This guide brings together the best information we’ve discovered and lessons we’ve learned at The Icarus Project and Freedom Center. It is not intended to persuade anyone to stop taking psychiatric medications, but instead aims to educate people about their options if they decide to explore going off. In a culture polarized between the pro-medication propaganda of pharmaceutical companies on the one hand, and the anti-medication agenda of some activists on the other, we offer a harm reduction approach to help people make their own Harm Reduction Guide to decisions. We also present ideas and information for people who decide to stay on or reduce their medications. Coming Off Psychiatric Drugs Many people do fi nd psychiatric drugs helpful and choose to continue taking them: even with the risks, this may be a better option given someone’s situation and circumstances. At the same time, psychiatric drugs carry great dangers and can sometimes do terrible harm, even becoming bigger problems than the conditions Published by they were prescribed to treat. Too often, people who need help getting off The Icarus Project and Freedom Center psychiatric drugs are left without guidance, and medication decisions can feel like fi nding your way through a labyrinth. We need honest information that widens the discussion, and we hope this guide helps people trust themselves more and take better care of one another. www.theicarusproject.net www.freedom-center.org Second Edition, revised and expanded. ISBN 978-0-9800709-2-7 Health Professional Advisors, continued Renee Mendez, RN Michael Smith, MD, Licensed Acupuncturist Windhorse Associates National Acupuncture Detoxifi cation Association Dawn Menken, PhD Susan Smith Process Work Institute Proactive Planning Harm Reduction Guide to Arnold Mindell, PhD Claudia Sperber, Licensed Acupuncturist Author, ProcessMind: A User’s Guide to Coming Off Psychiatric Drugs Connecting with the Mind of God Linda Star Wolf Second Edition Venus Rising Association for Transformation Joanna Moncrieff, MD Author, The Myth of the Chemical Cure Peter Stastny, MD International Network Towards Alternatives for Recovery Pierre Morin, MD, PhD Lutheran Community Services Sandra Steingard, MD Matthew Morrissey, MFT Ted Sundlin, MD Co-Editor, Way Out Of Madness Jefferson Behavioral Health Sharna Olfman, PhD Philip Thomas, MD Author, Bipolar Children Co-author, Post-Psychiatry Ilya Parizsky, MFT Krista Tricarico, ND Catherine Penney, RN Dina Tyler Dante’s Cure: A Journey Out of Madness Bay Area Mandala Project Judith E. Pentz, MD Scott Von, MD Maxine Radcliffe, RN Toby Watson, PsyD Action Medics Associated Psychological Health Services Myriam Rahman, MA, DiplPW Barbara Weinberg, RN, Licensed Process Work Institute Acupuncturist Lloyd Ross, PhD Charles Whitfi eld, MD Author, Not Crazy: You May Not Be Mentally Ill Nancy Rubenstein del Giudice Law Project for Psychiatric Rights Damon Williams, RN, PMHNP-BC Written by Will Hall Laughing Heart LLC Published by The Icarus Project and Freedom Center Judith Schreiber, LCSW Paris Williams, PhD Soteria Associates Author, Rethinking Madness 52 Health Professional Advisors While not co-authors, the following 61 health care professionals are experienced with helping people come off psychiatric drugs. They reviewed this guide for its usefulness, and we thank them for their involvement: Ed Altwies PsyD Mark Foster, MD David Anick MD, PhD Chris Gordon, MD The Icarus Project Marino Center for Integrative Health Massachusetts General Hospital www.theicarusproject.net [email protected] Ron Bassman, PhD Jen Gouvea, PhD, MSW Freedom Center is an award-winning support, advocacy and activism community created in Western Massachusetts, Author, A Fight To Be: A Psychologist’s Experience from Both Engaged Heart Flower Essences The Icarus Project is a website community, network of and now in transformation. Run by and for people who Sides of the Locked Door local groups, and media project created by and for people experience extreme states of consciousness, Freedom Mark Green MD struggling with mad gifts commonly labeled as “mental Center works for access to holistic alternatives, compas- Alexander Bingham, PsyD Westbridge Community Service illnesses.” We are creating a new culture and language that sionate care, and an end to forced psychiatric treatment. resonates with our actual experiences of madness rather than trying to fi t our lives into a conventional framework. Patrick Bracken, MD Nazlim Hagmann, MD Co-author, Post-Psychiatry Carina Håkansson Christopher Camilleri, MD Family Care Foundation Los Angeles County Department of Mental Health Second edition, June 2012, version 08-14. Your input and ideas are welcome for future versions of this guide. Lee Entel Hurter, Licensed Acupuncturist