Harm Reduction Guide to

Coming O Psychiatric Drugs

Published by

The Icarus Project and Freedom Center

Second Edition, revised and expanded.

ISBN 978-0-9800709-2-7

This guide brings together the best information we’ve discovered and lessons

we’ve learned at The Icarus Project and Freedom Center. It is not intended to

persuade anyone to stop taking psychiatric medications, but instead aims to

educate people about their options if they decide to explore going off.

In a culture polarized between the pro-medication propaganda of pharmaceutical

companies on the one hand, and the anti-medication agenda of some activists on

the other, we offer a harm reduction approach to help people make their own

decisions. We also present ideas and information for people who decide to stay

on or reduce their medications.

Many people do nd psychiatric drugs helpful and choose to continue taking them:

even with the risks, this may be a better option given someone’s situation and

circumstances. At the same time, psychiatric drugs carry great dangers and can

sometimes do terrible harm, even becoming bigger problems than the conditions

they were prescribed to treat. Too often, people who need help getting off

psychiatric drugs are left without guidance, and medication decisions can feel like

nding your way through a labyrinth. We need honest information that widens the

discussion, and we hope this guide helps people trust themselves more and take

better care of one another.

www.theicarusproject.net www.freedom-center.org

Harm Reduction Guide to

Coming O Psychiatric Drugs

Second Edition

Written by Will Hall

Published by The Icarus Project and Freedom Center

Second edition, June 2012, version 10-19. Your input and ideas are welcome for future versions of this guide.

Written by Will Hall. Thanks to Jacks Ashley McNamara for early contributions to this Guide.

Published by The Icarus Project and Freedom Center.

Additional thanks to: Ben Abelow, George Badillo, John Banister, Amy Bookbinder, Dave Burns, Kent Bye, Mick Bysshe, Monica Cas-

sani, Oryx Cohen, Colin, Marykate Connor, Laura Delano, Jacqui Dillon, Dionysia Dionysius, Marc Dinacola, Dianne Dragon, dreamer,

Sascha Altman DuBrul, Empties, Steve Fenwick, Marian B.G., Vikki Gilbert, Richard Gilluly, Rhiannon Grifth, Chaya Grossberg, Jen

Gouvea, Molly Hardison, Gail Hornstein, Lee Hurter, Jenna, Jonah, Julie, Marianna Kefallinou, Ed Knight, Inez Kochius, Peter Lehman,

Paul Levy, Krista MacKinnon, Jacks Ashley McNamara, Tsuyoshi Matsuo, Pheepho, Suzanne Richardson, Olga Runciman, Alex Samets,

Sarah Seegal, Seven, Janice Sorensen, Lauren Spiro, Bonre Madigan Shive, Stacco, Jessica Max Stein, Terramuggus, Amy Upham, Agustina

Vidal, Dorea Vierling-Claassen, Robert Whitaker, Kate Williams, Health Professional Advisors, and many other collaborators and allies.

Cover art: Jacks Ashley McNamara. Primary guide art contributor: Janice Sorensen.

Art design: Carrie Bergman (rst edition); Seth Kadish, Ivana Klement, and Cheryl Weigel (second edition).

Contributing artists: Fly, Gheena, Will Hall, Miss Led, Jacks Ashley McNamara, Erik Ruin, Janice Sorensen, and Bec Young.

This Guide is available as a free le download at Freedom Center, Icarus Project, and Will Hall websites,

in online and printer-ready versions. You are free to use and distribute. Also available in Spanish, German,

Greek, Italian, Japanese, Dutch, Danish, Thai, Bosnian, Chinese, Hebrew, Russian, French, and other translations.

The Icarus Project

www.theicarusproject.net

info@theicarusproject.net

The Icarus Project is a website community, network of

local groups, and media project created by and for people

struggling with mad gifts commonly labeled as “mental

illnesses.” We are creating a new culture and language that

resonates with our actual experiences of madness rather

than trying to t our lives into a conventional framework.

Freedom Center

www.freedom-center.org

Freedom Center is an award-winning support, advocacy

and activism community created in Western Massachusetts,

and now in transformation. Run by and for people who

experience extreme states of consciousness, Freedom

Center works for access to holistic alternatives, compas-

sionate care, and an end to forced psychiatric treatment.

Medical Disclaimer:

This guide is written in the spirit of mutual aid and peer support. It is not intended as

medical or professional advice. While everyone is different, psychiatric drugs are powerful,

and withdrawal -- especially suddenly or on your own -- can sometimes

involve risks greater than remaining on.

Contents

Author’s Note ................................................................................................................ 5

Introduction .................................................................................................................... 6

Harm Reduction For Mental Health ......................................................................... 7

Key Resources For Further Learning ........................................................................ 9

Looking Critically At “Mental Disorders” and Psychiatry...................................10

Universal Declaration of Mental Rights and Freedoms ......................................11

How Difcult Is Coming Off Psychiatric Drugs? ..................................................12

Politics of Withdrawal .................................................................................................12

Principles Of This Guide ............................................................................................13

How Do Psychiatric Drugs Work? ..........................................................................14

Do Psychiatric Drugs Correct Your Chemistry? .................................................. 15

Who’s To Blame? Yourself? Your Biology? Neither? .............................................. 17

How Do Psychiatric Drugs Affect the Brain? ........................................................ 18

Why Do People Find Psychiatric Drugs Helpful? .................................................19

Facts You May Not Know About Psychiatric Drugs .............................................20

Health Risks of Psychiatric Drugs ............................................................................ 21

How Withdrawal Affects Your Brain and Body .....................................................25

Why Do People Want To Stop Using Psychiatric Drugs? ...................................26

Staying On Medications and Harm Reduction ......................................................27

I Want to Come Off But My Doctor Won’t Let Me, What Should I Do? .......28

Before You Start Coming Off ....................................................................................29

Working With Fear .....................................................................................................32

Intermittent Use: Taking Psychiatric Drugs From Time To Time .......................32

What are the Alternatives to Using Psychiatric Drugs? ......................................33

Coming Off: Step by Step ...........................................................................................35

I Think Someone is Overmedicated, What Should I Do? ....................................38

Looking To The Future ................................................................................................ 39

Afterward: Special Considerations ..........................................................................40

Resources ...................................................................................................................... 45

Health Practitioner Editorial Advisors .................................................................... 51

Author’s Note

This is a guide I wish I had when I was taking

psychiatric drugs. Prozac helped me for a while, then

made me manic and suicidal. I was sick for days after

coming off Zoloft, with counselors telling me I was

faking it. Nurses who drew blood samples for my

lithium levels never explained it was to check for

drug toxicity, and I was told the Navane and other

anti-psychotics I took to calm my wild mental states

were necessary because of faulty brain chemistry.

I used many different psychiatric drugs over several

years, but the medical professionals who prescribed

them never made me feel informed or empowered.

They didn’t explain how the drugs work, honestly

discuss the risks involved, offer alternatives, or help

me withdraw when I wanted to stop taking them.

Information I needed was missing, incomplete, or

inaccurate. When I nally began to learn ways to

get better without medication, it wasn’t because of

the mental heath system, it was despite it.

Part of me didn’t really want to be on psychiatric

drugs, but another part of me desperately needed

help. My suffering was very serious – multiple suicide

attempts, hearing persecutory voices, extreme

mistrust, bizarre experiences, hiding alone in my

apartment, unable to take care of myself. Therapy

hadn’t worked, and no one offered me other options.

I was under pressure to see my problems as “biologi-

cally based” and “needing” medication, instead of

looking at medication as one option among many.

For a time medication seemed like my only way out.

It took years to learn that the answers, and my hope

for getting better, were really within myself.

When I nally left the hospitals, residential facilities,

and homeless shelters I lived in for nearly a year, I

began to do my own investigating. I started judging

my options more carefully, based not on mis–

informed authorities telling me what to do, but on

my own research and learning. That process led me

to co-found Freedom Center, a support community

in Western Massachusetts that brings together

people asking similar questions.

Through the Freedom Center I discovered

that I was denied a basic medical right: informed

consent, having accurate information about my

diagnosis and medication. I learned that the

mistreatment I went through is often business

as usual in the mental health profession. I came

across research ignored by the mainstream media,

including studies by the UK charity MIND and the

British Psychological Society, which conrmed my

experience: most professionals are uninformed

about coming off drugs, and even frequently stand in

patients’ way, sometimes ending up harming them.

The Freedom Center led me to work with the

Icarus Project, and together these communities

of mutual support have helped many people make

wiser decisions – whether it is to stay on medica-

tions when they are useful or explore the possibil-

ity of coming off when they are not. Many of us are

living without psychiatric drugs that doctors told

us we would need our whole lives, and despite a

diagnosis of schizoaffective disorder schizophrenia I

have been medication-free for more than 15 years.

This guide brings together the best

information we’ve come across and the

most important lessons we’ve learned

at the Freedom Center and the Icarus

Project. It’s not perfect, and I invite you to con-

tribute your experiences and research for future

editions, but it’s a guide that I hope can be helpful.

– Will Hall

Introduction:

On the one hand there is the War on Drugs,

which keeps some drugs illegal, overows our

prisons, and hasn’t ended drug use. Then there

are the acceptable drugs like alcohol and tobacco,

advertised everywhere with promises of happiness

and success while causing widespread addiction,

disease, and death. Legal prescription drugs such

as stimulants, pain killers, and anti-anxiety pills

are just as addictive and risky as street highs,

with a doctor’s seal of approval. And then there

are neuroleptics, lithium, and anti-convulsant

drugs, which have very risky adverse effects but

help manage and dampen consciousness when

people feel out of control, so we call them “anti-

psychotics” and “mood-stabilizers.”

With drugs in the picture, lives are often at stake,

whether from addiction, adverse drug effects, or

the risks that go along with emotional crisis and

madness. Combined with the confusing messages

from society about drugs, the result is a lot of fear.

Drugs become angels or demons. We need to stay

on them at all costs, or get off them at all costs. We

look only at the risks, or we’re too frightened to

look at the risks at all. There is no compromise: it’s

black and white, all or nothing.

It’s easy to fall into absolutist thinking when it

comes to psychiatric drugs. Pro-drug advocates

focus on the risks of psychosis and extreme

emotional states, while anti-drug advocates focus

on the risks of taking drugs. But it is the belief

of this guide, and the philosophy of our pro-

treatment choice work at the Freedom Center

and the Icarus Project, that either-or thinking

around drugs is a big part of the problem.

We live in a world that,

when it comes to drugs,

is quite crazy.

Absolutist approaches to drug and sex education

teach abstinence, “just say no,” and one way for

everyone. These work for some people, but not

most, and if you don’t follow the model you can

end up being judged, not helped.

“Harm reduction” is different: pragmatic, not

dogmatic. Harm reduction is an international

movement in community health education that

recognizes there is no single solution for each

person, no universal standard of “success” or

“failure.” Getting rid of the problem is not

necessarily the only way. Instead, harm reduction

accepts where people are at and educates them to

make informed choices and calculated trade-offs

that reduce risk and increase wellness. People need

information, options, resources and support so they

can move towards healthier living – at their own

pace and on their own terms.

Applying harm reduction philosophy to mental

health is a new but growing approach. It means

not always trying to eliminate “symptoms” or

discontinue all medications. It recognizes that

people are already taking psychiatric drugs, already

trying to come off them, and already living with

symptoms – and that in this complicated reality

people need true help, not judgment. Harm

reduction encourages balancing the different risks

involved: the harm from extreme states, as well

as the harm from treatments such as adverse

drug effects, disempowering labels, and traumatic

hospitalization.

Making harm reduction decisions means looking

honestly at all sides of the equation: how drugs

might help a life that feels out of control, how

risky those same drugs might be, and the role of

options and alternatives. Any decisions become a

process of experimentation and learning, including

learning from your own mistakes and changing

your goals along the way. Harm reduction accepts

all this, believing that the essence of any healthy

life is the capacity to be empowered.

Harm Reduction For Mental Health

Everyone’s

experience is

different.

There is no formula for coming off psychiatric drugs.

What there is, and what this guide presents, is some

common experience, basic research, and important

information that can potentially make the process

less difcult. Many people successfully come off

psychiatric drugs, with or without guidance, while

others nd it very hard. Many continue on psychi-

atric drugs because the benets are greater than

the drawbacks. But many people end up staying on

psychiatric drugs without ever exploring options,

just because they don’t know any other way.

When we’ve relied only on doctors, television,

and mainstream sources, it might seem impossible

to imagine dealing with our emotional extremes

without psychiatric drugs. Maybe we’ve never

heard of anyone going through what we go through

without medications. Maybe a prescription was

the beginning of people taking our need for help

seriously, and medications feel like the only way to

recognize that our problems are severe and out of

control. And when everyone around us has come to

view medication as essential to our survival, consid-

ering a new path can feel too risky to even try.

Many of us get help from psychiatric drugs, but might

not understand how they really work or what the

other options are. Some of us never found medica-

tions useful, or medications even made our problems

worse, and we are ready to try living without them.

Sometimes people are torn between the risks of

staying on and the risks of going off, or we take

multiple drugs and suspect we don’t need all of them.

Others may want to go off but it’s not the right time,

or may have tried in the past, experienced a return of

frightening symptoms, and decided to go back on for

now.

