Coming off meds

[ecomum]

Hi everyone , I have been on fluoxotine for about a year and a half and it has helped me a lot. 

I feel ready to come off now , not a decision I have taken lightly, but I am coping well and the side effects are getting me down . 

Obviously I will only do this if the Dr agrees.

What I wanted to ask though is if anyone has successfully come of meds and has any tips.  I was thinking of things like relapse prevention  self help.books etc .

Thank you

[PolarBear]

In my experience, those who are doing well on meds then come off them do rather poorly. Sort of like taking someone's crutch away.

[daja]

Yes if the Dr agrees and you decide to do it get their advice/help too.

[Andy333]

Bad move to come off them

[snowbear]

24 minutes ago, Andy333 said:

Bad move to come off them

That's a personal opinion only. Unless you can give reasons to back it up it's not helpful to ecomum either.

[Caramoole]

2 hours ago, PolarBear said:

In my experience, those who are doing well on meds then come off them do rather poorly. Sort of like taking someone's crutch away.

I don't often disagree with you PB but on this one I'm perhaps not in agreement entirely......largely because I feel that most often the cause is psychological, a cognitive problem rather than an organic/chemical one.....hence a cognitive behavioural change is so successful in improvement/cure.  If medication was  critical in all or most cases then recovery wouldn't be likely in those who don't take medication and that simply isn't the case.  OCD can be overcome without medication in many cases with the "right" sort of support and therapy.  The problems encountered when coming off medication can often be attributed to withdrawal effects.  Reduction can cause severe side-effects, often the patient is then put back onto medication......that doesn't necessarily mean that medication is needed, more that the effects of withdrawal were problematic.

Coming off medication and these powerful drugs can indeed be very difficult.  Very slow tapering is necessary with the support of a good GP or specialist.  I just wish excellent support and therapy were readily available to all so that perhaps reliance on medication wasn't the first line of approach in so many cases.  I'm not saying medication isn't sometimes required but in a large pecentage of cases  it's offered, not based on need but because it's the only tool available to busy GP's who are unable to offer anything else in the moment.  I know you feel to have benefitted completely from medication, and I'm so pleased it's worked for you.  I have experienced the opposite.......dire side-effects from medication, potentially life-threatening ones.......similarly by withdrawing from those same medications.  It's not One Size Fits All.  I know that (in my experience) OCD can be dealt with without medication but with the cognitive approach.

Sorry to disagree with you but in this instance it's something I feel strongly about

Back to Ecomum.....if you feel ready to come off medication, see your GP.  Do it with their support and guidance.....but further than that, do it slowly and in accordance with how you're feeling.  The approach should often be much slower than as laid down in guidance to GP's.  If you start to taper and find you're struggling stop, wait a while longer at a particular dosage....don't be pushed too hard.  It is possible you will feel some distress that you have to work through but it should be manageable and you should be in the driving seat.  You can be both in charge of OCD and medication free in most cases as long as you properly understand what and what not to do OCD wise

[snowbear]

4 hours ago, ecomum said:

Hi everyone , I have been on fluoxotine for about a year and a half and it has helped me a lot. 

I feel ready to come off now , not a decision I have taken lightly, but I am coping well and the side effects are getting me down . 

Obviously I will only do this if the Dr agrees.

What I wanted to ask though is if anyone has successfully come of meds and has any tips.  I was thinking of things like relapse prevention  self help.books etc .

Very sensible to consult your doctor.  

My view is there's no reason not to try to come off them if that's what you want. And if you're getting sideeffects it seems sensible to try without them while you're otherwise doing well.

In terms of relapse prevention, it's useful to identify what the medication does for you and ensure you have alternative means to cope with that in place. For example, fluoxetine typically lowers anxiety , so you could look into mindfulness meditation or relaxation techniques as a viable alternative. Also you'll have at your disposal all the CBT you've learned, so have a think about what your strategy should be if you start to get relapse symptoms and have a plan of action in place before you need it.

2 hours ago, PolarBear said:

In my experience, those who are doing well on meds then come off them do rather poorly. Sort of like taking someone's crutch away.

Two sided coin though.

 If you take someone's crutch away while they still have a broken leg then they may well stumble. But if the bone has healed and they are ready to weight bear, holding onto the crutch when it's no longer needed only creates an unecessary limp.

If ecomum feels she's ready to 'weight bear' and there's a chance she can get rid of unwanted sideeffects at the same time it would be a bit daft not to at least try!

[snowbear]

2 minutes ago, Caramoole said:

OCD can be overcome without medication in many cases with the "right" sort of support and therapy. 

The problems encountered when coming off medication can often be attributed to withdrawal effects.  Reduction can cause severe side-effects, often the patient is then put back onto medication......that doesn't necessarily mean that medication is needed, more that the effects of withdrawal were problematic.

I second both those statements.

 

3 minutes ago, Caramoole said:

if you feel ready to come off medication, see your GP.  Do it with their support and guidance.....but further than that, do it slowly and in accordance with how you're feeling.  The approach should often be much slower than as laid down in guidance to GP's.  If you start to taper and find you're struggling stop, wait a while longer at a particular dosage....don't be pushed too hard.  It is possible you will feel some distress that you have to work through but it should be manageable and you should begin the driving seat.  You can be both in charge of OCD and medication free in most cases as ,kng as you properly understand what and what not to do OCD wise

And this one too!

[Handy]

Medication becomes the compulsion, a way of avoiding the anxiety.  So the anxiety is going to come back & there is going to be withdrawal, which can take weeks or months. On top of that neurological stuff like tics may appear. 
 

It’s a good step though, more of a leap.  It takes courage.

