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Antipsychotic Withdrawal Symptoms, Side Effects, Treatment Help

This entry was posted in Antipsychotic on by .
Medically Reviewed Fact Checked

Last Updated on July 20, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

It is typically a big ask for a medical professional to navigate an antipsychotic withdrawal in an outpatient setting. There are common features and liabilities that would be challenging to manage without a higher level of support.

Antipsychotics given during a crisis often transform into a lifetime of being medicated and a continuance of the side effects that go with it. There is evidence that long-term antipsychotics can actually perpetuate psychosis.2 In over 75% of the cases we treat, people can navigate their lives better after having properly withdrawn from the drugs.

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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 the 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.

What are antipsychotics? What are they used for?

are antipsychotics neededAntipsychotics 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 when they have had a psychotic break, or when other medications failed to work. 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 bipolar disorder. In some cases, people take 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 can be manageable with treatment.

Examples of antipsychotics are Risperdal, Seroquel, Zyprexa and are often combined with a mood stabilizer like Lamictal or Lithium, where a person has a diagnosis of schizophrenia or bipolar disorder episodes. These drugs at times are also prescribed for severe depression or anxiety.

What is happening to create psychotic thoughts or behaviors?

The answer is specific for each individual, but one theory is an excess of dopamine. Dopamine is our “reward” neurochemical, and excess dopamine will make everything stimulating and can cause mania if in excess.13 This also can result from neurotoxins like methyl-mercury dysregulating 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, low-temperature sauna, and other methods. There could be a genetic factor that could impair how that individual clears toxins. For instance, a poor methylator won’t be able to clear heavy metals and will accumulate them 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 by correction of the diet. A study published by Schizophrenia Bulletin published in 2017 found that vitamin D, folate blood, 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.

Testing for and removal of the accumulation of toxic substances found in preservatives and clearing accumulations of chemicals from processed foods can be beneficial. There is evidence to support low-quality food consumption and the correlation psychosis, such as in the 2020 Neuropsyobiology report on Diet and Psychosis that showed that there was a connection between poor quality dietary habits and psychosis.16 Testing for low blood sugar, allergies, or other food problems is important as they may cause psychosis in sensitive people. Resolving these factors could have very positive results.17,18,19 There could well be underlying contributors that can be remediated. One may not have to suffer antipsychotic side effects for their entire life. There could be other means of relief.

Antipsychotic Withdrawal Neurochemistry

antipsychotic neurochemistry issuesAntipsychotics do not create new neurotransmitters. It is believed that they interfere with the expression of neurochemistry to provide the effects that they do. It may be helpful to have a better understanding of how antipsychotic drugs affect neurochemistry. Many antipsychotic drugs are thought to suppress or block the transmission of dopamine along nerve pathways, called dopamine antagonists.20 Dopamine is an excitatory neurochemical. When dopamine is limited due to the use of an antipsychotic drug, the brain is altered at the synapse. The synapse is where one nerve talks to another. Dopamine excites the impulse of the originating nerve to the next nerve receptors. When the dopamine level is low, neurology changes and the body attempts to compensate for this shortfall by making the dopamine receptors more active. This is called antipsychotic-induced dopamine supersensitivity psychosis.7 With supersensitive receptors, a smaller amount of dopamine may have the same stimulating effect (compensatory action) even in the presence of an antipsychotic. 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 even a tapering antipsychotic withdrawal, more dopamine is released and is now super responsive due to these upregulated receptors. This can result in an antipsychotic discontinuation psychosis.9 It often takes a professional in antipsychotic withdrawal to discern what are the withdrawal effects, and are they happening at a rate that the patient can manage and assess whether 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 towards 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, caffeine, limit the number of cigarettes and type to only organic tobacco, and utilize supplements that are known to be beneficial for these individuals and which will work towards stabilizing the neurochemistry. The other piece is the clearing out of accumulated neurotoxins. When the individual begins to feel the balance and sedation that these natural therapies provide, their medication can be reduced—slowly—and adjusted as needed.

Are There Holistic Solutions for Psychotic Symptoms?

psychotic breakSuccessfully 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, and also that 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 program that ease the process to its stable completion.