Our paths to healing are unique. Some of us don’t

need to make any life changes, letting time and

patience make change for us. Others may need

to make big shifts in nutrition, work, family life,

or relationships; we may need to focus more on

self-care, expression, art, and creativity; adopt other

approaches like peer support, therapy, herbalism,

acupuncture, or homeopathy; or nd new life

interests like going to school or connecting with

nature. We may discover that the rst step is getting

restful sleep; we may need structure to help get us

motivated; or to stop taking any recreational drugs

or alcohol. Our priorities might be to nd a home

or a new job; we may need to establish stronger

support networks of trusted friends; or it may be

important to speak up with greater honesty and

vulnerability about what we are going through.

The process might feel mysterious and arbitrary,

and an attitude of acceptance and patience is vital.

Learning means trial and error.

Because each of us is unique,

it’s as if we are navigating

through a labyrinth,

getting lost and

nding our way again,

making our own map

as we go.

Key Resources For Further Learning

Inner Compass - Withdrawal Project

https://withdrawal.theinnercompass.org/

MIND “Making Sense of Coming Off Psychiatric Drugs”

http://bit.ly/yPjusy

“Understanding Psychosis and Schizophrenia” British Psychological Society

http://bit.ly/1RtRS1T http://bit.ly/1RrXzDO

Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their

Families by Peter Breggin, Springer Publishing, 2012.

Coming Off Psychiatric Drugs

edited by Peter Lehmann, www.peter-lehmann-publishing.com

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing

Rise of Mental Illness in America by Robert Whitaker, Crown Books 2010.

Beyond Meds: Alternatives To Psychiatry website www.beyondmeds.com

Coming Off Psychiatric Drugs: A Harm Reduction Approach - video with Will Hall

http://bit.ly/zAMTRF www.willhall.net/comingoffmeds

Coming Off Psych Drugs: A Meeting of Minds - lm by Daniel Mackler

http://bit.ly/1UcVqNh

Gainining Autonomy on Medication GAM

http://bit.ly/GAM20

Doctors put people on psychiatric medications for

experiences labeled “mental disorders:” extreme

emotional distress, overwhelming suffering, wild

mood swings, unusual beliefs, disruptive behaviors,

and mysterious states of madness. Currently

millions of people world-wide, including infants

and elders, take psychiatric drugs when they are

diagnosed with bipolar disorder, schizophrenia,

psychosis, depression, anxiety, attention decit,

obsessive-compulsive, or post-traumatic stress. The

numbers are climbing every day.

For many people, psychiatric drugs are very

useful. Putting the brakes on a life out of control,

being able to function at work, school, and in

relationships, getting to sleep, and keeping a lid on

emotional extremes can all feel lifesaving. The sense

of relief is sometimes dramatic, and the medications

can stir very powerful emotions, and even feelings

of salvation. At the same time, the help psychiatric

drugs offer many people can leave little room to see

more to the picture: others experience these drugs

as negative, harmful, and even life-threatening. As a

result, it is rare in society to nd a clear understand-

ing of how and why these drugs work, or an honest

discussion of risks, alternatives, and how to come off

them if people want to.

Many doctors and TV ads tell people that psychiat-

ric medication is necessary for a biological illness,

just like insulin for diabetes. They promote the idea

that the drugs correct chemical imbalances and

treat brain abnormalities. The truth is different,

however. “Biology” and “chemical imbalances” have

become simplistic sound-bites to persuade people

to put their faith in doctors and quick xes. These

words are in fact much more complicated and

unclear. Biological factors (such as nutrition, rest,

and food allergies) affect everything we experi-

ence: biological “cause” or “basis” plants the belief

that medication is the key to solving our problems.

To say something has a biological cause, basis, or

underpinning can give a message that the solution

must always be a medical one and that “treatment”

has to include psychiatric drugs. Once people have

a diagnosis and start taking medication, it is easy to

think of the medications as physically necessary for

survival.

Not only is there is no solid science behind viewing

mental disorders as simple malfunctions of biology

“corrected” by drugs, but many people with even

the most severe diagnosis of schizophrenia or

bipolar go on to recover completely without

medication. The experiences that get labeled mental

disorders are not “incurable” or always “lifelong:”

they are more mysterious and unpredictable. For

some people psychiatric drugs are helpful tools

that change consciousness in useful ways, but they

are not medically necessary treatments for illness.

Once you acknowledge this, more options become

thinkable. And the potential risks of psychiatric

drugs come under greater scrutiny, because

they are very serious – including chronic illness,

Looking Critically at “Mental Disorders” and Psychiatry

mental impairment, dependency, worse psychiatric

symptoms, and even risk of early death.

Psychiatric medications have become a multi-billion

dollar industry like big oil and military spending,

and companies have incentive and means to cover

up facts about their products. If you look more

carefully into the research and examine closely

the claims of the mental health system, you will

discover a very different picture than what pill

companies and many doctors lead us to believe.

Companies actively suppress accurate assessments

of drug risks, mislead patients about how contro-

versial mental disorder theories are, promote a

false understanding of how psychiatric drugs really

work, keep research into alternative approaches

unfunded and unpublicized, and obscure the role

of trauma and oppression in mental suffering. For

much of the mental health system, it’s one size

ts all, regardless of the human cost: scandals are

growing, and the fraud and corruption surround-

ing some psychiatric drugs are reaching tobacco-

industry proportions.

In this complicated cultural environment, people

are looking for accurate information about possible

risks and benets so they can make their own

decisions. Too often, people who need help reducing

and getting off these drugs are left without support

or guidance. Sometimes they are even treated as

if the desire to go off the drugs is itself a sign of

mental illness – and a need for more drugs.

In discussing “risks” and “dangers,” it is important

to understand that all life involves risk: each of us

makes decisions every day to take acceptable risks,

such as driving a car, working in a stressful job, or

drinking alcohol. It may not be possible to predict

exactly how the risks will affect us, or to avoid the

risks entirely, but it is important to know as much

as we can about what the risks are. Looking at the

risks of drug treatment also means looking at the

risks of emotional distress/ “psychosis” itself, and

making the best decision for you. Maybe psychiatric

drugs are the best option given your circumstances

and situation, or maybe you want to try to reduce

or come off. This guide is not intended to persuade

you one way or the other, but to help educate you

about your options if you decide to explore going

off psychiatric drugs.

Because of pro-drug bias, there has been very little

research on psychiatric drug withdrawal. We based

this guide on the best available information, including

excellent sources from the UK, and worked with a

group of health professional advisors (see page 51)

including psychiatric doctors, nurses, and alternative

practitioners, all of whom have clinical experience

helping people come off drugs. We also draw on

the collective wisdom of an international network

of survivors, allies, colleagues, activists, and healers

who are connected with the Freedom Center

and the Icarus Project, as well as websites such as

Beyond Meds. We encourage you to use this

guide not as the denitive resource but as a

reference point to start your own research

and learning. And we hope that you will share

what you have learned with others and contribute

to future editions.

That all human beings are created different.

That every human being has the right to

be mentally free and independent.

That every human being has the right to

feel, see, hear, sense, imagine, believe or

experience anything at all, in any way, at

any time.

That every human being has the right to

behave in any way that does not harm

others or break fair and just laws.

That no human being shall be subjected

without consent to incarceration, restraint,

punishment, or psychological or medical

intervention in an attempt to control,

repress or alter the individual’s thoughts,

feelings or experiences.

Universal Declaration of Mental

Rights and Freedoms

In some ways coming off psychiatric drugs is deeply

political. People of all economic and educational

backgrounds do successfully reduce or go off

their psychiatric medication. However, sometimes

economic privilege can determine who has access to

information and education, who can afford alternative

treatments, and who has the freedom to make life

changes. People without resources are often the

most vulnerable to psychiatric abuse and injury

from drugs. Health is a human right for all people:

we need a complete overhaul of our

failed “mental health system” in favor

of truly effective and compassionate

alternatives available to everyone

regardless of income. We should stop

pushing risky, expensive drugs as the

rst and only line of treatment; priority

should be on prevention, safe places of

refuge, and treatments that do no harm.

Many studies, such as Soteria House in

California and Open Dialogue, show that non- and

low-drug treatments can be very effective and cost

less than the current system. And a medical product

regulatory establishment that was honest about drug

risks, effectiveness, and alternatives would likely have

never even put most psychiatric drugs on the market

to begin with.

Instead of viewing the experiences of madness

only as a “dis-ability,” which can be a stigmatizing

put down, it could be helpful to also view people

who go through emotional extremes as having

“diverse-ability.” Society must include the needs

of sensitive, creative, open, emotionally wounded,

and unusual people who make contributions to the

community – beyond the standards of competition,

materialism, and individualism. To truly help people

who are labelled mentally ill, we need

to rethink what is “normal,” in the same

way we are rethinking what it means

to be unable to hear, without sight, or

with limited physical mobility. Universal

design and accommodating those of

us who are different ultimately benet

everyone. We need to challenge able-ism

in all forms, and question the wisdom

of adapting to an oppressive, unhealthy,

and environmentally suicidal society, a

society that is in many ways itself quite crazy. A

social model of disability means accepting human

differences, seeing society as needing to change,

and no longer treating the impacts of poverty and

oppression as medical problems. Our real needs

are intertwined with the broader needs for social

justice and ecological sustainability.

In working with hundreds of people over many

years, we have found there is no way to predict how

the coming off process will go. There is really no

way to know in advance who can and who cannot

do well without psychiatric drugs, who can do well

with fewer drugs or lower doses, or how hard it will

be. We’ve seen people withdraw successfully after

more than 20 years, people who decide to continue

to take them after being on for just a year or less,

and people who struggle with long term withdrawal.

Because coming off is potentially possible

for anyone, the only way to really know is to

try slowly and carefully, and see how it goes,

remaining open to staying on. Everyone should

have the opportunity to explore this. The study by

MIND, the leading mental health charity in the UK,

conrms our experience. MIND found that “Length

of time on the drug emerged as the factor that most

clearly inuenced success in coming off. Four out of ve

people (81%) who were on their drug for less than six

months succeeded in coming off. In contrast, less than

half (44%) of people who were on their drug for more

than ve years succeeded. (Just over half of people who

were on their drug for between six months and ve

years succeeded.)” Facing these unknowns means

remaining exible and learning as you go: coming

off completely may, or may not, be right for you, but

everyone can become more empowered.

How Dicult Is Coming O Psychiatric Drugs?

The Politics Of Withdrawal

Principles of This Guide:

Choice: Psychiatric medications affect the most intimate aspects of mind and

consciousness. We have the right to self-determination: to dene our experiences as we

want, seek out practitioners we trust, and discontinue treatments that aren’t working for

us. We don’t judge others for taking or not taking psychiatric drugs: we respect individual

autonomy. When people have difculty expressing themselves or being understood by

others, they deserve accommodation, supported decision-making, and patience from caring

advocates, according to the principle of “rst do no harm” and the least intrusion possible.

No one should be forced to take psychiatric drugs against their will.

Information: Pharmaceutical companies, medical practitioners, and the media need

to provide accurate information about drug risks, the nature of psychiatric diagnosis, how

drugs work, alternative treatments, and how to go off psychiatric drugs. Medical ethics

require practitioners to understand the treatments they prescribe, protect patients from

harm, and promote safer alternatives.

Access: When we choose alternatives to psychiatric drugs and mainstream

treatments, there should be programs, affordable options, and insurance coverage available.

Choice without access to options is not real choice. Community controlled services

should be available to everyone who needs help going off psychiatric drugs or struggling

with extreme states of consciousness. We urge all health care practitioners to offer free

and low-cost services to some of their clients, and for everyone with economic and social

privilege to work to extend alternative treatment access to all.

Most people begin taking psychiatric medications

because they are “distressed and distressing.” They

are either experiencing overwhelming states of

emotional distress, or someone else is distressed

with their behavior and sends them to a doctor

– or some combination of both. There are many

labels for these states, like anxiety, depression, com-

pulsiveness, mania, psychosis, voices, and paranoia,

and labels change over time. Doctors tell people

that their emotional distress is due to a mental

disorder which has a biochemical basis, that their

distress is dangerous and must be stopped (such as

fears of suicide or claims of deteriorating illness),

and that medication with psychiatric drugs is a

necessary treatment.

Psychiatric medications act on the brain

to alter mood and consciousness like any

other psychoactive substance. Because many

medications can blunt or control the symptoms

of emotional distress – by either tranquilizing a

person, speeding them up, numbing sensitivity, or

getting them to sleep – they can take the edge

off extreme states. They help some people feel

more capable of living their lives. It is important

to realize, however, that psychiatric drugs do

not change the underlying causes of emotional

distress. They are best understood as tools or

coping mechanisms that sometimes alleviate

symptoms and pave the way for change – but with

signicant risks for anyone who takes them.

How Do Psychiatric Drugs Work?

Do Psychiatric Drugs Correct Your

Chemistry Or Treat Illness?

People are told that mental disorders mean brain

chemistry is “abnormal,” that illness is caused by genetic

“predispositions,” and that psychiatric drugs are needed

to interrupt a disease process and correct imbalances.

However, this is not how medications work, and brain

disease theories have not been proven by studies to

be true. Believing these claims can reinforce a sense

of being a helpless victim of biology, and leave people

feeling there are no options other than medications.

Despite decades of costly research, no chemical

imbalances, genetic predispositions, or brain

abnormalities have ever been found to consistently

cause a bipolar, depression, or schizophrenia diagnosis.

The media report “promising” research that “needs

further study,” but nothing conclusive has resulted. Even

the ne print of drug company ads now typically says

that conditions are “believed to be caused by” chemical

imbalances, rather than making denitive statements.

