Some people are asking me, “Why another series of webinars on withdrawing from psychiatric drugs?” That’s a reasonable question given that our first series, Withdrawal from Psychiatric Drugs, covered a lot of territory. We presented general information as well as more specific subjects like wellness, personal experiences, research findings, and the evidence base for drug withdrawal.
But this subject is a complex one, and our first course was just our start in exploring this topic. With this second course we are focusing on the challenges that drug withdrawal presents to prescribers.
As many have noted, prescribers may have extensive experience getting patients on psychiatric medications and then managing their drug use, but little or no experience helping patients taper off the drugs. As some have quipped, prescribers have learned to fly the plane but not land it.
Our presenters will tell about what they have learned about drug tapering through their experience and research. The webinars include:
· Dr. Joanna Moncrieff on the effects of withdrawal from neuroleptics and so-called antidepressants.
· Dr. Sandra Steingard on her experience with working in a public mental health setting.
· Dr. David Healy and colleague Johanna Ryan on the sexual dysfunction related to SSRI withdrawal.
· Dr. Sami Timimi reviewing the issues in helping children and adolescents withdraw from a variety of psychiatric drugs.
· Dr. Swapnil Gupta on the practice of “deprescribing.”
· Dr. Pesach Lichtenberg on Israel’s Soteria House approach to psychiatric drug withdrawal.
· New Zealand psychologist Roger Mulder, PhD, on his research on withdrawal from SSRIs, and other related withdrawal issues.
As many Mad in America bloggers have detailed, including blogs written by Stuart Shipko, James Moore, Sonya Styblo and others, psychiatrists and other prescribers are, in general, doing a poor job of providing their patients with informed consent about drug withdrawal. Prescribers often will not support a patient who wants to withdraw from his or her medications, or will provide the patient with little information about what to expect.
This second series of continuing education is intended to give mental health professionals, not only psychiatrists but also other mental health professionals and peer advocates, the information they need as more and more people seek to come off medications but have to confront the challenges of withdrawal.
The series begins on June 19 with a “town hall” format in which Robert Whitaker will moderate a discussion with a psychiatrist, an integrative medicine physician (who has personal experience withdrawing from psychiatric medicine) and an individual who has successfully taken herself off the drugs. This town hall is designed to put a focus on the many questions and issues that prescribers face with drug withdrawal.
One of the biggest challenges we have before us is how to get the attention of MDs and other prescribers who are not psychiatrists. After all, we know that primary care physicians are writing prescriptions for the majority of these drugs—from children diagnosed with ADHD to adolescents and adults being prescribed antidepressants and even, increasingly, neuroleptics off-label. We have been reaching out to progressive organizations like the National Physicians Alliance in an attempt to get attention for this increasingly important medical practice. Non-physician organizations like the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD), which serves county, regional and even some state entities, are also being contacted and have shown at least some beginning interest in helping us get word out.
Finally, the most unusual interest in this series comes from some courageous peer advocates in a state hospital. They are working with me to get permission to set up two ‘classroom’ sites and allow 20 or more individuals to view the series. This will likely require an MD to sit in on the sessions and do some debriefing of the issues that arise. However this turns out, I think it’s quite a step in the right direction with this even being a topic of discussion in one of the most unlikely settings.
This second series takes more significant steps toward filling the void that exists in a true informed consent process. While the course is nearly filled up, we have about 30 spots left, so anyone interested should sign up soon.
Please help us continue to get the word out and feel free to share ideas with me.
Robert Nikkel, MSW, is a Clinical Assistant Professor in the Public Psychiatry Training Program at Oregon Health and Science University. He was the State of Oregon’s commissioner for both mental health and addictions from 2003-2008. He is the director of the Mad in America Continuing Education project and a member of the Board of Directors of the Foundation for Excellence in Mental Health Care.