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For people with Down syndrome, family members, caregivers and professionals.

Weaning Off Psychotropic Medications

February 2022 | Brian Chicoine, MD - Medical Director, Adult Down Syndrome Center

A common and appropriate question is: Can a person be weaned off a psychotropic medication? A psychotropic medication is a medication prescribed to treat a psychological problem such as depression or anxiety.

The short answer is, “Yes.” We wean some individuals off their medications while others remain on them. 

Some factors to consider: 

  • The diagnosis: For some diagnoses, weaning is more appropriate. For example, many with depression can be weaned after their symptoms have resolved and they have remained stable for a time (often 6-12 months). For many, obsessive compulsive disorder or bipolar disorder may require ongoing treatment. 

  • Recurrence of symptoms: If a person was weaned off a psychotropic medication and had a recurrence requiring restarting the medication, recurrence of the symptoms is even more likely to happen if the person tries weaning or stopping the medication again.

  • Cause: For those who develop a psychological problem in response to a situation, addressing the situation can be part of successful treatment and may allow weaning the medications after stabilization. 

  • Other factors

    • If it was very difficult to get the person to a stable point, we may decide not to wean the medications to avoid a potential recurrence and having the individual go through that process again.

    • Even if the problems were readily treatable, if the symptoms were severe, we discuss possibly continuing the medication to avoid recurrence of those severe symptoms.

    • If the person continues to go through a stressful time (the COVID pandemic is a good example), we may recommend continuing the medication for now and considering weaning it when the stressor is gone. 

    • For many conditions, treatment includes additional interventions such as counseling, behavioral approaches, various therapies, home support and self-care programs, addressing sensory issues, treating medical conditions, and others. It is often beneficial to wait to wean the medication until the symptoms have improved and those additional treatments have been initiated and are being used successfully.

A couple other considerations: 

  • It is recommended to "wean" psychotropic medications rather than just stop them all at once. Even if it is not necessary to slowly reduce the medication from a physiologic standpoint (i.e., the medication has no tendency for withdrawal or for the body to respond in a negative way), we still typically wean psychotropic medications. People will often feel differently, even if only a little, as the medication is reduced. A sudden decrease may not cause a physical response by the body but the sensation of feeling different may trigger a behavioral change. 

  • This article describes psychotropic medications. Many medications for physical problems do not require weaning and can be stopped abruptly; however, some do require weaning. For example, we wean anti-seizure medications because they also affect the brain, and we have seen some change in behavior as those are reduced, especially if suddenly. 

 

Additional resources on mental health can be found in this section in our Resource Library. 

 

Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.

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