Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families

by Peter R. Breggin

As a physician who specializes in addiction medicine and drug withdrawal and written widely on them, I recommend Dr. Breggin's book to every health professional who deals with anyone taking psychiatric drugs. He gives highly useful information and reasons for stopping or avoiding them. It's an excellent one-stop source of information about psychiatric drug effects and withdrawal. Prescribers, therapists, patients, and families will benefit from this guidebook. Charles L. Whitfield , MD
Bestselling author of Healing the Child Within and many other books Peter Breggin has more experience in safely withdrawing psychiatric patients from medication than any other psychiatrist. In this book he shares his lifetime of experience. All of our patients deserve the benefit of our obtaining that knowledge. Bertram Karon , PhD
Professor of Psychology, Michigan State University
Author, The Psychotherapy of Schizophrenia
Former President of the Division of Psychoanalysis of the American Psychological Association This is such an important book. Describing the problem of withdrawal from psychiatric drugs in detail, and providing clear advice regarding how to deal with this problem as Peter has done so well in this book, is long overdue. For decades, the belief system that is mainstream psychiatry has denied the existence of withdrawal problems from the substances they prescribe so widely. In reality, withdrawal problems with psychiatric drugs is a common occurrence. Because of psychiatry's reckless denial of this real and common problem, millions of people worldwide have not had the support and care they desperately need when attempting to come off psychiatric drugs, often been erroneously advised that these problems are confirmation of the existence of their supposed original so-called 'psychiatric illness.' Dr. Breggin's book is therefore both timely and necessary." Terry Lynch , MD
Physician and Psychotherapist
Author of Beyond Healing Mental Suffering Without Drugs and A Key to the Recovering of
Emotional Well Being , Mental Health and the Prevention of Mental Health Problems Dr. Peter Breggin has written an invaluable reference for mental health professionals and lay-persons alike who are seeking a way out of dependency on psychiatric drugs. He describes the many dangers of psychiatric medication in straightforward research-based and contextually nuanced terms. Most helpfully, he articulates a method of empathic, person-centered psychotherapy as an alternative to the prevailing emotionally and system disengaged drug-centered approach. In this book, Dr. Breggin systematically outlines how to safely withdraw a patient from psychiatric medication with rich case examples drawn with the detail and sensitivity to individual and situational differences that reveal not only his extensive clinical experience, but his clear, knowledgeable, and compassionate vision of a more humane form of treatment. In this volume, Dr. Peter Breggin has again demonstrated that he is a model of what psychiatry can and should be. This is an indispensable text for both mental health trainees and experienced practitioners seeking a practical alternative to the dominant drug-centric paradigm. Gerald Porter , PhD
Vice President for Academic Affairs
School of Professional Psychology at Forest Institute This much needed book and guide to psychiatric medication withdrawal is clearly written and easy to understand. As people become more empowered and able to inform themselves about the effects of pharmaceuticals, practitioners will be called upon to wean their patients off of damaging medications. This book will provide that guidance. Thank you Dr. Breggin for having the courage to oppose conventional psychiatric thinking and the caring to improve the quality of life for individuals who are ready to experience their own innate healing instead of reaching for a pill to mask the symptoms. Melanie Sears , RN, MBA
Author, Humanizing Health Care and Choose Your Words Today many psychologists, nurses, social workers, and counselors are struggling with how to help adults and the parents of children who are over-medicated or who wish to reduce or stop taking their psychiatric drugs. Dr. Breggin's book shows non-prescribing professionals, as well as prescribers, how to respond to their patient's needs in an informed, ethical, and empowering fashion. Sarton Weinraub , PhD
Clinical Psychologist
Director, New York Person-Centered Resource Center, NYC This is the first book to establish guidelines and to assist prescribers and therapists in withdrawing their patients from psychiatric drugs, including those patients with long-term exposure to antipsychotic drugs, benzodiazepines, stimulants, antidepressants, and mood stabilizers. It describes a method developed by the author throughout years of clinical experience, consultations with experienced colleagues, and scientific research. Based on a person-centered collaborative approach, with patients as partners, this m...

Genres: Psychology, Mental Health, Health, Psychiatry, Medicine

352 pages, Paperback

First published July 1, 2012

About the author

Peter R. Breggin MD is a Harvard-trained psychiatrist and former Consultant at NIMH who has been called “The Conscience of Psychiatry” for his many decades of successful efforts to reform the mental health field.
His work provides the foundation for modern criticism of psychiatric diagnoses and drugs, and leads the way in promoting more caring and effective therapies.
His research and educational projects have brought about major changes in the FDA-approved Full Prescribing Information or labels for dozens of antipsychotic and antidepressant drugs.
Dr. Breggin has authored dozens of scientific articles and more than twenty books, including medical books and the bestsellers Toxic Psychiatry and Talking Back to Prozac.

