The decision to taper off of medications is not one to make lightly. The more information you have about what to expect if and when you do begin to taper, the better informed that decision will be. To that end, I would like to highlight the physical, emotional, and mental challenges I faced while tapering.
Keep in mind, the specifics of my experience may differ from yours. I was on nine drugs when I started to taper. Furthermore, I had been on some for more than a decade and was taking most medications at the highest dose legally prescribable. Unless you are on the same nine medications I was on for the same length of time and at the same dosages, your taper experience could and should differ. That being said, I think there are many commonalities between what I experienced and what many other people experience while tapering off of the same or similar medications.
A Guide for Tapering Off Medication
A resource that I believe is quite useful in preparing for and managing your psych med taper is called: “Coming off Psych Meds Harm Reduction Guide.” [i] It lists many useful coping strategies for dealing with a med taper. And, unlike so many other guides on the subject, it highlights the threat heavy metals and other toxins pose to mental health and touts the potentially positive role supplements play in alleviating the symptoms of medication taper and withdrawal. It is a measured, sensible overview of this critical topic.
Let me start by repeating a warning that is prominently posted on Dr. Peter Breggin’s homepage, portions of which appear on EVERY page of the Holistic Mental Health Institute’s homepage: “Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them. Withdrawal from psychiatric drugs should be done carefully under experienced clinical supervision” [ii] Here is the godfather of the anti-psych med movement telling all who seek advice from him that getting off of psychiatric medications can cause life-threating “emotional and physical withdrawal problems.”
I would like to underscore his warning. Many times, nay, MANY, MANY times I genuinely felt my life was threatened as I came off of my medication cocktail. I think it is instructive that he considers “emotional” withdrawal problems to be just as potentially life-threating as physical ones; indeed, my emotions threatened me far more than my body ever did while I was tapering.
My Cautionary Tale
Before I began to taper I had no idea what to expect. How could I? That naiveté, added to my exuberance to get off of meds, initially fueled an overly aggressive taper schedule. For those of you who would like to read the details of my first drastic taper, they are available on the Alternative to Meds Center blog under the topic “A Long Cymbalta Taper.” [iii] On the advice of my psychiatrist at the time, I foolishly cut my dose of Cymbalta from 120 MG, the maximum legal dose, to 60 MG overnight. I would like to take an excerpt from the blog referenced above to describe how I felt after that cut: “Picture a small child playing blissfully in the back seat of an ’87 Toyota, which is then rear-ended by an 18-wheeler driven by a drunk driver and tossed off of a single-span bridge into the icy water below; just so, my psyche – not to mention my nervous system – was twisted into a howling, writhing wreck by that first taper of 50%”
First the “zaps” hit me. Wave after wave of seismic shutters ripped through my nervous system. Although I did not experience out-right seizures, my body began to jerk spasmodically. My skin felt like it had been ripped off and salt and fire ants strewn about my raw flesh; I experienced relentless akathisia or restlessness. I wanted to rip off my own skin to get at the undulating vermin. Additionally, my head felt like it was being squeezed by a vice. I am a connoisseur of head pain. The head pain I experienced as a result of this initial cut, however, was a species I had never encountered before: voracious, unremitting, and volcanic.
This taper sent me into the most severe emotional gyrations I had ever experienced. I had previously been diagnosed as bi-polar I, so I had had my share of extreme mood swings before this. But these swings were unlike anything I had felt hitherto. After this initial taper, I felt utterly hopeless. Bleak waves crashed into me. A riptide of darkness seized me and held me under for what seemed like an interminable duration. I felt like an emotional pinball hurled against metal pins and rods slapping about violently. I know exactly why people kill themselves during med changes – up or down. Suicide seemed like such a seductively sweet option for much of this taper and during many others. Thankfully, I had people holding me as I writhed about telling me the darkness would pass. I had people imploring me not to allow myself to drown. Not everyone does.
And of course mentally, I felt completely shattered. Whatever semblance of identity I had glued together while I was increasingly destabilizing on my many meds was simply crushed under the blow of that first med cut. At times, I felt completely de-personalized, as if I was watching the life being snuffed out of someone else. Other times, I became manic or outright psychotic and did and said things “I” would never do in my right mind.
Our One-Way System
I mention this first taper as a cautionary tale. There is a reason Dr. Breggin recommends in his most recent book Psychiatric Drug Withdrawal not to cut any medication more than 10% per month. It was touch and go for me for months after that first cut. There is also a reason he urges people to make cuts “carefully under experienced clinical supervision.”Sadly, while most doctors are experts at putting us on meds, they are not at taking us off of them. Very few facilities for that matter have the expertise to help people taper safely. That is one reason I founded this institute. 79 million Americans are currently on one or more psychiatric medication. I can count on ONE hand the number of facilities I know and trust that can help people get off and stay off of their psych drugs. There is a glaring need for more.
