medications have been piled on to treat the side effects of other medications. Sometimes, patients tell me that they have tried to stop taking the medications on their own, but had the return of severe psychiatric symptoms or severe withdrawal symptoms that they could not tolerate. Many times, patients have told me that they feel like they are “addicted” to all of the psychiatric medications they’re taking because they can’t successfully get off of them. They tell me that they are extremely miserable and feeling hopeless and trapped.
The very good news is that there is, in fact, plenty of hope! In my experience, it is many times possible to safely wean a patient off of all or most of their psychiatric medications. While this of course varies based on the patient, I’ve had tremendous success with many patients with diagnoses including depression, bipolar disorder and schizophrenia. How is this possible? I believe there are three important guidelines, which if followed, lead to very high success rates. First of all, the process must be done under the close supervision of a trained psychiatrist. It’s extremely important that a patient doesn’t try to undertake this process on their own and in fact, this can lead to some poor outcomes. Ideally, the psychiatrist should be trained and experienced using integrative/holistic interventions and in helping patients come off of psychiatric medications. It’s imperative that a psychiatrist check in with with the patient to assess for any signs or symptoms that might not be apparent to the patient. Secondly, it is important to fully optimize the patient’s physical and mental health and treat any underlying causes prior to decreasing or stopping any medications. If underlying causes are not addressed, it’s likely that psychiatric symptoms will return or worsen as medications are decreased and stopped. In addition, there are many holistic interventions, which can decrease the associated withdrawal symptoms while also improving physical and mental health. Lastly, it’s important to go slowly! Abruptly stopping medications or decreasing them too rapidly can lead to serious withdrawal symptoms and the return of very severe psychiatric symptoms. In general, the slower the better, and the higher likelihood that the medication changes will ultimately be successful.
The bottom line is that for many, although not all patients, it is possible to significantly decrease and sometimes stop all psychiatric medications. However, in order to be successful, it is best done under the close supervision of a trained and experienced psychiatrist. There is hope and there are plenty of options!