Michael Cornwall, PhD Written by Will Hall. Thanks to Jacks Ashley McNamara for early contributions to this Guide. Monica Cassani Published by The Icarus Project and Freedom Center. David Cohen, PhD Publisher, Beyond Meds website Additional thanks to: Ben Abelow, George Badillo, John Banister, Amy Bookbinder, Dave Burns, Kent Bye, Mick Bysshe, Monica Cas- Co-author, Your Drug May Be Your Problem sani, Oryx Cohen, Colin, Marykate Connor, Laura Delano, Jacqui Dillon, Dionysia Dionysius, Marc Dinacola, Dianne Dragon, dreamer, Peter Lehmann Sascha DuBrul, Empties, Steve Fenwick, Marian B.G., Vikki Gilbert, Richard Gilluly, Rhiannon Griffi th, Chaya Grossberg, Molly Hardison, Celine Cyr Editor, Coming off Psychiatric Drugs Gail Hornstein, Lee Hurter, Jenna, Jonah, Julie, Marianna Kefallinou, Ed Knight, Inez Kochius, Peter Lehman, Paul Levy, Krista MacKin- non, Jacks Ashley McNamara, Tsuyoshi Matsuo, Pheepho, Suzanne Richardson, Olga Runciman, Alex Samets, Sarah Seegal, Seven, Janice Gaining Autonomy with Medication Sorensen, Lauren Spiro, Bonfi re Madigan Shive, Stacco, Jessica Max Stein, Terramuggus, Amy Upham, Agustina Vidal, Dorea Vierling- Bruce Levine, PhD Claassen, Robert Whitaker, Kate Williams, Health Professional Advisors, and many other collaborators and allies. Patricia Deegan, PhD Author, Surviving America’s Depression Epidemic: Cover art: Jacks Ashley McNamara. Primary guide artist: Janice Sorensen. CommonGround Art design: Carrie Bergman (fi rst edition); Seth Kadish, Ivana Klement, and Cheryl Weigel (second edition). Bradley Lewis, MD, PhD Contributing artists: Fly, Gheena, Will Hall, Miss Led, Jacks Ashley McNamara, Erik Ruin, Janice Sorensen, and Bec Young. Laura Delano Author, Narrative Psychiatry This Guide is available as a free fi le download at Freedom Center, Icarus Project, and Will Hall websites, RecoveringFromPsychiatry.com in online and printer-ready versions. Also available in Spanish, German, Greek, Italian, Japanese, Dutch, Danish, Krista Mackinnon, DipSSW Thai, Bosnian, Chinese, Russian, French, and other translations. Jacqui Dillon Families Healing Together Hearing Voices Network UK Creative commons copyright 2012: http://creativecommons.org/licenses/by-nc-nd/3.0/. Daniel Mackler, LCSW Freedom Center www.freedom-center.org Kelley Eden, MS, ND Director, Take These Broken Wings Neil Falk, MD Medical Disclaimer: Rufus May, Dclin Cascadia Behavioral Healthcare This guide is written in the spirit of mutual aid and peer support. It is not intended as Evolving Minds Bradford, UK medical or professional advice. While everyone is different, psychiatric drugs are powerful, Daniel Fisher, MD and coming off -- especially suddenly or on your own -- can sometimes Elissa Mendenhall, ND National Empowerment Center involve risks greater than remaining on. Amenda Clinic 51 Evelyn Pringle “Serotonin and Depression: A Disconnect between www.opednews.com/author/author58.html the Advertisements and the Scientifi c Litera- Contents ture” J.R. Lacasse and J. Leo PLoS Med. 2005; 2(12): e392 Psychiatric Drugs doi:10.1371/journal.pmed.0020392 Dr. Caligari, 1984 “Soteria and Other Alternatives to Acute Psychi- Author’s Note ................................................................................................................5 atric Hospitalization: A Personal and Professional “Psychiatric Drugs as Agents of Trauma” Charles L. Introduction ....................................................................................................................6 Review” Whitfi eld, The International Journal of Risk & Safety in Medicine Loren Mosher Journal of Nervous and Mental Disease. 1999; Harm Reduction For Mental Health .........................................................................7 22 (2010) 187:142-149 Key Resources For Further Learning ........................................................................9 “Psychiatric Drug Promotion and the Politics of “Pay Attention: Ritalin Acts Much Like Cocaine” Looking Critically At “Mental Disorders” and Psychiatry...................................10 Neoliberalism” by Joanna Moncrieff Vastag, B. 2001. Journal of Am Med Association, 286, 905-906 The British Journal of Psychiatry. 2006; 188: 301-302. doi: Universal Declaration of Mental Rights and Freedoms ......................................11 10.1192/bjp.188.4.301 “Clinical Risk Following Abrupt and Gradual How Diffi cult Is Coming Off Psychiatric Drugs? ..................................................12 Withdrawal of Maintenance Neuroleptic “Psychosocial Treatment, Antipsychotic Postpone- Treatment” Viguera, AC, Arch Gen Psych.54:49-55, 1997 Politics of Withdrawal .................................................................................................12 ment, and Low-dose Medication Strategies