In English and German: Peter Lehmann's 1998 Coming off Psychiatric Drugs

[Altostrata]

A compendium of stories from people, some institutionalized, who came off years of sometimes massive amounts of drugs and succeeded in living their lives drug-free. (Read summaries of their chapters here.)

 

This book does not discuss methods of tapering. Each contributor did it in his or her own way.

 

http://www.antipsychiatrieverlag.de/foreign/books/withdraw.htm

 

Peter Lehmann (Ed.)

Coming off Psychiatric Drugs: Successful Withdrawal from Neuroleptics, Antidepressants, Lithium, Carbamazepine and Tranquilizers

 

(English translation published in 2004)

 

From the Introduction (pdf at http://www.antipsychiatrieverlag.de/foreign/books/withdraw.htm) by Peter Lehmann

 

....

When one discusses the issue of dependency with psychiatrists, most often their first reflex is to deny the danger of dependency for users of antidepressants and neuroleptics. For example, the psychiatrists of the German Pharmaceutical Watch Group for Psychiatry have defined dependency as follows:

 

“Psychological dependency is understood as the irresistible longing for a medication in order to increase a feeling of well-being or to reduce un- comfortable symptoms. Physical dependence can be established with the appearance of withdrawal symptoms after the reduction or withdrawal of a medication.” (Grohmann/Rüther␣/Schmitz 1994, p. 279)

 

The risk of further problems developing in addition to the usual withdrawal symptoms, for example a rebound effect or hypersensitivity, should be taken into consideration when deciding whether or not to withdraw. Rebound effects are counter-regulatory adjustment reactions that lead to a temporary pronounced recurrence of the original symptoms.

 

Rebound effects have a mirroring-effect that make it particularly difficult to recognize withdrawal symptoms as distinct from the original problems. Because a prolonged use of psychoactive drugs raises the probability of various withdrawal problems—in addition to the usual damage of using the drugs—it is wise to consider sooner rather than later whether or not the time has come to limit these risks and to withdraw in a safe manner.

 

Taking psychoactive drugs can, under certain circumstances, lead to a temporary relief of psychological stress; but at the same time this leads many people slowly into dependency without their knowing it and with the support of the medical establishment. Many people attempt to stop taking psychiatric drugs, for a variety of reasons: lack of “therapeutic” effect; unwanted effects; pregnancy; lack of insight into their “illness.” Generally they have been left to cope with withdrawal problems on their own.

 

....

Typical withdrawal studies demonstrate quite serious methodological deficiencies, which have also been noticed by doctors: double-blind studies, in other words studies where neither the subject nor the treating physician knows what substance is actually being administered, are as rare as the ad- ministration of a placebo to a control group (which is also problematical). Furthermore, there has been a lack of systematic follow-up, a lack of information on the duration of hospitalization and of prior treatment as well as of the strength of dose of the psychiatric drug being withdrawn. Also, the period covered by the studies is too short, and finally, what is meant by any “relapse” mentioned is left completely unclear (Andrews/Hall/Snaith 1976). Those being treated were considered “improved” if in the eyes of the administrator of the psychiatric drugs they were not ready to be discharged but caused less trouble on the ward (Glick/Margolis 1962).

 

....

The fact that no distinction is made between withdrawal problems such as receptor changes caused by the treatment, rebound effects or supersensitive reactions and relapse is another serious deficiency. Brigitte Woggon from the Zurich University Psychiatric Hospital, who favors psychiatric drugs, sees problems with the lack of differentiation made, even drugs are abruptly withdrawn, between withdrawal symptoms and the return of the original psychological␣symptoms:

 

“Interestingly, in most studies on withdrawal no position is taken on possible withdrawal symptoms apparently because the studies are not set up to deal with these findings.” (Woggon 1979, p. 46)

 

Nonetheless, doctors continue to refer to their studies and speak with a great deal of pathos of a sudden relapse if the drugs are stopped without their authorization....