Deprescribing from Psychiatric Drugs: The Problems and The Solutions - Latest What Your GP Doesn't Tell You Podcast
Dr Mark Horowitz explains that to minimise withdrawal effects, patients need to taper off their medications much more slowly than has previously been thought
The latest episode of the What Your GP Doesn’t Tell You Podcast - Deprescribing from Psychiatric Drugs: The Problems and The Solutions is now available on Apple, Spotify and other podcast platforms. And you can sign up to the podcast mailing list at What Your GP Doesn't Tell You, where you can also find out more about the pod. The next episode of the podcast will go out on Tuesday 20th February.
This week I am talking to Dr Mark Horowitz, one of the authors, along with Professor David Taylor, of the new handbook Maudsley Deprescribing Guidelines. The manual provides step-by-step instructions on how to safely stop all commonly used antidepressants, benzodiazepines, gabapentinoids and z-drugs.
These medications have turned out to be far harder to stop than was recognised when they were first introduced. And for Horowitz, this is very much a personal, as well as a professional interest.
For at one point, as a patient, he was on five different drugs. And ironically, although he was working in London at the Institute of Psychiatry, found the most useful information about deprescribing came - not from doctors - but from peer support websites.
But given how many patients take these medications, what is puzzling is why it has taken the medical profession so long to recognise the serious withdrawal effects that they can cause.
Another area of confusion and misunderstanding has been the difference between a drug that causes withdrawal symptoms and physical dependence - and one that causes addiction. In the past, there has been a misplaced belief that if a drug is not addictive, it can’t cause withdrawal effects.
As Horowitz discusses in the podcast, coming off psychiatric drugs can cause a wide variety of symptoms. In this clip, he explains the psychological, physical and neurological withdrawal effects that the antidepressant selective serotonin reuptake inhibitor drugs, known as SSRIs, can cause.
Perhaps the most startling discovery of all has been the realisation that very small amounts of a drug can have a completely disproportionate impact on the brain. It was a shock for Horowitz when he first came across this research, as he realised it had major implications for how patients should taper off medication.
You can hear the full conversation on the podcast.
The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs by Mark Horowitz and David M.Taylor, published by Wiley-Blackwell, is released on 15 February 2024.
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