Kim M.
Google
Potential Problems When Reducing and Discontinuing
Neuroleptics
Note: The following two sections are an excerpt translated by Markus Kaufmann (member of the expert committee) from Breggin 2013 (pp. 119 ff.). Dr. Peter
Breggin is an American psychiatrist with extensive experience
in reducing and discontinuing psychotropic medications. There is currently very
little literature on this topic, particularly regarding the criteria for distinguishing between discontinuation symptoms and symptoms of the underlying psychiatric illness.
"Any psychotropic drug can produce withdrawal or discontinuation symptoms. This occurs partly because the brain adapts to the psychotropic drug and is left in an abnormally compensated state when the dose
of a medication is reduced or the medication is discontinued."
``` The following symptoms may occur when reducing and discontinuing neuroleptics:
1. Psychotic symptoms may occur during reduction and discontinuation as a result of changes in brain metabolism. They cannot always be reliably distinguished from the original psychotic disorder. They usually develop within days of the reduction and generally improve after 2–3 weeks. 2. Emotional lability or instability (such as anxiety, restlessness,
paranoid reactions, depression, irritability, aggression, and increased energy). These also usually develop within days or weeks after
reducing or discontinuing the medication.
3. Sleep disturbances can be distressing and contribute to instability.
4. Movement disorders (such as muscle stiffness, tremors, involuntary movements of the face, lips, jaw, tongue, arms, wrists, hands, fingers, legs, knees, toes, neck, shoulders, hips,
restlessness) can, in rare cases, be pronounced and associated with restlessness and anxiety.
5. Cognitive impairments such as difficulty concentrating, attention deficit, forgetfulness, and distractibility.
6. Gastrointestinal problems such as nausea, vomiting, diarrhea, abdominal cramps, and abdominal pain.
7. Other physical symptoms such as flu-like symptoms including malaise, sweating, muscle cramps, paresthesia, rapid heartbeat, increased pain sensitivity, headaches, dizziness, and high blood pressure.
The extent of these symptoms is significantly influenced by the size of the reduction step. Therefore, it is crucial to proceed slowly and with small reduction steps. Psychotropic medications are far, far more dangerous than the doctors who prescribe them would ever admit. I firmly believe that most people would never use psychotropic medications if they knew how dangerous they are, and I also believe that most doctors would stop prescribing them if they had any idea how dangerous they are.
In 2003, the FDA added a warning about the increased risk of stroke to the U.S. prescribing information for risperidone. The same warning followed in 2004 for olanzapine and in 2005 for aripiprazole.
Mood stabilizers are anticonvulsants that do not stabilize mood, but suppress emotional responses by sedating and calming people. Psychiatrists have never precisely defined this term. It's no surprise that doctors believe anticonvulsants work for mania, since anything that sedates people helps with mania. All information is provided without guarantee. This is simply meant to be constructive criticism that might help someone.