Physical tests, such brain scan or blood draw, aren’t used

for a diagnosis like bipolar, schizophrenia, or depression,

and can’t reveal that your brain is abnormal. (Altered

states with clear physical causes, such as, for example,

concussion, dementia or alcohol delirium, are instead

called “organic psychosis.”) A baseline has never even

been established for what constitutes a “psychologi-

cally normal” brain for all people. Three people with

the same diagnosis might have very different brain

chemistry, and someone with similar brain chemistry

might have no diagnosis at all. While many people face

physical problems like vitamin deciency that a doctor

or holistic practitioner can address, this might help

emotional problems – or it might not. Medicine has not

discovered the biology of mental illness the same way

as tuberculosis, Down Syndrome, or diabetes. Emotional

distress and madness remain open to interpretation.

What about genetics? Mental diagnoses can seem to

“run in families,” but so do child abuse and poverty.

Because of shared environment, expectations, and

intergenerational trauma, family history can mean many

things other than inescapable heredity. Studies claim

that twins tend have a slightly higher chance of the

same diagnosis, but this research is often awed

and results exaggerated. Parents know that children

have different temperaments even at birth, but

prenatal experience has an inuence. Individual

traits like sensitivity and creativity only become

madness after very complicated social factors, such

as trauma and oppression, have played a role. Even

sequencing the human genome has not revealed

any keys to mental illness, and the idea of genetic

“predisposition” remains speculative and unproven.

In fact, the more neuroscience discovers about

genes, behavior, and the brain, the more compli-

cated the picture becomes. Epigenetics shows that

instead of a “genetic blueprint,” the environment

interacts to turn genes on and off. Using genetic

science to oversimplify the diversity of human

behavior is a throwback to the discredited concepts

of social Darwinism and eugenics. It portrays some

people as destined to be inferior, defective, and less

than fully human.

Every feeling and thought exists somehow in the

brain as an expression of biology, but society, mind,

and learning intervene to make any causal relation-

ship impossible to establish. Stress, for example, is

associated with brain chemistry, but one person

can thrive under stressful circumstances that are

debilitating to another. The new science of “neu-

roplasticity” shows the brain is constantly growing

and that learning can itself change the brain: for

example, psychotherapy can reorganize brain

structure, and researchers found the brain regions

associated with memorizing maps were enlarged in

London cab drivers. If learning can affect the brain

in such a profound way, then we are not as limited

by biology as was once believed.

Philosophers and scientists have debated for

centuries over the “hard problem” of how con-

sciousness arises from the brain and body. Is what

gets called ‘mental illness’ a social and spiritual

question more than a medical one? Is being called

‘disordered’ a political and cultural judgement?

Psychiatry can make no credible claim to have

solved the mystery of the mind-body relationship

behind madness.

Without clear answers from science, psychiatric

diagnosis is ultimately not a statement of fact but a

doctor’s subjective opinion of a patient. The doctor

inevitably relies on their own bias, assumptions,

fears, and preconceptions. Doctors often disagree

with each other, people sometimes have many

different diagnoses over time, and discrimination

based on class, race, and gender is common.

The decision to take psychiatric drugs should

be based on the usefulness of the drug’s effects

relative to the risks involved, not any false

belief that the person “must” be on the drug

because of biology or genes.

If biology and brain chemistry aren’t to “blame”

for anxiety, voices, suicidal feelings, mania, or other

distress, does that mean the blame is on you? Is it

either your brain’s fault or your fault?

A psychiatric diagnosis can be a huge relief if the

only other option is blaming yourself as lazy, weak,

or faking it. When you feel powerless and people

haven’t been taking your pain seriously, a doctor

saying you have a mental disorder can be validating.

Choosing to reduce or come off medication might

seem like the wrong message, as if your suffering is

not that bad and you don’t really need help. And not

being able to come off can also feel shameful, like

you should just try harder and it’s all up to you.

This is unfair, either-or thinking that leaves people

helpless and trapped in the mental health system.

Pharmaceutical advertising preys on this dilemma:

if pain is really serious, it needs medication, if not,

you’re on your own. Empowerment means thinking

beyond a narrow view, and embracing broader ways

of looking at things.

Everyone needs support sometime: each of us

has parts of our lives where we feel powerless.

We all need to learn how to balance personal

responsibility with asking for help. You don’t have

to blame your brain to give yourself some

compassion.

Because medical science doesn’t have answers, it is

up to each person to understand their lives in the

way that makes most sense to them. The resources

in this guide can open new possibilities. For example,

the British Psychological Society suggests some

people might have greater “stress vulnerability” than

others. The Hearing Voices Movement encourages

us to accept and learn from unusual experiences,

rather than just treat them as meaningless

symptoms to get rid of. Many views of madness are

possible, such as trauma/abuse, spiritual awakening,

sensitivity, environmental illness, family dynamics,

being the “canary in the coal mine,” holistic health,

cultural differences, gifts as a medium, or the impact

of oppression. Some societies even accept as normal

the same things other societies call abnormal – such

as hearing voices or seeing signs.

And if people ask, it’s your decision what to say or

not say, such as “I’m a trauma survivor,” “I live with

extreme states,” or “I’m different than most people,

and I’m still guring it out” – or saying nothing

at all. Connecting with others who share your

experiences, such as peer support groups or the

internet, can be crucial to explore who you are.

Your suffering is real, whether you decide to take

medications or not. Feeling powerless and needing

help doesn’t mean you are a broken person or a

passive victim of biology. Explanations like trauma,

sensitivity, or spirituality are as valid as any. You still

deserve help, even if you don’t believe your brain is

abnormal and even if you think outside the language

of “psychiatric illness” and “mental disorders.”

Who’s to Blame? Yourself? Your Biology? Neither?

Like any mind altering substance, psychiatric drugs

are psychoactive and alter mind and behavior by

affecting brain chemistry. Their usefulness, and risks,

come from changing the brain/body and altering

consciousness, including expectation and placebo.

Current medical theory is that most psychiatric

drugs change the levels of chemicals called

neurotransmitters. Neurotransmitters are

very mysterious, and linked with mood, mental

functioning, and altered states. Cells of the

human nervous system, including brain cells, use

neurotransmitters to communicate with each other,

but neurotransmitters are also found in animals,

plants, and even bacteria. When neurotransmitter

levels change, “receptor” cells, which receive and

regulate neurotransmitters, become more sensitive,

and can grow or shrink to adjust.

SSRI anti-depressants (“selective serotonin

re-uptake inhibitors”) for example are said to

raise the level of the neurotransmitter serotonin

in the brain, and also reduce the number of brain

serotonin receptors. Anti-psychotic medications

like Haldol lower the level of dopamine and

increase the number of dopamine receptors in

the brain. Changing consciousness by changing

neurotransmitters and receptors works the same

for all psychoactive drugs, including recreational

drugs. Alcohol affects neurotransmitters including

dopamine and serotonin, and cocaine changes the

levels of both dopamine and serotonin, as well as

noradrenaline.

While these changes in your body take place, your

consciousness works to interpret and respond in

your own way. Alcohol might relax you or make

you nervous; anti-depressants energize some

people or make others less sensitive. Because

of the placebo effect and expectation,

everyone is different. Your experience of medi-

cation may not be the same as other people, and

will ultimately be uniquely your own. Trust yourself.

How Do Psychiatric Drugs Aect The Brain?

The benets of psychiatric drugs are widely promoted,

while their risks are often overlooked. The helpful

aspects of the drugs, however, tend to be mixed in with

misleading claims. The information below is an attempt

to cut through the confusion and describe the basic

ways that many people nd psychiatric drugs helpful.

• Sleep deprivation is one of the single biggest

causes of, and contributors to, emotional crisis.

Short term medication use can get you to sleep.

• Medication can interrupt and “put the brakes

on” a difcult extreme state of consciousness,

tranquilizing an acute time of crisis that feels out

of control.

• Many people feel medications protect them from

emotional crisis so severe it threatens their

stability and even their lives. Some report that

symptoms feel more manageable on medications,

and keep them more grounded in ordinary reality.

Ongoing use can sometimes prevent or ease

episodes of mania or depression.

• Interrupting crisis and getting some sleep can

reduce stress and settle you down, which can

reduce life chaos and help you take better care

of yourself with food, relationships, and other

basic issues. This can be much less stressful than

constant crisis, and might lay a groundwork for

greater stability and changes that might have

been more difcult otherwise.

• Medications can sometimes help you show up

for and function at work, school, in your life,

which is especially useful if you cannot take

a break or change circumstances. Work may

require you to get up in the morning, concen-

trate, and avoid mood swings, and relationships

or parenting may need you to avoid emotional

sensitivity.

• Continuing on some medications can itself

prevent medication withdrawal effects.

• All drugs have a powerful placebo effect: just

believing they work, even unconsciously, can

make them work. Recovery from very serious

illnesses is possible from taking a placebo sugar

pill or undergoing a “placebo surgery” believed

to be real. In clinical trials many psychiatric

drugs have little proven effectiveness beyond

placebo, because of this powerful mental effect.

The mind plays a central role in any healing, and

there is no way to determine whether effective-

ness for an individual comes from placebo or

drug chemistry.

• Compliance also contributes to the placebo

effect: sometimes people feel better believing a

clear ofcial explanation of their suffering, and

when they follow and get support from a doctor,

family member, or other authority gure. Drugs

tend to actually work better the stronger and

closer the relationship is with the prescriber.

• Advertising, especially direct-to-consumer

television advertising (allowed in the US and

New Zealand), is extremely powerful and

inuences people’s experience to t their

hopes and expectations. Newer drugs of any

kind, not just psychiatric drugs, often work

better just because of the expectation involved.

Why do People Find Psychiatric Drugs Helpful?

Facts You May Not Know About Psychiatric Drugs

Despite the medical principle of informed consent,

doctors leave out important information about the drugs

they prescribe. The following is an attempt to include less

known facts and provide a more balanced picture.

• Higher doses and longer use of psychiatric drugs

often mean brain changes can be deeper and

longer lasting. The drugs are then often harder

to come off and can have more serious adverse

effects. However, the human brain is much more

resilient than was once believed, and can heal

and repair itself in remarkable ways.

• Neuroleptic or major tranquilizer drugs are

claimed to be “anti-psychotic,” but in fact do

not target psychosis or any specic symptom

or mental disorder. They are tranquilizers that

diminish brain functioning in general for anyone

who takes them. They are even used in veteri-

nary science to calm down animals. Many people

on these drugs report that their psychotic

symptoms continue, but the emotional reaction

to them is lessened.

• The earliest drugs such as Thorazine and lithium

came onto the market before theories of

chemical imbalance were suggested, not as a

result of those theories. Doctors were looking

for “magic bullets” comparable to antibiotics, and

saw the sedating effects of chemicals on labora-

tory animals.

• Newer anti-psychotic drugs called “atypicals”

target a broader range of neurotransmitters, but

they work in basically the same ways as older

drugs. Manufacturers marketed these drugs

(which are more expensive than older ones) as

better and more effective with fewer side effects,

and they were hailed as miracles. But this has

been exposed as untrue, with some companies

covering up the extent of adverse effects like

diabetes and metabolic syndrome, leading to

multi-billion dollar lawsuits.

• People are often told that adverse drug effects

are due to an “allergic reaction” or “drug

sensitivity.” This is misleading: psychiatric

drug effects do not function the way food or

pollen allergies do. Calling drug effects “allergic

reactions” or telling people “you’re sensitive”

treats the problem like it is in the person taking

the drug, not the drug’s adverse effect itself,

which could affect anyone.

• Benzodiazepine addiction – Valium, Xanax, Ativan

and Klonopin – is a huge public health problem.

Withdrawal can be very difcult: benzodiazepines

are more addictive than heroin. Use for more

than 4-5 days dramatically increases risks.

• People are sometimes told they are on a “low

dose” even though it can still have powerful

adverse effects.

• Psychiatric drugs are widely used in prisons to

control inmates, foster care to control children,

and in nursing homes to control the elderly.

• Sleep medication like Ambien and Halcyon,

while sometimes useful in the short term,

can be addictive, worsen sleep over time, and

cause dangerous blackouts and altered states of

consciousness.

• Because they work like recreational drugs, some

psychiatric medications are even sold on the

street to get high. Stimulants like Ritalin and

sedatives like Valium are widely abused. Because

of their easy availability, illegal use of psychiatric

drugs, including by children, is widespread.

• The “War on Drugs” obscures the similarities

between legal psychiatric drugs and illegal

recreational drugs. Anti-depressant SSRIs

and SNRIs work chemically similar to slow-

administered oral cocaine. Cocaine was in fact

the rst prescription drug marketed for “feel

good” anti-depression effects, before being made

illegal. Coca, the basis of cocaine, was even once

an ingredient in Coca-Cola.

• Psychiatric drugs are toxic and can damage

the body. Neuroleptic “anti-psychotics” can

cause the life-threatening toxic reaction called

neuroleptic malignant syndrome, as well as

Parkinson’s disease-like symptoms and cognitive

impairment. Regular blood level tests are

required of some drugs such as lithium and

Clozaril to protect against physical harm. Many

drugs can lead to obesity, diabetes, sudden heart

attack, kidney failure, serious blood disorder, and

general physical breakdown. Other toxic effects

are numerous, and include interfering with the

menstrual cycle, threats during pregnancy and

breastfeeding, and life-threatening “serotonin

syndrome” from anti-depressants alone or

mixed with other drugs.

• Psychiatric drugs can injure the brain. The rate

of tardive dyskinesia, a serious neurological

disease that can disgure a person with facial

tics and twitching, is very high for long-term

patients on neuroleptic anti-psychotic drugs,

and even short-term use carries some risk.

