One in every 8 people in the world suffers from a mental health problem, according to a report by the World Health Organization (WHO).
In this context, there has also been an increase in the demand for the use of drugs to treat them.
But paradoxically, just as it has become common to use these medications, it is also common for people stop using them at any moment, experts told the BBC.
Many patients fall into this trap, often because the drugs are taking effect: because they feel good, they may have the impression that the problem is solved.
In other cases, it is the adverse effects of treatment that lead some people to stop treatment abruptly.
However, according to psychiatrists, anyone who decides to stop using the drug without consulting a doctor can suffer immediate and long-term effects.
The effects of abrupt interruption
Suspend medications such as those used to treat anxiety and depression, even for a day can alter chemical signals in the brain and cause symptoms such as nausea, tiredness, dizziness, and a “light head” feeling.
A recent study reports that more than half (56%) of people who try to stop taking antidepressants experience adverse symptoms, and almost half of them (46%) describe the side effects as serious.
is the call “abstinence syndrome”which can be caused by the discontinuation of the use not only of antidepressants and anxiolytics, but also of hypnotics, antipsychotics, mood stabilizers, and stimulants (including drugs used in the treatment of attention deficit hyperactivity disorder (ADHD).
Elson Asevedo, psychiatrist and technical director of the Center for Comprehensive Mental Health Care at the Federal University of Sao Paulo, adds another effect that he frequently observes in his medical practice.
Patients who initially respond well to a drug may respond more slowly or resist resuming treatment that was stopped abruptly.
“In some cases it may be necessary to increase the dose or change the drug, even having to combine several different drugs,” says Asevedo.
Why do they stop ‘from one day to the next’?
The main reason someone stops taking a medication is that the condition being treated seems to be stabilizing.
“When you notice an improvement in depression and anxiety, it is natural to feel that the medications are no longer necessary, since the symptoms seem to have subsided,” explains Asevedo.
“However, the catch here is that this improvement in symptoms often occurs before the physical improvement in the brain,” he adds.
The doctor compares the brain with a computer and the disease with a program installed in that machine.
Treatment removes the program, he explains, but in order for the brain to be protected against future relapses, a considerable period of drug use is needed for the brain to create new ways to function without the influence of depression.
“It is recommended that antidepressants be used for at least 12 months after medical discharge and can last up to two years or even indefinitely, if the patient has had two or more episodes of depression throughout his life,” says Antônio Geraldo, President of the Brazilian Association of Psychiatry (ABP).
Vanessa Favaro, director of the Outpatient Service of the Institute of Psychiatry at the University of Sao Paulo, says that many patients do not see treatment as part of a permanent search for mental health.
“Understanding the long-term approach can be challenging for some patients, especially when they are in distress. The search for immediate relief is natural, but not all suffering requires only momentary relief”, says the doctor.
“Understanding the disorder, its biological bases and maintaining mental health over time is essential. It is important to take into account not only the medication, but also other actions, such as psychotherapy and breathing techniques.
Another very common reason for stopping taking medications is unwanted effects on the body.
“It is relatively easy to tolerate the side effects of an antibiotic that we only have to take for seven days,” says Asevedo.
“But when it’s a depressive condition that requires continuous treatment for a year, it’s much more difficult to treat,” he adds.
Among the most common side effects of psychiatric drugs, the doctor cites:
- Decreased libido;
- Weight gain;
- Gastrointestinal effects;
In cases like these, it’s important that the doctor and patient feel confident enough to discuss the possibilities together.
“They can consider alternatives, such as changing the drug or even introducing an additional drug to mitigate the side effects,” says Asevedo.
How drugs work in the brain
Medications used to treat mental disorders alter the electrical signals that are transmitted within the brain through changes in the organ’s chemical makeup.
“The brain is a computer that, instead of cables, has neurons. But these neurons do not connect directly. There is a small space between them, where the neurotransmitters are found”, explains Asevedo.
Neurotransmitters are chemicals that allow electrical transmission from one neuron to another.
Serotonin, norepinephrine, and dopamine are some of the neurotransmitters that regulate the passage of electrical signals between neurons.
A mental disorder usually occurs when you are chemicals are not regulated.
Depression, for example, is caused by an imbalance in the neural transmitters responsible for the sensation of pleasure and well-being, experts say.
The drugs then work by regulating the production of neurotransmitters and increasing the transmission of electrical signals between brain cells.
How to Correctly Stop Taking a Psychiatric Medication
It is common for a person in psychiatric treatment to think that they will be doomed to consume these drugs forever, says Vanessa Favaro.
“Most of the time this doesn’t happen. Treatments usually have a beginning, a middle, and an end.“says the doctor.
The end requires a process that can last months or even years.
“The withdrawal should be gradual to avoid abrupt changes in the functioning of the brain”, affirms Favaro.
The first step, experts say, is to have the recommendation of the doctor accompanying the patient to do so.
“First we need that the symptoms have completely improved and that between six months and a year have passed,” says Asevedo.
“Prior to that, there hasn’t been an absolute improvement in the brain and it’s possible that the symptoms will come back.”
Then some strategies can be adopted, explains the psychiatrist, such as starting to take the medication every other day or gradually reducing the dose.
“It is important to consult a psychiatrist to assess the most appropriate medication for your type and pathology,” concludes Favaro.
* Juanes, talking about his depression, seeks to encourage people to talk about it, because with the right guidance you can lead a full and happy life.
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