When medications have assisted a patient through an emotional crisis or resolved a chronic mood disorder and the patient has demonstrated stability for a reasonable period of time, a consultation will be in order to discuss discontinuing medication. We first want to see how they do when we taper back to a lower dose. In fact, with some of our patients who are in a hurry to get off their meds, we may periodically experiment with a lower dose to see how well they respond.
If the patient has been prescribed a combination of medications, we address them one at a time. Usually, the most recently added medication will turn out to be the one we first begin to back off, but this isn’t a hard and fast rule.
When patients get nervous about discontinuing medication, I reassure them that if their nervous system is not ready to operate on its own, we reverse the process and taper up again. In the meantime, I do not want them to become overly vigilant in assessing their mood or become oversensitive to slight symptoms that may arise. Instead, I let them know that we’re looking for an overall trend during a reasonable time period. I also work with them through any possible side effects. Moreover, we choose a relatively stress-free time when patients do not have to deal with any major changes or upsets.
The nervous system has to make neurochemical adjustments when it is no longer assisted by an ample dose of mood-stabilizing medication. The purpose of tapering down is to allow time for these adjustments.
To learn more about the proper tapering process, as well as typical side effects that might emerge when taking specific drugs, purchase my Volume 3 book of Healing the Mind and Body: The Doctor and Patient Guide.