We at Mind bumped into James on Twitter, heard about his 'tapering kit' idea - and thought our followers and supporters would like to know about it. Read James' blog below and tell us what you think. Would a 'tapering kit' work for you?
I am sitting at my desk at work, my heart is pounding, I am dizzy, my vision is blurred and I am feeling very very sick. I am in the middle of a full blown panic attack and I am fighting hard not to run screaming from the building.
In late 2013, after many years of of trying to “tough out” my anxiety and depression, I found myself unable to work and practically house-bound with fear.
Prior to this I had worked in the Civil Service for over twenty years and, although I recognised my anxious tendencies, I just believed that my feelings and thoughts were normal and I was somehow weaker than others around me.
After several years of treatment and medication, I decided that I wanted to stop my anti-depressant; Mirtazapine, which I had been taking for 3 years. The advice of my local G.P. was “just take half for a week then stop”.
I found the experience of trying to stop my anti-depressant very difficult. I made repeated attempts to reduce, only to suffer physically with insomnia, nausea and agitation. This inability to reduce my medication easily intensified my feelings of being “weak”.
My Doctor told me that what I was experiencing was a return of my original symptoms, but to me it wasn’t. Eventually I managed to reduce to the lowest possible dose available in pill form – but I wasn’t able to reduce further. I asked for a liquid version of my medication but it was too expensive for my local health service to provide. I had also tried pill-cutting which proved to be difficult and still caused physical difficulties.
One day I started to wonder, the pharmaceutical companies manufacture most of these drugs in a wide variety of doses, how difficult would it be to be to create “tapering kits” to help people taper off at the end of treatment?
The idea of a ‘tapering kit’
A tapering kit would consist of a supply of tablets in ever-reducing dosages which would be dispensed by your G.P. or local pharmacist. By using the kit, a user would gradually reduce the dosage of their medication in a safe, well managed and controlled way.
Not only would this help the drug-user, it would reduce the burden on the NHS and save significant time for G.P.s, psychiatrists and Community Mental Health Teams. I believe that there would also be cost-savings in reducing the number of unnecessary prescriptions.
I feel strongly that pharmaceutical companies have a responsibility to support those users who wish to stop taking their products. These companies are already set up to manufacture huge quantities of these drugs, so I think it is unlikely to be a large additional cost to manufacture tablets of decreasing dosages. At most this is likely to be a tiny fraction of a percentage of profit – but would win a huge amount of public confidence that the Pharmaceutical firms have their customers safety at heart.
I decided to create an online petition at change.org to try and gauge how much this problem affects other users and to gain support for the idea. So far there has been a great deal of positive feedback and I feel that, with more support, we can start a dialogue which could result in real change for users of psychiatric medications.
My sincere hope is that we can reach a point where users of these drugs who have come to the end of treatment and wish to stop, can do so in a controlled, safe and well managed way, with the support of their local health service and the relevant drug manufacturer.
I am grateful to Mind for the opportunity to talk about my experiences and to be able to get feedback from others, who may be similarly affected.
I must stress that changing dosage or stopping any psychoactive medication should only be done with the guidance and support of your doctor or psychiatrist.
Katherine Darton, from our Information team says this:
James is absolutely right, we've talked to a lot of people who seem to find the last bit of withdrawal the hardest to do. And with liquid versions of drugs being so much more expensive than tablets, it's often very difficult to make the smaller reductions that work for them. I think pharmaceutical companies could definitely help people by making them more readily available.
I also agree with James about getting guidance and support from someone before trying to 'come off'. However I don't think this always has to be a Doctor.
Some doctors will deter people from attempting it, whereas in most cases it should be someone’s own decision whether to go on taking medication or not. Doctors are also sometimes not well informed as they could be about how to come off, as James' experience demonstrates.
I think the most helpful advice comes from others who have already done it, who understand the process and are aware of the problems that may arise.
Katherine has worked for Mind for over 20 years, she has a PhD in Physiology and is a specialist in psychiatric medication.