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How do you help patients get off medications?

March 23, 2017

I frequently get asked by practitioners new to functional medicine how and when to take patients off of medications.

vitaminmyth

When I am thinking of helping a patient get off a medication, I always have lifestyle, diet, and nutriceutical interventions in place first. The time to consider whether to taper off of a medication is after several months of consistent practice and clear benefits from lifestyle changes.  Then I always consider the half-life of the medication and the interactions between other supplements and medications. Usually, it’s best to taper off one medication at a time.

For example, with a patient experiencing depression taking a SSRI medication (prozac, paxil, zoloft, celexa, etc), I would get them working on sleep, exercise, diet/digestion, stress reduction, stress management, positive relationship development, and finding and creating and connecting to purpose in their lives. Then, after months of consistent practice and benefits, I would taper them off the medication SLOWLY, considering the half-life. If the half-life is 10 days, then I would reduce their dose by 25% every 2 weeks. When the patient was down to 10-20% of the original dose, I might mix in moderate 5HTP (50-100mg QD-BID).

With blood pressure and blood sugar medications, the same applies, except that the lifestyle measures may decrease the need for the medication and push blood pressure/sugar too low if you keep the patient on the medication at the same dose. These kinds of medications require the patient to do more frequent monitoring, and the medication will usually need to be stepped down as the lifestyle changes are having their effects.

If a practitioner cannot prescribe the medication in question, it is never ethical or advisable to recommend a patient stop taking that medication. Instead, they should encourage the patient to work with their prescribing provider or another provider who can prescribe that medication.

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