Reviews

[Damian Gamble · Rating 5 out of 5]

Inspiring and humbling

This book sets out clearly the case for prescribing less psychiatric medication for shorter periods. Peter Breggin has built a reputation for kindness, empathy and single minded commitment to his patients. He believes that most psychiatric medication does more harm than good and recommends that it should usually be reduced and discontinued. There are many practical tips for clinicians and patients wanting to follow his lead. His dedication to his work shines through.

[Brenda · Rating 5 out of 5]

A majority of people taking a psychiatric drug for 2 years or more will experience severe and disabling withdrawal symptoms upon cessation of the drug. Peter Breggin has written a comprehensive and insightful handbook with copious citations and external references for what to expect when coming off of psychiatric medication (aimed at therapists and prescribers, but useful for laypeople).

I wrote down a ton of quotes from this book because there’s so much good stuff in it:

“Why are psychiatric drug withdrawal problems so common and often so difficult to overcome? Because the brain adapts to all psychoactive substances, the abrupt withdrawal from any psychiatric drug can produce distressing and dangerous withdrawal reactions.” (Xxiii)

“Recently, a graduate student in my class on Empathic Therapy and Counseling expressed her personal concerns to the group of fellow students she felt that she no longer needed her psychiatric medications and worried that they were flattening her emotions and impairing her memory. She then explained in heartfelt tones, ‘I’ve been taking benzodiazepines and antidepressants for 10 years — since I was 14 years old. I’ve grown up on these drugs. I am terrified — terrified! — of ever trying to withdraw from them.’” (4)

“…medical disempower[ment] involves a self-destructive belief in the necessity of involving an authoritarian medical expert in order to recover.” (6)

“The syndrome of chronic brain impairment (CBI) can be caused by any trauma to the brain, including months or years of exposure to one or more psychiatric medications… CBI is probably the major contributor to the current epidemic of ‘mental illness’ and escalating psychiatric disability.” (19)

“The clinical effect of chronic exposure to psychoactive substances, including psychoactive drugs, produces effects very similar to those of closed head or traumatic brain injury.” (20)

“By definition, starting with Emil Kraepelin in the 1890s, bipolar disorder was intended to describe cycles of mania and depression without any overall or long-term deterioration. Characteristically, these patients lived highly productive lives in between episodes and did not get worse with time. Not so anymore. Patients with a diagnosis of bipolar disorder are routinely continued on antipsychotic drugs and mood stabilizers often in combination with antidepressants, stimulants and/or benzodiazepines— for years and decades at a time. Inevitably, most get worse and some become “rapid cyclers” with extreme mood variations and instability. After years of exposure to polydrug therapy, they develop CBI with cognitive deficits, apathy, emotional lability (misdiagnosed as bipolar disorder) and anosognosia.” (30)

“It is important to reemphasize that there are no known psychological or biochemical imbalances in the brains of people suffering from psychiatric disorders. That is why there are no laboratory tests for psychiatric disorders… Instead of correcting biochemical imbalances, these drugs cause biochemical imbalances.” (33)

“Many people feel that meditation, massage therapy, acupuncture, and other alternative medical approaches can enhances their physical and mental well-being, and if delivered by ethical practitioners, they are at least unlikely to be harmful.” (34)

Chronic brain impairment from psychiatric drug medication consists of the four following symptom complexes:
- Cognitive dysfunction, including short-term memory loss
- Apathy and loss of enjoyment in life activities
- Emotional worsening with lability, loss of empathy, and increased impatience and irritability
- Anosognosia - impaired self-awareness of these symptoms

“Clinical doses of haloperidol and olanzapine over 17-27 months duration in macaque monkeys have been shown to cause 8%-11% loss of tissue weight throughout the brain… The ‘cytotoxic properties’ of the older antipsychotics are acknowledged as ‘well known’ by researchers. A study of the atypical antipsychotics found them to be cytotoxic but less so than the older drugs. In defense of olanzapine, these researchers stated that olanzapine ‘actually stimulated proliferation of neuronal cells’, implying that this should be considered beneficial. Instead it should be viewed as a spectacular and ominious sign of toxicity. Neurons rarely proliferate — until recently, it was thought that they never did — and are known to do so only in response to injury. That many psychiatric drugs have now been shown to cause cell proliferation is a very serious warning sign. In addition, many studies of drug-induced neurogenesis have found cells that look grossly abnormal under the microscope.” (41)

