Coming off Psychiatric Drugs: Successful Withdrawal from Neuroleptics, Antidepressants, Lithium, Carbamazepine and Tranquilizers

Greg White: Review in Journal of Critical Psychology, Counselling and Psychotherapy

Psychiatric Drug Addiction – Review in openmind – the mental health magazine

Chris Stirk: Review in Hearing Voices Network Newsletter

Harold A. Maio: Review in www.raggededgemagazine.com

Mary Maddock: Review

Yakov Kostrovsky: Some thoughts about the book

Janine Soffe: Review in Journal of Critical Psychology, Counselling and Psychotherapy

Viveca Liventhal: Hvordan man holder op med psykofarmaka. Review in SIND blad (Denmark)

Jeffrey Masson: Review in Clinical Psychology Forum (United Kingdom), No. 43 (November 2004), p. 40

Read about successful coming off psychiatric drugs, do not run away!

In the preface of the book Pirkko Lahti, Director of the Finnish Association for Mental Health and President of the World Federation for Mental Health, writes:

"Many of my colleagues in the mental health field spend much of their time developing criteria for the application of psychiatric drugs."

She continues:

"Diagnoses and indications often result in a treatment with psychotropic drugs that can last for a long time. ... What risks arise from the withdrawal of neuroleptics, antidepressants and lithium? What factors favor successful withdrawal-successful in the sense that patients do not immediately return to the doctor's exam room, but live free and healthy lives, as all of us would wish? Have we not heard about pharmacogenic withdrawal-problems, receptor-changes, supersensitivity-psychoses, withdrawal-psychoses? Who is able to distinguish relapses from hidden withdrawal problems? Do we not leave our patients alone with their sorrows and problems, when they-for whatever reasons-decide by themselves to come off their psychotropic drugs? Where can they find support, understanding and good examples, if they turn away from us disappointed (or we from them)?"

These questions are so striking that I can only assent to them.

Lehmann does not make a simplistic appeal for the tossing out of psychiatric drugs. He expressly repudiates panaceas. The book has a provocative message; life-experiences sometimes differ from scientific agreements. 28 authors, (ex-) users and survivors of psychiatry from Australia, Austria, Belgium, Denmark, England, Germany, Hungary, Japan, the Netherlands, New Zealand, Serbia & Montenegro, Sweden, Switzerland and the USA, managed to come off psychiatric drugs sometimes well, sometimes with problems and sometimes after decades. What is striking is how rarely they received professional help in that process. The fact that the editor found additionally eight professionals, working in psychotherapy, medicine, social work, psychiatry, natural healing an even in a runaway-house, who report on how they helped in the withdrawal process, does not change the central argument that being-left-alone is often the very best remedy.

Learn a lesson from the courageous pioneers, who take responsibility and accompany the often necessarily slow withdrawal with help and advice. I especially recommend the story of Martin Urban's case: "'Am I really still disabled?' Psychotherapeutic support during withdrawal from psychiatric drugs". Urban, leader of the section "Clinical psychologists in psychiatry" in the occupational union of German psychologists, shows empathetically how to support people who were declared to have a chronic mental illness in their self-chosen withdrawal: without prejudice, but with respect and devotion-on the basis of an opinion independent of psychiatry. The results of his activity are impressive; he deserves the positive comment added to his story by his patient-read it for yourself in the book.

Regardless of how people working in the psychosocial field assess the motivation and risks of coming off psychiatric drugs, finally it is the users' decision, and they don't behave differently than the rest of society-up to 50% abandon the drugs they were prescribed. It is a good thing that there is this unique new book about a topic which has been badly neglected until now. Moreover, it is fun to read. Loren R. Mosher, the former Director of Soteria Associates and Clinical Professor of Psychiatry at the University of California at San Diego, who tragically died at July 10, 2004 in Berlin, wrote in his preamble to Peter Lehmann's book:

"This book is a must read for anyone who might consider taking or no longer taking these mind altering legal drugs and perhaps even more so for those able to prescribe them."

Jeffrey M. Masson, New Zealand (former Director of the Sigmund-Freud-Archives in Washington, D.C.)