Anti-psychotics have been shown to cause

brain shrinkage. Anti-depressants can also cause

memory problems and increased susceptibility

to depression. Other effects can include brain

injury and cognitive impairment.

• Pharmaceutical company effectiveness and

safety studies, as well as FDA regulation, are

extensively corrupted and fraud is widespread.

There are few long-term studies, or studies of

how drugs combine together. The real extent

of psychiatric drug dangers may never be

accurately known. Taking psychiatric drugs is in

many ways society-wide experimentation, with

patients as guinea pigs.

• Mixing with alcohol or other drugs can dramati-

cally increase dangers.

• Drug effects can lower the quality of life,

including impaired sexuality, depression,

agitation, and overall health problems.

• Drug-induced body changes such as restless-

ness, obesity, or stiffness can alienate you from

others and increase isolation.

• Lithium interacts with salt and water in the

body, and when these levels change, such

as from exercise, heat, or diet, potency can

uctuate. Even with regular blood tests and

dosage adjustments, this means people taking

lithium are sometimes at risk of exposure to

damaging levels.

• ADHD drugs such as Adderall and Ritalin

can stunt growth in children, and present

other unknown dangers to brain and physical

development. Like any amphetamines, they are

addictive and can cause psychosis and heart

problems, including sudden death.

Health Risks of Psychiatric Drugs

Making a decision about coming off psychiatric drugs means evaluating as best you can the risks and benets

involved, including important information often missing from mainstream accounts. Some risks may be worth

taking, other risks may not be worth taking, but all risks should be taken into consideration. Because each person is

different and drug effects can vary widely, address the uncertainty involved with your own best judgment and with

observations of how your body and mind are responding. This list cannot be comprehensive, as new risks are still

being uncovered.

• Psychiatric drugs can sometimes make

psychotic symptoms worse and increase the

likelihood of having a crisis. Drugs can change

receptors for such neurotransmitters as

dopamine, making a person “supersensitive”

to psychosis “rebound,” as well as increas-

ing sensitivity to emotions and experiences

in general. Some people report their rst

psychotic symptoms or suicidal feelings

occurred only after starting to take psychiatric

drugs. Doctors sometimes respond by giving a

more severe diagnosis and adding more drugs.

• Some drugs now carry warnings about the

increased risk of suicide, self-injury and

violent behavior.

• Many people experience negative personality

changes, including not feeling themselves,

feeling drugged, emotional blunting,

diminished creativity, and reduced psychic/

spiritual openness.

• People who take psychiatric drugs, especially

anti-psychotics, are sometimes more likely to

develop long-term problems and get stuck as

mental patients. Some countries that use less

medication have higher recovery rates than

countries that use a lot of medication; and

the Soteria and Open Dialogue projects show

lower medication can prevent chronicity.

• Once you are on the drug, your personality

and critical thinking abilities may be very

changed. It might be difcult to properly

evaluate the drug’s usefulness. You may

need to get off the drug, but not realize

it because of how the drug is affecting

your thinking. Overmedication, especially

with anti-psychotics, amounts to chemical

straitjacketing.

• Psychiatric drugs can interrupt and impair

the mind’s natural ability to regulate and heal

emotional problems. Many people report

having to “re-learn” how to cope with difcult

emotions when they come off psychiatric

drugs. Being too medicated can make it more

difcult to work through the feelings behind

your distress.

• Some people, even in the worst depths of

madness, say that by going through their

experiences rather than suppressing them,

they emerge stronger in the end. Sometimes

“going crazy” can be the doorway to trans-

formation. Artists, philosophers, poets, writers

and healers are often thankful for the insights

gained from “negative” emotions and extreme

states. Drugs can be helpful for some, but for

others they may obscure the possible value

and meaning of “madness.”

Mental Health Risks

Mental health risks are some of the least understood aspects of psychiatric medications, and can make drug

decisions and the withdrawal process very complicated. Here are some things that your doctor may not have told you:

Other Drug Risks and Considerations

Understanding the coming off drugs process means taking into account many different factors you may not

have considered before:

• While not publicized widely, peer support, alter-

native treatments, talk therapy, waiting, and even

the placebo effect can often be more effective

than psychiatric drugs, without the risks.

• Keeping up with taking pills every day is difcult

for anyone. Missing doses of psychiatric drugs

can be sometimes dangerous because of the

withdrawal effects, which leave you vulnerable if

the drug is interrupted.

• Doctors typically see patients infrequently for

short visits, making it difcult to spot potentially

serious adverse drug reactions.

• People with a mental disorder diagnosis often

have difculty getting insurance, and their

physical health problems may not be taken

seriously.

• Using psychiatric drugs often means giving up

control to the judgments of a doctor, who may

not make the best decisions for you.

• Medications can be expensive, keeping you stuck

in work and insurance plans.

• Medication sometimes goes along with a dis-

ability check, which can be helpful for a while

but can also become a lifelong trap.

• Taking psychiatric drugs can mean being seen

as mentally ill in society and starting to see

yourself in that role. The stigma, discrimination,

and prejudice can be devastating, and even

create a self-fullling prophecy. Diagnostic

labels cannot be stricken from the record the

way criminal histories can. Studies show that

trying to convince people that “mental illness is

an illness like any other” is a counterproductive

strategy that actually contributes to negative

attitudes.

• Psychiatric drugs can convey the false view that

“normal” experience is productive, happy, and

well adjusted all the time, without mood shifts,

bad days, or strong emotions. This encourages a

false standard of what it is to be human.

• Medication can lead to viewing normal feelings

as “symptoms” of illness to be stopped, which

denies people the process of working through

and learning from difcult emotions.

• Taking psychiatric drugs can put a passive hope in

a “magic bullet” cure rather than taking personal

and community responsibility for change.

In addition to placebo, all psychiatric drugs work

by causing organic brain changes. This is why going

off leads to withdrawal: your brain gets used to

having the drug, and has a hard time adjusting

when the drug is removed. It takes time to bring

the activity of receptors and chemicals back to

the original state before the drug was introduced.

While doctors sometimes use confusing terms like

“dependence,” “rebound,” and “discontinuation

syndrome” (and there may not be dosage

tolerance), the psychiatric drug action that causes

withdrawal symptoms is basically the same as

addiction. Tapering off slowly is usually best: it allows

your brain and mind time to get accustomed to

being without the drugs. Going off fast does not

usually allow enough time to adjust, and you may

experience worse withdrawal symptoms.

Important: the signs of psychiatric drug

withdrawal can sometimes look exactly

like the “mental illness” symptoms that

medications were prescribed for in the

rst place.

When someone goes off a psychiatric drug they

might have anxiety, mania, panic, insomnia, depres-

sion and other painful effects. They can become

“psychotic” or have other symptoms from the

psychiatric drug withdrawal itself, not because of

a “disorder” or condition. This may be the same,

or even worse, than what got called psychosis or

mental disorder before the drug was taken. Typically

people are then told this shows their illness has

come back, and that they therefore need the drug.

However, it may be the withdrawal effect from the drug

that is causing these symptoms.

These withdrawal symptoms do not necessarily

prove you need a psychiatric drug any more than

headaches after you stop drinking coffee prove you

need caffeine, or delirium after stopping alcohol

shows you need to drink alcohol. It just means your

brain has become dependent on the drug, and has

difculty adjusting to a lower dosage off it. Psychiat-

ric drugs are not like insulin for a diabetic: they are

a tool or coping mechanism.

However, when you have been on psych drugs for

years, it can sometimes take years to reduce or go

off them, or you may have long term physical or

psychological dependency. Sometimes people on

these drugs develop ongoing withdrawal symptoms,

chemical brain injury, and damage. This may not

be permanent, or sometimes people live the rest

of their lives with these brain changes. Scientists

used to believe that the brain couldn’t grow new

cells or heal itself, but today this is known to be

How Withdrawal Aects Your Brain and Body

It’s not an either-or choice

between taking psychiatric

drugs or doing nothing. There

are many alternatives you can

try. In fact, some problems

that are called symptoms of

“mental disorders” might turn

out to be caused by the drugs

people are taking.

untrue. Everyone can heal: new research into

“neurogenesis” and “neuroplasticity” means

the brain is always growing and changing.

Friendships and love, along with good

lifestyle, nutrition, and positive outlook, will

help nurture your brain and body to recover.

You may nd that the goal of going

off completely is not right for you

at this time. You may feel better staying

on your medication, and decide instead to

just reduce or continue at the same dosage,

and focus on new ways to improve your life.

Follow your own needs without judgment or

blame: get support for your decisions in the

face of any feelings of shame or powerless-

ness.

Why Do People Want to Stop Using Psychiatric Drugs?

People are often told that no matter what

the side effects, psychiatric drugs are always

better than suffering from “untreated” mental

disorders. Some doctors claim mental disorders

have a “kindling” effect, that early medication is

best, or that madness is toxic and medications

are “neuroprotective.” These theories remain

unproven -- though ongoing crisis and a life out

of control can certainly be cumulative stresses.

Doctors spread fears unfairly: while medications

are key in helping many people, others have

found ways to recover without psychiatric drugs.

Many report their lives are better without them.

Everyone is different, but sometimes people do

deal with “psychotic” states successfully without

medication. Diverse, non-western cultures often

respond to and understand these experiences

differently, even seeing them as positive and

spiritual. It remains a personal decision how to

relate to madness.

You may decide that, given the degree of crisis you are facing and the obstacles to workable alternatives,

you want to continue psychiatric medication. Don’t feel judged for making the best decision you can.

You have the right to do what works best for you, and other people don’t know what it’s like to live

your life. It may still be a good idea to take a harm reduction approach. Make changes to improve the

quality of your life and to minimize the risks associated with the medications you are taking:

• Don’t leave it all to the drug. Take an active interest in your overall health, alternative

treatments, and wellness tools. Finding new sources of self-care can ease adverse effects,

and may eventually reduce your need for medication.

• Get regular healthcare, and stay in communication about your medications. Get support

from trusted friends and family.

• Make sure you have the prescriptions and rells you need, because missing doses can

add stress to your body and brain. If you do miss a dose, don’t double up.

• Watch out for drug interactions. Learn the risks of combining with other medications, and

beware mixing with recreational drugs or alcohol. Grapefruit, St. Johns Wort, some herbs

and other supplements and meds can have adverse reactions. Research your medications.

• Don’t rely just on your doctor for guidance. Learn for yourself, and connect with

others who have taken the same medications as you.

• Discover what you can from a variety of sources about your medications. Use nutrition,

herbs and supplements to reduce adverse effects.

• Consider exploring lowering drug dosage, even if you don’t intend to go off completely.

Remember that even small dosage reduction can cause withdrawal effects.

• If you are starting a medication for the rst time, some people report that an extremely

small dose, much lower than recommended, can sometimes be effective, with fewer risks.

• Try to reduce the number of different drugs you take to just the essentials, understanding

which ones carry the greatest risks. Stick to temporary use if you can.

• Test regularly to monitor drug reactions, and have baselines done for new medication.

Tests may include: thyroid, electrolytes, glucose, lithium level, bone density, blood pressure,

liver, ECG, kidney, cognition, prolactin, and screening for other adverse effects. Use

the best, most sensitive tests available to reveal problems early.

• Anti-psychotics remain in the body, and some research suggests

“drug holidays” of a day or two off can ease toxicity.

Remember that everyone is different.

• Explore the emotional relationship with your

medications. Draw a picture, create a role play, give the

medications a voice and message and have a dialogue.

Do you know the energy or state the drug gives you?

Can you nd other ways to achieve this energy state?

Staying on Psychiatric Drugs and Harm Reduction

I Want to Come O My Psychiatric Drugs,

But My Doctor Won’t Let Me. What Should I Do?

Some prescribers have a controlling attitude and will not support a decision to explore

going off psychiatric drugs. They may hold the fear of hospitalization and suicide over

patients as a danger. Some see themselves as custodians, and feel like whatever happens

is their responsibility. Others never met people who’ve successfully recovered, or they

encountered so much crisis after abrupt withdrawal they assume no one can come off.

If your prescriber doesn’t support your goals, ask them to explain their reasons in

detail. Consider what they say carefully – if they are making sense, you may want to

reevaluate your plan. You may also want to get a friend or ally to help you express

yourself, especially someone in a position of authority like a family member, therapist,

or health practitioner. Present your perspective clearly. Explain that you understand

the risks, and describe how you are preparing to make changes carefully with a good

plan. Give them a copy of this Guide, and educate them about the research behind

your decision and the many people who succeed in reducing and going off their drugs.

Remind the prescriber their job is to help you help yourself, not run your life for you,

and that the risks are yours to take.

In all areas of medicine today patients are becoming empowered consumers, so don’t

give up! You may need to inform your doctor you are going ahead with your plan

anyway: sometimes they will cooperate even if they don’t approve. If your prescriber is

still unsupportive, consider switching to a new one. You can also rely on a health care

practitioner such as a nurse, naturopath, or acupuncturist. Sometimes people even

begin a medication reduction without informing their doctor or counselor. This isn’t

best, but may be understandable in many circumstances, such as if you have benets

that might be in jeopardy if you are considered “noncompliant.” Weigh the risks of such

an approach carefully.