On neuroleptic malignant syndrome: “The disease strongly resembles a viral disorder, lethargic encephalitis, which occurred in epidemic form during and shortly after World War I.” (49)

Peter Breggin went to Harvard! (54)

“Although antidepressants are the most widely prescribed category of psychiatric drugs, there is scant evidence for their effectiveness and considerable evidence for their hazards. Especially when starting the medication or at times of dose changes up or down, serious mental and behavioral abnormalities can occur, including suicide, violence, and mania. With prolonged use, there is a grave risk of a general worsening of the patient’s condition, which remains resistant to any intervention.” (57) Peter Breggin mentions a court case of a teenager with no previous history of violence who killed his friend after starting Prozac, then was perplexed and horrified at what he had done after he came off the drug. Violent behavior is a known possible side effect when starting or stopping SSRIs.

Compensatory changes (up regulation and down regulation of receptors and neurotransmitters) mean that long term use of SSRIs can make your depression WORSE in the long term. Page 60, Breggin goes into depth on the specific changes that happen to the serotonin reuptake mechanism with long term SSRI use.

“In 2011, another study found a two-fold increase in the rate of autism in the offspring of mothers exposed to SSRIs during pregnancy. The strongest effect was associated with first trimester exposure. There was no increased risk for mothers with a history of mental health treatment in the absence of prenatal SSRI exposure.” (67)

Yikes moment (the rare bad take that Breggin has, though they do exist): “In addition to direct effects on the fetus, I suspect that the apathy induced by these drugs in some of the mothers after the delivery of their children may have impaired their bonding with their children and contributed to causing autism.” (67-68) :( Very debunked refrigerators mothers cause autism theory.

(72)
When used for months or years, antidepressants frequently cause apathy and dysphoria, worsening the patient’s overall condition and quality of life.
Patients often stay on antidepressants because they confuse distressing withdrawal reactions with a mental illness, and therefore mistakenly believe that they need to continue the drug.

ADHD is not a real disease, and we are HURTING children by prescribing them stimulants. (73)

“A recent 33 year follow up of children originally diagnosed with ADHD continues the trend of blaming drug-induced atrophy of the brain on ADHD rather than on extensive exposure to psychiatric medication. Proal et al. (2011) found widespread atrophy in the brain, including a reduction in mean global cortical thickness in grown adults (mean age 41). The authors relate the findings of brain shrinkage to childhood ADHD, but in fact the grown adults had polydrug exposure to psychiatric drugs starting in childhood and continuing in adulthood when most of them were given additional psychiatric diagnoses and, no doubt, additional psychiatric drugs. They also had a lower IQ than the control group and their death rate far exceeded that of the control group…” (79)

(LOL’d) [comparing men who had taken ADHD medications in childhood to men who had not] “Many more were also extremely obese, as indicated by the higher rate of being too large for the scanner.” (79)

“The opiates and opioids used to treat pain also have sedative properties and they also cause withdrawal reactions. Except in very severe cases, withdrawal from these drugs is easier and leaves fewer lasting effects than withdrawal from the benzodiazepines and other psychiatric drugs including stimulants and antidepressants” (85)

Long term exposure to benzos causes dementia, memory impairment, and cognitive decline (86)

92 - medical gaslighting. Man takes benzo for 20 years, starts to have cognitive issues, his psychiatrist tells him his symptoms are from depression and not the benzo, finally comes off the drug but is left with permanent brain damage.

“Exposure to lithium for many months and years… leads to cognitive deficits as well as generalized deterioration of central nervous system function. Individuals exposed for years will find their quality of life deteriorating, sometimes into chronic depression. By 1990, Goodwin and Jameson, among the staunchest advocates of lithium, had to conclude ‘lithium can cause cognitive impairments of varying types and degrees.’ They warn the practitioner, ‘It is important to bear in mind that impairment of intellectual functioning caused by lithium is not uncommon.’” (100)

“Medication spellbinding (intoxication anosognosia) is caused by all psychoactive substances. It can render the individual unable to recognize or judge the adverse mental and behavioral effects of drugs.” (109)

“When patients have been withdrawn from psychiatric drugs and medication spellbinding starts to abate, it often feels to them as if a veil is being lifted. They realize for the first time that they have been acutely or chronically impaired in their mental life and that they have been unable to accurately evaluate themselves.” (114)

Things that distinguish withdrawal from relapse:
- Symptoms happen shortly after ceasing or tapering medication. “Withdrawal reactions can often be distinguished from the individual’s preexisting psychiatric disorder and from newly developing psychiatric problems during the taper. They usually develop shortly after a drug reduction and disappear after a return to the previous dose.” (119)
- Patient experiences both emotional and physical symptoms (dizziness, headache, muscle cramps, etc).
- Symptoms are experienced as very different from the experience of the mental illness which was originally treated.
- Symptoms are relieved when drug is reinstated.

