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Coming Off Psychiatric Drugs

Disclaimer:

This publication is based on a Mind UK publication and the original version may be found here: https://www.mind.org.uk/information-support/a-z-mental-health/

Thank you to Mind UK for sharing their valuable content with us. Content included in Mental Health A-Z is made available free of charge and does not form part of any commercial activity. The adaptation has been done independently by Mind HK and is intended for general information purposes only.

How do I look after myself as I come off? 

Choose a good time to come off

Coming off medication may be difficult and, if so, it may be hard to do other things at the same time. 

If you currently have stressful things to cope with in your life, it may be best to not also try to come off medication, but to wait until things have settled down. 

Stresses might be: 

  •  moving house 
  •  a new baby in the family 
  •  serious illness of a family member 
  •  job instability. 

But coming off may be just one part of a whole lifestyle change that you are undertaking. If you are consciously taking control and revising other aspects of your life – e.g. finding new interests, perhaps meeting new people – all this may also help you to come off. 

It’s important not to replace your medication with alcohol or street drugs. 

Plan your withdrawal

Having a personal withdrawal plan for reducing your medication over a number of weeks, months or even years can help you to stick to your original aim. You can always modify this as you go along, depending on how you progress. 

Tell people close to you

Explain to your friends and family what you are planning to do and how this may impact on your mood and emotions. 

If your feelings have been suppressed by medication, explain that it may take some time for you to get used to feeling emotions fully again. 

Tell them about withdrawal symptoms, so that they understand what is happening to you, and can help you to cope. 

Prepare an Advance Decision

An Advance Decision is a legally binding document, also known as an ‘advance directive‘ or ‘living will’. In it you can say how you would like to be treated if, for example, you have a serious crisis during the withdrawal process.

If you make an Advance Decision, you need to make sure that you give a copy to someone you can trust. Also give a copy to your doctor or psychiatrist, providing they are in agreement with your plan to come off medication. 

Get to know your triggers and warning signs for crisis

Many people get to know what situations they find stressful, and either avoid them completely or prepare themselves carefully so as to minimise the stress. You, your friends or family members may learn to recognise warning signs which suggest you may be becoming unwell. Keeping a diary may help you to spot any patterns.

Monitor your mood

Monitoring your mood during the withdrawal process can help you to spot subtle trends that might otherwise get overlooked. You could use: 

  •  a diary 
  •  an online tool such as Moodscope (see moodscope.com for details) 

Recording any side effects can help you to remain objective and recognise any less obvious patterns. 

“I’ve tried to come off my medication because I’m scared about what the medication is doing to my brain, and whether it is changing who I am as a person.”

Trust your own feelings

If you feel that something you are experiencing is a side effect of medication or a withdrawal effect, take this seriously. Other people may think that your symptoms indicate that your illness is coming back, but you may feel sure it is not. 

If you are following a programme of slow dose reduction and you reach a difficult phase, don’t be afraid to slow down, or to stop at the dose you are on for longer than you had planned. Adapt your plans to fit your experience. 

Learn how to look after yourself

  • Don’t be afraid to say ‘no’ if you feel something will be too much for you. 
  • Ask your friends or family for help, if that’s what you need to keep well. For example, you may find it much easier to keep an appointment if you have someone to go with you. 
  • Use a comfort object. If you have to do something you find stressful, it might help to take a particular comforter with you (for example: a scarf, a special stone to hold in your pocket, a teddy or whatever works for you). Don’t be afraid to use such things if they help you to cope and get on with your life. 

Look after your diet

You may find it helps to: 

  • eat regularly, starting with breakfast 
  • avoid sugary foods and drinks because they cause big fluctuations in blood sugar which can cause mood swings and anxiety 
  • be aware of foods and drinks that trigger depression or other mood changes in you. 

Keeping a diary of what you’ve eaten may reveal reactions that you weren’t aware of. 

Get enough sleep

Sleep is one of the most important factors in maintaining mental health. If you are coming off medication and one of the withdrawal effects is sleep disturbance, you may have to be prepared to put up with this for a while. You could find ways to minimise the ill effects, however. 

Exercise

This can help to reduce stress and anxiety, and can be prescribed as a treatment for depression. 

Taking exercise out in the fresh air, in the country or the park is most effective. 

Be prepared to change your plans

Coming off can sometimes be a big disappointment if it doesn’t bring the improvement you hoped for, or you find you can’t manage without medication after all. But even if you don’t manage to come off completely, you may succeed in reducing your dose, and this could make a significant difference to how you feel. 

In fact, trying to come off a particular medication can be a good way of finding your ‘threshold dose’. This is the lowest amount of medication required to relieve your symptoms and keep you well. 

You can also consider trying again at a later time. The fact that things did not go as you wished this time does not mean that they never will. 

