Is it possible to withdraw from antipsychotic medications safely and successfully, without the “chronic” psychotic condition recurring? YES! Although psychosis is one of the most difficult conditions to treat in psychiatry, it is definitely possible to safely and effectively taper off of antipsychotic medications.
When an individual becomes psychotic, typically an antipsychotic medication is used to ameliorate symptoms. However, there are many side effects associated with the use of antipsychotics, and no clear way to ever come off the medication once symptoms are under control. In addition, withdrawal from an antipsychotic medication, after taking it for several years, will often result in withdrawal symptoms that mimic the original psychotic illness.
Over the years, I have learned how to overcome the difficulties and dangers associated with antipsychotic medication withdrawal. In the beginning, I was under the misconception that because all these medications treated psychosis, that they will have the same level of difficulty when it came to withdrawal. Not so. Consider Zyprexa, it affects no less than 17 different subtypes of receptors, while Haldol affects only two dopamine receptor subtypes. In between, we have Abilify, which affects 10 different receptor subtypes, to Seroquel which affects seven different receptor subtypes. When these medications are lowered, the body has to adjust to the changes in how receptors are affected during the taper. Which medication do you think would be the easiest for the body to adjust to, the medication that affects 17 receptor subtypes, or the one that only affects two? For most individuals, this would be a rhetorical question.
In the process of learning about medication withdrawal in general and antipsychotic withdrawal in particular, I have discovered that in addition to supporting the body with plenty of supplements and energy medicine techniques, there are some certain aspects of the medication withdrawal process that are critical for a smooth and safe withdrawal process. They are as follows:
- Carefully follow sleep patterns: Do not reduce antipsychotic medications until sleep has increased through nutritional and energy medicine support to at least 9 hours per day, sleeping 10 hours per day would be preferable. Lowering antipsychotic medication when sleeping 8 hours or less would generally create a problem with insomnia.
- Use liquid antipsychotics whenever available: It is easier to taper down in small amounts when using liquid antipsychotics. Of course, this principle applies to antidepressants or anxiolytics as well. If liquid antipsychotics are not available, they can be specially compounded through certain compounding pharmacies, especially through pharmacies that also sell nutritional supplements.
- Antioxidant support: typically I use a combination of whole food powders such as acai, goji, and maqui powder to lower oxidative stress.
- Strengthen the GABA neurotransmitter system: I prefer to use GABA rice (about half a cup twice daily), GABA drops by Deseret Biologicals (typically 10 drops three times daily), and/or GABA 500mg capsules (2-3 capsules a day) to help support the GABA nervous system. Supporting the GABA neurotransmitter system allows individuals to avoid insomnia during antipsychotic withdrawal, but just as importantly, it helps to decrease the risk for mania associated with unblocking serotonin receptors during withdrawal from those antipsychotics that block these receptors. Of the three, it is my clinical experience that GABA rice is the winner when it comes to efficacy during withdrawal. Zojirushi makes GABA rice cookers and can make GABA rice from organic, brown rice. Organic, germinated brown rice cooked in a regular rice cooker will also make GABA rice.
- Most importantly, the “step-down process of withdrawal”: when lowering an antipsychotic medication that affects many different neurotransmitter subtypes, such as Zyprexa, it is important to use a “step-down process,” tapering down the antipsychotic through the use of another antipsychotic that affects fewer receptor sites. For example, when tapering down on Zyprexa, gradually increase the dosage of Seroquel. Once the individual is only on Seroquel and has safely and completely weaned off of Zyprexa, then gradually taper the dosage of Seroquel while gradually increasing the use of liquid Haldol. Once the individual has transitioned to Haldol and has completely been weaned off Seroquel, then very gradually lower Haldol. All the while, the individual should be using supplements and energy medicine to facilitate the recovery process. Tapering off Haldol, the last step of the “step-down process” will be a lot easier to accomplish successfully than coming directly off of Zyprexa.
Healing from psychotic episodes and getting off antipsychotic medications is possible. But a healthy respect for the withdrawal process will reward you with a safe and successful outcome. Otherwise, it would be easy to blame an unsuccessful withdrawal process as just another indicator that the patient has a “chronic” and severe psychiatric condition. I have come to understand “chronic” as another term for “failure in treatment.” Don’t let our traditional attitude towards psychotic conditions and our limited understanding of antipsychotic withdrawal be conveniently blamed on the disease process! You can get well if you are careful and have the right professional supports.