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Explains issues faced when coming off medication, how to approach it, techniques for gradual reduction, possible withdrawal symptoms and how to tell the difference between withdrawal and relapse.
As all psychiatric drugs change brain and body chemistry, they may all cause withdrawal symptoms, especially if you have been taking them for a long time. You will not necessarily get any withdrawal symptoms when coming off, but many people do. The symptoms differ to some extent between drug types.
Information on the withdrawal effects of different types of drugs is given on the relevant pages:
Information about the withdrawal effects of individual drugs is on the information page for each drug, found in the relevant A-Z.
If you have symptoms related to drug withdrawal, they:
If you have symptoms related to your mental health problem coming back, they:
If you are taking a drug with a short half-life and having problems with withdrawal symptoms, it may be possible for you to switch to a related drug with a long half-life, which should be easier to come off. You will need the help of a doctor to switch drugs because your prescription will need to be changed.
The benzodiazepine tranquilliser with the longest half-life is diazepam (Valium). If you are coming off one with a short half-life (such as temazepam) you could switch to diazepam.
Some people also use diazepam to help come off the ‘z’ sleeping pills, which act in a very similar way to benzodiazepines.
Change to 5mg of diazepam (Valium) from:
The SSRI antidepressant with the longest half-life is fluoxetine (Prozac). It may be helpful to switch from a drug with a short half-life (such as paroxetine) to fluoxetine and slowly withdraw from that. As fluoxetine takes a little while to build up in your system, some specialists suggest starting it while you lower the dose of the other drug, taking both drugs together for a week or two.
Change to 20mg fluoxetine liquid from:
When coming off antidepressants, an alternative to fluoxetine is to switch to clomipramine 100mg/day.
Drug switching techniques may be used with antipsychotics but you would need advice from a psychiatric pharmacist or psychiatrist on which drug to switch to.
You would need advice from an experienced psychiatrist or psychiatric pharmacist on whether this technique would work for mood stabilisers, and which drugs might be suitable to switch to.
It's possible that you might be advised to switch to antipsychotic medication.
This information was published in July 2016. We will revise it in 2019.
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