Stop? Sometimes it’s the hardest part of therapy. And interrupting a cure badly, or at the wrong time, is one of the most common mistakes. A first fundamental rule applies, as explained by the pharmacologist Sif Gianni Sava: «The longer a treatment has been, the more delicate is the path to follow to suspend it. In order to work, drugs interfere with the organism and this must have time to readjust to being without, to “wash” away the effects slowly ».
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The “most at risk” drugs
For some active ingredients the need to reduce the doses to “get used to” is known: i cortisonici, for example, they must be phased out gradually because they affect the natural production of hormones by the adrenal and one stopping too abruptly could cause adrenal insufficiency. «Less known, however, is the importance of stopping a therapy with benzodiazepine in a controlled manner: this is often done by changing drugs and switching to products with a longer half-life (that is, they remain in circulation for a longer time, allowing for a “thinning” of the pills and therefore a progressive abandonment, ed) “, says Sava .
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Withdrawal symptoms
The sudden interruption can in fact give symptoms of abstinence such as insomnia often associated with nightmares, severe anxiety up to panic attacks, muscle tension: a kind of “rebound”, with the appearance of the very symptoms for which these drugs are usually taken. Suddenly removing the inhibitory effect of benzodiazepines on the brain, to which we had become accustomed in months of therapy, in fact leads to an increase in the excitability of the nervous system, as if a brake were missing: then over time we return balance, thanks to the resumption of the functioning of the receptors on which these anxiolytics act, but the symptoms of a sudden stop can be very unpleasant. The drugs active on the central nervous system, however, are those for which the suspension of therapy must be carried out with greater attention, under the guidance of the doctor: a recent study by Mireille Rizkalla of the Department of Clinical Integration at Midwestern University in Chicago, for example, has reported that many patients may experience some sort of antidepressant withdrawal syndrome with disorders such as insomnia, headache, sensory and balance disturbances, flu-like symptoms. To avoid them, it is advisable to manage the abandonment of therapy with the doctor, perhaps associating the progressive reduction of dosages with a phase of greater non-pharmacological support with psychotherapy.
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Communicate with your doctor
“Abrupt interruptions, especially in psychiatric pathologies, can lead to relapses and must be avoided”, observes the pharmacologist of the University of Catania Filippo Drago. «In general, any suspension of treatment must be agreed with the doctor, who must understand the reasons why the patient would like to interrupt: is he still sick because the therapy is not correct? Or is he fine and therefore see no reason to continue? Depending on the case, it may be appropriate to change medication or increase the patient’s awareness of the need to continue treatment even if there are no more obvious discomforts. The alliance with the doctor is always indispensable to avoid any kind of therapeutic errors ».
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November 15, 2020 (change November 15, 2020 | 16:44)
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