Background

• Consumer reportso GPs and many psychiatrists not awareo Anecdotal reports of severe and prolonged MDS

• Lack of good research evidence

• Lack of simple high quality information for consumers & supports

• Produced by Matua Raki as part of Equally Well

• Extensive literature review

• *Begins after the decision to stop or reduce made

Peer review and advice from:

• Equally Well recovery prescribing group

• Royal College of General Practitioners

• Royal College of Psychiatrists

• Mental Health Advocacy and Peer Support (MHAPS)

• Support and Awareness Canterbury

Contents: Stopping and Symptoms

• What are medication discontinuation symptoms (MDS)?

• Planning to reduce or stop your medication

• How to taper your medication working with your doctor

• What to expect when reducing or stopping medication

• How common are MDS when stopping a mental health medication?

• What MDS could you experience?

• How to tell MDS from re-emergence of the original problem

• What to do if your MDS are severe or hard to tolerate

Contents:

Coping with MDS

• General strategies

• Strategies for specific problems

Use of terms

Key points

• This guide does not deal with the decision to stop medication

• Getting discontinuation (or withdrawal) symptoms when you reduce or stop taking a medication is not the same as addiction

• It is best to plan reducing or stopping medication ahead of timeo Plan for a time with few important things to doo Discuss with key supports, doctor and employer if possible

• MDS are unlikely until the medication has been taken for 6-8 weeks

• Roughly 50% of people stopping medication will experience MDS, and roughly 25% will experience problematic MDS

Key points

• MDS are highly variable from person to person

• MDS v re-emergence of the original problemo It can be very difficult to tello MDS usually emerge soon after (a few days to a week) stopping

the medication

Coping with MDS: General strategies

• Optimise general health and wellbeing

• Protect relationships

• Get active

• Divert attention using enjoyable activities

• Spiritual interventions e.g. karakia, prayer

• Meditation

• Rongoa Maori

Coping with MDS: Strategies for specific problems

• Suicidal thoughts

• Seizures

• Sleeping problems

• Nightmares

• Dizziness

• Anxiety

• Restlessness, agitation, irritability and anger

• Headache

• Nausea

Contents: Prescribers notes• Strategies for specific medications• References