ON MENTAL ILLNESS: The Effects of Quitting Medication Against Medical Advice

By Jack Bragen
Thursday January 24, 2013 - 11:29:00 AM

When a person with schizophrenia takes antipsychotic medication over time, it is possible that he or she may develop a tolerance to these drugs. A well-known doctor (whose name I will not mention) claims that certain prescription drugs produce the very diseases they are intended to treat. (I'm assuming he meant that this is because they create a tolerance.) This doesn't mean that someone with severe psychosis shouldn't be medicated-such a person is in trouble and needs the help of the medicine. 

Don't get me wrong, I advocate taking medication when it is needed; failing to take needed medication can cause dire results. The disease could progress unchecked, and the sufferer's behavior can entail danger to them and to innocent bystanders. Readers should not infer from this article that I am adopting an anti-medication position. 

Having a schizophrenic illness means that I need medication. If my innate psychosis is combined with the backlash of going off the medication, (if I were to quit taking it against medical advice) the double whammy of that is like being hit by a tsunami. It is not a pleasant experience. The relapse in my case comes quickly (but for many people happens gradually, over months). The relapse can bring a massive flood of symptoms that include extreme distress, delusional thoughts, voices, images, tactile hallucinations and a disconnection from my external environment. When it happens, it is clear that something is wrong. 

For someone in my situation, it is pure folly to try to quit medication against medical advice. 

Every time I try to quit medications, the ensuing rebound and psychotic episode will cause me to lose more brain power. This successive loss of brain which is caused by psychotic relapses eventually takes its toll on a person's mind. This could be one reason for the stereotype that persons with mental illness are dull-witted, or are a child in the body of an adult. (Yet it is upsetting to me and other "sharp" persons with mental illness when we are prejudged as lacking mental development when often this is not accurate.) 

Many persons who suffer from schizophrenia have difficulty learning from their mistakes. Schizophrenia robs a person of their judgment and of normal brain function. Thus, when the brain is (one hopes, temporarily) out of commission, the sufferer can not be counted upon to understand what is needed. That's one reason why schizophrenia is such an awful disease. 

Once a person has been on antipsychotic medication for a while, it will probably become impracticable to go off med's. This is one reason why, very importantly, an assessment by a doctor must be accurate. You don't want to medicate someone unnecessarily, yet, you don't want to deprive a person of medication when it is needed. 

When someone has been taking antipsychotic medication a while, then discontinues it against medical advice, and then relapses, it is hard to know how much of the relapse is due to withdrawing from medication, and how much of the relapse is merely the illness. I have seen numerous people try to quit medication, and it seems to be almost universal that as a result, they have a severe relapse. 

A gradual weaning off of antipsychotic medication seems to have no advantage over going cold turkey-the relapse will still probably happen and can be just as bad (or can be worse due to the longer time span of being borderline symptomatic.) 

Acceptance, in the Buddhist sense, has a role for people who need to deal with this. If, by meditative techniques, a person with mental illness can accept their situation on an emotional level, then they can proceed in their life without being stuck on the same issue. Meditative practices don't cure mental illness but they can help a person cope with their situation. 

The tsunami of symptoms caused by stoppage of medication is to be avoided. When uncertain as to how to proceed, a psychiatrist is a good person to talk to. Also, if unhappy with what a psychiatrists says, one can always get a second or third opinion.