Posted by 49er on September 13, 2009, at 10:16:43
In reply to Re: Suggestions re: Someone Who Refuses Medications » 49er, posted by SLS on September 13, 2009, at 9:09:41
<<Again, I agree with you that antipsychotics should be tapered. I even like your suggestion to restart a medication if withdrawal symptoms appear as the result of an abrupt discontinuation. However, I don't know how you can justify the necessity to follow your formula of a 5% reduction every 3-6 weeks. I'm going to let you do a little math for me. How many weeks would it take to arrive at a total discontinuation of an antipsychotic at the taper rate you recommend?>>
I can justify the necessity because that that is the safe approach to take usually. A person may be able to get away with a fast taper but the problem is by the time they find out they can't, it might be too late.
According to my withdrawal spreadsheet, if a person started tapering a med at 100mg every 3 weeks, they would be at 2.5mg by 11/3/2013.
Yes, that is a long time, no question. But I would be willing to bet you that the person who tapers slowly vs. the one who tapers alot faster is going to have a much better chance of staying off of meds permanently.
Why is that so threatening to you?
Of course, there are exceptions to every rule. If someone has a life threatening condition that is caused by a med, then obviously tapering slowly probably isn't the answer. But for alot of people, it is.
To answer your question, if someone is on 100mg of a drug and tapers by 5% every 3 weeks and started today,
<<To be clear, I am not advocating the forced medicating of people who are functional enough to remain as outpatients. However, I think there are times when encouragement to accept medication is critical, despite the verbalizations of the patient. There isn't necessarily a lack of respect for patients, but there can be lack of confidence in their judgment and a disagreement as to what is best for their welfare.>>
Frankly, I find that frightening. So really this isn't about a patient being functional vs. non functional. Essentially, you're saying that because someone has a mental health label, they don't have the judgment to decide what is best for their welfare and they need to take meds come heck or high water. Side effects be d---med.
Sadly, your view is shared by many mental health professionals.
" That's part of the job of the health workers overseeing the care of others, regardless of the nature of the illness. It is unfortunate that, in mental illness, the processes that are necessary to effectively deliberate decisions are impaired in many cases. I think this is what separates these illnesses from all others.""
Uh, someone who doesn't manage his/her diabetes, blood pressure can be impaired and can cause car wrecks. But we don't court order them to take their medication.
49er
poster:49er
thread:915268
URL: http://www.dr-bob.org/babble/20090912/msgs/916855.html