There are multiple reasons as to why people decide to taper off their psychiatric medications, some of which include but aren’t limited to feeling psychiatrically stable, wanting to lessen the side effects of the medications, wanting to learn to deal with their situation using other means, etc.
Whatever the case may be, wanting to have this discussion with your psychiatric provider is completely okay and completely justified.
That being said, tapering off of psychiatric medications can’t be done haphazardly.
There are many risks involved including experiencing a rebound of the initial symptoms, withdrawal symptoms, etc. That is why it’s extremely important that you have a comprehensive plan for this and that you involve your entire care team for this process.

Preparing for the Conversation

Asking for what you want and clearly stating your reasons is extremely important for getting the outcome you want. Before going for your appointment, write down your reasons for your goal as well as your concerns.
Some reasons for your goal may include the following:

• Physical side effects
• Symptom remission
• Interest in relying more on non-pharmacological tools

Record your recent stability by jotting down your mood and how well you sleep.
Write down the side effects you’re experiencing. They can be emotional or physical.
List the tools you’re using to manage your stress. These tools may include your individual psychotherapy, tools you’ve learned during other types of therapy, etc.

Ask the Right Questions

Turn your visits with your psychiatrist or nurse practitioner into a team effort. Use these questions to initiate a discussion.

• “I’ve been stable on my current dose for a while. Would it be possible to attempt a taper at this point?”
• “What does a slow, structured, taper schedule look like for this medication?”
• “What are withdrawal symptoms and rebound effects that I should look out for?”
• “If my symptoms return while tapering, what do we do?”

Understand How Safe Tapering Works

Transitions in medicine are typically balanced by (a) gradual adjustment and (b) careful control of the process, complemented by (c) ongoing observation and monitoring.

• Phase 1: [Provider Review]
  Evaluate Stability & Lifestyle Balance
• Phase 2: [Gradual Dose Reduction]
  Micro-Adjustments over Weeks/Months
• Phase 3: [Support & Monitoring]
  Track Mood & Sleep Integration

1. Timing Matters

Lighter doses work better during periods of general calm in your life. Don’t attempt a taper during times of elevated stress and chaos in your life (job changes, significant moves, high conflict family matters, etc).

2. Incremental Changes

Not all classes of medications allow for quick, significant reductions. Some anti-anxiety and anti-depressant meds require micro dose reductions over a period of months.

3. Distinguishing Withdrawal/Relapse

Temporary discontinuation effects (dizziness, mild irritability, sleeplessness, etc.) are different from the return of your baseline/underlying symptoms. Your provider will help you differentiate the two.

Create Your Integrative Support System

When adjusting your dosage of psychiatric medication, there is more to it than just changing your dose. There is also the fact that your brain health can and will change at various points during the process, and support for this is vital.

What to Do if Your Provider Advises Waiting

• Ask for the reasoning behind your provider suggesting waiting.
• Ask them to define what sort of goals or milestones they would need you to meet before reassessing — such as symptom stability for a certain period of time, or another supportive therapy being in place, etc.

Take the Next Step with Guidance

For more information and to get personalized support, contact us. With your overall wellness in mind – our integrative mental health team will provide you the loving, personalized care you need and deserve.