Top 6 Safety Tips for Stopping Your Meds
Stopping your medication abruptly may not only negatively affect your condition, it can be flat out dangerous. Talk to your healthcare provider first.
1. Talk to Your Healthcare Provider First
Many factors need to be considered before you stop any medication that has been prescribed for you, that’s why it is so important to talk to your doctor first.
Discontinuing a medication quickly can often be associated with unpleasant side effects and worsening of symptoms based on your drug treatment, its chemistry profile, and how your drug is broken down (metabolized) and excreted from your body.
Ideally, talk to your healthcare provider about how, when (and if) to stop a drug when it is first prescribed for you.
In some cases, it may be necessary for you to stop a medicine quickly, like a severe allergic reaction or other life-threatening side effect. Contact emergency medical services (call 911) in these circumstances.
2. Discuss Your Medications With Your Doctor
About 54% of adults 65 years of age and older report taking 4 or more prescription drugs, which may include medications they no longer need. Some medications -- like sleeping pills or some pain medications -- are typically only used short-term.
- How about allergy medications that may only needed in the spring or fall?
- Did you lose those few extra pounds? If so, maybe your blood pressure has dropped back into the normal range and you don’t need as much medication to manage your high blood pressure.
- Should you continue with your stronger opioid painkiller, or can you back down to a milder, non-addicting pain reliever like acetaminophen (Tylenol) or an NSAID like ibuprofen or naproxen?
Any of these can be reasons to discontinue your medication, but only if okayed by your doctor first. You may be able to save on monthly health care costs, too, by using less medicine.
Talk with your doctor to see if any of your meds can be cut down or stopped.
3. Stop for the Right Reason
According to a report from CVS Caremark, half of patients taking maintenance medications for chronic conditions will stop taking them within the first year of starting therapy. This "non-adherence" (not sticking to your treatment plan) results in roughly a $300 million charge to health care costs per year. Non-adherence can lead to worsening of long-term health conditions, increased hospitalizations, and worse outcomes overall.
If you feel better after taking a medication, say an antidepressant or arthritis medication, your symptoms can return when you stop taking the medication. In addition, some conditions, like hypertension and high cholesterol, have no real symptoms at all, lessening the chance you’ll stick with your meds.
Many people think they can stop their treatment when they feel better, but this is usually not the case. Not only will your condition worsen, you may experience side effects from abrupt medication withdrawal.
If you read or hear news from the media about your medication that is concerning to you, do not stop your medication before you speak to your healthcare provider. The news reports, including those from social media, may be unfounded, or the particular concern may not be relevant to your condition.
4. Ask Your Doctor How to Best Stop Your Medication.
Some drugs can be stopped immediately without a special discontinuation schedule, but many medications require a taper, which is a slow reduction in dose or frequency over a longer period of time. Slow tapers help to avoid disagreeable side effects or even withdrawal symptoms that you might experience if you stopped the drug quickly.
If you are stopping several medications, you may want to taper them one at a time to avoid added side effects -- always check with your doctor.
5. Learn Your Medicine Side Effects if You Quickly Stop.
Many medicines that should not be stopped abruptly can be linked with a host of side effects. Here's a few common examples, but there are many more. Ask your doctor before you abruptly stop any medicine.
Antidepressants
Abruptly stopping some antidepressants prescribed to help with anxiety or depression -- for example, selective serotonin reuptake inhibitors (SSRI) like Paxil or Zoloft -- can lead to a host of disturbing side effects, such as anxiety, dizziness, upset stomach, or fatigue. This is called antidepressant discontinuation syndrome.
Antidepressant discontinuation syndrome can occur with many antidepressants, not just the SSRIs.
Not everyone experiences an antidepressant discontinuation syndrome, only about 1 in 5 people. It is not usually dangerous, but can be uncomfortable. It typically subsides in a few days depending upon your drug.
Antidepressant discontinuation syndrome may be more common with certain antidepressants that stay in your body for a shorter period of time, although longer-acting antidepressants may cause withdrawal side effects, too.
Examples of common antidepressants that can lead to antidepressant discontinuation syndrome include:
- Cymbalta (duloxetine)
- Effexor (venlafaxine)
- Lexapro (escitalopram)
- Brisdelle, Paxil (paroxetine)
- Zoloft (sertraline)
Statins
Some patients want to stop taking their cholesterol medicines known as statins due to bothersome side effects like muscle pain, liver damage or memory problems. Statins include medicines such as atorvastatin (Lipitor) and rosuvastatin (Crestor).
These drugs are important heart medications and can be life-saving by lowering cholesterol and reducing the risk of a heart attack or stroke.
Before you stop your statin due to a side effect, talk to your doctor. Many people complain of side effects with these drugs but there may be other options. A change in dose, a different statin, or even a different type of cholesterol-lowering medication might be helpful to reduce the risk of side effects.
Sleep medicines
Drugs used to help with sleep, like benzodiazepines or the non-benzodiazepines (sometime called "Z-Drugs"), can lead to a host of side effects if suddenly stopped after longer-term use. These drugs include medications like Xanax, Ambien or Lunesta.
