It is typically a big ask for a medical professional to navigate antipsychotic withdrawal in an outpatient setting. There are common features and liabilities that would be challenging for anyone 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. Evidence exists 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perpetuate psychosis.2 In over 75% of the cases we treat, people can navigate their lives better after having properly withdrawn from the drugs.
Do Your Symptoms
Require Antipsychotic Meds?
For 15 years, Alternative to Meds has been the only licensed center helping people find alternatives to antipsychotic medications. We have published evidence regarding our long-term success. While each case is different, we typically find that there were medical conditions like hypoglycemia, drug use, or food allergies, or that the crisis had multiple factors leading to an imperfect diagnosis.
15 Years Experience by Professionals Who Understand Your Journey.
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.
How Long Does Antipsychotic Withdrawal Last?
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 the neurochemistry to regulate, antipsychotic withdrawal will take as long as it takes to regulate neurotransmission. The process can be significantly aided by 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 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:
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, especially 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.
Much research has transpired on the relation between psychosis (and other disorders). Many factors have been isolated that give an opportunity for effective intervention with the inclusion of phytochemicals, omega 3 fatty acids, B vitamins, fruits and vegetables, as examples, in the daily diet. Where a diet was high in refined or processed foods, low in fibre, nutrients, and omega 3 oils, research showed an increased number of patients experienced psychotic symptoms. Restoring balance in the microbiome (gut) is also an effective measure that supports mental wellness, according to a massive review of studies on diet and psychosis, published in the Journal of Neuropsychobiology in 2020.16
Many of these issues can 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.
As mentioned above, one of the first actions taken is to draw lab tests to investigate the root causes of 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. It is vital to support the client with diet and supplementation, to repair the person’s neurochemistry back to a state of balance.
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. One of our friendly and knowledgeable staff will be happy to answer any questions you may have about the residential inpatient 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. We are ready to take the time to answer your questions about our antipsychotic withdrawal program.
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 2022 May 17]
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.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
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.