Jul 6, 2018
On MIA Radio
this week, Akansha Vaswani and Dr Peter Groot discuss Tapering
Strips, a novel and practical solution for those who wish to taper
gradually from a range of prescription drugs.
Akansha is a doctoral candidate
at the University of Massachusetts, Boston and her dissertation
research will involve interviewing psychiatrists in the US about
their experiences helping people stop or reduce their dose of
antidepressant medication. Dr Groot is a researcher and geneticist
who has led the development of Tapering Strips.
In a recent study, published in
the journal Psychosis, Dr Groot, together with Jim van Os, reported
on the results of their trial which recorded the experiences of
people using Tapering Strips.
In this episode we
- What motivated Peter to be
interested in and study the effects of coming off antidepressants
- That the observational study
reported in Psychosis was based on questionnaires completed by
users who had made use of tapering medication (Tapering Strips) to
slowly reduce their medication dosage.
- How the questionnaire asked
about withdrawal symptoms and the ease of tapering using the strips
and whether people had tried to withdraw previously using
- That Tapering Strips offer a
flexible and necessary addition to standard doses that have been
registered by the pharmaceutical companies.
- That current guidelines advise
doctors to let patients start on the same recommended dose of an
antidepressant, without taking into account large differences that
exist between patients (weight, sex, etc).
- How we would be surprised if,
when we came to buy shoes or clothes, our choices were limited to
only a few sizes, but we don’t question this limitation with our
- How current guidelines are based
on group averages and do not help a doctor to determine how a given
individual patient should taper.
- How shared decision making, in
which the patient and the doctor work in a collaborative way, can
make tapering easier.
- How shared decision making has
contributed to the success of the use of tapering medication and
the availability of tapering medication makes shared decision
making practically possible.
- How shared decision and the
availability of tapering medication makes life easier for the
doctor as well as for the patient.
- How working initially as a
volunteer to develop Tapering Strips brought Peter into contact
with Professor Jim van Os and the User Research Centre of
- That, in the study, 1,750
questionnaires were sent, with 1,164 received, a response rate of
- Of those returned, 895 said
their goal was to taper their antidepressant drug completely and
70% succeeded in this goal.
- That the median time taken for
people in the study to withdraw from Venlafaxine was 56 days or two
- There were a variety of reasons
reported for those who didn’t reach their goal, including the fact
that some of the patients were still tapering.
- Other reasons reported for not
withdrawing completely were due to the occurrence of withdrawal
symptoms, relapse of an original condition or even issues related
to reimbursement of the cost of the tapering medication by
- That 692 patients reported that
previous attempts to withdraw had failed in comparison to the
successful use of Tapering Strips.
- That people using multiple drugs
should only ever taper one medication at a time and in discussion
with a medical professional.
- That Peter’s goal for Tapering
Strips is to make sure that people that want to withdrawal
gradually can access Tapering Strips and have the cost reimbursed
by health insurers.
- That Tapering Strips were not
developed to get everyone off their antidepressant drug but to
enable patients to get to a dosage that provides benefit for them
(which can be zero) while minimising adverse effects.
- That people outside the
Netherlands can get Tapering Medication, but only with a
prescription signed by a certified doctor, instructions and
receipt/order forms can be found at taperingstrip.org.
- That Tapering Strips are also
available for antipsychotics, sedatives (benzodiazepines),
analgesics and for some drugs other than psychotropics, like some
anti-epileptic drugs, which are currently being
- That Peter warns against
tapering by taking doses on alternating days, particularly for
drugs like paroxetine or venlafaxine that have a short metabolic
half-life, because this will lead to more severe withdrawal
Tapering Strips (website of the
User Research Centre of Maastricht University)
Treatment guidelines for the use of tapering strips
Summary of the tapering study in the journal Psychosis
Tapering Strips study from the journal Psychosis
Peter Groot interviewed on Let's Talk Withdrawal
Claire shares her
experience with Tapering Strips (YouTube)
Petition requesting use of Tapering Strips in the UK
Mad in America report on Tapering strips study
Time for Shared Decision Making
Shared Decision Making
© Mad in America 2018