[Angst]

Psychiatric medication is always a controversial issue. But the scientific evidence at NICE does point to its efficacy in the case of OCD along with the efficacy of CBT. I find that SSRIs and if necessary for short periods neuroleptic/grand tranquillisers/ antipsychotics (all synonyms) supplements helpful in times of high objective stress such as loved ones serious ill, rat infestation in a dwelling etc, we can improve our coping skills. A number of people of the forum take neuroleptic supplements. In times of great stress the calming effect of medication can help. I personally don’t believe in the brain chemical deficit hypothesis but the calming effects of the medications.

As an extreme example mental ill health is always high in war zones and cases of post traumatic stress are  high. Not saying that I have been in such zones but as an extreme example of where our coping skills are under strain.  I am fortunate I have a good GP well versed in mental healthand so far have no problems coming off or on such medications. For me official drugtaking is not a compulsion. Though the evidence does suggest that neuroleptics can have quite serious adverse effects if taken at high doses over a long period.

So talk it over with your GP and take their guidance on your choice.

 

 

 

 

 

 

[felix4]

Hi Ecomum,

I reckon you'll be fine, providing you do this very slowwwly!  

I am afraid I don't share the same view with regards to a "crutch being taken away", unless it either addictive type benzo's, or antidepressants where the sufferer is claiming to be doing better than they let on.

I too am pushing to stop meds soon for much the same reasons, @ecomum.

Let us know how you get on, & all the best 

[Caramoole]

Hi Angst.....the problem I have is the potential message that medication is a long term necessity and that anyone comng off it will do badly.  

[PolarBear]

Caramoole, I should have expanded on my post. I actually agree with you.

In sum total, a lot of the sufferers here who have been doing well on meds then stop them, for lack of a better term, fall flat on their face. OCD rears its ugly head and they're tight back to that awful place.

However (and this is the part I missed), so often the reason things go bad is that those sufferers do not have a plan in place to deal with the inevitable return of symptoms, and/or do not follow through with that plan.

I am not saying no one should ever come off meds. But I can't count how many times a sufferer has reported here that thry csme off meds and now they're dealing with terrible OCD symptoms.

[ecomum]

Thank you for all your replies.

I had a couple of massive triggers today which made me realise maybe I aren't as ready as I thought. I'm very overworked and stressed which I think brought them on but ocd led my response.  I feel I need to do a bit more work than I realised.

My daughter is on same meds as me as the issues run in family. My sister takes meds successfully and my mum won't and still suffers extensively.I am definitely the person who when I come off , needs to go back on.

It's more that the side effects are getting me down than the meds  themselves which help me so much. My daughter has same side  effects too and we just don't know what to do . ( foggy memory , blurred reading vision , tiredness , weight gain,  joint pain ) she's 21 and I'm 47 so I can't just blame my age .

Thank you for all your insights 

Sorry if I opened a can of worms. Your replies were insightful but I guess today's trigger swung it for me.

Best wishes all of you , its not easy is it  ❤

 

[Andy333]

I have been on Sertraline 200mg for 2 years. I am lucky that have tolerated them really well. No side effects at all. I have made a lot of good progress with OCD recovery using CBT. It's difficult to identify what impact each had. I decided to stick with it. I am now on the harder parts of CBT, which I am struggling with. Veale says it's fine to go up to 400mg daily. I trust him. I feel if it can help me to get to fill recovery, it would be really good. Any views on this?

 

[Andy333]

2 minutes ago, ecomum said:

Thank you for all your replies.

I had a couple of massive triggers today which made me realise maybe I aren't as ready as I thought. I'm very overworked and stressed which I think brought them on but ocd led my response.  I feel I need to do a bit more work than I realised.

My daughter is on same meds as me as the issues run in family. My sister takes meds successfully and my mum won't and still suffers extensively.I am definitely the person who when I come off , needs to go back on.

It's more that the side effects are getting me down than the meds  themselves which help me so much. My daughter has same side  effects too and we just don't know what to do . ( foggy memory , blurred reading vision , tiredness , weight gain,  joint pain ) she's 21 and I'm 47 so I can't just blame my age .

Thank you for all your insights 

Sorry if I opened a can of worms. Your replies were insightful but I guess today's trigger swung it for me.

Best wishes all of you , its not easy is it  ❤

 

Good decision, in my opinion

[Caramoole]

9 hours ago, Andy333 said:

I have been on Sertraline 200mg for 2 years. I am lucky that have tolerated them really well. No side effects at all. I have made a lot of good progress with OCD recovery using CBT. It's difficult to identify what impact each had. I decided to stick with it. I am now on the harder parts of CBT, which I am struggling with. Veale says it's fine to go up to 400mg daily. I trust him. I feel if it can help me to get to fill recovery, it would be really good. Any views on this?

 

If, as you say, you are tolerating the medication well and it is allowing you to work with the CBT effectively.....then that's great.  It is the CBT and changes to your reaction that will help you learn to deal with your OCD.  As you learn to get that under control you should find that your general anxiety will reduce.  As that happens you may want to consider reducing at that stage.

Medication doesn't cure OCD.  If it did, everyone would take it and the problem would be fixed.  It isn't and doesn't.  The forum is full of people taking medication (often for years) who struggle badly with OCD.  Bottom line, if it helps and isn't causing significant problems.....use it but use that improvement to then work with CBT to address the core problem behaviourally and cognitively

[Andy333]

Thanks Caramoole, amazing reply. I agree, I often see the Sertraline as temporary symptomatic relief max 20% temporary decrease in symptoms. It is definitely good CBT that can kill the OCD, and on a long term basis. I have decided I will go for the higher dose. I feel I kind of need that helping hand as I tackle the higher up harder OCD problems. Thanks for replying