Better Thinking
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- เผยแพร่เมื่อ 24 มี.ค. 2024
- In this episode of Better Thinking, Nesh Nikolic speaks with Dr Mark Horowitz about exploring expert strategies for tapering off SSRIs and managing withdrawal symptoms.
Dr Mark Horowitz MBBS PhD is a Clinical Research Fellow in Psychiatry in the National Health Service (NHS) in England and an Honorary Research Fellow at University College London (UCL) and a trainee psychiatrist. He runs a deprescribing clinic in the NHS helping people to stop psychiatric medications.
He co-authored the Royal College of Psychiatry guidance on “Stopping Antidepressants”, and his work informed the recent National Institute for Clinical Excellence (NICE) guidelines on safe discontinuation of psychiatric medications. He also published work on how to safely taper antipsychotics in JAMA Psychiatry and Schizophrenia Bulletin.
He has authored chapters of the Maudsley Prescribing Guidelines on how to stop mood stabilisers, antidepressants, antipsychotics, benzodiazepines, z-drugs and gabapentinoids. He is currently writing the Maudsley Deprescribing Guidelines in Psychiatry which will be published in 2023. He is Co-Investigator on the RELEASE trial in Australia evaluating the effect of gradual, hyperbolic tapering of antidepressants compared to care as usual.
He has an interest in rational psychopharmacology and deprescribing psychiatric medication. He has experienced the difficulty of coming off psychiatric medications first-hand which has informed much of his work. His work can be found at markhorowitz.org/
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Lexapro of 10 years, my emotions are significantly numbed, I have sexual dysfunction 😢 I’m happy to hear that my sexual dysfunction will possibly improve and that I can have my emotions fully back to their normal state. I’m a young mother with 3 kids and a supportive husband. I’m on the liquid for my taper. Thank you Mark for being a HUGE help.
💎🦋Dr.Mark Horowitz 💖👏
Thank you for the timing of this post! I was on Day 15 of brain zaps, etc. after tapering from 50 mg sertraline over 3 weeks to nothing. Went back on the last dose of 12.5 mg daily after watching this last night and will be discussing with my NP next week how to taper in much more smaller mg increments (or using fluoxitine as a bridge to taper off from) from here.
I’ve been on 100mg for the last 25 yrs. I’m getting ready for the long journey of withdrawing. Good move by going back on for the time being. You got this!
Hopefully someday US doctors will get the message as well. Most of them are so far behind in their thinking and practice.
Yes, hopefully medical schools can start teaching this if they haven’t already because they are going to need it TREMENDOUSLY in the future. 😢
For about 33 years, I have been taking prescription medications through legal prescriptions, taking various antidepressants and benzodiazepine medications. For the past 15 years, I have been regularly taking Zoloft 50mg and Bromazepam (Lexotanil) 6mg, half a pill in the morning and half a pill in the evening. I am now 55 years old and a teacher
In Third World countries, doctors still consider that there is no danger in continuing to take the drug and no danger in stopping it after a few weeks.
I've recently started cutting back on my benzo medication, from what I've heard from you.
Question: Should I taper both medications together or start with one?
Thank you for what you are doing to educate people
Start with Zoloft, 10% of the previous dose every x weeks (depending on the symptoms you have). They used to say the benzo should be tapered first but nowadays it seems starting with the AD is better.
Not together. Benzodiazepines are harder to come off. I’ve heard it stated multiple times that start tapering from the easiest drug to come off of first. The Benzo is the harder of the two. Best wishes!
In my way taper benzo first ..do not taper both ..but last 10 percent is very difficult to taper meanwhile u can hold last benzo cut and taper anti depression ..Benzos are very hard drug
I own his wonderful book on Deprescribing.
Withdrawal symptoms can be delayed by several months after stopping,not just weeks. 3-6 months is a common timeframe off the drugs when people crash and that has happened to me several times after coming off with a too quick taper and I know it wasn't a relapse because it happened again this time but I got through it,and now 21 months off albeit still in a Protracted withdrawal. Dr. Josef has an interview with a woman where the withdrawal symptoms occurred after a year off the drugs.
I don't think you can safely say after any amount of time after stopping that it's a relapse of an original condition.
9 months off zoloft 14 year use. Too fast taper, almost c/t. Severe WD. Feels like injury in my case. Reinstatement didnt work. Is there any hope? Cant work. In despair. Can I even heal. Will it take several years, I don't know if I can handle it.
Thanks