“It is now abundantly clear that antidepressants in the long term make people more depressed and often disabled.” (137)

“Clinicians are understandably concerned about the risk of a patient committing suicide. But keep in mind that the class of drugs most often given to suicidal patients, the antidepressants, carry suicide _warnings_.” (156)

“Helplessness is the opposite of personal responsibility. Otherwise independent individuals may lapse into helplessness when dealing with clinicians, and especially with prescribers who hold so much authority and power in our society. They look to the prescriber or the therapist to tell them what to do.” (162)

“Medication is likely to cause harm to the brain and, if continued for weeks or months, will impair brain function and impose the risk of chronic disability and even brain damage.” (175)

“People who have episodes that get labeled ‘schizophrenic’ almost always are struggling with spiritual crises.” (183) Another one of Breggin’s rare bad takes. He seems to imply that schizophrenia has spiritual or emotional causes (“I also explained to them both that ‘psychosis’ (withdrawing and hearing voices) was the opposite of being in touch with other human beings. We lose our trust and our connections with others, and then we withdraw into craziness.” (235)). I think this is dangerous. There is evidence to back up Peter Breggin’s other claims, like that taking psychiatric medication long term causes brain damage, that bipolar is overdiagnosed, and that many mental illnesses can be treated through talk therapy rather than medication. There is no evidence that I am aware of that shows schizophrenia has spiritual causes or that it can be successfully treated through talk therapy. Antipsychotics are so toxic to the body that the choice to take them is a difficult one, but for many people with schizophrenia, they might end up making that choice to improve their functionality in day-to-day life. However, this doesn’t mean a person with schizophrenia should be medicated against their will, and it doesn’t mean antipsychotics are the only or most effective treatment option (for instance, the ketogenic diet has been used to successfully treat schizophrenia). There is a good argument to make that we should try to treat people with schizophrenia first without medication, and only use antipsychotics (which kill brain cells, shrink the brain, and cause tardive dyskinesia) as an absolute last resort, with fully informed patient consent.

“…many prescribers have come to believe that ‘mental illness’ is a lifelong disorder, again because every abrupt attempt to stop medication leads to a withdrawal reaction, which is mistaken for a return of the patient’s original disorder.” (195)

“Therapy that may uncover or stimulate painful and difficult emotions should usually be avoided until patients have recovered successfully from drug intoxication or withdrawal.” (242)

Psych meds in children can “impair their physical growth, cause serious developmental delays, harm their brains, undermine their sense of self-control and autonomy, and steal their childhoods.” (243)

Peter Breggin wrote this book at age 76!

[Ana Hauser · Rating 5 out of 5]

Excellent and highly informative reading

Dr. Breggin is an amazing doctor and scholar!
He is also a potent educator of doctors, therapists, patients and their families.
I recommend this book to anyone who has ever taken psychiatric drugs or who has someone in their family who does. I thank Dr. Breggin for his knowledge, experience and for having generously taking his time to generously share his life saving experience with us.

[Emmanuelle · Rating 5 out of 5]

An incredible and very timely book on the treatment of mental and other illnesses in a society under the auspices of the pharmaceutical industry. An individualized and visionary approach to human suffering with little or no medication when one can borrow honesty and loyalty. Very well documented in different pharmaceutical categories.

[Charlene · Rating 4 out of 5]

Valuable insights, easily readable, in layman's terms. Helpful, thank you. Not much in the way of this kind of literature and help.

[John Hancock · Rating 5 out of 5]

This book is essential for anyone who is attempting to withdraw from psychotropic drugs, but it should be required reading for everyone in the world. https://psychiatricsurvivors.wordpres...

[Rev. F. L. Green]

Very very good

I really enjoyed and was incredibly educated by this book! It is especially helpful since I am going through a VA tapering program myself. The book is an excellent resource that I wish all medical providers should read!