The withdrawal from psychiatric medication tapering can be incredibly complex, and doing it safely requires both medical and psychological support. But, as Dr. Anders Sørensen highlights in this interview, the guidelines around medication tapering and withdrawal miss a lot of important nuances that can prevent people from being successful. In this interview, psychologist and PhD researcher Dr. Anders Sørensen shares his decade-long experience helping people taper off psychiatric medications. He covers the biological and emotional aspects of withdrawal, the science behind tapering strategies like hyperbolic tapering, and why psychotherapy plays a vital role during and after the process. You'll also learn how short-term clinical studies shaped medical guidelines and why those guidelines may not reflect the lived experience of long-term patients. Timestamps: 0:00 - Introduction to Dr. Anders Sørensen and deprescribing psychiatric medications. 5:07 - The context around deprescribing medications. 8:13 - How does the research around deprescribing medication compare to what is seen in the personal experience of patients? 12:19 - Synthetic drugs vs the natural brain. How does the brain respond to these drugs? How does this lead to withdrawal? 20:10 - How is tapering medication individualized for a patient? 26:27 - What is the difference between mild and severe medication withdrawal? 30:34 - What happens after someone is off medications? How do people’s experiences change 41:40 - Where to hear more from Anders Sørensen. :::spoiler summerizer Summary This video features an in-depth interview with Dr. Andrew Sorenson, a Danish psychologist with a PhD in psychiatry, who specializes in helping people safely taper off psychiatric medications and manage their emotional recovery afterward. The discussion addresses the significant disconnect between clinical guidelines on medication withdrawal and the real-world experiences of patients. Dr. Sorenson explains that current guidelines, based on short-term studies, often describe withdrawal symptoms as mild and brief, which contradicts the prolonged and severe symptoms many patients endure after long-term use. He emphasizes that withdrawal symptoms are a physiological response to the brain’s adaptation to the synthetic substances introduced by psychiatric drugs. Dr. Sorenson stresses the importance of a carefully managed tapering process, known as hyperbolic tapering, which involves very small, gradual dose reductions, especially at lower doses where the drug’s effects are most potent. He highlights that stopping medications too quickly can lead to severe withdrawal symptoms that may be mistaken for relapse or illness recurrence, causing patients to believe they need the drugs indefinitely. The tapering process must be personalized, as rigid schedules do not suit everyone. Beyond tapering, the interview explores the emotional and psychological challenges that arise once medications are discontinued. Dr. Sorenson advocates for psychotherapy to help individuals reconnect with their emotions, understand their triggers, and develop internal emotional regulation skills—an essential part of sustaining recovery. He discusses how psychiatric drugs often numb emotions, and coming off them can lead to a difficult but ultimately liberating process of “waking up” to oneself. Importantly, Dr. Sorenson acknowledges that psychiatric medications are neither inherently good nor bad and that many people benefit from them. However, the body’s biological adaptation to these drugs means that cessation requires care and support. He also underscores the complementary role of metabolic and lifestyle therapies, such as ketogenic diets, which can aid in managing symptoms during tapering and beyond. Throughout the interview, Dr. Sorenson calls for an update to clinical guidelines to reflect the lived experiences of patients, better education for clinicians, and a more integrated approach combining medical, psychological, and lifestyle support for people coming off psychiatric medications. Highlights 🧠 Dr. Andrew Sorenson bridges psychology and psychiatry to help patients safely taper off psychiatric medications. ️ Clinical guidelines underestimate the severity and duration of withdrawal symptoms after long-term drug use. Withdrawal symptoms occur because the brain adapts to synthetic drugs and must readjust during tapering. Hyperbolic tapering—very gradual dose reduction—is crucial, especially at lower doses, to minimize withdrawal. Emotional recovery post-tapering requires psychotherapy to help patients understand and regulate feelings returning after drug cessation. Metabolic and lifestyle therapies, including