A. Too many people today have not been prescribed the correct medication or the correct dosage.
B. Too many people drink wine, beer or other alcohol, or do illicit drugs, all which have an effect on the potency of their prescribed psychiatric medication.
C. Too many people are not compliant and are not taking their medications as prescribed and/or are not reporting side-effects, communicating with their prescribing physician who may be able to adjust the dosage or the medication to help them.
D. Too many people today are taking medications that make them sick or give them intolerable side-effects with very little or no benefit.
E. Too many people today are on medications that they may not need.
If your situation is A, B, and C, speak to your prescribing physician AND your therapist. If you feel you are possibly coping with D and E, then you might want to explore the option of going off your medication, and discuss this with your prescribing physician AND therapist.
Whether or not going off meds is a good idea, depends on several factors. Here are some basic rules and guidelines, the ones that will help you prevent a painful and dangerous withdrawal process.
1. Discuss going off the medications with your both prescribing physician AND your therapist. These are not always the same person, so make sure both are on the same page and are in consultation with each other.
2. If either your prescribing physician or your therapist (or both) do not feel going off your meds is a good idea, ask them why. Think about their answers and the consequences of going off your meds. Are your meds needed to control behavior that could be mentally-emotionally or physically dangerous to you or others? Do you find you face bottomless depression, mania, hallucinations, overwhelming compulsions, dangerous behaviors or use of illicit substances or alcohol when off your medication?
3. If you disagree with your prescribing physician or therapist, get two (2) second opinions, and make sure your physician and therapist share your case notes with the professionals from whom you seek a second opinion. You are best off getting a second opinion both from a psychiatrist familiar with your diagnosis and a therapist.
4. In some cases, a mentor, peer counselor, close family member or friend, or spiritual adviser may be very helpful in the decision-making process.
5. Do not do this alone. Never go off your medications without medical or therapeutic support and supervision.
6. If your physician, therapist, and/or both your second opinion experts agree to support your efforts ask them to manage your dosages as you titrate down off the medication. Together with your therapist and psychiatrist, create and follow a plan and allow for adjustments either up or down.
7. In some cases you may need to be hospitalized during the titration process in order to be monitored by your psychiatrist. This depends on a variety of factors including the type of medication you are taking.
8. Part of your plan should include a lot of support in the form of proactive and goal oriented approach to therapy. Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and other behavioral approaches can be very helpful.
10. Part of your plan should include relaxation methods such as meditation, prayer, breathing exercises, etc.
10. Part of your plan should include daily exercise, at an age and fitness appropriate level for you.
11. Part of your plan should include regular, but not overwhelming social activities. Even though quiet time is important, now is not the time to cut yourself off completely from people.
12. Part of your plan should include regular spiritual activities if appropriate for you.
13. Part of your plan should include nutritional support. Eating nutrient-rich foods high in B vitamins, Essential Fats, and so on.
14. Be patient. This may need to take weeks or even months.
15. Some people find it helpful to keep a journal or diary. Every day monitor your feelings, progress, activities, etc.