How to Discuss Ending or Reducing Treatment with Your Provider

You’ve been feeling well for a long time. Your symptoms are gone, you’ve learned new coping skills, and you feel stable and confident. A thought begins to form in your mind: “Do I still need this medication? Can I stop my treatment?” This is a very normal and common question to have when you have achieved a sustained period of wellness. The desire to be on the least amount of medication necessary is a healthy one.

At Televero Health, we believe that the decision to change or stop treatment is one of the most important conversations you can have with your provider. It must be a thoughtful, collaborative, and carefully planned process. Simply stopping your medication on your own can be ineffective and even dangerous. Having an open conversation with your doctor is the key to making a safe and informed decision.

Why You Should Never Stop Medication on Your Own

This is the most critical point: never stop taking a psychiatric medication abruptly without talking to your doctor. There are two major risks involved.

1. Risk of Relapse: As we’ve discussed, stopping medication, especially too soon, carries a high risk of your original symptoms returning. Your brain has adapted to the presence of the medication, and removing it suddenly can destabilize the chemistry that is keeping you well.
2. Risk of Discontinuation Syndrome: Many psychiatric medications, particularly antidepressants like SSRIs, can cause a physical withdrawal-like syndrome if they are stopped too quickly. This is not the same as addiction, but it can be very unpleasant. Symptoms can include dizziness, nausea, fatigue, muscle aches, and a “brain zap” sensation. This syndrome is temporary, but it can be avoided with a proper taper.

Having the Conversation with Your Provider

When you feel ready to discuss the possibility of reducing or stopping your treatment, schedule an appointment specifically for that conversation. This allows you and your provider to have a thorough discussion and weigh the pros and cons together.

Your provider will consider several factors:

• Your Diagnosis: For some chronic conditions like bipolar disorder, lifelong maintenance treatment is the standard of care to prevent severe relapses. For a single episode of mild depression, tapering off might be a reasonable option.
• Your History: How many past episodes have you had? How severe were they? The higher your risk of recurrence, the stronger the recommendation will be to continue maintenance treatment.
• Your Current Stability: How long have you been completely well? A general rule of thumb is that you should have been in remission for at least 6 to 12 months before even considering a change.
• Your Support System and Coping Skills: Do you have a strong support system in place? Do you feel confident in your ability to use the coping skills you’ve learned in therapy?

Based on this discussion, you and your provider will make a shared decision. It is not just your doctor’s choice or your choice; it is a partnership.

The Process of Tapering

If you and your doctor decide to proceed with stopping a medication, you will do it through a process called tapering. This means reducing the dose very slowly and gradually over a period of several weeks or even months. This allows your brain to slowly readjust to the absence of the medication, which minimizes the risk of both discontinuation syndrome and a sudden relapse.

During the tapering process, you will have frequent check-ins with your provider. They will monitor you closely for any signs of returning symptoms. It is crucial to be very honest about how you are feeling during this time. If your symptoms start to come back, it is not a sign of failure. It is simply important information. It may mean that you need to stay on a low dose of the medication for maintenance, or that now is not the right time to stop. The taper can always be paused or reversed.

The decision about whether to continue or stop treatment is a significant one. It deserves a careful and considered conversation with the medical expert you trust. By approaching it as a team, you can make a choice that is safe, informed, and right for your long-term health and well-being.

Key Takeaways

• Never stop taking a psychiatric medication abruptly or without consulting your doctor due to the risks of relapse and discontinuation syndrome.
• The decision to reduce or end treatment should be a collaborative conversation with your provider, weighing the risks and benefits based on your specific history and diagnosis.
• If you decide to stop a medication, it must be done through a slow, gradual tapering process over several weeks or months to allow your brain to adjust.
• During a taper, it is essential to monitor for any returning symptoms and to be in close communication with your provider.

Ready to take the first step? We can help. Get started with Televero Health today.