Starting And Stopping Medications For Mental Health
Dear fellow gardeners;
Many people who have taken medication for any chronic medical condition, consider stopping it at some point. Patients taking medication for mental health conditions are no different. There are multiple reasons they may consider stopping meds.

Image item

One very common reason for a person not to take their medication as ordered is a lack of understanding of their illness. They may balk at a diagnosis of mental illness or feel that they have been misdiagnosed. While denial is common in all chronic illnesses, it can be even more pervasive in mental illness. Consider this article your permission slip to ask questions of your provider about why they are giving you the diagnosis that they are giving you. You also have a right to ask about your options for treatment. This applies to starting medication as well as the entire process of treatment along the way. Understanding your illness and how the medications that you are prescribed will help you will go a long way to helping you take your medications as prescribed. It will also help you get feeling better as soon as possible. 
Another reason people have difficulty taking medications as prescribed is dependency on other substances. Use of alcohol or illicit drugs can interfere with taking medications as directed for a variety of reasons. Use of substances can be very difficult to discuss with your healthcare provider as it can feel very private. It is crucial to be honest about your substance history so that your provider has the best chance of developing the safest and most effective medication regimen possible. If you are concerned about how your lifestyle habits will affect your ability to take your medications as ordered, the sooner you discuss this with your provider, the better able they will be to help you.
Patients may feel better than they did before starting medications. This can lead to a feeling that the medication is no longer needed. It is worthwhile to think twice if this describes you. The medication may be the REASON you feel better and stopping the medication could cause your symptoms to return. 
Side effects can also cause people to stop taking medication as described. Any medication has the potential to cause side effects. Mental health medications are no different. Your prescriber will likely ask you to make a return visit or check in several weeks after starting a new medication. This is both to see if the medication is working as expected and to determine if you have any side effects from the medication. It is important to keep these appointments, as communication is key in properly managing any medication. Some people are embarrassed to discuss side effects with their provider. One common example of this is sexual side effects that occur with some medications. You may feel that you have already had to be very vulnerable in discussing your mental health difficulties, and discussing sexual difficulties is just too intimate. Rest assured that health providers have heard it all. Your provider really wants to help you feel your best. It is crucial to be direct about what you are experiencing so your provider can use their hard-earned knowledge to help you meet your goals. The good news is that there is often an alternate medication that your provider can prescribe that will help your mental health without causing unpleasant side effects. 
Depending on the medication you are taking, you may be having difficulty affording your medication or affording the visits needed to get your medication. You may be having difficulty getting to appointments due to transportation issues. Again, this is a great opportunity to communicate with your healthcare provider to find the right treatment for you. Many medications are available in less expensive, generic forms that may work just as well for you as the more expensive medication. If you are taking a medication that does not have a generic form, your provider may be able to help you work with your insurance company to cover the medication. Or they may be able to help you get the medication covered through a patient assistance program. Most healthcare providers are excellent problem solvers. If you let them know what the problem is, they will do their best to solve it.
Some people start a medication and then find out it doesn’t seem to be working for them. It is crucial that you talk to your provider about this. Many mental health medications take 4-6 weeks to show their complete positive effects. Realistic expectations are key in the process of starting new medications and attaining the goals of treatment. But if you have given the medication an honest trial and still feel like you aren’t improving, then the next step is to talk to your provider about a better alternative for you. The dose of the medication may need to be adjusted or you may need a different medication.
Carefully choosing a healthcare provider that you feel you can trust is a big part of taking your medications as ordered. A lack of trust between patient and provider can interfere with the success of treatment. In today’s complex healthcare system, your choice of provider may be made by your insurance company, so you may not always feel you have total control here. However, doing what you can on your end to form a trusting relationship with your provider is crucial.
Some people want to stop medications because they feel that if they aren’t taking medications for their mental health they won’t be mentally ill. Some get tired of taking medications on a daily basis. Some people find that their medication regimen is too complicated for their lifestyle and they are having difficulty taking medications as they are ordered. This can be frustrating and can cause it to take longer for you to notice improvements. All of these things are very normal and common concerns. If you communicate them to your healthcare provider they can help you find solutions. They may find a long acting form of the medication that needs to be given less frequently or help you modify your medication regimen to better fit your life and schedule. 
Withdrawal Symptoms: 
Stopping medications abruptly may cause withdrawal symptoms. Abrupt discontinuation of antidepressants can lead to flu-like symptoms like fatigue, lethargy, malaise, headaches, muscle aches, diarrhea and nausea. You may also have trouble sleeping or experience dizziness/lightheadedness, visual changes, tingling sensations, anxiety/agitation. 
Despite their name, antipsychotics are a class of medications that may be used for more than just psychosis. They may be used as add on therapy for a variety of other mental health conditions. Discontinuing them abruptly may lead to: nausea, vomiting, abdominal pain, diarrhea, headaches, fast heart rate, dizziness, increased perspiration, muscle soreness, restlessness, anxiety, and difficulty sleeping. 
Benzodiazepenes are a common class of drugs used for anxiety. Abrupt stopping of these medications may cause nausea, vomiting, tremors, headache, anxiety, and difficulty sleeping. More importantly, withdrawal from this class of medications can potentially be life threatening as it can cause seizures.
If any of these classes of medications are slowly tapered under direction from your healthcare provider instead of abruptly stopped, withdrawal symptoms will be less likely. If they do occur, they will be milder in nature. If you are being monitored by your healthcare provider as you wean off medications, you are also less likely to experience a severe rebound of the symptoms that caused you to need the medications in the first place. He or she can either start you on different medication or can assist you in making changes to your life that will reduce the severity of your symptoms. Your provider has been educated on the best ways to discontinue the medications they prescribe and can be a tremendous asset in this process. 
If you have considered the above and still want to stop or change your current medication regimen, call your provider and schedule an appointment. If you are nervous about that conversation, write down a list of your concerns before your appointment so you don’t forget what you wanted to say. Your prescriber will be able to discuss SAFE ways to discontinue your medication and alternative medications that you can try. Often you will be instructed by your provider to gradually reduce your dose of medication over days or weeks. This will allow you to significantly reduce the risk of withdrawal symptoms or rebound symptoms. When you embark on a relationship with a healthcare provider, communication is the key to getting what you need from the experience. If you are open and honest with your provider about what you are experiencing, he or she will be in the best position to help you feel your absolute best!