For many people, medication is really beneficial for their mental wellbeing. It can help to alleviate the intensity of distressing thoughts and feelings. Medications prescribed by medical doctors are well controlled and regulated in the UK, and there are clear guidelines on how they should be used. People who choose to continue taking medication for long periods should remain in contact with the person who prescribes it to ensure that everything is going well.
However, it is perfectly reasonable that people would want to be free of medication. Some of the reasons for this are:
- Feeling that medication has done what it was supposed to do and isn’t needed anymore
- Unpleasant side-effects
- Wanting to start a family or wanting to breastfeed
- Wanting to try other ways of managing distress
The general advice is to speak to a doctor or prescriber before stopping medication so that the easiest way of doing so can be explored. There are other important things to think about, such as:
- Having a support network for difficult times
- Being conscious of not using other substances to replace the effects of medication (eg alcohol)
- Getting some knowledge about a healthy lifestyle, including how physical activity and a balanced diet can help
- Preparing an Advance Statement which can include preferences for if coming off doesn’t go well
There are only limited circumstances where a person can be forced to take medication; these are set out in the Mental Health Act. Therefore, anyone should be able to discuss coming off with their doctor/prescriber. Ask for a second opinion if necessary.
It’s important to remember that there are certain medications which shouldn’t be stopped suddenly as this can be dangerous. These include Lithium, Clozapine and benzodiazepines.
Real Life Experience
Coming off medication is not a decision to be taken lightly and certainly is not right for everyone. Before making a decision to come of medication it is vital that you do your research and determine whether you feel it really is what you want to do. No one has the right to make that decision for you and both taking medication and coming off medication come with risks, it is about balancing those risks to achieve a life that you're happy with. For me, coming to terms with my condition, reading about self-management techniques, symptoms and triggers, as well as developing my own self-awareness were vitally important to successfully reducing and coming off medication without having a negative effect on my mental health.
My advice to anyone who is considering coming of medication would be to hope for the best but prepare for the worst. What I mean by this is that you need to have a plan in place in case you react badly. I read a huge amount about what can happen when coming off medication and also about alternative ways of managing bi polar disorder such as exercise and relaxation techniques. I think it is very important that you have the support of those close to you, your friends, family, and professionals involved in your care and make sure they are aware of when they need to act to ensure your safety should you become unwell during this period of change.
I have a diagnosis of bipolar disorder and before coming off my medication I wrote a very detailed person care plan, detailing the types of things that people need to look out for and agreeing what should be done in the event that various scenarios should take place. The plan included detailing my known triggers, what types of behaviour I may exhibit if I were to head towards a depressive episode and the types of activities I should be encouraged to do to try and prevent this, but also the same for an episode of mania. I described how people should approach me if they were worried about my mental health, for example I stated that I would like people to give specific examples of what they concerned about, rather than just saying that they are worried to enable me to decide whether their concerns are justified. I made a plan with my psychiatrist about the rate and which I would reduce my medication and how often I would check in with professionals during this period. I made sure that both myself and my family were aware of who should be contacted if I were to become unwell at various points. I also made a plan for what I would like to happen should I need to be hospitalised again, who I would like to visit, who should be informed and at what point people should act on my behalf.
Many people tried to persuade me not to come off my medication, that it was too risky and that I should carry on the medication that had stabilised me, however I was very unhappy with the side effects of the medication and how it was impacting on my life. I felt that I had a much better understanding of myself having come to terms with my diagnosis and wanted to give myself a chance at managing my condition without the use of mood stabilisers and antipsychotics. I am not against medication and know that the time may come in the future when I will need to take medication again, however at the moment I have been medication free, and stable, managing my condition myself, for nearly three years. I am able to lead a normal life, unaffected by the side effects of medication and I can honestly say that coming of medication, for me, was the best decision I could have made.