Maintaining a Workable Relationship with a Prescriber During Psychiatric Drug Withdrawal

doctor handing over a prescription

Having trouble maintaining a strong, collaborative relationship with your prescriber during withdrawal? Feeling reluctant to even openly discuss your genuine feelings and desires in relation to your medication dosage levels? Below is a list of some of the approaches and strategies that laypeople have reported trying in such a situation.

They make efforts to reduce their prescribers’ anxieties and deepen the level of trust and confidence that their prescribers may have in them.

  • They build out the support system in their life – this can reassure a prescriber that they have other people to turn to during difficult times.
  • They let their prescriber know about other efforts they may be making to improve their overall sense of well-being, such as exercise, meditation, better nutrition, spending time with friends, etc.
  • They consider how some of the things that they say or do in the presence of their prescriber may at times actually provoke anxiety or concern for their well-being, and ask themselves how they might begin to give their prescriber a more balanced, anchored feeling about their situation.
  • They don’t try to “do it all in one day”. If their prescriber has seen them go through dramatic ups and downs in the past, then it will understandably take more than one session for them to help their prescriber become more confident about the trajectory that they are on.

They tell their prescribers that they wish to reduce or come off their medications and give them their reasons, even if they know that they’ll at first face disapproval and disagreement.

  • They listen openly and with empathy to their prescriber’s responses and concerns so that they can respond thoughtfully with their reasons for wanting to come off medications.
  • They explain their reasons carefully, and emphasize the amount of time and effort that they’ve put into researching, thinking through, weighing the pros and cons of, and carefully planning their taper, so that their prescriber can see that they aren’t making rash or poorly considered choices.
  • They discuss their wishes with their prescriber over the course of a number of meetings before actually starting the taper, so that their prescriber has time to become accustomed to the idea and also to feel as if their own professional concerns are being heard and addressed.
  • They make sure to carefully assess the possible risk of being forcibly medicated or hospitalized and invite their prescriber to develop a collaborative plan with them for dealing with any problems that might come up along the way.

They conclude that their relationship with their prescriber is too tenuous, and decide to start tapering without their prescriber’s knowledge while seeking out other expert assistance.

  • They carefully think through the possible negative consequences or impacts of being misleading or dishonest about such an important aspect of their life with their prescriber, as this could potentially make the relationship even worse. Laypeople have shared how important it is to carefully think through the decision to “covertly” taper, and to consider the possible consequences of being “caught keeping a secret”—especially being “dropped” as a patient, forcibly hospitalized, or forcibly medicated. In addition, they’ve shared how important it is to stay cognizant of the fact that if family members or others are aware of a taper plan and are not strongly supportive, they may feel compelled to tell a prescriber or even call emergency services if they see difficulties emerging.
  • They seek out and try to build a collaborative relationship with a new prescriber who is more knowledgeable about tapering and supportive of their patients’ autonomy, considering the full spectrum of possible options: psychiatrists, family physicians, other types of medical doctors, and nurse practitioners. (In some U.S. states, certain psychologists also have prescribing rights.) They may particularly look for prescribers who also have interests in complementary, holistic or integrative medicine.
  • They try to find supportive pharmacists or other specialists with expertise about drugs with whom they can consult as necessary.
  • They find out which psychiatric drug forms cannot be safely tapered and need to be changed with the help of a prescriber, and make sure that they get any of these necessary changes done well before beginning their taper. (See Step 10 and Step 11 in The Withdrawal Project’s Companion Guide to Psychiatric Drug Withdrawal.)
  • They seek out practical tips and emotional allies elsewhere, as many people find it difficult to taper without any kind of support.