Tapering off antidepressants
In January 2021, the first tapering clinic in the Netherlands was opened by GGZ InGeest and Amsterdam UMC. Here, a team of psychiatrists, nurse specialists, psychologists and pharmacists provide advice and treatment for stopping antidepressants. The experiences they gain are used for scientific research.
Patients from all over the Netherlands can contact the tapering clinic with a referral from their GP. After an intake, it is decided whether a patient can start tapering off and if so, how. Not everyone is advised to (already) start tapering. “I think for some people taking antidepressants for life really is best. But there are also many people who can stop.” says psychiatrist Christiaan Vinkers of the finishing clinic.
Special finishing policy
A second tapering outpatient clinic has recently been set up at GGZ Noord-Holland Noord. Here, a team of psychiatrists, psychologists, nurse specialists and pharmacists work together to help people taper off psychotropic drugs. In addition to helping to taper off antidepressants, they also help to taper off antipsychotics, sleeping pills and tranquilizers, mood stabilizers, and ADHD medications. This special tapering outpatient clinic in Hoorn has so far only been accessible to clients of the mental health institution itself.
pharmacies
Pharmacists are the medication specialists who know everything about medicines in relation to diseases and possible side effects of medicines. In addition, they can help with dosages. There is a large group of pharmacists who help people reduce their medication. This care is not yet standardly reimbursed by health insurers. There’s a lot of discussion about this.
The Transvaal Pharmacy in The Hague is working on a pilot project that is reimbursed by large insurers such as VGZ, CZ and Zilveren Kruis. At this pharmacy they offer a personally tailored tapering process with guidance for tapering off antidepressants. The Transvaal Pharmacy is also a so-called compounding pharmacy, which allows them to prepare an adjusted dose of antidepressants if necessary.
Taperingstrips
The Rainbow Pharmacy in Alkmaar has developed a tapering method for antidepressants that works with so-called ‘tapering strips’. The pharmacy packs tailor-made tapering medication in daily doses.
“A 4-week tapering strip consists of 28 plastic bags, each containing the medication for one day. The daily dose in each sachet is chosen so that each day is slightly lower than or equal to that of the previous day. Practitioners can prescribe tailor-made tapering schedules in consultation with the patient.”
Currently, this method is only reimbursed by a few smaller health insurers. The inventor of this tap ring strip method is currently conducting legal proceedings to enforce reimbursement by health insurers.
Looking for more information?
There is hardly any scientific knowledge about the responsible phasing out of psychotropic drugs. Psychiatrist Remke van Staveren wrote the book “Swallow less”. She has mainly combined her psychiatric knowledge with knowledge of experts by experience in order to arrive at a responsible self-help book. For more information about phasing out, you can also contact peer groups that are active on social media. For example, you have two Facebook groups: Safe and Responsible Tapering and Antidepressants, and then! Here you can share experiences and ask questions.