ketogenic diets, can support tapering and emotional well-being. Dr. Sorenson advocates for updated guidelines, clinician education, and holistic care to improve withdrawal experiences. Key Insights 🧬 The Disconnect Between Guidelines and Reality: Current psychiatric withdrawal guidelines are primarily based on short-term studies (8-12 weeks), yet many patients take medications for years. This leads to a mismatch where guidelines describe withdrawal as short-lived and mild, while real-world patients experience prolonged, severe symptoms. This disconnect causes confusion and self-blame, as patients believe their symptoms mean relapse or personal failure, not withdrawal. Updating guidelines to include long-term use data is critical for better patient care and clinician awareness. ️ Homeostasis and Brain Adaptation: Psychiatric medications are synthetic compounds that alter neurotransmitter activity. The brain’s homeostatic mechanisms counteract these changes by adjusting receptor sensitivity and neurotransmitter production. This biological adaptation means that when medication is reduced or stopped, the brain is temporarily out of balance, producing withdrawal symptoms. Understanding this mechanism reframes withdrawal symptoms not as signs of illness recurrence, but as physiological signals to taper more cautiously. Hyperbolic Tapering and Dose Sensitivity: The effect of psychiatric drugs is not linear to the dose. At higher doses, larger reductions can be tolerated, but at lower doses, even small decreases can cause disproportionate withdrawal symptoms. This necessitates hyperbolic tapering, involving dose reductions as small as 3-10% of the previous dose, sometimes requiring dissolution or compounding of pills. This nuanced approach challenges the common “cut by X% every Y weeks” advice and demands individualized, flexible tapering schedules. Withdrawal vs. Relapse—A Crucial Distinction: Withdrawal symptoms and relapse of the original mental health condition are often conflated. Withdrawal symptoms arise from neurochemical imbalance during tapering, whereas relapse indicates the return of the underlying illness. Misinterpreting withdrawal as relapse leads patients to restart medications unnecessarily, perpetuating dependency. Recognizing withdrawal’s temporal nature and managing it through slower tapering and supportive therapy can prevent this cycle. Psychotherapy as an Integral Part of Coming Off: Psychiatric medications often numb or distort emotions. When medications are withdrawn, emotions resurface strongly and sometimes painfully. Psychotherapy plays a vital role in helping patients identify, understand, and regulate these emotions rather than suppressing or fearing them. Teaching emotional literacy, acceptance, and internal locus of control enables patients to navigate this transition healthily, reducing the risk of emotional overwhelm and relapse. Lifestyle and Metabolic Interventions Support Withdrawal: Psychological tools alone may not address all symptoms experienced during tapering. Dr. Sorenson highlights the importance of metabolic therapies, such as ketogenic diets, to alleviate physical and emotional symptoms like inner restlessness and anxiety. Integrating diet, exercise, and other lifestyle factors with tapering and psychotherapy can create a more comprehensive support system for patients, enhancing outcomes and quality of life. Need for Holistic, Informed Care and Education: The current psychiatric system often lacks sufficient training and resources for managing withdrawal effectively. Dr. Sorenson’s work emphasizes the need for clinicians to be educated on the complexities of withdrawal, including hyperbolic tapering and emotional support strategies. Additionally, patients benefit from access to multidisciplinary teams combining medical, psychological, and metabolic expertise. Shifting the narrative away from blaming patients toward validating their withdrawal experiences is essential for compassionate care. Conclusion This interview sheds critical light on the challenges faced by individuals withdrawing from psychiatric medications and the gaps in current clinical practice and guidance. Dr. Sorenson’s expertise reveals that withdrawal is a complex physiological and psychological process requiring slow, individualized tapering and comprehensive emotional support. His call for updated guidelines, clinician education, and integrated therapeutic approaches aligns with a growing movement to improve patient-centered care in psychiatry. The insights provided offer hope and practical direction for patients and providers navigating the difficult journey of coming off psychiatric drugs. :::