Adjunctive yoga therapy for weaning off psych meds: A therapist’s notes on discontinuation of psychotropics

Apr 25, 2019 | Blog | 3 comments

By Cheryl Hurst

Patients taking psychotropic medications—prescription drugs like antidepressants and antipsychotics—shouldn’t suddenly stop taking them because of their potential withdrawal effects. Physicians significantly reduce the risk of unpleasant and destabilizing symptoms by systematically tapering down the doses of these medications to wean patients off over time.

Photo by Anastasia Dulgier

Because I have a background in health psychology, clients have called on me to assist them in tolerating the discontinuation process using yoga therapy as a support. (Note that I’m NOT talking here about folks who are using psychotropics to their advantage, only those clients who initially reach out with “getting off psych meds” as a primary goal.)

We don’t yet have yoga therapy studies in this area, but psychology research has long addressed the use of psychotherapy in discontinuing psychotropics. My training and experience has pointed me toward a viable model for how to manage the process safely with yoga therapy clients.

New possibilities

First, it is essential to work in conjunction with the client’s doctor and healthcare team, whether directly or through the client. Understanding the intended use of the medications guides yoga therapy care planning.

Next, guided by medical staff, comes a tentative tapering schedule that takes into account the practicalities of clients’ lives. Early on, I focus on helping them to build a repertoire of self-management skills—before the medical team adjusts any medications.

The next priority is to identify and teach nonpharmacological self-management strategies that fit the client’s needs and lifestyle. For someone weaning off anti-anxiety meds, I might teach tailored relaxation strategies like restorative forward-bending poses and calming breathwork. Practices like pratyahara (sensory withdrawal) can quickly reduce nervous system overstimulation. I also teach clients strategies from yoga philosophy, including pratipaksha bhavana, or cultivating the opposite, to address negative thinking.

Discontinuing antidepressants such as SSRIs or SNRIs usually requires techniques that not only quell anxiety but also boost energy and uplift mood. For example, inversions are thought to help clear the mind and fight fatigue, a symptom of depression, while supportive chest-opening poses like supta baddha konasana (reclined bound angle) may help to boost mood. When mood stabilizers are being discontinued, practices to counter anxious and depressive symptoms and poses for grounding are often foundations of self-management.

With SNRIs used for a coexisting pain condition, planning can become complicated if the patient is still getting some pain relief from the medications during the tapering period. Effectively addressing pain depends on patient experience and self-report, so this scenario provides a good example of adjusting the plan to reflect what’s actually happening for the client over time.

Medical guidance is very important for safety throughout the sensitive process of discontinuing psychotropic medications. Yoga therapy can provide a useful adjunct by helping to empower patients through training in practical self-soothing strategies that naturally counter potential withdrawal effects during and after the transition.

Cheryl Hurst, PsyD, C-IAYT, is a health psychologist and yoga therapist offering psychotherapy and yoga therapy in downtown Chicago. She has 20 years of experience helping clients heal from the inside out.