“He said, ‘Oh, this little pill is going to change your life,’ ” Ms. Hempel said. “Well, did it ever.”
The drug blunted her PMS symptoms, she said, but also caused her to gain 40 pounds in nine months. Quitting was nearly impossible — at first, her doctor tapered her too quickly, she said.
She succeeded in her last attempt, in 2015, by tapering over months to 10 milligrams, then five, down from 20 milligrams and “finally all the way down to particles of dust,” after which she was bedridden for three weeks with severe dizziness, nausea and crying spells, she said.
“Had I been told the risks of trying to come off this drug, I never would have started it,” Ms. Hempel said. “A year and a half after stopping, I’m still having problems. I’m not me right now; I don’t have the creativity, the energy. She — Robin — is gone.”
At least some of the most pressing questions about antidepressant withdrawal will soon have an answer.
Dr. Mangin, of McMaster University, led a research team in New Zealand that recently completed the first rigorous, long-term trial of withdrawal.
The team recruited more than 250 people in three cities who had been taking Prozac long-term and were interested in tapering off. Two-thirds of the group had been on the drug for more than two years, and a third for more than five years.
The team randomly assigned the participants to one of two regimens. Half tapered slowly, receiving a capsule each day that, over a period of a month or longer, contained progressively lower amounts of the active drug.
The other half believed they were tapering but got capsules that in fact maintained their regular dosage. The researchers followed both groups for a year and a half. They are still working through the data, and their findings will be published in the coming months.
But one thing is already clear from this effort and other clinical experience, Dr. Mangin said: Some people’s symptoms were so severe that they could not bear to stop taking the drug.
“Even with a slow taper from a drug with a relatively long half-life, these people had significant withdrawal symptoms such that they had to restart the drug,” she said.
For now, people who haven’t been able to quit just by following a doctor’s advice are turning to a method called microtapering: making tiny reductions over a long period of time, nine months, a year, two years — whatever it takes.
“The tapering rates given by doctors are often way, way too fast,” said Laura Delano, who had severe symptoms while trying to get off several psychiatric drugs. She has created a website, The Withdrawal Project, that provides resources on psychiatric drug withdrawal, including a guide to tapering off.
She is hardly the only one bewildered by the scarcity of good medical advice about unwinding prescriptions that have become so common.
“It has taken a long, long time to get anyone to pay attention to this issue and take it seriously,” said Luke Montagu, a media entrepreneur and co-founder of the London-based Council for Evidence-Based Psychiatry, which pushed for Britain’s review of prescription drug addiction and dependence.
“You’ve got this huge parallel community that’s emerged, largely online, in which people are supporting each other though withdrawal and developing best practices largely without the help of doctors,” he said.
Dr. Stockmann, the psychiatrist in East London, wasn’t entirely convinced withdrawal was a serious issue before he went through it himself. His microtapering strategy finally worked.
“There was a really significant moment,” he recalled. “I was walking down near my house, past a forest, and I suddenly realized I could feel the full range of emotions again. The birds were louder, the colors more vivid — I was happy.”
“I have seen lots of people — patients — not being believed, not taken seriously when they complained about this,” he added. “That has to stop.” (Click to Source)
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