The leading UK charity MIND, in their study on coming off psychiatric drugs, found

that “People who came off their drugs against their doctor’s advice were as

likely to succeed as those whose doctors agreed they should come off.” As a

result of this nding, MIND realized doctors are sometimes too controlling, and so

they changed their ofcial policy: MIND no longer recommends that people attempt

to go off psychiatric drugs only with their doctor’s approval. Support is usuallly best

however, so try to collaborate with prescribers when possible.

Everyone is different, and there is no cookie-cutter or

standard way to withdraw from any psychiatric drug.

The following is a general step-by-step approach

that many people have found helpful. It is intended

to be shaped to suit your needs. Be observant:

follow what your body and heart are saying, and

look to the advice of people who care about you.

Finally, keep a record of how you reduced your

medications and what happened, so that you can

study the changes you are going through and teach

others about your experience.

Get Information About Your

Drugs and Withdrawal

Prepare yourself by learning all that you can about

withdrawing from your psychiatric drug. Read from

mainstream sources as well as alternative sources,

Meet with and discuss reducing with others. List

your adverse effects, and make sure you are getting

proper tests. Additional resources are listed at the

end of this guide.

CONSIDER YOUR Timing

When is a good time to start coming off? When is

a bad time?

If you want to reduce medication, timing is very

important. It is usually better to wait until you have

what you need in place rst, instead of starting to

come off unprepared (though sometimes the drugs

themselves make this difcult). Remember, coming

off might be a long-term process, so you may want

to prepare just like you were making any major life

change. Reducing and coming off drugs will likely

not be a solution in itself, but the beginning of new

learning and challenges.

• Do you have stability in your housing,

relationships, and schedule? Would it be better

to focus on these rst?

• Have you been putting off big problems or issues

that need attention? Are there worrisome things

you should prioritize? Settling other matters

might help you feel more in control.

• Did you just come out of a hospital, or were you

recently in a crisis? Is this a bad time to begin

withdrawal, or is the drug part of the problem?

• Do you have hard anniversaries this time of year?

Are you sensitive to the weather or darkness?

Anticipate months where you might have the

most difculty.

• Do you notice worsening of drug effects, or have

you been on the drugs for a long time and feel

“stuck”? Have you been feeling more stable and

capable of facing difcult emotions? These might

be good times to prepare to reduce and come off.

• Make a list of the stressors that led to crisis in

the past. How many are present today? Do you

anticipate any in the future? Give yourself time to

address these before starting a reduction.

Before You Start Coming O

cultivate Support

• Get help if you can. Develop a collaborative

relationship with a prescriber if possible,

discuss with friends and family, and get support

developing your plan. Explain that strong

emotions might come up for you. Make sure

they know that withdrawal might be rough, but

that withdrawal symptoms do not necessarily

mean “relapse” or that you need to go back on

the drug. Make a list of people to call and stay

with if things get difcult. Lacking support is not

necessarily an obstacle to coming off drugs –

some people have done it on their own – but in

general a supportive community is a crucial part

of everyone’s wellness.

• List your triggers and warning signs.

How do you know you might be heading towards

crisis, and what will you do? Sleep, isolation,

strong emotions, or altered states might show

you need extra care and wellness support.

• Create a “Mad Map” or “advance

directive,” which tells people what to do if

you have trouble communicating or taking care

of yourself. Include instructions on what to say to

you, who to contact, and how to help, as well as

treatment and medication preferences. Hospitals

and professionals look to your advance directive

for guidance, and eventually they may be legally

enforceable like a living will. Remember, the

hospital is just a step in a larger learning process,

not a sign of failure. Check the National Resource

Center on Psychiatric Advance Directives at www.

nrc-pad.org.

• Get a comprehensive health evaluation

by a practitioner who can thoroughly assess your

well-being and offer restorative and preventive

ways to improve your health. Many people

with psychiatric diagnoses have unaddressed

physical health problems. Chronic medical/

dental issues, toxic exposure, pain, hormone

imbalance, and adrenal fatigue can all undermine

your health and make it harder to reduce or go

off your medications. Thyroidism, heavy metal

toxicity, carbon monoxide poisoning, anemia,

lupus, Celiac disease, allergies, glycemia, Addison’s

and Cushing’s diseases, TBI, seizure disorders

and other conditions all can mimic mental illness.

Take the time to work on your physical health

rst, including searching for affordable options.

Consider seeing a holistic practitioner: many

have sliding scale or barter arrangements.

• Pay extra attention to your health

while withdrawing. This is a stressful

detoxication process. Strengthen your immune

system with plenty of rest, fresh water, healthy

food, exercise, sunlight, visits to nature and

connections with your community. Get wellness

practices in place before you begin.

explore your Attitude

Believe that you can improve your life. With the

right attitude you will be able to make positive

changes, whether it is coming off, reducing your

medications, or increasing your well-being. Many

people, even if they’ve been on high doses of

psychiatric drugs for decades, have gotten off, and

others have reduced drugs or improved their lives

in other ways. Afrm that you can take greater

control of your health and life. Make sure people

around you believe in your capacity to make

change.

Remember that just lowering your dosage

can be a big step, and might be enough, so be

exible! The important thing is believing you can

improve your life and take charge of your medica-

tion choices.

Prepare to Feel Strong

Emotions

When you go off psychiatric drugs you may have

to learn new ways to work with feelings and

experiences. You may become more sensitive

and vulnerable for a time. Be patient with

yourself and do the best you can, with support.

Remember that life constantly presents us with

challenges: strong emotions are not necessarily

signs of crisis or symptoms in need of more

medication. It is okay to have negative feelings

or altered states of consciousness sometimes:

they may be part of the richness and depth of

who you are. Talk with others about what you

are going through, try to stay connected with

sensations in your body, and gradually build up

your skills. Tell people close to you what to say

and do that helps.

Plan Alternative Coping

Strategies

It’s not always possible, but if you can, create

alternatives before you start reducing. You have

been relying on the drug to cope, and you may

need new coping mechanisms. There are many

alternatives, such as peer support groups, nutrition,

holistic health, exercise, therapy, spirituality, and

being in nature. Everyone is different, so it will take

some time to discover the “personal medicine”

that works for you. You may want to gain some

condence in your new tools before undertaking

drug withdrawal. Make sure your helpers know

about your alternatives, and can remind you to use

them. If you can, give yourself enough time to put

alternatives in place rst.

Many people who have come off psychiatric

drugs report that fear is the greatest obstacle to

beginning the process. You may worry about going

into the hospital again, losing a job, conicting with

friends and family, stirring powerful altered states of

consciousness, facing difcult withdrawal, triggering

suicidal feelings, or losing a tool you use to cope

with underlying emotions and problems. And since

there may be real risks, some fear makes sense.

Beginning a medication reduction is like embarking

on a trip or journey: the unknown can be an

exciting possibility or an intimidating threat. It is

important to acknowledge that you may be

a very different person now than when you

rst started taking psychiatric drugs. You may

have grown, developed new skills, and gained new

understanding. You are handling things differently

than when you were rst put on medication:

past stressors may no longer be present, and life

circumstances may have changed. And whatever

difculties you do have aren’t necessarily symptoms

of a disorder or signs you need medication.

It may be helpful to list your fears and get a friend

to help you examine what is real and what might

be exaggerated, as well as anything you may not

have thought about. Can you be realistic about your

fears and honest about the different possibilities?

What kind of preparations can you make? What

resources, tools, and supports do you have? Can

you nd room for hope – and transformation?

The future doesn’t necessarily have to be the same

as the past: don’t let a label of “disorder” or a dire

prediction from a doctor convince you that change

is impossible.

Some drugs take time to build up effect in the

body, but others – especially to help with sleep

and episodes of distress – work right away.

It might be wise to occasionally use them to

get rest, prevent crisis, or protect you when

you start going into overwhelming emotional

extremes. Be exible but cautious in considering

the middle ground between daily use and

intermittent, as-needed use. Many people who

go off drugs do take them again after some time,

for example briey using an anti-psychotic or a

benzodiazepine when they feel the need. There

is, however, little research on the possible risks

of going off and then back on lithium, anti-

depressants, or anti-convulsant medications.

Working With Fear

Intermittent Use: Taking Drugs From Time to Time

• Friendships – with people who believe in

your capacity for empowerment – can be

crucial. Ideally these should be people who

have seen you on your “bad days,” who you can

be honest with, are there for you when you’re

in trouble, and are prepared for the difculties

that can come from withdrawal. At the same

time, they should be friends who know the limits

of what they can offer and how to say “no” to

protect themselves from burnout.

• Consider going off recreational drugs and

alcohol. Many people are more sensitive than

others, so what affects your friends one way may

affect you more strongly. Abstaining from drugs

and alcohol can improve your mental health, and

even milder drugs like caffeine can undermine

health, stability, and sleep for some people.

Sugar (including sweet juices) and chocolate can

also affect mood, and some people even have

reactions to blood sugar levels or caffeine that

get mistaken for psychosis. Be cautious about

marijuana: for some it might ease withdrawal

symptoms (especially CBD), while for others it

can contribute to depression or psychotic crisis.

• Rest. Find ways to ensure a healthy sleep

routine. Prescriptions might be a good backup if

used sparingly, but start rst with exercise; herbs

such as valerian (occasionally), hops, and skullcap;

homeopathy and acupuncture; supplements

including melatonin, calcium, and magnesium; or

over-the-counter products. Address any stress

or conict contributing to sleeplessness, and

consider eliminating caffeine such as coffee and

sodas. Even if you get enough hours, being asleep

earlier than 11pm is most restful. Make your bed

area peaceful, and give yourself “wind-down” time

before sleep, free of computers and stimulation.

Take short naps if they don’t interfere with your

night schedule, and if you can’t sleep at all, resting

quietly while awake can still be of benet.

• Wait it out. Sometimes time is on your side,

especially for withdrawal, and your natural healing

process just needs patience.

• Nutrition can play a huge role in mental

stability and overall health. Explore what

foods you might be allergic to, such as gluten,

caffeine, and milk. Consider taking supplements

that many have found to nourish the brain and

help the body heal, such as vitamin C, sh oil,

essential fatty acids, vitamins D and B, amino

acids (such as GABA, 5-HTP, tyrosine, and

theanine), and probiotics to restore digestive

What are the Alternatives to Using Psychiatric Drugs?

health. Eat plenty of vegetables, protein, fresh

fruit, and healthy fats, and beware of sugar and

junk food (try switching foods you crave with

healthier alternatives). Be careful about a veg-

etarian or vegan diet – it might help, or without

planning might make you weak and ungrounded.

Some people are affected by articial sweeteners,

preservatives, and other chemicals in processed

foods. Learn about food glycemic index if your

blood sugar is unstable. If you take herbs or

medical drugs for physical illness, consult with an

herbalist about interactions with supplements,

especially if you are pregnant or nursing.

• Exercise such as walking, stretching, sports,

swimming, or bicycling can dramatically reduce

anxiety and stress. Exercise also helps the body

to detox. For some people, meditation is also

very helpful for stress.

• Drink plenty of fresh water (nothing added)

throughout the day: water is crucial to your

body’s ability to detoxify. Each glass of alcoholic

drink, coffee, black tea or soft drink dehydrates

you, and needs to be replaced with an equal

amount of water. If your tap water is not good

quality, consider a lter. If you are overheated,

sweating, or become dehydrated, make sure to

replenish sodium, sugar, and potassium electro-

lytes.

• Chemical exposure and toxins in the

environment can stress the body and cause

physical and mental problems, sometimes

very severe. If you can, reduce your exposure to

pollutants such as furniture and carpet fumes,

household cleansers, harsh noise, paint, carbon

monoxide, outdoor pollution, and uorescent

lights. Consider careful removal of mercury

dental llings. For some people, going off psychi-

atric drugs might make them even more sensitive

to toxins for a while.

• Take a close look at other medications you

are taking for physical diagnoses. Some, such

as the steroid Prednisone, can themselves cause

anxiety, sleep disturbance, and psychosis.

• Hormones play a big role in emotional

stability. If your menstrual cycle is irregular or

you have strong hormonal shifts, get support

from a healthcare provider.

• Some holistic practitioners such as ho-

meopaths, naturopaths, herbalists, and

acupuncturists will assist people reducing

psychiatric drugs. They can provide powerful,

non-toxic alternatives that might help with

anxiety, insomnia, and other symptoms. Try to

make recommended lifestyle changes such as

diet and exercise. If money is an obstacle, be per-

sistent: some providers have sliding scale. Find a

referral from someone you trust, because some

alternative providers are unreliable. If you do

take herbs or supplements, check for side effects

or drug interactions (many doctors and main-

stream sources exaggerate risks about herbs and

supplements).

• A peer support group, therapist, body-

worker, or energy healer can be very

helpful. Allow yourself time to settle in as a

new participant or client.

• For many people, spirituality helps to

endure suffering. Find a practice that is non-

judgmental and accepts you for who you are.

• Being in nature and around plants and

animals can help center you and give you a

bigger perspective on your situation.

• Art, music, crafts, dancing, and creativ-

ity are powerful ways to express what

is unreachable with words, and discover

meaning in your ordeal. Even a crayon sketch

in a journal or a simple collage with the theme

“What do I feel right now?” can be very helpful;

listening to compelling music, including with

earphones, is a lifeline for many people.

• Consider on-line support networks such

as Inner Compass Withdrawal Project, www.

beyondmeds.com, and The Icarus Project as an

addition to, but if possible not replacement for,

direct support.

