More about ‘tapering kits’

On this page I have tried to cover some of the main questions you may have about tapering kits. If you have other questions that you think would be useful please contact me and I'll gladly add them

Why would someone want to stop taking their antidepressant?

There are actually a number of reasons that someone may want to stop:
  • The person may feel better and wish to stop.
  • They may want to try an alternative form of therapy or drug.
  • They may be prescribed a second medication for a different issue that is incompatible with an antidepressant.
  • The drug manufacturer may have stopped manufacturing the drug in question.
  • The side effects of the drug in question may be too much to tolerate.
  • Or they may simply feel that there was no benefit to being on the drug.
Who would benefit?

The user
  • The user can safely and confidently reduce their dosage over time.
  • The user can minimise the unpleasant effects of withdrawal.
  • Stopping the drug is likely to significantly reduce the unintended long-term consequences of the drug compared to someone who were to take it for life.
  • If a drug is stopped by the manufacturer there is a safe way of coming off the drug for the user.
  • When starting a new drug there is the reassurance of knowing that there is an accepted method of stopping at the end of treatment.
The GP/Psychiatrist
  • The GP/Psychiatrist can prescribe with the confidence of knowing that the risks of withdrawal are minimised.
  • The GP/Psychiatrist can focus on the patients recovery rather than the effects of withdrawal.
  • The patient is likely to need less time compared to someone attempting to stop without structured support.
The NHS
  • A significant and ongoing reduction in antidepressant prescription costs (£780,000 per day in 2015).
  • Less treatment required for the unintended long-term consequences of the drug compared to someone who were to take it for life.
Pharmaceutical manufacturers
  • A huge boost in public confidence and a positive good news story.
  • The opportunity to phase out older drugs with less risk of extensive and expensive litigation.

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What is the ‘right’ way to taper?

This is an area that needs more research, preferably some high quality randomised controlled trials to demonstrate that tapering is the most effective way to minimise withdrawal effects and to determine the best approach.

In his book, Coming off Antidepressants, Joseph Glenmullen M.D. proposes a number of tapering regimes based on a study of patients and that differ by individual drug half-life. If you want to understand the details that need to be considered when tapering, this book is a great place to start
amazon uk link amazon us link

As an example, let’s assume that a patient is taking a tablet which, at 10mg, is the lowest dosage available in pill form. The tapering kit would get the patient from 10mg to 0mg over a period of 14 months using the following reductions.

table

In the above table, while the percentage reduction increases, the amount of reduction in milligrams decreases over time. Please note that this is just an example, the details would have to be worked out by people much cleverer than me!

Are there any drawbacks with this method?

This approach is not meant for everyone, some users will be able to reduce more quickly while others may want to reduce more slowly. Good quality randomised controlled trials are the best way to determine the most effective approach.

There is a cost to factor in for the drug manufacturers to produce tablets in decreasing dosages, but this has to be weighed against the potential costs of litigation and the costs of reversing the negative public perception that surrounds the prescribing of these drugs.

Please note that you should never make changes to your psychoactive medications without the agreement and support of your Doctor or Psychiatrist.

The following are a selection of comments from the generous folk who have signed the petition so far, there are many more on the petition too.

"I'm signing because I work for the pharmaceutical industry and have knowledge of these drugs. This idea makes enormous sense to me and would give me pride in my industry.”

“I have worked in mental health for 30 years and know how desperately this is needed. It could save many lives.”

“This would make things safer for patients and more cost-effective for the NHS. Brilliant idea. Please implement this!”

“I am a healthcare professional who is worried about the over prescription of psychotropics in mental health care, and the lack of support for those that do not wish to be on such drugs.”

"I'm signing because I would really like to come of antidepressant Citalopram which I have taken for years on & off. I have tried a couple of times. Really think this would be a great way of doing it."

“I am a psychiatrist and I witness the problems people have discontinuing these medications.”

"I avoided taking antidepressants for too long as I was so worried about what would happen when I stopped taking them. It got to the stage where I lost my job and became agoraphobic. If these tapering kits were available I would have sought help far earlier and not got myself in such a state."

"Watching my Mum being stripped off her full prescription and being told to go cold turkey was not the answer and made her very ill!"

"This is such a big issue and many of my patients go through severe withdrawal and as a consequence it affects their mental wellbeing. I have experienced the same and it's a terrible cycle to go through!"

"This would make things safer for patients and more cost-effective for the NHS. Brilliant idea. Please implement this!"

"It's a huge missed opportunity to get willing patients off their meds. Advice when stopping meds is patchy and disorganised, plus there's no continuity. Tapering packs would help that consistency and continuity."

"Withdrawing from Venlafaxine was a very unpleasant experience and makes me wary of ever taking SNRI or SSRI again."

"I have seen how desperately hard it is for people who are recovering from anxiety and depression to stop taking medication. The withdrawal symptoms can be as difficult to live with as the condition."