Greg White: Review in Journal of Critical Psychology, Counselling and Psychotherapy (United Kingdom), Vol. 4 (2004), No. 3, p. 200

There is no tyranny so great as that which is practised for the benefit of the victim. (C. S. Lewis)

Madness is the traditional way of expressing deep unresolved frustration and anger. In ancient times it was accepted as a given, often perceived as a distinguishing feature of the individual. Since the Inquisition, however, especially for women and children, such expression is positively dangerous, even in one's own home. This is so it seems, because the 'mentality of normality' – as we know it – has been progressively constructed around the idea that negative feelings, especially by women and children, are antisocial, bad.

Previously stigmatised as a mark of possession by evil spirits, now, as the power of old religion has waned, this scapegoating is being carried on pharmacologically by clinical psychologists, psychiatry and medicine, on behalf of a new bio-psychiatric religion. Clearly the resultant stigmatised feeling that death is safer than madness is at bottom a fundamental cause of suicide.

For me Coming off Psychiatric Drugs is the first serious challenge to scientific religion posing as medicine, by those most qualified to do so: the whistle-blowing patients. Containing often amusing but mostly harrowing and painful accounts of personal suffering by twenty eight de-toxing individuals, it is above all the healing way out for many whose only sin is that they simply do not fit in. This book is a must read ready reference for those souls still able (indeed willing) to find the path back to 'normality' and the all too few isolated but courageous professionals with the heart to accompany them.

Greg White, Ballineen, County Cork (Ireland)

Psychiatric Drug Addiction – Review in: openmind – the mental health magazine (United Kingdom, March/April 2005, No. 132, p. 23

There is no guarantee that coming off psychiatric drugs will be easy, and the uniqueness of individuals – their particular problems and possibilities – means that no single approach can work for everyone. Nevertheless, users/survivors will be encouraged by the sheer diversity of strategies offered by contributors to Coming Off Psychiatric Drugs: the accounts of 28 people who successfully discontinued using drugs and eight professionals who supported them.

There is a consensus that reducing doses by degrees is the best way to minimise withdrawal risks. This is especially important if a psychiatric drug has been taken for more than one or two months. A successful withdrawal is also more likely if the right kind of help is present, including a good self-help group and qualified specialists. But usually, the circumstances for coming off are likely to be less than ideal. And often, there may be no alternative to self-help. As Gerda Wozart, one of the contributing former users of psychiatric drugs, encourages: 'We are on our own, called upon to live in a responsible way. We are not only sentenced by others, muzzled by others. We always have more forces (and self-helping forces, too) available than we might have thought in dark days.'

Faced with the refusal of many mental health professionals to tackle the difficulties of withdrawal and dependence, contributors to Coming off Psychiatric Drugs found their own solutions: socialising and working together; exploring the meaning and nature of madness; trying to avoid stressful (family) relationships; searching for meaning in their lives; living closer to nature; doing therapeutic bodywork, meditation, yoga, spiritual practice and prayer. Most important, they took precautionary measures to cope with a possible return of their original problems. They sought (and found) support from doctors or homeopathic doctors, therapists (psychotherapy, hypnosis, massage etc.), natural healers, and from other therapies such as breathing techniques, vitamin treatments, acupuncture and many more.

Review in: Hearing Voices Network Newsletter (United Kingdom), 2004

... "This book is more than just a 'how to' manual for those who want to come off psychiatric medication. Each of these stories of withdrawal is different and unique, each is a testimony to the fact that regaining our lives from the diminishing and deadening limbo that psychiatry cajoles, bullies or coerces us into is truly a reclaiming of our full, creative individualilty and humanity ... It is to be hoped that these stories will be an inspiration to many others to find their own paths to reclaiming their lives."

Chris Stirk, England, September 2004

Do-it-yourself drug withdrawal (in www.raggededgemagazine.com/reviews)

A review by Harold A. Maio

Millions of people are taking psychiatric drugs – Haloperidol, Prozac, Risperidone, Zyprexa. To them, detailed accounts of how others came off these substances without once again ending up in the doctor's office are of fundamental interest.

