Areas › Worry and anxiety › Treatment and medication
A small dose that has not changed in years is not automatically something to fix. Stopping carries risks of its own, and they have to be weighed rather than assumed away.
Coming off can bring withdrawal, a rebound of the original anxiety, and worse if it is done abruptly. Set against the risks of staying on, which are real too, this is a genuine judgement and it belongs to the prescriber and the person together. What often drives a rushed decision is not the evidence at all but embarrassment about being on anything.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not despair of God's mercy (Quran 39:53). Being on a medicine for a long time is not a thing to be ashamed of, and shame is a poor reason to change it.
۞قُلۡ يَٰعِبَادِيَ ٱلَّذِينَ أَسۡرَفُواْ عَلَىٰٓ أَنفُسِهِمۡ لَا تَقۡنَطُواْ مِن رَّحۡمَةِ ٱللَّهِۚ إِنَّ ٱللَّهَ يَغۡفِرُ ٱلذُّنُوبَ جَمِيعًاۚ إِنَّهُۥ هُوَ ٱلۡغَفُورُ ٱلرَّحِيمُ
Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful
Qur’an 39:53read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
There is research showing that people who had taken on shame about having a psychiatric condition were less likely to stay with treatment and more likely to stop their medication on their own. It looked at people at a single point in time, so it cannot show which came first. It does suggest that shame and stopping travel together, which is worth noticing in yourself before you decide anything.
Kamaradova D, Latalova K, Prasko J, Kubinek R, Vrbova K, Mainerova B, Cinculova A, Ociskova M, Holubova M, Smoldasova J, Tichackova A. (2016). Connection between self-stigma, adherence to treatment, and discontinuation of medication.. Patient preference and adherence doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Changing a settled arrangement is itself an intervention, with its own risks to weigh.
When not to
Any change of dose belongs with the prescriber rather than with a decision made at home.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Take a few photographs of your bedroom, then look at them later and circle whatever has to change or go. Seeing the room in a picture shows you things you stopped noticing years ago while standing in it.
How well something works in the moment and whether it is right for the long run are two separate questions. Fast relief is extremely convincing, which is exactly why it is worth pausing over.
There is an older antihistamine used for anxiety that works by making you drowsy and carries no risk of dependence. It suits a rough stretch, and it is a bridge rather than somewhere to settle.