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Cited by 73Treatment of Major DepressionBipolar Disorder and TreatmentElectroconvulsive Therapy Studies

What I have learnt from helping thousands of people taper off antidepressants and other psychotropic medications

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Framer, Adele·2021·Therapeutic Advances in Psychopharmacology
DOI 10.1177/2045125321991274PMC PMC7970174
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Abstract

Although psychiatric drug withdrawal syndromes have been recognized since the 1950s – recent studies confirm antidepressant withdrawal syndrome incidence upwards of 40% – medical information about how to safely go off the drugs has been lacking. To fill this gap, over the last 25 years, patients have developed a robust Internet-based subculture of peer support for tapering off psychiatric drugs and recovering from withdrawal syndrome. This account from the founder of such an online community covers lessons learned from thousands of patients regarding common experiences with medical providers, identification of adverse drug reactions, risk factors for withdrawal, tapering techniques, withdrawal symptoms, protracted withdrawal syndrome, and strategies to cope with symptoms, in the context of the existing scientific literature.

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  • Many patients benefit from understanding withdrawal symptoms as physiological in origin rather than psychological.

    “Many patients benefit from understanding withdrawal symptoms as physiological in origin rather than psychological (sometimes called ‘neuro-emotions’) (Framer, 2021; Guy, Davies, & Rizq, 2019).”

    From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Framer, 2021

    In “The significance of withdrawal symptoms” (page not available), Framer describes withdrawal symptoms as the unwinding of neurophysiological adaptation. “Emotional spirals and neuro-emotions” (page not available) likewise describes withdrawal-related emotions as neurologically generated rather than necessarily a psychiatric disorder. The copy does not establish that many patients benefit specifically from understanding this distinction. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Severe affective symptoms during withdrawal may be misdiagnosed as primary mental disorders by clinicians unfamiliar with the process.

    “as severe affective symptoms may be misdiagnosed as primary mental disorders by clinicians unfamiliar with the process (Framer, 2021).”

    From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Framer, 2021

  • The roughly exponential regimens (5%-10% reductions of the most recent dose) derived from clinical experience are supported by the analysis.

    “This seems to support the validity of the roughly exponential regimens (5%–10% reductions of the most recent dose) derived from clinical experience (Ashton, 2002; Framer, 2021; Nice, 2018).”

    From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Framer, 2021

  • There is a linear relationship between GABA-A occupancy and clinical effects, supported by seizure-threshold studies in primates.

    “This suggests a linear relationship between GABA-A occupancy and clinical effects, supported by seizure-threshold studies in primates (Ashton, 2002; Framer, 2021; Nice, 2018).”

    From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Framer, 2021

    The Harm reduction tapering section discusses gradual, hyperbolic tapering, and The pitfalls of hyper-reactivity and kindling reactions says partial receptor occupancy can suffice for an antidepressant effect. Neither passage addresses a linear relationship between GABA-A occupancy and clinical effects or seizure-threshold studies in primates. Searches for those terms found no supporting passage in our copy. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Framer, A.
Affiliations
SurvivingAntidepressants.org, San Francisco, California, USA
Corresponding author
Framer, Adele
ORCID
Framer, Adele
Venue
Therapeutic Advances in Psychopharmacology
Publisher
SAGE Publications
Published
2021-01
Volume
11
Pages
2045125321991274-2045125321991274
ISSN
  • 2045-1253 (ISSN-L)
  • 2045-1261
DOI
10.1177/2045125321991274
PMC
PMC7970174
OpenAlex
W3137004684
Cited by
73
References
34
Citations by year
2026: 7 · 2025: 13 · 2024: 19 · 2023: 14 · 2022: 9 · 2021: 10 · 2020: 1
FWCI
1.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Therapeutic Advances in Psychopharmacology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
antidepressant withdrawal syndrome, medication tapering, adverse drug reactions, patient-provider communication, coping strategies

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