An Overview of Antipsychotic Withdrawal:

Do you want to successfully withdraw from antipsychotics?

Everyone, who has ever been prescribed an antipsychotic, has yearned for the day when they would no longer need it.  Unfortunately, many who attempt to slowly lower their antipsychotic medication on their own, experience debilitating anxiety, insomnia, lack of appetite, and psychosis.  Stopping the medication often leads in 1-3 months to a recurrence of the illness and renewed reliance on an antipsychotic to recover from relapse.  Basically, once you take this class of medication, it is extremely difficult to figure out a way to get off of it.

This article is a clinical review of antipsychotic withdrawal, summarizing 15 years of clinical experience with antipsychotic withdrawal in an easily understandable format.  The goal of this article is to provide a brief glimpse into this complex process, and to guide patients and their families toward a more informed approach to antipsychotic withdrawal.

For all patients in my practice, a mix of energy and functional supports is integrated into a “regimen,” which is updated weekly to match the patient’s healing needs over time.

Many initial supplement regimens aim at healing underlying causes for oxidative stress and inflammation.  Some supplements may also aim at lowering possible viral causes for inflammation.  Lymph drainage (by Deseret Biologicals), glutathione, and liver extract, among other supplements, are often used to strengthen the patient’s ability to detoxify.  Antioxidant support is given through Goji powder, Acai powder, Moringa powder, or essential oils.  The purpose of the early regimens is to build a strong foundation for recovery and resilience to stress. 

A few weeks into the withdrawal process, additional supplements for withdrawal may be necessary, such as: Inositol, magnolia, Prolent, Taurine, Potassium Chloride, Li-Zyme Forte, liposomal GABA, Opsin II/Allqlear/Histazyme, or CBD oil, to help to lower medications safely (depending on the receptor profile of the medication).  Often, after being on these additional natural supports for a week or more, patients will feel “overmedicated” and can lower their medications gradually (10% or less), without problems with anorexia or insomnia.

Sleep is one of the most sensitive indicators of the patient’s state of health.  If a patient’s sleep becomes disrupted during the withdrawal process, it indicates that something is off balance and need to be addressed immediately.  Either go to a higher dosage of medication until sleep is restored, or integrate a natural support to relieve the imbalance and restore healthy sleep.

Working with withdrawal over the years has taught me that every one of the classes of receptors affected by a medication needs to be in a state of balance, if a patient is to successfully withdraw.  For example, Abilify strongly affects five types of receptors and 17 subclasses of receptors that had been studied.  All of these receptors need to remain in a state of balance, during the withdrawal process, for withdrawal to flow smoothly.

Another important aspect of medication withdrawal sheds light on the difference in difficulty between the beginning vs. the end of medication withdrawal.  Almost always, it is more difficult for patients to withdraw at the end than at the beginning of the withdrawal process. 

The exciting key to unraveling this mystery, is understanding that the benefits from medications are dose dependent, while hypersensitivity to the medication is not dose dependent.  Hypersensitivity to medications increases over time, and a small amount of medication can create a immune cascade reaction, similar to a vaccine, pollen, or other antigen/foreign substance.  At the tail end of medication withdrawal, the dose dependent benefits from the medication are at their lowest, and the hypersensitivity reaction to the medication is at its highest. 

Histamine goes up due to the hypersensitivity reaction.  Histamine is a neuromodulator of the adrenals.  The adrenals release adrenalin in response to increasing histamine.  The patient then moves into the “fight or flight” mode, with adrenalin causing increasing anxiety and insomnia.

The early months, a vulnerable time . . .

The longer a patient takes a medication, the stronger the immune reaction to that product.  Since inflammation is one of the key underlying causes for both neurological and psychiatric problems, it is understandable why, over time, medications can evolve from a helpful, to an ineffective or even harmful intervention. 

The most vulnerable period of time during withdrawal is the first 6 months after stopping a medication.  During that time, environmental and personal/relationship stressors can more easily create a relapse without the buffering and numbing effects of the medications.  It is a transitional phase when the body is getting acclimated to longer periods of time without the medication. My hope is that, over time, more will be learned about the intricacies of the medication withdrawal process.    

Alice W. Lee, MD

Additional note: since this article was published, I have added support to help diminish stress from EMF stressors coming from electronic equipment.  I hope that interventions that decrease harmful EMFs will ease stress for the sickest patients who are often the most sensitive to disturbances in light, sound, and vibrational frequencies.