Some people find out that they are happier taking medication after all. This is also helpful to know: it may be easier to get on with the rest of your life once you have accepted that medication is part of it, and you feel that the decision was yours rather than your doctor’s. 

“I hope I can come off medication completely one day.”

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What is iACT Service?

Improving Access to Community Therapies (iACT®) is one of the services from Mind HK. Trained Wellbeing Practitioners will offer initial assessment and early intervention for people dealing with mild to moderate symptoms of depression, anxiety, or other emotional difficulties.

 

The service includes 6-8 sessions of low-intensity psychological support, the flexibility of the service allows individuals to receive free and timely support when needed.

If you’re aged between 18 – 65 and are facing some emotional challenges, we would like to invite you to take an online assessment for us to gain a better understanding of your current emotional struggle.

 

If you’re eligible, we’ll get you connected with a Wellbeing Practitioner within two weeks to sort out the next steps.

The service runs for about 3 months and includes 6-8 support sessions, tailored to your needs.

 

We encourage you to attend all sessions and actively practice the tips and exercises provided by your Wellbeing Practitioner.

We take your privacy seriously. Your chats with the Wellbeing Practitioner are confidential.

 

We won’t share any of your info unless you’ve provided consent or if there are risks detected.

This programme isn’t suitable for people facing emergencies, major setbacks, or those diagnosed with serious or complex mental health conditions.

 

If you’re having thoughts of suicide or self-harm, this programme might not meet your needs, so please seek help right away. You can check out Mind HK’s “Find Help Now” page for immediate information and services.

Most of our Wellbeing Practitioners have backgrounds in psychology or counselling and are passionate about mental health. They’ve gone through about 140 hours of intensive training and completed at least 120 hours of supervised clinical practice over 9 months to ensure the quality of service.

 

They’re trained by accredited local experts in the mental health field, including clinical psychologists, counselling psychologists, counsellors, and psychiatrists. Plus, we regularly check how effective our services are. All service outputs and performances are subject to consistent monitoring.

Who is suitable for participating in this programme?

This programme welcomes anyone between the ages of 18 and 65 who may be feeling lost or facing emotional difficulties. Please note that this programme is not suitable for individuals diagnosed with severe or complex mental health conditions.

This programme is not suitable for individuals diagnosed with severe or complex mental health conditions, but suitable for those who experience mild to severe moderate anxiety, mild to moderate depression, or other emotional challenges. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

After signing up, our Wellbeing Practitioner will contact you within two weeks to schedule a convenient time for a 45-minute conversation, either via video or phone call, according to your preference. During the conversation, the Wellbeing Practitioner will understand your current situation and help you gain a better understanding of your emotional state based on the questionnaire you filled out during application. Additionally, they will provide recommendations for appropriate community resources based on your needs, helping you take an important first step in taking care of your mental health.

Although the intervention procedure is mostly standardised, Wellbeing Practitioners will work flexibly with clients to address individual presenting problems and unique characteristics.

Our Wellbeing Practitioners are trained to support people who experience mild to moderate mental health difficulties primarily. This programme is not suitable for the situations mentioned above. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

Your conversations with the Wellbeing Practitioner are absolutely confidential. Any information about you will not be shared with anyone without your consent unless you or others are at immediate risk or the Wellbeing Practitioner has reason to believe that you may be in imminent danger.
Supervisors will monitor trainees’ development throughout the placement to ensure that they are meeting the required level of competency to pass the training course at the end of the placement.

Yes, it is necessary to book an appointment in advance by filling out the form. Additionally, you can select one of the five stores yourself. We will allocate clients to different Wellbeing Practitioners based on their chosen location.

Before having the conversation, we will ask you to fill out a basic questionnaire for preliminary screening assessment. This screening process aims to ensure that the training received by the Wellbeing Practitioners is sufficient to meet the needs of the individuals receiving the service. If it is determined after the screening assessment that the service is not suitable for you, Mind HK will provide alternative recommendations to ensure your safety and support.

For adults who are suitable for this service, all Wellbeing Practitioners have received training on how to identify and respond to safety and risk issues. If you have any concerns about the support process, the Wellbeing Practitioners have appropriate measures in place and will develop response plans based on the urgency of the situation. They can also access support from clinical practitioners from Mind HK or participating organisations.

What private training does Mind HK provide?

Mind HK provides 4 themes of mental health training, including: Supporting Self, Supporting Others, Family Wellbeing and DEI (Diversity, Equity and Inclusion).

 

Check out the brochure here for more information.

Mind HK provides a wide range of standardised mental health training, which can be tailored to different circumstances. Chat with our team to explore more! 

Our trainers come from a diverse, accredited pool of clinically experienced professionals. Check out our trainers’ biographies here.

