Alternative to Meds Antipsychotic Withdrawal Resources
This article provides information on antipsychotic withdrawal symptoms, antipsychotic side effects, and holistic mental health treatment options and services provided by Alternative to Meds Center. If you are looking for information regarding tapering antipsychotics, please see our antipsychotic tapering page. And, if you are looking for non-drug or natural alternatives to antipsychotics, please see our antipsychotic alternatives page.
How Long Does Antipsychotic Withdrawal Last?
The following summary of factors that can influence the timeline for antipsychotic withdrawal is further expanded below.
Factors that influence the timeline for antipsychotic withdrawal include:
- Diet and sleep quality
- Nutritional deficiencies
- Bioaccumulation of neurotoxins
- How long the drug was used
- The person’s general health
- Medical conditions, hypoglycemia
- Whether multiple medications are in use
- History of recreational drug use
- Genetic or other factors influencing the rate of drug metabolism
How long antipsychotic withdrawal will take is not the same for everyone. The onset of withdrawal symptoms can range from 36 – 96 hours, and symptoms may persist for weeks or even months.7 The mechanics of how the brain adapts to antipsychotic medications have only recently been given much clinical attention, and the subject warrants further research, especially given the rising rates of prescribed medication use across all populations. 21,22
Antipsychotic withdrawal is also called “deprescribing” and is recommended within strictly managed safety protocols to prevent the harms associated with such medication, especially associated with long-term use.23
Because of the need to allow our neurochemistry to regulate, antipsychotic withdrawal will take as long as it takes to regulate neurotransmission. The process can be significantly aided by the correction of diet, toxin removal, very gradual antipsychotic withdrawal, a safe and compassionate setting, counseling, and other strategies that support a healthy, stable outcome.
More information is given below outlining the most common antipsychotic withdrawal symptoms.
What are antipsychotics? What are they used for?
Antipsychotics are a variety of medications used primarily to manage psychosis, hallucinations, delusions, mania, and disordered thought. Though often effective at the onset, antipsychotics are typically not well tolerated for long-term use and often lead to significant unwanted side effects.1
A person is usually put on an antipsychotic after a psychotic break, or when other medications failed to work. Antipsychotics are used heavily in the treatment of schizophrenia, which is discussed in more detail below. After people are medicated on these drugs they are often unable to perform in life as they would like to, find it hard to set goals, and have difficulty perceiving rewards in life. These side effects are commonly deemed better than continued visits to the hospital or loss of sleep in the case of extreme insomnia, so the person remains on the drug.
These medications are prescribed for individuals who have been diagnosed with schizophrenia or episodes of mania or psychosis sometimes associated with bipolar disorder. In some cases, people have been prescribed these medications for severe depression or anxiety. Side effects of these medications can be quite harsh, especially when these medications are taken long-term.3 However, these adverse effects for many can be reduced and successfully overcome, and antipsychotic withdrawal symptoms and original symptoms in many cases can be manageable with holistic-based treatment.
Examples of antipsychotics are Risperdal®, Seroquel®, and Zyprexa® which are often combined with a mood stabilizer like Lamictal® or lithium when a person has a diagnosis of schizophrenia or bipolar disorder-related episodes of mania or psychosis. In drug-based therapy, if drugging the condition doesn’t “work”, even with multiple drugs of the antipsychotic class, then ECT is often added to the treatment as a “last resort.” However, the studies done on vitamin therapy are largely ignored, which is still surprising as the results from such were promising, as demonstrated in the works of Hoffer and others.25,26
What is happening to create psychotic thoughts or behaviors?
The answer is specific for each individual, and dysregulation of neurotransmitters is often cited, including glutamate, dopamine, and serotonin.24 One theory focuses on an excess of dopamine. Dopamine is our “reward” neurochemical, and excess dopamine will make everything stimulating and may induce mania.3 Psychotic and other psychiatric symptoms can also result after exposure to neurotoxins like methyl-mercury, which dysregulate the neurology.12 Before and during antipsychotic withdrawal, we work at correcting the source of symptoms. Exposure to toxins can be tested, and then resolved through chelation, sauna, and other deep-cleansing methods. There could be genetic factors that could impair how well or how poorly that individual clears toxins. For instance, a poor methylator won’t be able to clear heavy metals and these will accumulate in nerve and brain tissue.14 A poor diet that leads to a deficit in essential nutrients such as vitamin B6, vitamin C, niacin, and zinc, for instance, may resolve symptoms by correction of the diet. A study published by Schizophrenia Bulletin published in 2017 found that vitamin D, folate, and to some degree vitamin C blood levels were significantly deficient in those with first-episode psychosis.15 Such knowledge is a valuable asset that can convert into a successful treatment, but it is important to note that there can be no “one-size-fits-all” approach to treatment.
