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Why People Stop Taking Their Medications
Most often, people with a mental illness stop taking their medications unilaterally – in other words, without the advice of a physician. This isn’t how medication should be discontinued, of course. Medication discontinuation should always be done under the supervision of a doctor. But why do people stop taking their medications on their own if we know that a doctor should be involved in the decision?
Stopping a Medication Due to Side Effects
Not surprisingly, the number one reason people stop medications is due to side effects. Side effects from medications range from dry mouth and headaches to hair falling out, crippling dizziness, vomiting, and, of course, weight gain. Any one of these side effects might make you consider stopping your medication, some side effects being more persuasive than others. Weight gain, (sometimes massive weight gain) for example, is one of the most common and troubling side effects of antipsychotics, and people absolutely hate weight gain. It makes them feel bad about themselves, which is pretty much exactly the opposite effect we wish the drugs to have.
Stopping a Medication Because of Primary Effects
Second to side effects, people stop taking their medications precisely because of how the medications make them feel. Some people hate the feeling of being on medication. Some people feel like zombies. Some people feel deadened. Some people miss the people they were before they started medications. Yes, some people miss parts of the illness (like mania or hypomania).
Other Reasons People Stop Taking Their Medication
Other reasons people might stop taking their medication include:
- The perception that they no longer need their medication (this usually happens, ironically, because the medication is working so well)
- Other concerns
Why Do People Stop Medications Without Talking to Their Doctor?
While any of these reasons might convince a person to stop taking their medications, why do people do it without talking to their doctor first? If a doctor prescribed the medication and explained how to properly take it, doesn’t it stand to reason that they should be involved in the decision to stop taking the medication too?
It does stand to reason, nevertheless, people either don’t know about this or don’t place any value on it. This is because:
- Some people feel their doctors don’t listen to them and won’t respect their wishes to get off the medication
- Some believe that getting off a medication is “no big deal”
- Some people don’t know about the effects of withdrawal
- Some are not prepared to wait until their doctor can next see them
- Some believe they can handle whatever happens when they get off the medications
And often it’s a combination of those factors.
What Happens When You Stop Taking Your Medication?
Whatever the reason a patient has to stop, and whatever the reason a patient has not to inform their doctor, they are not sufficient to override the dangers of stopping medication, particularly abruptly. The withdrawal effects from getting off of any medication can be, well, hell—but with medical oversight this can be mitigated. With medical oversight and a proper discontinuation schedule, getting off of medications can be made considerably more tolerable.
Stopping medication can cause very unpleasant and sometimes dangerous withdrawal effects or a re-emergence of the underlying illness—possibly making the person harder to treat. Doctors do work to prevent these things as best they can.
Doctors Don’t Want You to Stop Your Medication
It is a fact that many doctors will try to persuade you not to stop taking your medication because they fear the re-emergence of your illness—the whole reason you started treatment in the first place. And this is completely reasonable. In many cases it is not appropriate to cease medication. Of course, you have the right to go against medical advice (except in extreme cases where you pose a danger to yourself or others) but you should at least hear your doctor out first.
If You Want to Discontinue Medication
If you have decided to stop your medication, you should:
- Talk to your doctor about it and listen to any concerns he may have. They may not change your mind, but at least consider them.
- Be honest with your doctor and explain your reasons for wanting to stop your medication calmly and clearly.
- Make a plan for how to stop taking your medication.
- Make a plan for what will happen should withdrawal effects of underlying symptoms re-emerge.
Next week I’ll be discussing more on when it’s appropriate to stop medications and how it should be done.