For anyone in a mental health profession, anyone studying for a mental health profession, anyone teaching those students, anyone prescribing psychotropic drugs, and anyone with a loved one taking psychotropic drugs, this book is a reference of great value. And of course, it's of great value for individuals taking psychotropic drugs themselves, and their relatives. It belongs in every mental health library for its very personal stories of self-advocacy, self-discovery and self-efficacy.

Twenty-eight people from throughout the world – Australia, Austria, Belgium, Denmark, England, Germany, Hungary, Japan, the Netherlands, New Zealand, Sweden, Switzerland and the U.S. – write about their experiences with withdrawal. Another eight people, these in mental health professions, report how they helped people in the withdrawal process.

Withdrawal from psychotropic drugs is not for everyone. It should be considered with caution, as this book carefully explains, and like withdrawal from any drug is not to be taken lightly. Withdrawal is a process, a careful process, and one which, once decided upon, must be painstakingly approached.

My own experiences with withdrawal – sudden, precipitous and without knowledge or support – contrasts starkly with the careful approach of each of the contributors: On December 24, 2003, a doctor precipitously ended my relationship with her office, denying me renewals on all the psychotropic medications I was taking, and had taken for a period of 2 years under the guidance of one of her colleagues, who had taken a leave of absence. What followed were weeks of fear, tension and stress; terrible flu-like symptoms, which finally abated, but which so weakened me that I developed pneumonia. Neither my wife nor I understood what was happening to me: the pain, sweats, fatigue, the onset of pneumonia. Together we learned just how debilitating sudden withdrawal from psychotropic drugs can be.

The physician's abandonment so frightened me that I now have a very difficult time visiting any doctor, fearing yet another negative experience, another abuse. Since the withdrawal I have taken no psychotropic drugs. I have encountered no exacerbated symptoms of depression.

Regina Bellion, in recounting her story, explains it well: "Each individual must make their own decision regarding whether or not they wish to withdraw from psychiatric drugs. It would never occur to me to tell someone else what they should do," she writes. Her own tale of withdrawal and self-discovery is a personal Odyssey carefully retold, described in such detail that the reader will accompany her every emotion on the journey:

"There are techniques (gymnastics, breathing exercises, posture) for influencing and changing your condition," she writes. "Everyone must discover the techniques appropriate for him or herself. This is not something that can be done quickly in one's spare moments. It takes time and energy to develop one of those techniques into an aid that can be promptly utilized. An example: As quickly as I can bring myself into a stressful state with quick short breaths, I can also bring myself into a peaceful state with calm, deep breaths. Or if I constantly slink around with my head low, then it is no wonder that my mood becomes depressed. Such simple things are not a panacea. But they have effects that I can make use of."

As is each narrative, Bellion's is a journey in search of self. Having withdrawn from drugs, she now applies her mind to understanding personal defenses and strategies to assure a healthy life.

The journeys of each of the authors of this publication will come alive for you, and whether you do or do not wish to encourage the idea of withdrawal, the journeys will enlighten you.

Posted Sept. 20, 2004

Harold A. Maio, Consulting Editor of the Psychiatric Rehabilitation Journal, heads The Mental Health Clearing House. His last article for Ragged Edge was The Diminution of Self.

Review by Mary Maddock (unpublished)

All the people who write in Coming Off Psychiatric Drugs have one thing in common, namely, they all see how destructive psychiatric drugs are. Unfortunately that is not true for everyone taking psychiatric drugs on a long term basis. Because each person is unique with different life-experiences, they come to this conclusion in their own special way – some without pharmacogenic problems, some step by step, some with professional help and a few thought that stopping sometimes was better than taking them forever.

Eight professionals in the field, including Marc Rufer from Switzerland added their very valuable insight. Most people who find themselves on long-term drugs have another common factor – they live in fear. This leads to low self-esteem and depression. To rid the body from all toxic substances, usually against great odds, helps to boost self-esteem but this is not enough. They are still vulnerable. It is easy to relapse. It is necessary first to deal with the anxiety that can absorb a person's whole being.

Coming Off Psychiatric Drugs is a huge task because everyone who has to do this has suffered so much already and this usually will entail even more suffering. All the professionals who contribute to the book have excellent wisdom but I would like to pay special attention to Marc Rufer whose contribution is entitled 'Creating Fear/Removing Fear'. He writes 13 pages and all his ideas are valid. I want to draw attention to what he has to say about tolerance. He makes the point that every psychiatrist knows that drugs should be introduced gradually but the same attention is not given to that of withdrawal. How many people taking drugs realise this? Many of them discontinue 'cold turkey' and think the withdrawal symptoms are the recurrence of so-called mental illness.