Reducing Drug Dosage

Safely

The following are general considerations, and no

single pattern ts everyone:

• Usually it is best to go slow and taper

gradually. Though some people are able

to successfully go off quickly or all at once,

withdrawing from psychiatric drugs abruptly can

trigger dangerous withdrawal effects, including

seizures and psychosis. Benzodiazepines and

some antidepressants risk debilitating protracted

withdrawal syndrome from going off too fast. As

a general principle, the longer you were on the

drug, the longer you might need going off. Some

people take years to come off successfully.

• Start with one drug. Choose the drug giving

you the worst negative effects, you feel is the

least necessary, is likely to be easiest to get

off, or the one you are most drawn to start

with. (Injections wear off unevenly, so consider

reducing dose, or switching/adding a pill.)

• Make a plan and revise it as you go. Some

people may go slower or faster, but one way to

start is a test of 10% or less reduction of your

original dose every 2-3 weeks or longer. Do this

until you reach half the original dosage, then

go down by 10% of the new level. Make a chart

showing dosages by date. Get pills of different

size, a pill cutter (some pills shouldn’t be cut),

or measuring cup for liquid. For example, if

you started with 400 mg. daily, you could rst

reduce the dose by 10 percent (40 mg.), to 360

mg. After 2 weeks or more if the feelings are

tolerable, the next 40 mg. reduction would take

you down to 320 mg., and so on. If you got to

200 mg. and a further drop of 40 mg. was too

difcult, you could reduce by 10 percent of 200

mg. (20 mg.), and then go down to 180 mg. etc.

This is just a general guideline, however, and

many people do things differently; consider

starting with a test dose and revising as needed.

• If you have been on a medication a very

long time, you may want to start with an even

smaller reduction and then stay there

for a while. Be exible - coming off completely

might not be right for you.

Coming O: Step by Step

• While gradual is usually best, some side

effects are so serious, such as neuroleptic

malignant syndrome or lamictal rash, that abrupt

withdrawal is medically necessary. Keep up with

lab tests and communicate what’s happening.

• After your rst reduction, monitor any

effects carefully. Stay in close contact with

your prescriber, a friend, support group, or

counselor. Consider keeping a journal of your

experience, maybe with someone’s help. Remind

yourself that if things got worse directly after you

reduced the drug, they may be withdrawal effects

and may pass.

• Especially with anti-depressants and

benzodiazepines, you can sometimes ease

withdrawal by switching to an equivalent dose

of a similar drug with a longer “half-life” – more

gradual time leaving your system. Allow yourself

time, at least 2 weeks or more, to adjust to your

new drug, or longer if there is difculty switching.

• If you need very small or irregular doses,

use compound pharmacies, or change to

liquid form and a measuring cup or syringe to

control dosage. Ask your pharmacist, and some

brands may have different liquid potencies.

• If you are taking anti-Parkinson’s or other

drugs for side effects, remain on them until you

substantially reduce the anti-psychotic, then start

to gradually reduce the side-effect medication.

• If you are taking medical drugs along with

your psychiatric drugs, dosages and effects might

be interacting. Research the drugs, be especially

careful and slow, and get good medical advice.

• If you are taking a drug as needed (“prn”),

not on a set regular dosage, try to rely on it less,

but keep it as an option to help you withdraw

from other drugs. Then gradually stop using this

drug as well. You may want to have it available for

the future as a backup, such as for sleep.

•

• Benzodiazepines are highly addictive and

sometimes the most difcult to come off of,

especially towards the end. Abrupt withdrawal is

dangerous. You may want to leave these to last.

• It is very common for people to start the

reduction process and then realize they are

going a bit too fast. If withdrawal is unbear-

able, too difcult, or continues for too long,

increase the dose again. Give yourself two weeks

or more and try again. If you still have difculty,

raise the dose and then reduce more slowly, or

just stay at the dosage where you are.

• If you do end up in crisis, see it as one

step in a larger process of learning and

discovery, not a failure. If you can, resume

the minimum medication needed to regain your

stability, rather than starting all over again. Keep

in mind that your obstacle might be the drug

withdrawal itself, not underlying emotions or

extreme states -- or a combination of both.

• Remember, you may nd it difcult to go

off completely, so accept this as a possibility

and be exible with your goals. Include other

ways to improve your life and well-being, and

wait to try again when the time is right.

What Will It Feel Like?

Everyone is different, and it is important to keep your

mind open towards what you will experience. You

may not feel any withdrawal at all – or withdrawal

may hit you like a ton of bricks. You might go through

several rough weeks then even out, or you might

notice withdrawal effects long-term.

Forty percent of people in the MIND coming

off drugs study reported no signicant problems

withdrawing. Sometimes, however, withdrawal can

be so severe you may need to try to go back on the

drug or raise your dosage. It appears that the longer

you have been on them, the more likely you will have

signicant withdrawal. General health, good support,

coping tools, and a positive loving attitude can

make you more able to tolerate withdrawal effects.

The chemical changes in your brain can be still be

dramatic, and everyone is vulnerable. Support your

body’s natural healing ability, and remember that time

is on your side in any detoxication process. It’s key

to prepare for possible problems, including how to

deal with crisis. Don’t just expect the worst though:

be open to what is happening.

The most common withdrawal effects are anxiety

and trouble sleeping. Other effects cover a wide

range, and can include but are not limited to: feeling

generally ill, panic attacks, racing thoughts/obsessions,

headaches, u-like symptoms, depression, dizziness,

fatigue, tremors, difculty breathing, memory

problems, extreme emotions, involuntary movements,

muscle spasms and twitching, and nausea. Withdrawal

can also trigger crisis, personality changes, mania,

psychosis, delusions, agitation, and other psychiatric

symptoms. Symptoms associated with anti-depres-

sants can include severe agitation, “electrical jolts,”

suicidality, self-harm such as cutting, and aggression.

Often people report the worst withdrawal effects at

the end of the coming off process, when they have

reduced their dosage to nearly zero. Be creative and

exible.

Withdrawal from lithium and anti-seizure “mood

stabilizer” drugs does not appear to act on

neurotransmitters, but on electrical and blood ow

to the brain, which can lead to withdrawal effects

similar to other drugs. Lithium can create much

greater susceptibility to mania during withdrawal, and

sudden withdrawal from anti-convulsant or anti-

seizure medications can trigger seizures. Be especially

cautious with reducing these drugs.

All of these effects may subside in a few days,

weeks,or more, so it is important to be as patient

as you can. Detoxing and emotional adjustment can

last months or even a year or more, as you learn to

deal with feelings and experiences that have been

suppressed by the drugs and as your brain and body

recover. For many people the most difcult part

is at the end or after you are off the drugs and

struggling with your emotions and experiences,

including long-term detoxication and healing.

Neuroleptic malignant syndrome is a very serious

condition which can develop as an adverse effect and

sometimes during withdrawal. It can be life-threaten-

ing and involves changes in consciousness, abnormal

movements and fever. If you have been on neuroleptic

anti-psychotics and have any of these symptoms, it is

important to discontinue the drug and seek medical

treatment. Tardive psychosis is a condition of extreme

agitation, vomiting, muscle twitching, and psychotic

symptoms that persist when you withdraw from

neuroleptic anti-psychotics. These symptoms usually

diminish when the dose is increased again. Once you

feel better, start again with a more gradual reduction.

Identifying Withdrawal,

Returning Emotions,

And new challenges

Not all painful symptoms when coming off medi-

cations are part of withdrawal: you may experience

a return of difcult emotions or extreme states

which the drug has been helping to suppress, or

new emotions. Withdrawal symptoms tend to

begin right after a dosage reduction, and may ease

over time as your brain adjusts: you may need to

just wait it out. Returning or new emotions could

take longer to resolve, and may need to be worked

through with active engagement and understanding.

There is no denitive way to distinguish between

them, especially with the role of the placebo effect

and expectation. If the symptoms are unbearable or

too disruptive, you may be going too fast. Consider

increasing the dosage and trying again more slowly.

If the withdrawal symptoms remain intolerable, you

may decide to remain on the medication longer

term. Your body may have developed a dependency,

and the risk of this dependence increases the

longer you have been taking the drugs. Long term

dependency tends to be more likely with Paxil, the

benzodiazepines, and neuroleptic anti-psychotics.

Stay at the same dosage for a while, and keep

focused on the bigger goal of improving your life.

Sometimes people don’t realize they are over-

medicated, or they have a hard time speaking up or

having hope for change. And psychiatric drugs can

be very intoxicating, like someone who is so drunk

they don’t realize they are drunk. If you notice

tremors, excessive sleeping, body stiffness, blunted

emotions, agitation, severe weight gain, slowness,

cognitive impairment, or other possible signs of

overmedication, don’t just assume the doctor is

taking care of it. Be an active bystander. Afrm your

respect for the person’s decisions, but raise the

issue gently. Don’t judge or jump to conclusions,

just stick to what you notice and ask the person if

they notice it too. Ask whether they told their pre-

scriber and what the response was. Start a dialogue

about the risks and benets of their medication

choices, and if the person is especially withdrawn

or passive, consider approaching friends, family, or

any professionals who work with them. Don’t let

your own bias and fears get in the way – you don’t

know what it is like to be them – but do become

involved, and make sure what you observe is com-

municated clearly. It can take people time to make

real changes, but “choice” shouldn’t become an

excuse for neglect. Help the person get support to

speak up, and remind them they have options.

I Think Someone is Overmedicated, What Should I Do?

Suffering can put diagnosis and medications at the

center of our identity. While attention to mental

health may be lifesaving for a time, we reach a point

where we need to rejoin the larger community, and

focus more on our gifts, talents, and positive contri-

butions. As you improve your relationship to your

medications, ask yourself: How did crisis interrupt

my life, and what do I want to regain? What are my

future plans? Where do my dreams lead me? What

can I offer others? The lessons you learned are very

valuable, so consider sharing your experience. You

may want to write or video your story, and close

one life chapter to begin a new one.

Whether it’s coming off completely, reducing

your medications to a better level, or just gaining

a greater sense of control, celebrate your new

empowerment. Being human isn’t about living

without hardship or scars: it is about following and

expressing your deepest truth. Even if you have a

diagnosis, take medications, or have lived through

crisis, you are still a full and equal human being. Your

suffering made you who you are today, and it might

have even made you wiser.

Looking to the Future

Afterward: Special Considerations

Drugs in Liquid Form,

Half-Life, and Compound

Pharmacies

Switching to the liquid form of a drug gives you

greater control over reducing the dosage slowly;

ask your pharmacist, as some brands may have

different potencies. You can also go to a “compound

pharmacy” (found on the internet) that will mix

your drug into doses of your specication. Some

pills can be dissolved in water, and a pill cutter can

also be useful (time released and other pills should

not be cut or dissolved, so ask a pharmacist).

“Half-life” means how abruptly the drug washes out

of your system when you stop taking it. Shorter

half-lives means the drug leaves your body faster.

Withdrawal effects will likely be more difcult

on drugs with shorter half-lives, so you may want

to switch drugs of equivalent dosage with longer

half-lives before reducing. That way you are taking

the same dosage but on a drug that will leave your

system more gradually.

Children and Psychiatric

Drugs

More and more young adults and children, and

even infants, are being given psychiatric diagnoses

and put on psychiatric drugs. Most prescriptions

are stimulants for ADHD, but the number of anti-

psychotic neuroleptics and other drugs is growing.

This is a trend that reects aggressive marketing by

pharmaceutical companies.

No long term studies exist on the impact of

psychiatric drugs for children. Some prescribed

drugs are not even FDA approved for child use.

Only recently has psychiatry accepted diagnosing

children with mental illnesses: in the past they

were considered still developing with changing

personalities, and not subject to the same criteria

as adults.

The exact extent of drug risks to children is

unknown, and companies have not been honest.

For example, it took years of pressure before

anti-depressant packaging carried the “black box”

warning that they could cause suicide, or warnings

on ADHD drugs that they can cause addiction and

psychosis.

Child behavioral problems are very real, and

families do need help in dealing with them.

However, trying to solve these problems with

drugs raises serious issues. Unlike adults, children

do not have the legal right to refuse drugs. The

brains and bodies of children are still forming and

exceptionally vulnerable. Child personalities are

very inuenced by their surroundings and the

support they receive, making it even more difcult

to assess the nature of behavioral problems.

Some families are under growing pressure to

compete and perform at school, including getting

the additional help that medication and a “special

needs” status can provide. Labeling can bring

lifelong stigma and create an expectation that a

child cannot change.

Confusing matters more is that sometimes

children with behavioral problems get attention

– punishment or different treatment – when they

do the very behaviors that are a problem, which

can end up inadvertently reinforcing the behavior.

Children also sometimes become the “identied

patient” of a family system or community that itself

need help to change. Child problems can reect

larger problems overlooked by diagnosis.

Because of their youth, the relatively short time

they are usually on drugs, their physical resilience,

and the way their lives are supervised, children

are often very suited for reducing and going off

psychiatric drugs. Creating alternatives often

means trial and error: addressing the needs of

parents, working on family conicts, and changing

the circumstances the children are living in. While

many pressures on families are economic and

circumstantial, parenting skills classes and family

therapy have proven effective and helpful, as are

many other alternatives including diet, exercise,

sleep, homeopathy, and being in nature.

Lawsuits

If you have taken a psychiatric drug and

experienced any negative effects, including difculty

withdrawing, you may be eligible to le suit against

the drug manufacturer if they acted improperly.

This is especially true about newer drugs. Over

the years thousands of people on psychiatric

drugs have received settlements totaling billions of

dollars. Contact a reputable lawyer for information.

Future Drugs

Pharmaceutical companies plan to introduce a

wide range of new drugs in the future. Many of

these drugs will be marketed as improvements

over past drugs.

