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Category Archives: Psychiatric Medication

New study highlights stories of successful withdrawal

My latest paper has just been published in the open access journal, Therapeutic Advances in Psychopharmacology, as part of their special collection on discontinuing psychotropic medication.

You can read the full text free here: Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication (Larsen-Barr and Seymour, 2021).

Abstract

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this.

Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process.

Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences.

Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

Learning To Cope And Thrive Through Psychiatric Medication Withdrawal

Will Hall is offering a free online workshop called Learning to Cope and Thrive through Psychiatric Medication Withdrawal on Friday the 5th of February at 8-9:30 am NZ time. Register on EventBrite at the link below.

https://www.eventbrite.com/e/learning-to-cope-and-thrive-through-psychiatric-medication-withdrawal-tickets-135165097445

Will Hall is a counselor and advocate whose work and learning arose from his experiences of recovery from madness. He holds a Diploma and Masters Degree in Process Work from the Process Work Institute, and studies over the years have included training with Jaakko Seikkula and colleagues in Open Dialogue at the Institute for Dialogic Practice, and the WRAP facilitators’ training. He was a co-author of the Harm Reduction Guide to Coming of Psychiatric Drugs with the Icarus Project and is currently a PhD candidate at Maastricht University Medical Center – School for Mental Health and Neuroscience, supervised by Dr. Jim van Os doing research into alternatives to psychiatric medications.

Town Hall Series on Psychiatric Drug Withdrawal

Mad in America has teamed up with the International Institute for Psychiatric Drug Withdrawal and the Council for Evidence-Based Psychiatry to share a series of live ‘Town Hall’ discussions exploring what we do and don’t know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants.

The first event in the series was aired on the 15th of January (GMT) and if you didn’t get a chance to tune into the live stream you can find the video on Youtube at the link below.


Psychiatric Drug Withdrawal Town Hall 1 – Introducing the Series
https://youtu.be/Pj-mLG7tYi4

The ‘patient voice’ on antidepressant withdrawal effects

A new qualitative study exploring antidepressant withdrawal effects and prescribing experiences was published in November which is well worth a read. In this paper, Anne Guy and co-authors outline the results of a qualitative study of 158 people who gave descriptions of their experience of psychotropic medication withdrawal for petitions sent to British parliaments. 

“The themes identified include: a lack of information given to patients about the risk of antidepressant withdrawal; doctors failing to recognise the symptoms of withdrawal; doctors being poorly informed about the best method of tapering prescribed medications; patients being diagnosed with relapse of the underlying condition or medical illnesses other than withdrawal; patients seeking advice outside of mainstream healthcare, including from online forums; and significant effects on functioning for those experiencing withdrawal.”

There are a few links to prescriber resources in among the references that might be useful to explore.

Read the full open-access article here: https://journals.sagepub.com/doi/10.1177/2045125320967183

Guy, A., Brown, M., Lewis, S., et al, (2020). The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition. Therapeutic Advances in Psychopharmacology, 10, DOI: 10.1177/2045125320967183

World Antipsychotic Withdrawal Survey

Over the last couple of years, I’ve had the privilege of advising on the World Antipsychotic Withdrawal Survey and last week I met with the project lead and the statistics whizz to prepare for data analysis. You can colour me excited because it is shaping up to be huge – 4000 people and counting so far! The NZ sample is still relatively small but the survey is still open, so if this is relevant to you, do take a look and think about getting amongst it if it feels right for you.

This is a PhD research project led by Will Hall under the supervision of Jim van Os and John Read.

Find out more here: https://www.antipsychoticwithdrawalsurvey.com/

Clinical experiences of supporting people to taper off antipsychotic medication

Tapering Antipsychotic Treatment
Mark Abie Horowitz, Robin M. Murray, David Taylor, JAMA Psychiatry. Published online August 5, 2020. doi:10.1001/jamapsychiatry.2020.2166

In this paper three leading researchers in the field of psychiatric drug withdrawal summarise their clinical experience in supporting people to taper off antipsychotic medication.

You can request a full-text copy of this short, peer-reviewed opinion piece directly from the authors on Research Gate here: www.researchgate.net/publication/343467517_Tapering_Antipsychotic_Treatment

More results from The Experiences of Antipsychotic Medication Study

Read online at Science Direct
or request a copy of the full-text on Research Gate

New Research: Support makes a difference in antipsychotic medication withdrawal

An important part of my doctoral research and some further analysis has just been published in Social Psychiatry and Psychiatric Epidemiology. You can follow this link to view a copy of the full text online, but will need a subscription to download a pdf copy to keep:  https://rdcu.be/MpKs

Here’s a screenshot of the abstract for quick reference…

Abstract Attempting to Stop Antipsychotic Medication Success Supports and Efforts to Cope

Robert Whitaker reviews the evidence on antidepressants

Robert Whitaker has written a critical review of the antidepressant literature for the Mad in America website.

The review has three parts.

  • “The evidence for the efficacy of antidepressants over the short term in RCTs, which is the evidence that psychiatry relies on to claim that the drugs “work.”
  • The evidence for the effectiveness of antidepressants over the short term in “real-world” patients.
  • The evidence regarding their long-term effectiveness in real-world patients.

This broader review of the research literature does then lead to a dichotomous question for society. Do antidepressants, as they are being prescribed now, “work” for society? Do they produce a public health benefit?”

Read the full article Do Antidepressants Work: A People’s Review of the Evidence here.

New Study: no such thing as chemical imbalance?

A recent study looked at the “Effects of a chemical imbalance causal explanation on individuals’ perceptions of their depressive symptoms.”

A group of participants was given “a bogus but credible biological test demonstrating their depressive symptoms to be caused, or not caused, by a chemical imbalance in the brain”.

“Results showed that chemical imbalance test feedback failed to reduce self-blame, elicited worse prognostic pessimism and negative mood regulation expectancies, and led participants to view pharmacotherapy as more credible and effective than psychotherapy. The present findings add to a growing literature highlighting the unhelpful and potentially iatrogenic effects of attributing depressive symptoms to a chemical imbalance.”

In short, it might be harmful to believe that you have a chemical imbalance. A diagnosis of “depression caused by chemical imbalance” might cause depression.

Study authors:

Joshua J. Kempa, James J. Lickelb, Brett J. Deacona

Link here.