Naturopathic Approach to Tapering off Antidepressants
Over 6 years ago, a man was referred to my naturopathic practice by a psychologist because he was “stuck.” How was he “stuck?” He had been prescribed multiple antidepressants including Effexor the decade prior, due to anxiety and insomnia that he had experienced during grad school. Now he had spent the last 5 years trying to wean himself, but had literally gotten stuck on his first step-down dose of Effexor. What was keeping him from tapering more? Not a return to anxiety or insomnia, but rather terrible withdrawal symptoms including “brain buzz,” difficulty thinking, and strange creepy crawling sensations in his arms.
Through working together over the course of 5 months, he was able to get off antidepressants for good without withdrawal symptoms. And because the sexual side effects from the antidepressants also had disappeared, he and his wife were able to conceive, delivering a healthy baby girl 9 months later.
All of this just shows that having a qualified naturopath on your team when tapering off your antidepressants can be the difference between being perpetually “stuck” and truly and safely weaning yourself off for good.
When To Stop Antidepressants (or other meds)
When it comes to knowing when to taper off antidepressants, it is definitely a personal choice that is up to the individual. But typically, it is when a patient is overwhelmed and fed up with the unfavorable side effects of their antidepressant—weight gain, decreased sexual desire, headaches, insomnia, nausea, etc.—that they decide it’s time to make a change. Additionally, if a patient is taking any MAOIs (monoamine oxidase inhibitors), tricyclic antidepressants, or certain antipsychotics, these are contraindicated during pregnancy, and so it would not only be favorable but necessary to taper off of these drugs as soon as possible for someone who is either pregnant or planning to become pregnant.
From a naturopathic standpoint, a patient might choose to come off their antidepressant when they feel that the meds have only been a band-aid solution, and they’d rather delve deeper and address the actual cause of their depression, anxiety, or even sleep issues. And for many who complain that their antidepressants leave them feeling flat or numb, they decide to eliminate these drugs because they are finally ready to really feel and confront a whole range of emotions.
Why Tapering Off Antidepressants is So Hard
Similar to the gentleman who was referred to me who felt “stuck,” the challenge with tapering off antidepressants, anxiolytics, and sleep medications is seldom the fear of returning to depression, anxiety, or insomnia. Rather, it’s the withdrawal symptoms that can stop the tapering process in its tracks. The collective range of symptoms that can come when tapering off is known as discontinuation syndrome, and it can be debilitating.
Some common discontinuation syndrome symptoms include:
Brain zaps or brain buzz
Dizziness
Flu-like symptoms
Insomnia
Nausea
Imbalance
Sensory disturbances
Abdominal pain (and other IBS-like symptoms)
Statistically speaking, about 1 in 5 will experience some symptoms of discontinuation syndrome during the tapering process, especially if they taper too quickly or have been on the medication for a long period of time. In fact, when many of the antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) were originally marketed years ago, they were intended to be taken for about 2 months. But nowadays, millions of people take these meds for years at a time. And the longer you are on a medication of this nature, the more likely you are to have discontinuation syndrome symptoms.
Tapering Off: Working with a Naturopath
Working with a naturopath like me in the tapering off process is about so much more than just a tapering schedule, though that is definitely important and will be established. Naturopaths can guide you through a more gentle tapering schedule, working alongside your prescribing physician. Additionally, depending upon the medication being tapered (in this case, I’m referring to benzodiazepines), I like to use what is called the Ashton Tapering Method. This method can effectively prevent many withdrawal symptoms by tapering slower with nutrient cofactors and amino acid precursors. As a result, neurotransmitters such as dopamine and serotonin stay in better, more controlled balance. Working with a naturopath also means we can address dietary and lifestyle choices that will help to bring more emotional and physical balance to the body.
A naturopathic approach to tapering off can also look at the “why” behind the depression, anxiety, or insomnia from the standpoint that these things exist due to dysregulation of other symptoms. This means that I look at factors like adrenal gland function, thyroid function, the reproductive system, and even the digestive system. These intricate physical systems can have far reaching negative emotional effects, and it’s my job to help you figure out if there’s a connection between the two.
Essentially, by tapering off antidepressants with a naturopathic doctor, the whole person is addressed not just during but afterwards, with continued strategies to thrive in the world without medications.
Book an Appointment With Dr Ivy
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