"I am signing because I have seen many patients struggle to reduce their SSRI doses . I have also had to provide a lot of counselling to patients who have wanted to reduce their SSRI intake."
“I am presently withdrawing from Venlafaxine and a tapering kit would have eased the process considerably. As it is, I have to break open the capsules, remove a couple of beads, and reassemble, tapering at the rate of 10% per month.”

“I fully support this as I have been on anti-depressants from an early age and one day would like to taper off.”

“I am currently taking a very high dose of Sertraline (150mg) and have been given no advice or help as to how to reduce this dose with the view of coming off them.”

“This is such a big issue and many of my patients go through severe withdrawal and as a consequence it affects their mental wellbeing.”

“I've been on anti-depressants for 12 years and have tried several times to come off them without success. I fear I will be on them forever.”

“I too have experienced this problem and it's a nightmare ! I agree with James that it makes you feel just more of a failure because it's something else you can't do, my current medication which I intend to remain taking causes obvious withdrawal symptoms even if I forget just one day!”

“I have tapered off both Mirtazipine & Prozac in the past & had awful problems which resulted in me taking a different medication to help with the withdrawal . A vicious circle I think!”

“Brilliant idea. If this became available to buy, I would get a kit immediately. Been trying to quit for years but finding it impossible to taper below 50mg.”

“I don't want to be taking an antidepressant forever. I want to be able to reduce dosage safely.”

“I had great difficulty coming off antidepressants, even though I'd lowered my dose for 6 months beforehand. I suffer from anxiety now but don't want to go back on antidepressants knowing the hassle that involves coming off them!”

“I'm on medication wishing to stop and completely agree with what James is suggesting.”

“This is a fantastic idea to stop patients feeling so awful when stopping medication and I've been through it myself.”

“It's a huge missed opportunity to get willing patients off their meds. Advice when stopping meds is patchy and disorganised, plus there's no continuity. Tapering packs would help that consistency and continuity.”

“I'm trying to wean off my medicine and I've no idea how I'm going to get from my curent dosage to nothing without having time off work due to the side affects - which are extremely unpleasant.”

“I've also struggled to come off antidepressants - the doctors generally just advised that reducing for a couple of weeks will be okay, but I felt awful doing this. Tapering kits/more advice would be great.”

“I too am a sufferer but hope one day to be able to live again without medication. I feel this would certainly help me when the time comes.”

“I have tried & failed to stop taking my medication and support anything that might help me be drug free.”

“I would love to start removing my daily intake of depression tablets to complete my recovery but the side effects are horrid. I have tried several times before without success. Taper kits are a great idea!”

“I have been on my antidepressants for 16 years and would love to come off them. I have tried many times, once successfully for 18 months before a relapse.”

“I myself have encountered this problem with my anti-depressant medication and have tried unsuccessfully many times over several years to wean myself off it. I am therefore still taking this drug after 15 years 'by default' . I would welcome this initiative with open arms.”

“I am in need of a tapering kit, I also work with many people who would benefit from such a kit.”

“I'm signing because I too have tried numerous times to stop but unsuccessfully. A measured course of meditation would be a great option for me.”

“I have seen how desperately hard it is for people who are recovering from anxiety and depression to stop taking medication. The withdrawal symptoms can be as difficult to live with as the condition.”

“I believe a lot more should be done to help people come off medication. It would also reduce the burden on the NHS.”

“What a great idea! Great for pill-takers and excellent PR for Big Pharma too!”

“I am signing because I have a very close friend who desperately wants to come off all the drugs she is taking!”

“The worst and most frightening times in my life has been trying to taper my antidepressants under GP supervision. It's virtually impossible without correct reduced dosages, difficult to cut pills in half etc also need better guidelines on how often to make a drop and how much to drop.”

“I'm worried about how my teenage son will come off anti-depressants.”

“I am signing because I have seen many patients struggle to reduce their SSRI doses. I have also had to provide a lot of counselling to patients who have wanted to reduce their SSRI intake.”

“It has been a horrible nightmare for my husband who tried to wean off Olanzapine and Mirtazapine after starting them 20 months ago on the advice of his psychiatrist for having insomnia. His doctors deny the withdrawals and kept adding on more drugs, leading to more side effects and complications. With this petition, we hope the drug companies will be more transparent and educate the doctors and patients on dealing with the side effects and withdrawals of such potent drugs!”

“I developed withdrawal syndrome after tapering off of Zyprexa over the course of four months. Stabilised after reinstating. Will have to crush into a powder and weigh on a scale everyday for the next five years to taper. Tapering should be more accessible.”

“I'm signing this because I believe that patients who choose to decrease their psychotropic medications should be able to so safely and effectively!”

“I would love to start removing my daily intake of depression tablets to complete my recovery but the side effects are horrid. I have tried several times before without success. Taper kits are a great idea!”