How to Stop Medication

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Issues to Consider in Stopping Medication You will want to stop taking the medication if it has not been effective for you. Even if it has been effective for you, however, the question still arises: how long do you need to stay on it? There are three issues you need to consider in making the decision about whether or not to stop medication.

The Nature of the Disorder Different psychiatric disorders require treatment for different periods of time. Crises such as distress over the loss of a loved one may require short-term use of medication, whereas an ongoing illness such as schizophrenia or bipolar disorder may require medication indefinitely. Some people with depression may stop medication without difficulty once the life circumstances that led to the depression have resolved. Others find that they get more depressed when they go off their medication and elect to stay on them for many years.

The Positive and Negative Effects of the Medication You must weigh the effectiveness of the medication against the side effects you experience. Weight gain from imipramine and the need to diet may be unpleasant, but the diminished anxiety and depression may be worth the price. The potential for a life-threatening blood disorder may seem terrible, but that may be better than being stuck in a hospital overwhelmed by hallucinations and delusions. On the other hand, the sexual dysfunction caused by fluoxetine may be enough to dissuade you from its use even though you feel somewhat better on it. Methylphenidate may help your son's dis-ruptiveness in school, but his headaches, stomach cramps, and the potential for stunted growth may override any benefits you see.

The Effectiveness of Other Treatments You need to judge the effectiveness of alternative treatments. Are there other treatments that would allow you to get off the medication at some point? For example, panic attacks often resolve with a combination of brief psychotherapy, relaxation exercises, and lifestyle changes. While taking medication during the first few weeks after they've started may provide enormous relief, taking them for many years without even trying these treatments makes little sense.

Drug Holidays There are times when it makes sense to stop the medications on a regular basis for brief periods. For example, some children with ADHD take methylphenidate only on school days, not on weekends or during vacation. This minimizes the retarding effect methylphenidate can have on growth. Some people find that omitting one or two doses of their antidepressant improves the impairment the drug causes to their sexual functioning. A drug holiday needs to take the above issues into account, however, and should never be undertaken without consulting with your doctor.

Steps to Stop Your Medication There are four things to do if you decide to stop your medication.

Consult with Your Doctor It is vital to consult your doctor. You will cause yourself needless distress if you don't learn about the effects you may experience when you stop the medication. Use the benefit of your doctor's training and experience with other people who have stopped their medication to help you go through the process.

Educate Yourself about What to Expect First, you may experience transitory physical and psychological changes that are primarily due to the withdrawal of the drug. As long as you are aware of these, they should not cause you to doubt the wisdom of your decision to stop, though they may be unpleasant. You may also experience a reemergence of the symptoms that led you to go on the medication in the first place. If this occurs, you will need to reconsider your decision to stop, reevaluating the nature of your disorder, the positive and negative effects of medication, and the usefulness of other treatments.

Taper Gradually You need to take into account the physical effects of withdrawal and the psychological changes you will experience. For example, benzodiazepines and antidepressants cause a variety of physical and emotional changes. These changes are far more easily tolerated when there has been a small decrease in the total amount you are taking rather than a complete cessation. Make sure your body has adapted to one change before you undertake another. In the case of some antidepressants, this may take months.

Monitor All Changes You should expect physical and psychological changes as you taper your medications. Ideally these will be transitory, but you will feel confident that this is the case only if you've educated yourself about what you may experience and if you monitor yourself during the process.

Call your doctor if you notice a change for which you are unprepared. It is much better to address any problems when they first arise, rather than waiting until they've gotten significantly worse. Err on the side of a phone call that may turn out to be unnecessary rather than waiting until a problem arises that overwhelms you.


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