The industry’s record should make us skeptical

about these innovations. Repeatedly drugs are

brought to market as “new and improved.” Then

serious problems and toxic effects are revealed,

corruption is exposed, and lawsuits are led. The

the next cycle begins, with “new and improved”

drugs introduced once again. The “atypical” anti-

psychotics are a clear example.

Medications lose their protability when their

patents expire after a few years. It is in companies’

interest to pit new, expensive drugs against older,

cheaper ones available generically, even when they

have to deceive the public to do so.

Marketing new drugs amounts to social experi-

mentation. There is huge potential for dangerous

negative effects and abuse. Like past drugs,

miraculous claims are likely to give way to scandal.

Choice and “Do No Harm”

Medication prescribers have a responsibility to

work collaboratively with clients and respect

their choices about treatments. At the same

time, prescribers are bound by the principle of

“do no harm.” This means that when there are

signs of overmedication, adverse effects that aren’t

justied by usefulness, or if a client wants to take

medications that are dangerous or only contribute

to addiction, the prescriber cannot just go along.

They should inform patients about why they

disagree, on grounds of medical ethics, and work

to nd viable alternatives. Otherwise respect for

choice can become an excuse for neglecting clients’

real needs.

“Insight” and Forced Drugging

The mental health system sometimes forces people

to take psychiatric drugs against their will, with the

justication that they lack insight and risk harming

themselves, harming others, or can’t take care of

themselves. In practice, the denition of “insight” and

“risk of harm to self or others” is very blurry and

subjective. It can depend on the doctor you get, the

facility you are in, or even what your parents think

is best, rather than any objective standard. Being in

conict, or acting in ways others don’t know how

to control, can lead to forced drugging, and force is

often a convenience for overworked staff untrained

to help in other ways. Sometimes people are forced

onto drugs just for yelling, or for cutting (which is

usually not a suicide attempt). Biological theories

that say people “need their medication” are used to

support forced drugging, and in many court settings,

“lacking insight” amounts to disagreeing with a

psychiatrist who thinks you are sick and should be

medicated.

The legacy of psychiatric treatment is violent and

abusive. Today, thanks to patients’ rights activism

and the psychiatric survivor movement, laws often

do recognize the harm that can be done by forced

drugging, and there are protections that mandate the

least intrusive, and least harmful, treatments be used.

These protections, however, are rarely fully followed,

and few alternatives receive funding.

Forcing people into treatment and taking

drugs often traumatizes them and makes

things worse, creating fear and avoidance

of help. Force undermines a healing relationship,

and violates the human right to integrity of mind

and sense of self. Drugging and locking someone

up because of “risk” is a double standard that can

deny someone’s freedom just because professionals

are afraid of something they can’t predict. While

some people do feel helped by an involuntary

hospitalization or forced drugging, the rights

infringement and dangers of trauma are too great,

especially when other, voluntary approaches can be

tried but aren’t. We need alternatives to the ‘either-

force-or-nothing’ trap.

Sometimes people seem to “lack insight” or be

unable to acknowledge problems, but this is one

person’s opinion about someone, and not grounds to

label others with a medical disorder and take away

basic rights. Trying and then learning from mistakes is

how people grow. Even people who are in trouble and

making bad choices need the same opportunity as

everyone else to discover and learn. What someone

else considers “self-destructive” may be the best way

a person knows how to learn and cope, given other

things they are struggling with: forced treatment may

be more damaging than someone’s “self-destructive”

behavior. Sometimes spiritual states of consciousness,

nonconformist beliefs, conicts with family members,

or trauma are called “lack of insight,” but they

deserve to be listened to, not made into illnesses.

People do need help, but help should also do no

harm, and should be based on what the person

denes help to be, not what others dene for

them. From the outside, cutting, suicidal thoughts,

or recreational drug use might seem like the most

important issue, but the person themselves may

decide they need help with housing, an abusive

boyfriend, or access to health care. We need a

mental health system based on voluntary services,

compassion, and patience, not force, control, and

paternalism. We also need communities taking

more responsibility to care for each other.

If people have a hard time communicating, they

have a right to supportive helper advocates

who can bridge the gap between madness and

“ordinary” reality. When people need help,

gentleness, exibility, patience and acceptance

usually work best. Because forced drugging

claims to act in the patient’s best interest,

“advance directives” can help people dene

for themselves what they want and don’t want.

Advance directives are like a living will for

crisis, where you give instructions on what to

do, who to contact, and treatment preferences

(including leaving you alone) in case you are in

crisis and having a hard time communicating.

Advance directives are not legally binding (which

may change through movement advocacy), but

do sometimes carry weight in how people are

treated.

Redefining “Normal”

What is the denition of “normal?” New research

supports the harm reduction principle that it’s not

always best to just get rid of everything considered

a “symptom.” Madness shouldn’t be indulged or

romanticized, but consider this: many people learn

how to live with hearing voices; suicidal feelings

are more common than we realize and can be part

of a need for change; and depression might be a

part of the creative process. Sometimes paranoia

is a message about abuse, or reects sensitivity

to nonverbal communication; self-injury is often

a useful way to cope with overwhelming trauma;

believing the universe is talking to you is shared by

many world religions; and manic states can be an

escape from impossible circumstances to nd deep

spiritual truths. Even falling in love often feels like

going crazy.

These experiences are unusual and mysterious

- and can make it impossible to work or go to

school - but rather than just suppressing them

with powerful drugs, what if we included theas

part of humanity’s mental diversity? Might they be

worth exploring to discover their meaning and

purpose? Could madness be like other human

challenges in life, offering us opportunities to

discover and transform who we are?

Many cultures have better rates of recovery when

they welcome people in extreme states rather than

excluding them; all societies should nd a place for

anyone going through madness. To redene normal,

our communities need to talk more openly about

emotional suffering and the limits of psychiatric

treatments. “Coming out” with our mental

difference could lead the way to social change.

Resources

FREE DOWNLOADS and

translations:

This Guide is available free in several languages in online and

printer-ready versions. You have permission to print,

copy, share, link, and distribute as long as you don’t

alter or sell it. www.willhall.net/comingoffmeds

Key resources

Inner Compass Withdrawal Project http://bit.ly/yPjusy

MIND “Making Sense of Coming Off Psychiatric

Drugs” http://bit.ly/yPjusy

“Understanding Psychosis and Schizophrenia” British

Psychological Society

http://bit.ly/1RtRS1T http://bit.ly/1RrXzDO

Coming Off Psychiatric Drugs: Successful With-

drawal from Neuroleptics, Antidepressants,

L i t h i u m , C a r b a m a z e p i n e a n d Tr a n q u i l i z e r s

Peter Lehmann, ed. www.peter-lehmann-publishing.com

Anatomy of an Epidemic: Magic Bullets, Psychiatric

Drugs, and the Astonishing Rise of Mental Illness in

America by Robert Whitaker, Crown Books 2010.

www.beyondmeds.com

Coming Off Psychiatric Drugs: A Harm Reduction

Approach video with Will Hall http://bit.ly/zAMTRF

Psychiatric Drug Withdrawal: A Guide for Pre-

scribers, Therapists, Patients and their Families

by Peter Breggin, Springer Publishing, 2012

Coming Off Psych Drugs: A Meeting of Minds

lm by Daniel Mackler http://bit.ly/1UcVqNh

www.SurvingAntidepressants.org

Gainining Autonomy on Medication GAM

http://bit.ly/GAM20

COMING OFF Medications

SUPPORT

Antidepressant Solution: A Step-By Step guide to

Safely Overcoming Antidepressant Withdrawal

by Joseph Glenmullen Free Press, 2006

Benzo Buddies

www.benzobuddies.org

Benzodiazepines: Co-operation Not Confrontation

www.bcnc.org.uk

Benzodiazepines: How They Work and How To

Withdraw (The Ashton Manual)

by C. Heather Ashton

Benzo.org

www.benzo.org.uk

Benzo Withdrawal Forum

http://benzowithdrawal.com/forum/

Benzo-Wise: A Recovery Companion

V. Baylissa Frederick 2009, Campanile Publishing

Bristol & District Tranquilliser Project

www.btpinfo.org.uk/

Council for information on Tranquilizers, Antide-

pressants, and Painkillers

www.citawithdrawal.org.uk/

Doing Without Drugs: A Guide for Non-Users and

Users 1991 Sylvia Caras,

www.peoplewho.org/documents/doingwithoutdrugs.htm

Halting SSRI’s

David Healy www.mind.org.uk/NR/rdonlyres/

59D68F19-F69C-4613-BD40-A0D8B38D1410/0/

DavidHealyHaltingSSRIs.pdf

Paxil and Withdrawal FAQ

www.paxilprogress.org/

If you are looking for information about psychiatric drugs and mental disorders,

consult the following sources and references we used to write this guide.

Protocol for the Withdrawal of SSRI Antidepres-

sants

David Healy www.benzo.org.uk/healy.htm

Psychiatric Drug Withdrawal Primer

Monica Cassani http://bipolarblast.wordpress.

com/2009/09/22/psychiatric-drug-withdrawal-primer/

Recovery Road - tranquilizer and anti-depressant

dependency

http://recovery-road.org/

Schizophrenia & Natural Remedies

Withdrawing Safely from Psychiatric Drugs

Dr Maureen B. Roberts www.jungcircle.com/schiznatural.

htm

Surviving Antidepressants

http://survivingantidepressants.org/

The Icarus Project

www.theicarusproject.net

Tranquilizer Recovery and Awareness Place

www.non-benzodiazepines.org.uk/benzo-faq.html

Your Drug May Be Your Problem: How and Why to

Stop Taking Psychiatric Medications

Peter Breggin and David Cohen HarperCollins Publishers, 2007

MEDICATION RESOURCES

“Addressing Non-Adherence to Antipsychotic Medica-

tion: a Harm-Reduction Approach”

by Matthew Aldridge, Journal of Psychiatric Mental Health

Nursing, Feb, 2012 http://bit.ly/wbUA6A

Advice On Medications

by Rufus May and Philip Thomas

www.hearing-voices.org/publications.htm

Critical Thinking RX

www.criticalthinkrx.org

Depression Expression: Raising Questions

About Antidepressants

www.greenspiration.org

“Drug Companies and Doctors: a Story of Corrup-

tion” Marcia Angell, New York Review of Books, 2009

“Full Disclosure: Towards a Participatory and Risk-

Limiting Approach to Neuroleptic Drugs” Volkmar

Aderhold and Peter Stastny www.psychrights.org/Research/

Digest/NLPs/EHPPAderholdandStastnyonNeuroleptics.pdf

The Heart and Soul of Change

http://heartandsoulofchange.com/resources/psychiatric-

drugs/

“How do psychiatric drugs work?” Joanna Moncrieff

and David Cohen British Medical Journal 2009; 338

www.mentalhealth.freeuk.com/howwork.pdf

MIND “Coping With Coming Off” Study

www.mind.org.uk/help/information_and_advice, www.portland-

hearingvoices.net/les/

MINDUKCopingWithComingOffPsychiatricDrugs2005.pdf

My Self Management Guide to Psychiatric Medica-

tions

Association des Groupes d’Intervention en Defense des

Droits en Sante Mentale du Quebec

Peer Statement on Medication Optimization and

Alternatives

http://bit.ly/h1T3Fk

Take These Broken Wings: Recovery From Schizo-

phrenia without Medication - lm

http://www.iraresoul.com/dvd1.html

GENERAL RESOURCES

Alliance for Human Research Protection

http://ahrp.blogspot.com/

Alternatives Beyond Psychiatry

edited by Peter Stastny and Peter Lehmann

www.peter-lehmann-publishing.com/books/without.htm

Daniel Mackler

www.iraresoul.com/

Families Healing Together

www.familieshealingtogether.com

Harm Reduction Coalition

www.harmreduction.org

Healing Voices lm

www.healingvoicesmovie.com

Hearing Voices Network

www.intervoiceonline.org; ww.hearing-voices.org

Hearing Voices Network USA

www.hearingvoicesusa.org

The Heart and Soul of Change, Second Edition:

Delivering What Works in Therapy. Duncan, Barry et.

al, eds. American Psychological Association, 2009.

Law Project for Psychiatric Rights

www.psychrights.org

International Network Towards Alternatives

and Recovery

www.intar.org

Philip Dawdy

www.furiousseasons.com

Pat Deegan

www.patdeegan.com

Emotional CPR

www.emotional-cpr.org/

Factsheets and Booklets

by MIND UK

www.mind.org.uk/Information/Factsheets

Foundation for Excellence in Mental Health Care

www.femhc.org

Mad In America: Bad Science, Bad Medicine, and

the Enduring Mistreatment of the Mentally Ill

by Robert Whitaker, Perseus Publishing

Mad In America

www.madinamerica.com

Madness Radio: Voices and Visions From

Outside Mental Health

www.madnessradio.com

Manufacturing Depression: The Secret History of a

Modern Disease

by Gary Greenberg, Simon & Schuster 2010 www.garygreen-

bergonline.com

MIND National Association for Mental Health (UK)

www.mind.org.uk

The Mood Cure: The 4-Step Program to Rebalance

Your Emotional Chemistry and Rediscover Your

Natural Sense of Well-Being

by Julia Ross, Viking Adult publishers, 2002.

