The use of antidepressant and antianxiety medication is on the rise. In fact antidepressant and antianxiety medication prescriptions have grown by 65% in women over the past 15 years. Women are also twice as likely to be prescribed an antidepressant as men are.But does that mean you need to stay on antidepressants forever? Most people don’t. So while the usage is on the rise, unless you plan to stay on it forever, you need a plan to taper off safely.  Here is my list of how to taper off antidepressants and anti-anxiety medication safely and effectively.

Here’s why: Long term use of SSRI’s and SNRI medication (this includes Zoloft, Prozac, Effexor etc.)  actually can deplete your neurotransmitters, particularly serotonin, making you feel worse over time. When this happens, instead of tapering off many people start the cycle of changing medication or stacking medication to help them feel better.  This cycle feels like it never ends and really isn’t the best plan for everyone. 

I see this a lot in my office, women who have been taking antidepressant or antianxiety medication for more than 10 years and still feel anxious or depressed.  WHen they consider coming off their medication traditional taper-off plans often do cause people to feel worse. Why, because plans either happen too fast (could even be cold-turkey) and the brain basically can’t catch up.

How to begin the process of tapering off your psych medication(s)

To come off antidepressants or anti-anxiety medication safely and securely you do need a plan, but ideally one that includes your whole body chemistry not just your psychological symptoms. When you have this kind of taper off plan, you will be less likely to see an increase in your depression but rather will start to feel like yourself again, maybe even for the first time.

Before we continue it is important to understand that I am not anti medication. I do believe there is a time and a place for psychiatric medication. But, it is also a belief of mine that we are becoming a society that is overmedicated often from childhood on. Most likely this is due to the demands on our lives to perform and the idea that we need a quick fix because we don’t have time for something that takes time. 

With that being said, psychology needs to evolve. Psychology is the only field that doesn’t “look under the hood” to see what is actually happening despite having the medical advances to do so. 

This is why a plan matters…

Think about this: if you go to the doctor for a broken arm, the doctor will never give you a symptom checklist to determine if your arm is actually broken. Instead they will take an x-ray as a diagnostic tool. In psychology we rely on symptom checklists to diagnose mental health conditions. But, we do not dig further than that. 

Add to it that you are more than just your emotions. You are a whole system of interwoven parts that include your feelings, but also your body chemistry, the food you eat, your sleep patterns and more.  

Because I have many clients that come to me specifically to get off their psychiatric medication, I felt that I should share some of my best tips to do so safely and for the long term. 

Firstly, never go off cold turkey. And, never do it without the support of your prescribing doctor and someone to help you understand whether your symptoms are increasing, decreasing or staying the same. Those are the first rules of tapering off. 

If you’re ready to taper of antidepressants or anti-anxiety medication, here are the 6 things you must do to make the change safe and long-lasting.

1. Work with your prescribing doctor – Firstly, and I cannot stress this enough, you need to work with your prescribing doctor or nurse practitioner. Some medications can be prescribed in liquid form or in tablets that can be split. Only your prescriber can help you with this. I know most people don’t want to hear this, but having a team is important. 
2. GO SLOW! – Many doctors titrate or taper way too fast! They will even do an every other day medication roller coaster. The longer you have been prescribed the slower you must go. A typical medication taper should be at least 6 months to a year. The slower the better! Your brain needs a chance to catch up. 
3. Get a solid nutrition plan in place – Neurotransmitters are based in nutrition. Primarily proteins and other nutrient cofactors. Make sure you focus on your nutrition prior to the taper and keep it going throughout and beyond the taper. 
4. Understand where your neurotransmitter imbalances are– This should be number 1, but I have it at number four because all too often people start and quit plans without a realistic sense of how long things take. With that understanding it is critical that you know what’s happening inside your body and how your own chemistry is responding to the reduction in your medication. When you get a check on your neurotransmitters are, you will learn more about what’s happening with things like your serotonin levels, glutamate, dopamine levels are etc. These specific details tell you what parts of your personal chemistry are in need of extra support and which ones are doing fine.  It also allows you to understand what specific nutritional support is needed to help you feel better as you taper off your antidepressant or anti-anxiety medication. In my practice, we handle gathering this information by having you get a lab test to check your neurotransmitter levels and then a specific plan for your body/chemistry can be devised. If you’re unsure of how to do this or what to ask your provider for, this is a great time to reach out to me and ask for support.  
5. Get support – Make sure you have a support person, therapist or brain-health coach supporting you. Check in frequently to assess mood, motivation and other factors that will contribute to a successful taper. 
6. Don’t Give Up! – If it feels too difficult, then you likely need some lifestyle tweaks, a change in nutrient support, or just more motivation to keep going. It might be a longer process than you had hoped for, but once you start just keep following your plan. If your mood feels worse, please seek help from your therapist or doctor. 

Tapering off antidepressant or anti-anxiety medication should be something well planned and something everyone considers wisely. Work with your doctor, therapist and someone like me to help. Together you will understand the whole picture so you’re not in the dark, worried or feeling badly.

The worst thing is to quit when you’re almost there… with a plan and the right insights you can make the transition off medication in a way that doesn’t disrupt your life. Instead it will bring you the relief and choices that are aligned with the goals you have in place.

If you need help with getting off your medication, please reach out. I am happy to do a free consultation with you to explore what you need to do to ensure your tapering off is safe, healthy, and productive.