Deprescribing in Recovery: What's It About?

Deprescribing describes the process of helping people reduce or eliminate prescription drugs safely. Doctors and therapists can help their clients work towards this goal if it is appropriate. Many people who are new to recovery also have co-existing mental health disorders. Often, it’s hard to gauge which symptoms are caused by addiction versus mental health issues when a person is initially getting sober. After all, many people who are addicted to substances also self-medicate. They may find as months go by and the body detoxes from drugs and alcohol, psychiatric symptoms may become less severe. Or, they may have other reasons they wish to take less medication to improve their quality of life.

Deprescribing was a term first coined by people who worked with geriatric patients who were suffering quality-of-life issues due to medication side effects. In many cases, cognitive issues declined after certain drugs were lessened or ceased entirely. For people with mental health disorders, the concept is the same. Deprescribing should only be used if a patient has the tools to continue to live a fulfilling life. There are many reasons a psychiatrist or other mental health professionals may want to help a client through deprescribing. Sometimes, it's the patient's idea.

Deprescribing for Health Reasons

Mental and physical health needs change throughout life, even for people diagnosed with a lifelong mental health disorder. If a person loses weight, their dose of an antidepressant drug may be unnecessarily high. Or, they may take a medicine that interacts with their psychiatric medication and want to lessen the side effects.

Some medications can cause severe side effects. In some cases, long-term use can be disabling or reduce a person’s quality of life significantly. One class of drugs, antipsychotics, can cause tardive dyskinesia over time (TD). TD is a condition that causes uncontrollable body movements. For many people, withdrawal of the drug doesn’t stop the disorder, but lowering the dose or switching to a different drug can minimize future damage.

Discontinuing any medication due to side effects requires the help of a healthcare professional. This way, a person can taper slowly and be monitored for any adverse side effects as they discontinue its use. Your psychiatrist may want to find an alternative drug for you to take once you have safely tapered.

Deprescribing in Recovery

Deprescribing is a decision that should be made between an individual, their therapist, and a doctor or psychiatrist. When a person first gets sober, they may have trouble coping with their emotions. This is especially true when somebody has been self-medicating a mental health disorder. Many people who have co-occurring conditions such as anxiety or PTSD experience a worsening of their symptoms when they first get sober.

Anxiety can be high when a person first gets sober. Medication can help people function when their anxiety is a barrier to growth. People also learn tools to cope with stress throughout recovery and may get to a point where they think they don’t want to take as much medication. This is a choice that is between them and the professionals involved in their mental health plan.

Understanding the benefits and the risks of decreasing or stopping mental health medication is essential. Do not stop taking medication that treats any mental or physical illness without a medical professional's explicit permission and guidance.

A therapist can help you increase your coping skills and evaluate your symptoms. You need to have a definitive plan on how to taper medication. The professionals can help you plan what to do if you have an adverse reaction while decreasing any psychiatric medication.

Don’t try to taper from medication or get sober alone; there are risks of side effects and withdrawal symptoms.

Getting Help for Addiction

If you or somebody you love needs help with a substance use disorder, we're here to help! The help of a caring, supportive staff experienced in addiction and recovery can help you begin your journey toward healing. Please call us at 619-363-4767 to learn more about the services we offer and how we can help.