Marc writes "If tolerance has developed , then withdrawal delirium can occur if the drug is stopped abruptly, causing disturbances in perception as well as disorientation, confusion and hallucinations. Such delirium is well known following withdrawal from alcohol, benzodiazepines and anticholinergics such as anti-Parkinson drugs. Far too little attention has been paid to the fact that this can also occur when neuroleptics are stopped." Gradual reduction is very important. He goes on to write "On the other hand, it must not be forgotten that neuroleptics, anti-depressants, anti-Parkinson drugs as well as alcohol, cocaine and amphetamines can cause toxic delirium. Disorientation, confusion , hallucinations and disturbances in perception, therefore, can also be a sign of intoxication with these substances. If toxic delirium results from treatment with high doses of psychiatric drugs, they must be stopped immediately."

I was on three different toxic substances – Largactil- a neuroleptic, Surmontil- an anti-depressant and Lithium – an element. I took high dosages of all three together for ten years and was on some toxic drugs for almost twenty years. I found every word Marc Rufer writes to be true from my life experience. I am now happy to say I am four years free from all drugs leading a full, healthy and enjoyable life at the age of 56. I have re-discovered myself. I wish all my sisters and brothers all over the world were so lucky.

Mary Maddock, MindFreedom Ireland

Yakov Kostrovsky: Some thoughts about the book (unpublished)

I want to express my gratitude to the authors and the editor of this valuable book for their open-hearted stories, experiences, willingness to share them with readers.

The book is opened with a note about liability of readers (users) and it makes them from the beginning think and refrain from immediate actions to withdraw from their drugs. My opinion is that a user should read the whole book from the beginning to the end before making any decision.

The book tells a reader about experience (positive and negative moments as well) of the authors. For users/survivors the reading will be useful regardless of their present willingness to cut off the drugs: maybe just to think of and to refresh their own views on their life. For doctors it will be useful to read it for better understanding of the situation, to recollect about existence of non-pharmacological methods of healing. Having read the book, relatives of users may see facets of life of their mentally-challenged nearests, probably not noticed before; it can help understand the nearests deeper.

A user/survivor can take knowledge on how to act during the withdrawal process. In addition, most of this information will be useful to weaken and, probably, escape relapses and, generally, to live more healthy everyday life (even if a user who have read the book will decide not to withdraw the drugs).

Lastly, I would like to mention that the book was published very good: its cover, paper, type are excellent. It is pleasant to hold in hands and to read.

It would be wonderful to see the Russian language edition of this book in future. It would be useful for many people.

Yakov Kostrovsky, St. Petersburg (Russia), September 30, 2004

Janine Soffe: Review in Journal of Critical Psychology, Counselling and Psychotherapy (United Kingdom), Vol. 5 (2005), No. 1, p. 50

'The Verve' were right, as this book focuses on how the 'drugs don't work, they just make things worse'. But then the majority of us know that anyway don't we?

The book does what it says on the cover. It details the experiences of people all over the world who've been prescribed psychiatric drugs and their journey to realising what 'The Verve' put so succinctly. There are also contributions from mental health workers describing the oft denied phenomena of withdrawal effects and how they have supported those people who have decided to live a life free of psychiatric medications.

This text seems particularly timely given the recent more widely publicised debate around the prescribing of antidepressants such as Prozac and Seroxat and the so-called 'evidence base' purporting to support their effectiveness. Obviously the researchers forgot to talk to people such as the ones who described their experiences in this book, or maybe they did and what they had to say wasn't seen as 'scientific enough', what ever that is.

It is also hopeful reading in giving space for people to tell their stories of managing their lives without psychiatric drugs, thereby contesting the much repeated psychiatric myth that people need to take such drugs for the rest of their lives. I would concur with Loren Mosher that this book should be required reading for all people whose lives are affected by the psychiatric drug industry in whatever form, none more than so than those who prescribe the drugs.