Testing for and removal of the accumulation of toxic substances found in preservatives and chemicals in processed foods can be beneficial. The 2020 Neuropsychobiology report on Diet and Psychosis16 showed a connection between poor quality dietary habits and psychosis. Testing for low blood sugar, allergies, vitamin deficiencies, or other food-related issues is important, especially in sensitive people. Resolving these factors could have very positive results.17,18,19,26 There could well be other underlying contributors that can be remedied. One may not have to suffer antipsychotic side effects for one’s entire life. There could be other means of relief to explore with less liability on the quality of a person’s life.
Antipsychotic Withdrawal Neurochemistry
Antipsychotics do not create new neurotransmitters. It is believed that they interfere with the expression of neurochemistry to provide their effects. It may be helpful to have a better understanding of how antipsychotic drugs affect neurochemistry. Many antipsychotic drugs (dopamine antagonists) are thought to suppress or block the transmission of dopamine along nerve pathways.20 Dopamine is an excitatory neurochemical. When dopamine is limited due to the use of an antipsychotic drug, the communication of reward messages is blocked at the synapse. The synapse is where one nerve talks to another. Dopamine’s “job” is to excite the impulse of the originating nerve to the next in the chain of nerve receptors. When the dopamine flow is restricted, neurology changes and attempts to compensate for this shortfall by making the dopamine receptors more active. This can induce antipsychotic-induced dopamine supersensitivity psychosis.7,8,9 With supersensitive receptors, a smaller amount of dopamine may have the same stimulating effect (compensatory action) even in the presence of an antipsychotic drug. So in an attempt to quell stimulation, the dosage is often increased, which may bring on more side effects — the proverbial revolving door.
When the person quits taking the drug, as in missing a dose, or during antipsychotic withdrawal, more dopamine is released and is now super responsive due to these upregulated receptors. This can result in antipsychotic discontinuation psychosis.5,6,8 It often takes a professional well-versed in antipsychotic withdrawal to discern what are the withdrawal effects, and whether are they happening at a rate that the patient can manage well. A professional can assess each step of the process, so they can subsequently restabilize without a crisis.
How to Efficiently Get Off of Antipsychotics
Though these drugs can be necessary in extreme cases, antipsychotics may not the only solution for psychotic symptoms. To successfully assist a person to get off of antipsychotics, we must do some preliminary work aimed toward discovering what the underlying problems may be.
First, we run lab tests to identify the potential root causes of the symptoms. In many cases, toxicity is found to be a large contributor.10,11,12 Whether toxicity is a result of the person’s environment or poor detoxification genetics, we work towards clearing it out. We restrict the use of processed foods, sugar, and caffeine, limit the number of cigarettes (and only organic tobacco), and utilize individually prescribed supplements that are beneficial for stabilizing neurochemistry. When the individual begins to feel the balance and sedation that these natural therapies provide, their medication can be reduced—slowly—and carefully adjusted to as low a dosage as is possible, sometimes successfully to zero.
Are There Holistic Solutions for Psychotic Symptoms?
Successfully tapering from antipsychotic medication is made more possible when investigative work is done first to try and discover any underlying causative factors that may have preceded medication. At the Alternative to Meds program, the initial action is to run labs to identify any root causes for the symptoms that are troubling the person.
The largest contributor we have found is the presence of toxicity, sometimes as a result of exposure to environmental poisons, which may accumulate over time as a result of the individual’s genetics. In both cases, the goal is to gently clear these out of the body. We provide many holistic supportive therapies during the antipsychotic withdrawal program that ease the process to its stable completion. Examples include:
- medically managed inpatient antipsychotic withdrawal, and tapering protocols
- orthomolecular medicine — correction of diet, testing for and addressing nutritional deficiencies including micronutrients, herbal medicine applications
- IV + NAD treatments
- CBT, mindfulness meditation, and other personal counseling
- relaxation treatments and physical activity: yoga, Qi Gong, therapeutic massage, exercise
- cleansing strategies: mineral baths, therapeutic sauna, colon hydrotherapy
- peer support program
- equine therapy
- art therapy
- a co-occurring disorder treatment plan