Potential withdrawal or discontinuation side effects can include anxiety, insomnia, nausea, and even seizures. Talk to your doctor about a plan to stop these drugs slowly to help lower this risk.
See more: Drugs That Can Cause Side Effects When Stopped Too Quickly
6. Chart Your Discontinuation Plan
If you are started on a new medication, you should ask these questions and record the responses for future reference, including:
- Your dose and when and how you take it.
- Your expected outcome from using the medicine.
- Common side effects, including if the drug is abruptly stopped.
- Cost of your drug and generic availability.
- How long you will take the medication.
You may need to switch drugs due to side effects or lack of effectiveness. If you are switching from one medication to another in the same class, you can usually switch drugs immediately or start the new drug at a lower dose while slowly tapering off of the first drug. However, this is not always the case, so you must consult with your prescribing doctor, especially if the drugs are from different medication classes.
Table 1: Important Classes to Avoid Abrupt Withdrawal
Drug Class or Drug | Example Drugs | Side Effect Risks with Abrupt Withdrawal |
---|---|---|
antidepressants | paroxetine (Paxil), Sertraline (Zoloft), Venlafaxine (Effexor) | Panic, agitation, worsened depression, nightmares, confusion, insomnia |
antipsychotics | aripiprazole (Abilify), clozapine (Clozaril), olanzapine (Zyprexa), quetiapine (Seroquel) | Severe relapse of symptoms, anxiety, withdrawal dyskinesia or dystonia (involuntary muscle movement), parkinsonian symptoms, neuroleptic malignant syndrome |
benzodiazepines | alprazolam (Xanax), oxazepam, temazepam (Restoril), triazolam (Halcion), diazepam (Valium) | Abrupt discontinuation can be serious: seizures, anxiety, rebound insomnia (trouble sleeping), tremors, nausea, heart palpitations, hallucinations |
systemic corticosteroids | prednisone, methylprednisolone | Pain, fatigue, low blood pressure, anxiety, insomnia, irritability, depression, nausea, vomiting |
HMG Co-A reductase inhibitors (statins) | atorvastatin (Lipitor), lovastatin, rosuvastatin (Crestor), simvastatin (Zocor) | Possible rapid rise in C reactive protein (CRP) and LDL cholesterol levels; worsening of heart disease risks |
insomnia medications (for sleep) | eszopiclone (Lunesta), zaleplon (Sonata), zolpidem (Ambien) | Anxiety, rebound insomnia, muscle cramps, nausea, seizures |
lithium | lithium | Mood instability, manic relapse |
proton pump inhibitors (PPIs) | esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) | Rebound GERD (reflux or heartburn) |
hormone therapy | estrogen (Premarin), estrogen with progestin (Prempro) | Menopausal symptoms, hot flashes, flushing, sweating |
nonsteroidal antiinflammatory drugs (NSAIDs) | aspirin, celecoxib (Celebrex), ibuprofen (Advil, Motrin), naproxen (Aleve) | Increased risk of heart attack due to blood clotting (aspirin); rebound headaches (NSAIDs) |
opioids | codeine, hydrocodone, oxycodone, tramadol | Agitation, irritation, chills, shivering, cramps, diarrhea, insomnia, muscle pain |
Learn More: Prescription Drug FAQs
See also
- Common Drug Side Effects
- Does grapefruit juice interact with my medications?
- Drug Expiration Dates - Are expired drugs still safe to take?
- Generic vs Brand Drugs: Your FAQs Answered
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- How to Safely Dispose of Your Old Medications
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- Top 150 Prescription Abbreviations & Medical Meanings
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- What are the risks vs. benefits of medications?
- What is the half-life of a drug?
- What is the placebo effect?
Sources
- Howland RH. Potential adverse effects of discontinuing psychotropic drugs. Part 3: Antipsychotic, dopaminergic, and mood-stabilizing drugs. J Psychosoc Nurs Ment Health Serv. 2010;48:11-4. DOI: 10.3928/02793695-20100708-01
- Tartakovsky M. Discontinuing Psychiatric Medications: What You Need to Know. PsychCentral. Oct 11, 2022. Accessed August 16, 2024 at https://psychcentral.com/lib/discontinuing-psychiatric-medications-what-you-need-to-know/
- van der Harst P, Asselbergs FW, Hillege HL, et al; PREVEND-IT Investigators. Effect of withdrawal of pravastatin therapy on C-reactive protein and low-density lipoprotein cholesterol. Am J Cardiol. 2007 Nov 15;100(10):1548-51. doi: 10.1016/j.amjcard.2007.06.054.
- Statin side effects: Weigh the benefits and risks. Mayo Clinic. Accessed August 16, 2024 at https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013
- Kirzinger A, et al Data Note: Prescription Drugs and Older Adults. KFF. August 9, 2019 at https://www.kff.org/affordable-care-act/issue-brief/data-note-prescription-drugs-and-older-adults/
- Consumers Reports. When (and how) to stop taking a drug. Accessed August 9, 2024 at https://www.consumerreports.org/cro/2012/04/when-and-how-to-stop-taking-a-drug/index.htm
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.