National Coalition for Mental Health Recovery

www. ncmhr.org/

National Resource Center on Psychiatric Advance

Directives

www.nrc-pad.org

Open Dialogue

www.dialogicpractice.net

Outside Mental Health: Voices and Visions of

Madness

by Will Hall, Madness Radio, 2016

Peter Lehmann Publishing

www.peter-lehmann-publishing.com

Portland Hearing Voices

www.portlandhearingvoices.net

Ron Unger

http://recoveryfromschizophrenia.org/

Self-Injurer’s Bill Of Rights

www.selnjury.org/docs/brights.html

Soteria Associates

www.moshersoteria.com

Trauma and Recovery The Aftermath of Violence-

-from Domestic Abuse to Political Terror

by Judith Herman, Basic Books, 1997

Universal Declaration of Mental Rights and

Freedoms

www.adbusters.org

Venus Rising Association for Transformation

www.shamanicbreathwork.org

Healing Schizophrenia: Using Medication Wisely

by John Watkins, Michelle Anderson Publishing 2006.

Wellness Recovery Action Plan

by Mary Ellen Copeland

www.mentalhealthrecovery.com

Will Hall Counseling and Consulting

www.willhall.net

SCIENTIFIC STUDIES

“Are Bad Sleeping Habits Driving Us Mad?” Emma

Young, New Scientist, 18 February 2009

“Are Schizophrenia Drugs Always Needed?” Benedict

Carey, The New York Times, March 21, 2006

www.freedom-center.org/pdf/

NYT3-21-06AreSchizophreniaDrugsAlwaysNeeded.pdf

“Atypical Antipsychotics in the Treatment of

Schizophrenia: Systematic Overview and Meta-

regression Analysis” John Geddes, et al.,British Medical

Journal. 2000; 321:1371-1376 (2 December). Cited in

“Leading Drugs for Psychosis Come Under New Scrutiny”

Erica Goode, The New York Times, May 20, 2003

“Brain Volume Changes After Withdrawal of

Atypical Antipsychotics in Patients with First-epi-

sode Schizophrenia” G. Boonstra, et al., J Clin Psychophar-

macol. Apr;31(2):146-53 2011

“The Case Against Antipsychotic Drugs: a 50 Year

Record of Doing More Harm Than Good” Robert

Whitaker, Med Hypotheses. 62: 5-13 2004

“Childhood trauma, psychosis and schizophrenia:

a literature review with theoretical and clinical

implications.” J. Read, et al., Acta Psychiatr Scand 2005

“Diagnosis and Management of Benzodiazepine

Dependence” Heather Ashton, Current Opinion in Psychiatry

18(3):249-255, May 2005

“Does treatment of schizophrenia with antipsy-

chotic medications eliminate or reduce psychosis?

A 20-year multi-follow-up study” Harrow, M. et al.

Psychological Medicine 2014 .http://bit.ly/1Us0MDz

Drug-Induced Dementia: A Perfect Crime

Grace E. Jackson MD, AuthorHouse 2009

“The Emperor’s New Drugs: An Analysis of Anti-

depressant Medication Data Submitted to the U.S.

Food and Drug Administration” by Irving Kirsch, et. al..

Prevention & Treatment. July; 5(1) 2002

“Effects of the Rate of Discontinuing Lithium

Maintenance Treatment in Bipolar Disorders” RJ

Baldessarini, Journal of Clinical Psychiatry 57:441-8, 1996

“Factors Involved in Outcome and Recovery in

Schizophrenia Patients Not on Antipsychotic Medi-

cations: A 15-Year Multifollow-Up Study” Martin

Harrow and Thomas H. Jobe, Journal of Nervous & Mental

Disease. 195(5):406-414 May 2007 http://bit.ly/1pTIYVs

“Empirical correction of seven myths about schizo-

phrenia with implications for treatment.” C. Harding

Acta Psychiatrica Scandinavica 384, suppl., 14-16, 1994

http://psychrights.org/research/Digest/Chronicity/myths.pdf

“The Vermont Longitudinal Study of Persons

with Severe Mental Illness, I. Methodology, study

sample, and overall status 32 years later.” C.M.

Harding, et al. American Journal of Psychiatry. 144: 718-28.,

1987

“Illness Risk Following Rapid Versus Gradual

Discontinuation of Antidepressants” RJ Baldessarini,

American Journal of Psychiatry, 167:934–941, 2010

“Initiation and Adaptation: a Paradigm for Under-

standing Psychotropic Drug Action” SE Hyman and EJ

Nestler Am J Psychiatry,153:151-162, 1996

“Is Active Psychosis Neurotoxic?” T. H. McGlashan

Schizophrenia Bulletin vol. 32 no. 2006

“Is it Prozac, Or Placebo?“ by Gary Greenberg

Mother Jones. 2003; http://bit.ly/MDUbQl

“The Latest Mania: Selling Bipolar Disorder” David

Healy PLoS Medicine. Vol. 3, No. 4, e185

“Long-term Antipsychotic Treatment and Brain

Volumes” Beng-Choon Ho, et al. Arch Gen Psychiatry. 68,

2011

“Long-Term Follow-Up Studies of Schizophrenia”

by Brian Koehler

http://isps-us.org/koehler/longterm_followup.htm

MIND Coping With Coming Off Study

www.mind.org.uk/NR/rdonlyres/BF6D3FC0-4866-43B5-

8BCA-B3EE10202326/3331/CWCOreportweb.pdf

or http://snipurl.com/MINDComingOffStudy

“Rethinking Models of Psychotropic Drug Action”

J. Moncreiff and D.Cohen, Psychotherapy and Psychosomatics

74:145-153, 2005

The Myth of the Chemical Cure

Joanna Moncrieff, Palgrave Macmillan, 2008.

“Needed: Critical Thinking About Psychiatric

Medications” David Cohen, Ph.D www.ahrp.org/about/

CohenPsychMed0504.pdf

“Gradual, 10% Dose Reductions Dramatically

Reduce Antidepressant Discontinuation Symptoms:

Presentation at the Canadian Psychiatric

Association”Alison Palkhivala, Nov. 2007 http://www.

docguide.com/gradual-10-dose-reductions-dramatically-

reduce-antidepressant-discontinuation-symptoms-presented-

cpa

“Paper In New ‘Psychosis’ Journal Shows Many

Patients Do Better Without Psychiatric Drugs”

Medical News Today Mar 2009

“Physical Illness Manifesting as Psychiatric Disease.

Analysis of a State Hospital Inpatient Population”

Hall RC, et. al. Arch Gen Psychiatry. Sep;37(9):989-95. 1980

“Predictors of Antipsychotic Withdrawal or Dose

Reduction in a Randomized Controlled Trial

of Provider Education” Meador KG, J Am Geriatr

Soc. Feb;45(2):207-10. 1997

“Prevalence of Celiac Disease and Gluten Sensitivi-

ty in the United States Clinical Antipsychotic Trials

of Intervention Effectiveness Study Population”

Cascella., N et al. Schiz. Bull doi: 10.1093/schbul/sbp055 2009

Evelyn Pringle

www.opednews.com/author/author58.html

Psychiatric Drugs

Dr. Caligari, 1984

“Psychiatric Drugs as Agents of Trauma” Charles L.

Whiteld, The International Journal of Risk & Safety in Medicine

22 (2010)

“Psychiatric Drug Promotion and the Politics of

Neoliberalism” by Joanna Moncrieff

The British Journal of Psychiatry. 2006; 188: 301-302. doi:

10.1192/bjp.188.4.301

“Psychosocial Treatment, Antipsychotic Postpone-

ment, and Low-dose Medication Strategies in First

Episode Psychosis” Bola, J. R., Lehtinen, K., Cullberg,

J., & Ciompi, L. (2009) Psychosis: Psychological, social and

integrative approaches, 1(1), 4-18

“Are There Schizophrenics for Whom Drugs May

be Unnecessary or Contraindicated?” M. Rappaport,

International Pharmacopsychiatry 13, 100-11, 1978

“Prejudice and Schizophrenia: a Review of the

“Mental Illness is an Illness Like Any Other”

Approach” Read, John el al. www.vermontrecovery.com/

les/Download/foramanda.pdf

“Recovery in remitted rst-episode psychosis at 7

years of follow-up” Wunderlink et al. Journal of American

Medical Association Sept 2013 http://1.usa.gov/1TXw997

Rethinking Psychiatric Drugs: A Guide for Informed

Consent

Grace Jackson, AuthorHouse Publishing, 2009

“Review of ‘The First Episode of Psychosis: A

Guide for Patients and Their Families’” by John Bola

and Will Hall. Best Practices in Mental Health: An International

Journal, 6(2), 138-142. (2010)

“Five-year experience of rst-episode nonaffective

psychosis in open-dialogue approach: Treatment

principles, follow-up outcomes, and two case

studies” Seikkula, J, Psychotherapy Research 16(2): 214-228,

2006

“Schizophrenia, Neuroleptic Medication, and

Mortality” Joumkaa, M., et al. (2006) British Journal of

Psychiatry, 188, 122-127, http://bit.ly/KIGxyu

“Serotonin and Depression: A Disconnect between

the Advertisements and the Scientic Litera-

ture” J.R. Lacasse and J. Leo PLoS Med. 2005; 2(12): e392

doi:10.1371/journal.pmed.0020392

“Soteria and Other Alternatives to Acute Psychi-

atric Hospitalization: A Personal and Professional

Review”

Loren Mosher Journal of Nervous and Mental Disease. 1999;

187:142-149

“Pay Attention: Ritalin Acts Much Like Cocaine”

Vastag, B. 2001. Journal of Am Med Association, 286, 905-906

“Clinical Risk Following Abrupt and Gradual

Withdrawal of Maintenance Neuroleptic

Treatment” Viguera, AC, Arch Gen Psych.54:49-55, 1997

“Withdrawal Syndromes Associated with Antipsy-

chotic Drugs” G Gardos, et al. Am J Psychiatry 1978; 135

Ed Altwies PsyD

David Anick MD, PhD

Marino Center for Integrative Health

Ron Bassman, PhD

Author, A Fight To Be: A Psychologist’s Experience from Both

Sides of the Locked Door

Alexander Bingham, PsyD

Patrick Bracken, MD

Co-author, Post-Psychiatry

Christopher Camilleri, MD

Los Angeles County Department of Mental Health

Michael Cornwall, PhD

David Cohen, PhD

Co-author, Your Drug May Be Your Problem

Celine Cyr

Gaining Autonomy with Medication

Patricia Deegan, PhD

CommonGround

Laura Delano

Inner Compass Withdrawal Project

Jacqui Dillon

Hearing Voices Network UK

Kelley Eden, MS, ND

Neil Falk, MD

Cascadia Behavioral Healthcare

Daniel Fisher, MD

National Empowerment Center

Mark Foster, MD

Chris Gordon, MD

Massachusetts General Hospital

Jen Gouvea, PhD, MSW

Engaged Heart Flower Essences

Mark Green MD

Westbridge Community Service

Nazlim Hagmann, MD

Carina Håkansson

Family Care Foundation

Lee Entel Hurter, Licensed Acupuncturist

Monica Cassani

Publisher, Beyond Meds website

Peter Lehmann

Editor, Coming off Psychiatric Drugs

Bruce Levine, PhD

Author, Surviving America’s Depression Epidemic:

Bradley Lewis, MD, PhD

Author, Narrative Psychiatry

Krista Mackinnon, DipSSW

Families Healing Together

Daniel Mackler, LCSW

Director, Take These Broken Wings

Rufus May, Dclin

Evolving Minds Bradford, UK

Elissa Mendenhall, ND

Amenda Clinic

Health Professional Advisors

While not co-authors, the following 61 health care professionals are experienced with

helping people come off psychiatric drugs. They reviewed this guide for its usefulness,

and we thank them for their involvement:

Renee Mendez, RN

Windhorse Associates

Dawn Menken, PhD

Process Work Institute

Arnold Mindell, PhD

Author, ProcessMind: A User’s Guide to

Connecting with the Mind of God

Joanna Moncrieff, MD

Author, The Myth of the Chemical Cure

Pierre Morin, MD, PhD

Lutheran Community Services

Matthew Morrissey, MFT

Co-Editor, Way Out Of Madness

Sharna Olfman, PhD

Author, Bipolar Children

Ilya Parizsky, MFT

Catherine Penney, RN

Dante’s Cure: A Journey Out of Madness

Judith E. Pentz, MD

Maxine Radcliffe, RN

Action Medics

Myriam Rahman, MA, DiplPW

Process Work Institute

Lloyd Ross, PhD

Nancy Rubenstein del Giudice

Law Project for Psychiatric Rights

Olga Runciman

Hearing Voices Denmark

Judith Schreiber, LCSW

Soteria Associates

Michael Smith, MD, Licensed Acupuncturist

National Acupuncture Detoxication Association

Susan Smith

Proactive Planning

Claudia Sperber, Licensed Acupuncturist

Linda Star Wolf

Venus Rising Association for Transformation

Peter Stastny, MD

International Network Towards Alternatives for Recovery

Sandra Steingard, MD

Ted Sundlin, MD

Jefferson Behavioral Health

Philip Thomas, MD

Co-author, Post-Psychiatry

Krista Tricarico, ND

Dina Tyler

Bay Area Mandala Project

Scott Von, MD

Toby Watson, PsyD

Associated Psychological Health Services

Barbara Weinberg, RN, Licensed

Acupuncturist

Charles Whiteld, MD

Author, Not Crazy: You May Not Be Mentally Ill

Damon Williams, RN, PMHNP-BC

Laughing Heart LLC

Paris Williams, PhD

Author, Rethinking Madness

Health Professional Advisors, continued