The Role of Dopamine in Psychotic Thoughts and Behavior

Dopamine is the “reward” neurochemical. Too much dopamine can make everything extremely stimulating, potentially leading to mania and other problems. Where this is the case, often it can be an excess of neurotoxins that are stimulating the neurology, throwing it out of balance.13

Genetics, Diet, Nutrition

We have seen that a genetic problem may affect how effectively (or ineffectively) toxins are being cleared. One example is a poor methylator may not efficiently clear out heavy metals, such as mercury, and these will then accumulate within the nerve and brain tissues causing havoc.12,14 But also a diet may be inadequate in certain essentials like vitamin C, zinc, B6, B12, etc. In combination with preservatives, low blood sugar, or other food-related problems this is a recipe that may trigger psychosis in people with sensitivity to such issues.15-19 But one may not have to suffer psychotic symptomatology if these issues can be sufficiently addressed.

Many of these issues should be addressed prior to undergoing antipsychotic medication withdrawal. It is not advisable to suddenly stop an antipsychotic medication. Always seek help and guidance for tapering off this type of medication safely.

Alternative to Meds Center’s Approach to Antipsychotic Withdrawal

Our approach to antipsychotic withdrawal is the only one like it in the world. It can be a complex process with many parts and is specifically tailored to the individual. The process can often include genetic considerations and holistic remedies for improvements, as well as stabilizing the neurochemistry using natural supplements and substances.

A thorough cleanse of neurotoxic material is very often fundamental to that stabilization process.

The overall goal is to achieve maximum stabilization, and the least amount of medication, and the least amount of side effects, while still allowing the person to enjoy a satisfactory quality of life and ability to function. Whether that can be accomplished during the residential program is determined on a case-by-case basis.

In some cases, such as where a person has taken antipsychotic medication over a long number of years, it may be more realistic to focus on the goal of stabilizing the person’s neurochemistry, reducing the medication as low as possible, and then work on optimizing function. For a 6- or 12-month period of time, the person returns home and using after-care resources and under local medical supervision, the person may continue to slowly continue to reduce their dosage after they have some at-home life stability.

Our coaches and counselors, as well as the team of case managers and our peer support model, can provide an effective container that can provide a workable alternative to continuing life on psychiatric drugs.

Summary:  How to Get Off Antipsychotics

We offer programs for:

antipsychotic withdrawal helpThe first action is to draw lab tests to investigate the root causes for the original symptoms. That information leads to corrective actions such as removing neurotoxins. Dietary changes are implemented such as restricting neurotoxic food additives, chemicals, sugars, caffeine, etc., and providing the supplements that will be most beneficial to soften antipsychotic side effects as well as antipsychotic withdrawal symptoms and support correction of the person’s neurochemistry so that it can be repaired back to a state of balance.

Our program is aimed at stabilizing the person’s neurochemistry with natural substances, and we use detoxification to remove accumulated environmental neurotoxins, targeted nutritional therapy, amino acid therapy, nebulized glutathione, yoga, art therapy, peer support, counseling, massage, Qigong, equine therapy, and other holistic therapies that efficiently address the anticipated antipsychotic withdrawal symptoms, providing comfort and calm. Once the person begins to experience sedation and stability as a result of the natural therapies, the medication is then reduced slowly and adjusted if needed.

Discover How We Help Various Mental Health Issues

Contact Alternative to Meds Center for Antipsychotic Withdrawal

We have helped thousands of people over more than 15 years to reach their goal of overcoming antipsychotic medication withdrawal.

Please reach out to us for assistance. Someone will speak with you when you call and will be happy to answer any questions you may have about the services offered at Alternative to Meds Center, costs, and insurance details. If you or someone you love is not benefiting as you had hoped from taking antipsychotics, we invite you to call us and obtain the assistance you have been searching for. Please call us and speak with one of our informed, friendly counselors who is ready to take the time to answer your questions about our antipsychotic withdrawal program.

1. NIMH article, “What are the possible side effects of antipsychotics?,” published in the US National Library of Medicine [accessed online 2019 Oct 21].

