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Ostrow, 2017 Discontinuing psychiatric medications: a survey of long-term users

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Psychiatr Serv. 2017 Dec 1;68(12):1232-1238. doi: 10.1176/appi.ps.201700070. Epub 2017 Jul 17.

Discontinuing Psychiatric Medications: A Survey of Long-Term Users.

Abstract

OBJECTIVE:

Individuals undergoing long-term psychiatric treatment frequently choose to stop taking psychiatric medications. To enhance service user choice and prevent undesirable outcomes, this first U.S. survey of a large sample of longer-term users sought to increase knowledge about users' experience of medication discontinuation.

METHODS:

A sample of 250 U.S. adults with a diagnosis of serious mental illness and a recent goal to stop up to two prescribed psychiatric medications, which they had taken for at least nine months, completed a web-based survey about experiences, strategies, and supports during discontinuation.

RESULTS:

About half (54%) met their goal of completely discontinuing one or more medications; 46% reported another outcome (use was reduced, use increased, or use stayed the same). Concerns about medications' effects (for example, long-term effects and side effects) prompted the decision to discontinue for 74% of respondents. They used various strategies to cope with withdrawal symptoms, which 54% rated as severe. Self-education and contact with friends and with others who had discontinued or reduced medications were most frequently cited as helpful. Although more than half rated the initial medication decision with prescribers as largely collaborative, only 45% rated prescribers as helpful during discontinuation. Of respondents who completely discontinued, 82% were satisfied with their decision.

CONCLUSIONS:

Discontinuing psychiatric medication appears to be a complicated and difficult process, although most respondents reported satisfaction with their decision. Future research should guide health care systems and providers to better support patient choice and self-determination regarding the use and discontinuation of psychiatric medication.

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LarryS

I like the information that "82% were satisfied with their decision" to try and reduce or stop their psychiatric drug.

My psychiatrist says that 80% of people who have been on psychiatric drugs for three separate episodes fail to get off the drug.  Assuming this is true, I still believe that I'm in the 20% who will succeed.

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peng
16 hours ago, LarryS said:

I like the information that "82% were satisfied with their decision" to try and reduce or stop their psychiatric drug.

My psychiatrist says that 80% of people who have been on psychiatric drugs for three separate episodes fail to get off the drug.  Assuming this is true, I still believe that I'm in the 20% who will succeed.

He may be correct.

I have hit a brick wall of low mood (depression) and anxiety the last couple of days after tapering, mostly without serious setback, from 225mg to 62.5mg in 2 years.

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bubbles

Peng, I'm so sorry that you're feeling unwell. I've posted on your thread.

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WantoffVen

My psychiatrist said 90%. I try not to think about that. One day at a time. One small drop at a time.

 

 

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bubbles

WantoffVen, what did your psychiatrist say about 90%? 90% will find it difficult?

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WantoffVen

Yes 90% cannot be without antidepressants. I read that somewhere so no doubt he's just part of the pack.

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bubbles

He's probably right that 90% of people will suffer if they try to stop antidepressants in the way that doctors tell us to stop. Or if they get "off", they crash and burn soon after (which is the same thing, really).

 

I don't think that it relates to those of us who are really tapering slowly. We are a tiny number of people doing it so doctors don't generally see it, and there has been absolutely zero research about slow tapers. (When they talk about "slow tapers" the times are always absurdly rapid, from our point of view here at SA.)

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