Going off your meds Taper dont go cold turkey

I've discussed the potential problems that come with going off SSRIs in the past. In my experiences, these have included light-headedness, a feeling of going inside your head, a feeling of distance from the world around you -- and, in the case of Paxil, what some call the "zaps," the feeling that there are tiny electrical storms taking place in your brain. (Quite disconcerting, this sensation.) In the past, when I've gone off SSRIs -- and I've discontinued taking several of them over the years, either because I was feeling well and convinced I could do fine without them, or because I was sick and tired of the side effects -- I've had more success at avoiding unpleasantness when I weaned myself slowly rather than stopping suddenly, all at once.

But it turns out that the downsides of quitting psychiatric medications cold turkey go beyond discomfiting sensations while your brain is adjusting to life without meds. According to a recent study in the American Journal of Psychiatry, cited here, going off your meds quickly can result in your ailment storming back into your life. From the link:

In patients with major depressive disorder, panic disorder, or bipolar disorder, the risk for illness recurrence is far greater following abrupt or rapid, vs gradual, discontinuation of clinically effective antidepressant treatment....
"The general point for clinical practice," Dr. [Ross J.] Baldessarini said, "is that it appears that most psychotropic drugs, when discontinued abruptly or rapidly, can lead to early and severe exacerbations of the illnesses being treated.

"It is my impression that this concept has been widely accepted and that clinical practice has been modified appropriately in many cases to include gradual dose tapering and slow discontinuation when feasible clinically," he added.

Optimal dose-tapering times and protocols still need to be worked out, Dr. Baldessarini noted. However, in general, he said, it is wise to taper off most psychotropics during at least several weeks.

Dr. Baldessarini is an MD at Harvard Medical School and Massachusetts' McLean Hospital, so if you're not willing to listen to me when it comes to this stuff, perhaps his voice carries a little more authority to you.

Apparently panic disorder and life in the NBA dont mix

We've talked about Royce White here on PANIC! in the past. He's a young basketball player who's been attempting to make it in the NBA despite a fear of flying and other issues related to severe panic disorder. Last year, he was a bust with the Houston Rockets. This year, he was cut by the Philadelphia 76ers.

My take is that he's been kind of immature in the way he's gone about trying to carve out a professional hoops career -- at least with the Rockets, his approach seemed kind of antagonistic, replete with complaints in the press about the ways the team wasn't accommodating his needs, in a profession where, let's face it, criss-crossing the country is a fact of life and continuity of player availability is a key component of successful team chemistry -- but ultimately there are at least two sides to every story, and I have no idea what really went on behind closed doors.

At the same time, I admire his willingness to put the truth about his condition on the table, to make mental health and how employers deal with it part of the public discussion. I wish him well, and hope he finds his way to an NBA career, because he's a real talent, a big man with scoring ability and excellent court vision and passing skills. And he's courageous. Immature, maybe, but courageous. Let's not forget that.