DO NOT MAKE THIS MISTAKE! #healing #healthtips #motivation #medication

Introduction to Safe Medication Tapering 0:00

What if you're ready to come off of a psychiatric medication, but you are not sure what's normal, what is withdrawal, or how to start or even how do it safely? A lot of people think or are even told, just stop the medication. You won't have any issues. And then they do, and some people suddenly end up dealing with symptoms they were not expecting. That experience can be very scary. It can feel like something's wrong with you or that you need the medication forever because you have these symptoms.

But in many cases, what you're experiencing isn't relapse, it's your brain adjusting. I'm Dr. Arwen Podesta, I am a psychiatrist. On this channel, we break down mental health, neuroscience, and integrative strategies in a way that's practical and evidence-based, whether you are a clinician or someone trying to better understand your own mental heath. Today we're talking about how to safely decrease or stop certain psychiatric medications when it's appropriate and most importantly how do it with support,

What Discontinuation Syndrome Is 0:52

with clarity, and with hope. I go into deeper concepts like neuroadaptation and targeted supplementation strategies in my book Hooked, especially in the chapters on brain biology and recovery. Okay. Let's start here. Many people can safely reduce or discontinue psychiatric medications when it's clinically appropriate with no problem at all. But how you do it matters. It's not about just stopping. it is about working with your brain and not against it. Well, what happens when you stop certain types of medicines?

When you take a psychiatric medication consistently for weeks to months or really for years, like many, your brain is going to adapt to it. So when you remove that medication, you brain has to readjust, recalibrate again. And this is where something we call discontinuation syndrome can come in. It's very common in certain SSRIs and SNRI's or serotonin reuptake inhibitors or Serotonan epinephrine reuptake inhibitors, especially after months of use. And symptoms typically begin within one day to a week, and they can include dizziness, nausea, fatigue, headache, insomnia,

Why Some Medications Are Harder to Stop 2:06

sensory disturbances that a lot of patients call brain zaps, or it's like an electric shock sensation. If you've experienced that, you know it is very real. This word discontinuation, what does it actually mean? Well, here's the important part. These symptoms are usually not dangerous, especially with those medicines I'm talking about right now, SSRIs and SNRI's, but they can be really uncomfortable and sometimes very intense. They're typically mild to moderate. They are typically self-limiting or they resolve over time.

And that time frame looks like usually a few weeks, but in some cases it is longer and longer, and even feels more severe. Importantly, it's not the same as relapse. It's your brain recalibrating after removing the thing that it adapted to.

How to Taper Safely and Manage Symptoms 2:56

And not all medicines behave the same. Some medications are harder to stop. Actually, one major factor about that is their half-life. Half-Life means how long the medicine stays in your system. For example, a shorter half life medication, such as paroxetine, tends to cause more discontinuation symptoms. Whereas a longer half live medication like fluoxetin, it's actually kind of self-tapers because it is so long it stays on the system and slowly excretes. That's why some medicines are harder to stop, even if the doses are the same.

One of the most important principles in discontinuation is this. Go slowly. Abrupt stopping a medication increases the risk for more intense symptoms, longer duration of symptoms misinterpreting withdrawal as a relapse. A gradual taper allows the brain to adjust receptor sensitivity, to rebalance neurotransmitter systems and reduce kind of the shock to the system. And what if symptoms do occur as someone is decreasing their medication? Well, one evidence-based strategy is temporarily reinstating the medication, then tapering more slowly.

This is one strategy that can significantly reduce discomfort and improve success.

Working With Your Prescriber and Support Team 4:10

There's a role for nutrients and supportive strategies for sure. And this is where the integrative approaches can be really helpful. Some emerging data and lots of case studies show that certain amino acids may support the process such as L-tryptophan, DL-phenylalanine, and more. So these help support neurotransmitter pathways during the taper. Also, another clinical strategy is adding a low dose long acting antidepressant such as fluoxetine because of its long half-life and therefore it can act as kind of a built-in taper gradually decreasing the body withdrawal after stopping.

I talk about more of these strategies in the underlying neuro adaptation in my book Hooked. If this is useful for you, let's talk about how to talk to your prescriber. This is one of the most important parts of that process is having a team helping you. If you're thinking about reducing or stopping medications, start the conversation with your prescribed. You can say things like, I'm wondering if I still need this medication. I'd like to explore tapering. Can we make a plan? What would a safe reduction look like for me?

And a good attentive prescribing should certainly take your considerations seriously, should help assess whether it's appropriate to taper in the first place, and should create with you an individualized gradual taper plan and then most importantly monitor the symptoms along the way. If you feel dismissed or rushed, that's important information too because you deserve a thoughtful and collaborative approach. There are resources and support help. You don't have to do this alone. Helpful supports can include certainly your prescribing clinician, a therapist, and nutrition and lifestyle guru or coach.

What to Monitor During a Taper 6:00

Peer support certainly has a lot of utility and then there's lots of educational resources available. Tracking your symptoms during tapering can also help, it can help identify patterns, distinguish withdrawal from relapse, guide nuanced adjustments. And these processes work best when it's intentional, not reactive. Okay, what to watch for? Well, during a taper off, it is important to monitor new or worsening symptoms, timing of symptoms. as in withdrawal versus an underlying condition, and then other components such as sleep, stress and overall health.

And remember, if symptoms become overwhelming, it's okay to pause or adjust because this is not a race. So let's bring this together. Discontinuing psychiatric medications can be done safely, but it requires awareness, planning, support and patience.

Key Takeaways and Next Steps 6:52

If you're experiencing symptoms, It doesn't mean something's wrong with you. It means that your brain is adapting. Again, and with the right approach, that process can be supported. If this was helpful, make sure to subscribe so you don't miss future videos where we break down mental health and treatment in practical evidence-based ways. I'm Dr. Arwen Podesta. Thanks for being here. And in the next video, we're gonna talk about symptom worsening during substance withdrawal, recovery, treatment and how to understand what's really happening in brain.