Managing Schizophrenia Recovery: When and How to Stop Medication

Schizophrenia

Hello, doctor.
I have previously suffered from schizophrenia, but I have since recovered and am still taking medication (SOLIAN).
I would like to know what to pay attention to if I want to stop taking the medication.
Here is my history: In the first grade of elementary school, I rode a bicycle without brakes down a hill and crashed into a house to stop.
The next day, while playing at the door, I got so nervous that I fell into a ditch, and my aunt had to come to rescue me.
After that, I became a bit impatient.
In the sixth grade, I witnessed a little girl fall from playground equipment onto the concrete, hitting her head and bleeding everywhere.
The next day in class, my leg kept shaking, which made the teacher angry and come to scold me.
My middle school years were relatively normal, though I was easily impulsive and impatient, but my grades were acceptable.
In my second year of high school, I organized a bike trip with classmates from Taipei to Taichung.
However, a classmate had an accident midway, and the activity was not completed.
After that, I felt very down, and my grades plummeted.
After graduating from high school, I became easily anxious and had insomnia, often experiencing reversed day-night cycles, poor mental health, and irritability, but I did not have hallucinations.
My university years were the darkest period of my life, with chaotic thoughts and constant anxiety.
I once had a conflict in class and shouted profanities, only to feel deep guilt afterward.
My grades fell drastically.
After military service, I managed my condition with medication, but I still struggled with insomnia and anxiety, relying on smoking to suppress my emotions.
My psychiatrist suggested quitting smoking for a chance at recovery.
After fully explaining my situation to a smoking cessation specialist, the heaviness in my mind disappeared, and I recovered.
I felt lighter and more mentally stable, no longer experiencing insomnia, and my daily routine became normal.
My emotional fluctuations were not as intense as before, but I still smoke.
Since my recovery in 2017, I have continued taking medication, specifically Solian.
Initially, I took 200 mg once a day, and after recovery, I reduced it to 100 mg every day and a half.
I would like to know how much longer I need to take the medication before I can completely stop.
I feel that the medication suppresses my emotions, and I do not feel completely relaxed.
What should I pay attention to when considering stopping the medication? In every outpatient visit, I can only tell the doctor that everything is normal, and the doctor keeps saying to continue taking the medication and observe.

Niming, 40~49 year old female. Ask Date: 2019/07/19

Dr. Huang Xiaoxian reply Psychiatry

Dear Arowana, thank you for your question.
I understand that you have a 20-year history of schizophrenia, which is generally considered a chronic condition, similar to diabetes and hypertension, requiring medication management.
Therefore, physicians often recommend consistent medication adherence to prevent relapse, as relapses can lead to cognitive decline and other functional impairments.
However, statistics show that a small number of patients may remain relatively stable after discontinuing medication.
I suggest discussing your thoughts with your treating physician to understand the pros and cons of stopping medication before establishing a discontinuation plan.
Wishing you all the best!

Reply Date: 2019/07/19

More Info

Managing the discontinuation of medication for schizophrenia, particularly after a long period of treatment, requires careful consideration and collaboration with your healthcare provider. It is commendable that you have made significant progress in your recovery since your diagnosis, and it is understandable that you are contemplating the possibility of stopping your medication, specifically Solian (amisulpride).
Firstly, it is essential to recognize that schizophrenia is often a chronic condition that can require long-term management. Medications like Solian are typically prescribed to help stabilize mood, reduce symptoms, and prevent relapse. While you may feel that you have recovered, the risk of relapse remains a significant concern, especially if you have been on medication for an extended period.
When considering stopping medication, the following steps should be taken:
1. Consult Your Psychiatrist: Before making any changes to your medication regimen, it is crucial to have an open and honest discussion with your psychiatrist. Share your feelings about the medication, including any side effects you may be experiencing, such as emotional suppression. Your psychiatrist can provide insights into the potential risks and benefits of discontinuing the medication.

2. Gradual Tapering: If you and your psychiatrist decide that discontinuing medication is appropriate, it is generally recommended to taper off the medication gradually rather than stopping abruptly. This approach helps to minimize withdrawal symptoms and reduces the risk of relapse. Your psychiatrist will create a tapering schedule tailored to your specific situation.

3. Monitoring Symptoms: During the tapering process, it is essential to monitor your mental health closely. Keep a journal of your mood, thoughts, and any symptoms that arise. This information can be valuable for your psychiatrist to assess how you are coping without the medication.

4. Support System: Engage your support system, including family and friends, during this transition. They can provide emotional support and help you recognize any early signs of relapse or distress.

5. Therapeutic Alternatives: Consider incorporating therapy into your recovery plan. Cognitive-behavioral therapy (CBT) or other forms of psychotherapy can be beneficial in managing symptoms and developing coping strategies as you reduce or discontinue medication.

6. Lifestyle Changes: Focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep. These factors can significantly impact your mental health and overall well-being.

7. Be Patient: Understand that recovery is a process, and it may take time to adjust to life without medication. Be patient with yourself and allow for the possibility of ups and downs during this transition.

8. Emergency Plan: Have a plan in place for what to do if you experience a resurgence of symptoms. This may include contacting your psychiatrist or seeking immediate help if necessary.

In summary, while the desire to stop medication is understandable, it is vital to approach this decision thoughtfully and collaboratively with your healthcare provider. The goal is to ensure your continued well-being and to minimize the risk of relapse. Remember that recovery from schizophrenia is a journey, and maintaining open communication with your psychiatrist and support system is key to navigating this process safely.

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