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Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs

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Tremendously exciting news in the U.K. on a new guidance release for psychological therapists. Endorsed by several recognised bodies including the BACP, UKCP . As this British Psychological Society release explains:

New guidance for therapists with clients taking prescribed drugs

04 December 2019

New guidance from the BPS and its partners, published today, gives psychological therapists the information they need to help clients struggling with side effects and withdrawal issues which have resulted from an increase in the prescription of psychiatric drugs.

 

 

Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs was produced following Public Health England’s acknowledgment of the growing problem of prescribed drug dependency and withdrawal in its recent ground-breaking report.

 

The guidance means clients will be better supported to understand the difference between emotional distress, relapse and the side and withdrawal effects of psychiatric drugs.

 

A 2019 survey of psychological therapists revealed that most work with clients who have taken, or are taking, psychiatric drugs. Fewer than one in ten felt their training equipped them to deal adequately with client’s questions on this topic.

 

Our chief executive Sarb Bajwa said:

 

“We strongly recommend this guidance to psychological therapists. Our members have continually told us they need more support to work confidently with clients taking or withdrawing from prescribed drugs.

 

“The evidence reviewed in this guidance provides an up-to-date summary of the main effects, adverse consequences and possible withdrawal reactions of psychiatric drugs.”

 

The guidance, facilitated by the All-Party Parliamentary Group for Prescribed Drug Dependence in the last parliament, has been steered and endorsed by the four psychological therapy organisations that represent 80,000 of the UK’s psychological therapists, and by senior clinicians and researchers in the field.

 

They are the British Psychological Society, UK Council for Psychotherapy, British Association for Counselling and Psychotherapy and National Counselling Society. The National Survivor User Network has also endorsed the guidance.

 

(https://www.bps.org.uk/news-and-policy/new-guidance-therapists-clients-taking-prescribed-drugs)

 

The guidance booklet can be accessed here for free:

file:///C:/Users/franc/Downloads/APPG-Guidance-for-therapists-WEB-v2.pdf

https://prescribeddrug.info/

 

Podcast on the guidance on Mad In America:

https://www.madinamerica.com/2019/12/psychological-support-psychiatric-drug-withdrawal/


1999:  Paroxetine (20mg). Age 16. 2007-2008: Fluoxetine (Prozac) for 1.5 years (age 25) Citalopram 20mg 2002-2005, 2009: Escitalopram (20mg), 2 weeks, (age 26) (adverse manic reaction)/*Valium 5mg/Temazepam 10mg 2010: Mirtazipine (Remeron)( do not remember dosage) 2010, 5 months.                     

2010-2017: Citalopram (20mg) (age 27 to 34) 2016: i.1st Sept- 31st Oct Citalopram 10mg , ii.1st November 2017-30th November 2017, Citalopram 5mg iii.1st December 2017- 4th February 2018, Citalopram 0mg, iv.5th February 2018- March 2018 Citalopram 5mg (10mg every other day) 28th February- tried titration of 5mg ( some adverse effects)

2018: 1st March 2018- 1st June Citalopram 10 mg (tablet form) /started titration 8mg , then 7 mg.2018: June 15th- 10th July Citalopram 10 mg pill every other day 2018: 10th July - 13th Sept Citalopram- 0mg  (CBD oil first month of 0mg, passiflora on and off) 2018 13th Sept Citalopram  2mg ,  approx 16th Sept 4mg , approx 25th Sept 6mg held.  2019: 11 Feb 19: 7mg (instant bad rxn) 12 Feb 19 6mg held 1 May 19 5.4mg held 5 Oct 19 5.36mg 22 Oct 19 5.29mg 30 Oct 19 5.23mg 4/NOV/19 5.18mg 12 Nov 19 5.08mg 20 Nov 19 4.77mg

(Herbal/Supplements since 1st September: Omega Fish Oil 1200mg, 663mg of EPA- 2 tablets a day, magnesium and magnesium bath salts)

I did not die, and yet I lost life’s breath
- Dante

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hayduke

https://prescribeddrug.info/

 

My psychologist sent me this PDF from various UK mental health peak bodies, as found above.  Professor Joanna Moncrieff is among the contributors.  It's good to see progress in the clinical space busting harmful myths and clearing the way for better mainstream health services practices.

 

This doco may be helpful to show counsellors, doctors and prescribers to gauge whether they will be helpful to you, or to update their information on the topic if you already have a regular.