Yes, the Mental Health First Aid class of Mind HK is internationally accredited by the MHFA International. The content and certification is delivered by trainers certified from the Mental Health Association of Hong Kong. You can find out our trainers accreditation here.

We are here to support your mental health education journey! Reach out to us and chat with our team.

How do I look after myself as I come off?

How do I look after myself as I come off? 

Choose a good time to come off

Coming off medication may be difficult and, if so, it may be hard to do other things at the same time. 

If you currently have stressful things to cope with in your life, it may be best to not also try to come off medication, but to wait until things have settled down. 

Stresses might be: 

  •  moving house 
  •  a new baby in the family 
  •  serious illness of a family member 
  •  job instability. 

But coming off may be just one part of a whole lifestyle change that you are undertaking. If you are consciously taking control and revising other aspects of your life – e.g. finding new interests, perhaps meeting new people – all this may also help you to come off. 

It's important not to replace your medication with alcohol or street drugs. 

Plan your withdrawal

Having a personal withdrawal plan for reducing your medication over a number of weeks, months or even years can help you to stick to your original aim. You can always modify this as you go along, depending on how you progress. 

Tell people close to you

Explain to your friends and family what you are planning to do and how this may impact on your mood and emotions. 

If your feelings have been suppressed by medication, explain that it may take some time for you to get used to feeling emotions fully again. 

Tell them about withdrawal symptoms, so that they understand what is happening to you, and can help you to cope. 

Prepare an Advance Decision

An Advance Decision is a legally binding document, also known as an 'advance directive' or 'living will'. In it you can say how you would like to be treated if, for example, you have a serious crisis during the withdrawal process.

If you make an Advance Decision, you need to make sure that you give a copy to someone you can trust. Also give a copy to your doctor or psychiatrist, providing they are in agreement with your plan to come off medication. 

Get to know your triggers and warning signs for crisis

Many people get to know what situations they find stressful, and either avoid them completely or prepare themselves carefully so as to minimise the stress. You, your friends or family members may learn to recognise warning signs which suggest you may be becoming unwell. Keeping a diary may help you to spot any patterns.

Monitor your mood

Monitoring your mood during the withdrawal process can help you to spot subtle trends that might otherwise get overlooked. You could use: 

  •  a diary 
  •  an online tool such as Moodscope (see moodscope.com for details) 

Recording any side effects can help you to remain objective and recognise any less obvious patterns. 

“I’ve tried to come off my medication because I’m scared about what the medication is doing to my brain, and whether it is changing who I am as a person.”

Trust your own feelings

If you feel that something you are experiencing is a side effect of medication or a withdrawal effect, take this seriously. Other people may think that your symptoms indicate that your illness is coming back, but you may feel sure it is not. 

If you are following a programme of slow dose reduction and you reach a difficult phase, don't be afraid to slow down, or to stop at the dose you are on for longer than you had planned. Adapt your plans to fit your experience. 

Learn how to look after yourself

  • Don't be afraid to say 'no' if you feel something will be too much for you. 
  • Ask your friends or family for help, if that's what you need to keep well. For example, you may find it much easier to keep an appointment if you have someone to go with you. 
  • Use a comfort object. If you have to do something you find stressful, it might help to take a particular comforter with you (for example: a scarf, a special stone to hold in your pocket, a teddy or whatever works for you). Don't be afraid to use such things if they help you to cope and get on with your life. 

Look after your diet

You may find it helps to: 

  • eat regularly, starting with breakfast 
  • avoid sugary foods and drinks because they cause big fluctuations in blood sugar which can cause mood swings and anxiety 
  • be aware of foods and drinks that trigger depression or other mood changes in you. 

Keeping a diary of what you've eaten may reveal reactions that you weren't aware of. 

Get enough sleep

Sleep is one of the most important factors in maintaining mental health. If you are coming off medication and one of the withdrawal effects is sleep disturbance, you may have to be prepared to put up with this for a while. You could find ways to minimise the ill effects, however. 

Exercise

This can help to reduce stress and anxiety, and can be prescribed as a treatment for depression. 

Taking exercise out in the fresh air, in the country or the park is most effective. 

Be prepared to change your plans

Coming off can sometimes be a big disappointment if it doesn't bring the improvement you hoped for, or you find you can't manage without medication after all. But even if you don't manage to come off completely, you may succeed in reducing your dose, and this could make a significant difference to how you feel. 

In fact, trying to come off a particular medication can be a good way of finding your ‘threshold dose’. This is the lowest amount of medication required to relieve your symptoms and keep you well. 

You can also consider trying again at a later time. The fact that things did not go as you wished this time does not mean that they never will. 

Some people find out that they are happier taking medication after all. This is also helpful to know: it may be easier to get on with the rest of your life once you have accepted that medication is part of it, and you feel that the decision was yours rather than your doctor’s. 

“I hope I can come off medication completely one day.”