How to get off anti-depressant drugs—and psychotropic, mind-altering drugs in general—is an issue I deal with it all the time in my practice. It was interesting to read the story of one man’s journey on and off anti-depressants, as detailed in an article in the New York Times Magazine. Find it at Self Non-Medication In this article much important information is discussed, and I recommend it for anyone taking anti-depressants.
My general policy in my practice is that when the patient is getting better, and I see improvements in their well-being and their state, then I have a discussion on tapering off anti-depressants. Overall, most of my patients have not encountered much difficulty. Occasionally it will be bumpy, mainly because the homeopathic case needs more attention.
Even when feeling good, there are good reasons for people to get off anti-depressants. One is the “numbing effect” that anti-depressants tend to have. One often does not experience a full-range of emotion while on them. This is discussed in the New York Times article. Perhaps the best known side-effect is the loss of sexual desire, which I commonly see in people taking them. There are also issues of weight gain in certain people--a common issue in psychotropic medications. One thing not talked about much is the effect anti-depressants can have on dental health. Because they tend to reduce saliva in the mouth, and saliva is a major factor in the health of the gums, anti-depressants can predispose to bacteria overgrowth and the resulting bad effects of gum disease. Anti-depressants likely have other harmful long-term effects on certain individuals that are difficult to pick up.
In getting off an anti-depressant, one important consideration is the half-life of the particular drug. The half-life refers to the time any given drug stays in the blood stream before it is broken down and excreted. Those with short-half lives—such as Zoloft and Effexor--often are much more difficult to discontinue. If there is a problem, the doctor can switch the patient to Prozac, which stays in the blood stream a long time and gradually tapers off by itself. Nevertheless, in my practice, I have rarely found it to be necessary to switch people from Effexor to Prozac. The key point, based on my experience, is give the patient a deep-acting prescription, and psychiatric medications lose their importance for the patient's feeling of well-being.
Occasionally I will get a new patient who tells me, “You can treat me with homeopathy, but no way are you touching my psychiatric meds.” Usually they have attempted to get off them before and spiralled relentlessly downward. I am fine with this; in fact, it makes a good marker. Always it is the patient's choice. I give a remedy, and if the patient makes a jump forward, usually he reaches a point where his attitude shifts. When he tells me, “OK, you can taper my meds,” then I know for sure my prescription was dead on. Patients can feel when they are better at a deep level.
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