2. Harrow M, Jobe TH, Tong L. Twenty-year effects of antipsychotics in schizophrenia and affective psychotic disorders. Psychol Med. 2021 Feb 8:1-11. doi: 10.1017/S0033291720004778. Epub ahead of print. PMID: 33550993. [cited 2021 Feb 22]

3. The Case Against Antipsychotics A Review of Their Long-term Effects Robert Whitaker July 2016 [cited 2021 Feb 22]

4. Harrow M, Jobe TH, Tong L. Twenty-year effects of antipsychotics in schizophrenia and affective psychotic disorders. Psychol Med. 2021 Feb 8:1-11. doi: 10.1017/S0033291720004778. Epub ahead of print. PMID: 33550993. [cited 2021 Feb 22]

5. Mad in America Recovery Rate Six Times Higher For Those Who Stop Antipsychotics Within Two Years By Peter Simons February 22, 2021 [cited 2021 Feb 22]

6. Harrow, M. “Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications.” J Nerv Ment Dis 195 (2007):406-414. [cited 2021 Feb 22]

7. Chouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M, Iyo M. Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy. Psychother Psychosom. 2017;86(4):189-219. doi: 10.1159/000477313. Epub 2017 Jun 24. PMID: 28647739. [cited 2021 Feb 22]

8. Fallon P, Dursun S, Deakin B. Drug-induced supersensitivity psychosis revisited: characteristics of relapse in treatment-compliant patients. Ther Adv Psychopharmacol. 2012 Feb;2(1):13-22. doi: 10.1177/2045125311431105. PMID: 23983951; PMCID: PMC3736929. [cited 2021 Feb 22]

9. Moncrieff J. Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse. Acta Psychiatr Scand. 2006 Jul;114(1):3-13. doi: 10.1111/j.1600-0447.2006.00787.x. PMID: 16774655. [cited 2021 Feb 22]

10. Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence Annual Review of Public Health Vol. 40:239-259 (Volume publication date April 2019) First published as a Review in Advance on 2019 Jan 11 [cited 2020 Dec 29]

11. Collaborative on Mental Health and the Environment Mental Health and Environmental Exposures from the Learning and Developmental Disabilities Initiative, November 2008. [cited 2020 Dec 29]

12. Farina M, Aschner M, da Rocha JBT. The catecholaminergic neurotransmitter system in methylmercury-induced neurotoxicity. Adv Neurotoxicol. 2017;1:47-81. doi:10.1016/bs.ant.2017.07.002 [cited 2020 Dec 30]

13. Tost H, Alam T, Meyer-Lindenberg A. Dopamine and psychosis: theory, pathomechanisms and intermediate phenotypes. Neurosci Biobehav Rev. 2010;34(5):689-700. doi:10.1016/j.neubiorev.2009.06.005. [cited 2020 Dec 30]

14. Advanced Functional Medicine: Impact of toxins and heavy metals on methylation by Jarrod Cooper – ND, 14 August 2020

15. Joseph Firth, Rebekah Carney, Brendon Stubbs, Scott B Teasdale, Davy Vancampfort, Philip B Ward, Michael Berk, Jerome Sarris, Nutritional Deficiencies and Clinical Correlates in First-Episode Psychosis: A Systematic Review and Meta-analysis, Schizophrenia Bulletin, Volume 44, Issue 6, November 2018, Pages 1275–1292

16. Aucoin M, LaChance L, Cooley K, Kidd S: Diet and Psychosis: A Scoping Review. Neuropsychobiology 2020;79:20-42. doi: 10.1159/000493399

17. Acute Hypoglycemia Presenting as Acute Psychosis Tanveer Padder MD, Aparna Udyawar MD, Nouman Azhar MD, Kamil Jaghab MD From the Department of Psychiatry, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow NY 11554 USA. First Published December 2005. [cited 2020 Dec 28]

18. Brady WJ Jr, Duncan CW. Hypoglycemia masquerading as acute psychosis and acute cocaine intoxication. Am J Emerg Med. 1999 May;17(3):318-9. doi: 10.1016/s0735-6757(99)90140-7. PMID: 10337905. [cited 2020 Dec 28]

19. Great Plains Laboratory Beyond The Gut: The Relationship Between Gluten, Psychosis, And Schizophrenia May 16, 2018 JAMES GREENBLATT, MD & DESIREE DELANE, MS

20. Swaiman’s Pediatric Neurology (Sixth Edition), 2017 Dopamine Receptor Blocking Agent [cited 2020 Dec 28]

Originally Published Nov 4, 2019 by Lyle Murphy, Founder

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Antipsychotic Withdrawal Symptoms, Side Effects, Treatment Help
Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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