 

It's not a primary source but as it's clinical in context I thought better to post it here than the 'in the media' section.

 

A few highlights:  the "medical model" is challenged, quick tapers are looked at critically, and some people who were put on these drugs are heard from.


*** I am not a health professional - your actions are your own ***

 

My taper visualised as a graph   |   My intro thread

 

10mg olanzapine 2003-06.  3mg risperidone 2006-2014 gave slight weight loss but mediocre sleep.  Abrupt x-taper to try aripiprazole Dec 2014 increasingly restless (Freddy the blind man could've seen that coming, shame about the pdoc) then back onto 10mg olanzapine after 3 weeks.

Round 1:  2015 10 -> 7 1/2 -> 6 2/3 -> 5mg olanzapine.   Hadn't researched, just decided to try it myself with pill cutter.  Easy enough.  Next cut to 3 1/3mg for 2 weeks had me struggling to function.  Reverted to 5mg, thought that was as far as I could go.

Round 2:  Given Breggin to read, found SA.  Taper from 5 to 2.5mg over five months.  Titrate liquid suspension using Rhi's method.  Cuts and holds all done by feel.  All samples at start of month in mg:

2018:  Feb 5.0 | Mar 4.5 | Apr 4.25 | May 3.7 | Jun 3.3 | Jul 3.1 | Aug 2.9 | Sep 2.5 and six month hold

Round 3:  2.5mg and below.  EMDR work unearthed and resolved root trauma at around 2.1mg

2019:  Jan 2.5 | Feb 2.3 | Mar 2.215 / EMDR / Apr 1.976 | May 1.875 | Jun 1.825 | Jul 1.625 | Aug 1.525 | Sep 1.46 | Oct 1.3 | Nov 1.225 | Dec 1.25

2020:  Jan 1.214 | Feb 1.1 | Mar 1.0 🙂 | Apr 0.88 | May 0.82 | June 0.74 | July 0.69 | Aug 0.61 | Sep 0.59 | Oct 0.525

‘If you think you’re enlightened, spend a week with your family.’  -- Ram Dass

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hayduke

Sorry India, hadn't seen you post this when I reposted the same document above.  Hope you're doing ok.


*** I am not a health professional - your actions are your own ***

 

My taper visualised as a graph   |   My intro thread

 

10mg olanzapine 2003-06.  3mg risperidone 2006-2014 gave slight weight loss but mediocre sleep.  Abrupt x-taper to try aripiprazole Dec 2014 increasingly restless (Freddy the blind man could've seen that coming, shame about the pdoc) then back onto 10mg olanzapine after 3 weeks.

Round 1:  2015 10 -> 7 1/2 -> 6 2/3 -> 5mg olanzapine.   Hadn't researched, just decided to try it myself with pill cutter.  Easy enough.  Next cut to 3 1/3mg for 2 weeks had me struggling to function.  Reverted to 5mg, thought that was as far as I could go.

Round 2:  Given Breggin to read, found SA.  Taper from 5 to 2.5mg over five months.  Titrate liquid suspension using Rhi's method.  Cuts and holds all done by feel.  All samples at start of month in mg:

2018:  Feb 5.0 | Mar 4.5 | Apr 4.25 | May 3.7 | Jun 3.3 | Jul 3.1 | Aug 2.9 | Sep 2.5 and six month hold

Round 3:  2.5mg and below.  EMDR work unearthed and resolved root trauma at around 2.1mg

2019:  Jan 2.5 | Feb 2.3 | Mar 2.215 / EMDR / Apr 1.976 | May 1.875 | Jun 1.825 | Jul 1.625 | Aug 1.525 | Sep 1.46 | Oct 1.3 | Nov 1.225 | Dec 1.25

2020:  Jan 1.214 | Feb 1.1 | Mar 1.0 🙂 | Apr 0.88 | May 0.82 | June 0.74 | July 0.69 | Aug 0.61 | Sep 0.59 | Oct 0.525

‘If you think you’re enlightened, spend a week with your family.’  -- Ram Dass

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ChessieCat
34 minutes ago, hayduke said:

Sorry India, hadn't seen you post this when I reposted the same document above.  Hope you're doing ok.

 

I've merged the 2 topics.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 17 Oct 2020:  Pristiq 0.56 mg (compounded + liquid)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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