I made subsequent tapers in the shadow of and while still recovering from that first hellacious taper. It was so harrowing that I took thirteen months to get off of my remaining medications. I simply refused to subject myself to that level of destabilization again. Even so, these additional tapers were dreadful in their own way. Even though I was still punch-drunk from that fist dramatic taper of Cymbalta, I felt the need to push on. I felt I had learned a valuable, albeit painful lesson, and was prepared to taper the rest of my medication at a more measured pace.
I targeted my Lithium next as I, first and foremost, and the clinical and medical teams supervising me perceived that it was the greatest threat to my physical well-being. Next, I eliminated my two benzos, Klonopin and Ativan. Benzo taper and withdrawal is a topic worthy of multiple blogs. There are numerous message boards dedicated to the subject. Whole support organizations have sprung up to help those recovering from the ravages of this one class of medication. And I can understand why: benzo withdrawal is often drawn out and complicated by life-threatening “emotional and physicalwithdrawal problems.”
Withdrawal is Complicated and Life-Threatening… Yet Life-Giving
For me these included: delirium, disorientation, psychosis, heart palpitations, lethargy, flu-like symptoms, incontinence, rapid mood swings, aggression, obsessive and repetitive thoughts, morbid thoughts, restlessness, shaking, tardive dyskinesia, extreme nerve pain, nausea, and vomiting – to name just a few. A more extensive list of symptoms commonly associated with benzo taper and withdrawal can be found at: http://www.bcnc.org.uk/symptoms.html. Each day I interact with people by phone, internet, or in person who are suffering from benzo withdrawal so the trauma I went through remains constant and raw. I try to channel the righteous indignation I feel from watching so many people who suffer from benzos into my writing and into my work for this institute.
I often visit forums dedicated to supporting those suffering from benzo withdrawal. What I do find remarkable is the almost religious zealousness with which people on benzo recovery boards attack the use of chelators and supplements such as amino acids. Supervised chelation and a carefully crafted protocol of supplements helped me endure many of the symptoms that I experienced during benzo taper and withdrawal. In my opinion, people who choose not to chelate toxins out of their systems and who take no supplements whatsoever to repair their damaged systems during benzo taper and withdrawal are suffering needlessly.
That’s not to say that taking supplements willy nilly will help with much of anything. Still, certain chelators have shown time and time again to be effective with certain toxins that contribute to mental health disorders. And certain supplements have proven effective in mitigating certain kinds of withdrawal symptoms. Finding a medical professional who can help you craft a supplement regimen that is right for you may SUBSTANTIALLY alleviate both taper and withdrawal from benzos or other types of psych meds. One of the goals of this institute is to systematically document which vitamins and minerals help the most while tapering and withdrawing from each and every psych med. My goal is to create a widely accessible database that provides a list of supplements that have been proven in double-blind clinical trials to be effective at helping individuals taper off of and stay off of each and every medication. Until that time, I fear there will remain a bias against the use of such supplements to treat symptoms associated with medication withdrawal.
Detox: My Reclamation Project
I can say with supreme personal conviction: the more I detoxed while I tapered, and the more I repaired my body while I tapered, the less debilitating the tapers became.
After the benzos, tapering off of Ambien was by far the most problematic and painful. Ambien works on the brain in a very similar manner as benzos. Plus, for me, Ambien is inextricably intertwined with addiction and pain. As such, the psychological whiplash I experienced while tapering off of it was far greater than what I experienced while tapering off of any other medication. The raw cravings I had for Ambien were insurmountable at times. I discuss my struggle with Ambien in another blog called: “Confessions of an Ambien Zombie.”[iv] Suffice it to say that the effort required of me to in getting nearly perfect marks at a top-drawer college as well as in learning 3,000 Chinese characters along with several other languages – all added together – still pales in comparison to the physical and psychological will it took for me to overcome this one medication.
Tapering off of medications in each class of meds provided its own brand of hell. Some induced more physical symptoms such as burning, violent shaking, and night terrors. Others incited far more mental turmoil – the sense of a shattered, disjoined reality or manic, destructive thoughts and behavior.
But it was all worth it.
By staying the course, and, more importantly, by addressing the underlying toxicity that was certainly the cause of my mental health problems, I was able to succeed in extricating myself from the psych med prison I had been in for almost thirty years. Yes, it was harrowing. Yes, I felt like I was dying much of the time. Yes, it was the most painful experience in my life. But, I have reclaimed my physical, emotional, and mental health at long last.
If I can do it, so can you. I went into it not knowing if it was at all possible or what condition I would be in when I made it out the other side. I imagine you feel the same. If you are in the midst of a taper, you may be wondering if it is worth seeing it through. I assure you it is.
The best of yourself awaits. An acuity and clarity that perhaps you forgot you had, and most certainly feared you could never recover, awaits. A lifetime of purpose, passion, and creativity awaits.