Information clarifying our petition
The current ‘one-size-fits-all‘ tapering guidelines can lead to dangerous situations. Guidelines should recommend more a personalised approach and close monitoring. Read more below.
"Guidelines recommend short tapers, of between 2 weeks and 4 weeks, down to therapeutic minimum doses, or half-minimum doses, before complete cessation. Studies have shown that these tapers show minimal benefits over abrupt discontinuation, and are often not tolerated by patients....
Source: Tapering of SSRI treatment to mitigate withdrawal (2019)
"... He (Mark Horowitz) decided to wean off his medication, and as a doctor with psychiatric training, Horowitz decided he was comfortable handling the medication taper on his own. He knew the clinical consensus was that antidepressants could be tapered to zero over a period of about four weeks with minimal risk. To be extra cautious, Horowitz decided to taper his medication over four months. During this process, however, he became blindsided by insomnia, dizziness, anxiety, and panic attacks so severe and persistent that he had to go back to his original antidepressant dose...."
Source: To Minimize Medication Withdrawal, Taper Slowly (2021)
By Nick Zagorski
"...The quality of the clinical practice guidelines was overall low. Current major clinical practice guidelines provide little support for clinicians wishing to help patients discontinue or taper antidepressants in terms of mitigating and managing withdrawal symptoms...."
Source: Clinical practice guideline recommendations on tapering and discontinuing antidepressants for depression: a systematic review
New guidelines should incorporate all available evidence, including observational studies and case studies of people with lived experience of tapering. Read more below.
"...Turning to online support groups for people coming off antidepressants, Horowitz found numerous testimonials by people experiencing antidepressant withdrawal symptoms for weeks or even months after tapering their medications based on the recommendations of their doctors. These online groups also included testimonials by people who reported they had avoided withdrawal symptoms by reducing their dose by tiny amounts over a year or more (some of them going as far as buying jeweller’s scales so they could weigh out tiny fractions of pills)."
New guidelines should recommend very gradual tapering, reducing the medication in smaller steps and more slowly as one approaches zero. This is why.
"...The Horowitz-Taylor method for personalised tapering of psychiatric medication recognises that tapering should be ‘hyperbolic’ to achieve a linear reduction of receptor occupancy to prevent withdrawal, which is otherwise more likely to occur, especially at the end of a taper when lower than registered dosages are required, which were and still are not provided by pharmaceutical companies. Hyperbolic means that the steps by which the dose is lowered are made smaller and smaller as the dose decreases. Hyperbolic tapering is essentially what many patients, implicitly and without using the word hyperbolic, have been advocating for many years and have tried to achieve themselves by applying do-it-yourself pharmacotherapy companies..."