I have to admit that the medication holiday is not a good idea. My son is almost 19 and I have watched him spiral through one diagnosis to another since he was 5 years old. He has been on so many medications and I do feel at times was overmedicated. However, after failing the 11th grade he told me that he wanted to get his GED and join the military. Being from a family with a strong military background I thought this was an excellent idea for him and might just turn his life around. I convinced his doctor to allow him to come off his medications and I admit that he had been on medicine for so long that I was curious as to wether he needed the medication or if his problems were being caused by taking uneccessary meds. I now know that I have made a mistake. Now that he is off the medication he has begun to self medicate heavily and will not even discuss going back on any type of medication at all. Of course the idea of joing the military only lasted until he came off his medicine. Instead of turning back into the sweet loving little boy he once was he has further withdrawn to the point that I feel I don’t even know him anymore. I feel I have lost my son and I don’t know what to do next. Anyone thinkning of taking a medication holiday should seriously discuss it with their doctor and then listen to the doctors advice. Despite my concern that my son was being over medicated to support his doctor I know see that his doctor was only trying to find the right answers for him. Answers that we are now completely without. It is a very scary time for us.

This is an interesting take on drug holidays, and a much better alternative suggested by a psychiatrist.

http://en.allexperts.com/q/Bipolar-Disorder-2192/Bipolar-Medication.htm

Susan

Hi.
You are very funny today… Despite of your sore throat, cough,
headache, fever and stomach ache.
………………………………………………………………………………
Stupid things on the Internet is something usual.
It’s up to you to estimate or check if you are interested.
Bye

Hello,
I have not taken a medication holiday nor have I thought of taking one. However, my husband is trying to tell me to get off all medicine. He doesnt understand bipolar so he doesnt want me on ANY medication. I am continually arguing with him over this. I have no support system really. There is none available in my area. I have a good friend I talk to for about 3-6 hrs a day who listens and understands so she is my rock. She is who I lean on. Thanks for listening. Barbara

David: Your counsel on this matter should be well heeded. When I was first learning about BP I stopped my medications twice. Each time I eventually fell into deep depression. Since then, based on my learning, experience and self education through support groups and books, I have learned that your caution is absolutely correct.

I have become a born-again medication program person. When I hear BP survivors who talk about a medication holiday or not taking meds, I absolutely get livid.

In fact, I have read many books, attended many support groups, and have researched BP extensively on the web. BiPolar Central remains the best source of counsel, education and wisdom that I have seen. This site is remarkable and your efforts cannot be praised enough.

Thanks for you work…and people, take your meds. Alan

I read your letters every day, it’s what helps me through the day. Thank you. Oh ya in your letter you wrote fill sorry for you not me . About not filling good.
think you, Anna

I am in full agreement with you that stopping one’s meds just to take a break is a very, very ill-advised idea. Things like that are why it was a long time before I would even consider trusting things that were promoted on the Internet. Unfortunately, though, whether it’s the Net, TV, magazines, or even irresponsible health care professionals, it’s still “buyer beware” and it is our responsibility as intelligent consumers to question, verify, double-check, and seek wise counsel from those that have shown themselves to be trustworthy. Yes, there are bad doctors out there and I’ve seen a few. I know of one local psychiatrist right now who was just fired as medical director of a treatment facility because his medication prescribing techniques were totally off the wall. He did some real damage before I and others who were more seasoned brought the situation to the owners of the clinic and filed complaints with appropriate state and even federal agencies documenting this doctor’s incompetence. Because I was a patient in the clinic’s outpatient program at the time and was briefly under his care, I saw firsthand what he was doing. He wrote prescriptions for me which I knew would probably catapult me into instability based on past experience with and knowledge of those meds. Although I didn’t have the money for a more expensive but experienced psychiatrist, I managed to get to one, to seek a second opinion. When I told this doctor the kinds of things the other doc was doing, he helped me take things through channels and backed me up when I exposed the first doctor. I am still looking for an affordable yet qualified psychiatrist (is that an oxymoron or what?) but have enough prescription refills for several months while I continue to search.

As a person who has been involved in MEDICAID and MEDICARE for a long time, I feel compelled to warn people who are in treatment with doctors who are either working for state facilities (Here in Texas, that’s MHMR, the department of Mental Health and Mental Retardation) which is the only resource many people have for psychiatric care. These docs, some of whom are very well-intentioned and may actually be good, are often overworked at that agency and you’re lucky if you get ten or fifteen minutes with them every few months. Although the clinic where I had the recent bad experience is a private nonprofit one, most of its patients are low-income and are on MEDICAID, SSI or SSDI and MEDICARE, but fewer and fewer docs in private practice are taking MEDICARE and MEDICAID anymore and that seems to be the trend all over the country. Thankfully, though I am no fan of the current administration and we won’t even go to its foreign policy, I have to say that the MEDICARE Part D drug prescription Act is a good thing. But if those meds covered under that act are not properly prescribed and followed up with, then there will still be problems.

It’s interesting that you bring up the “medication holiday” idea. Believe it or not, it is not new and is not something someone has simply hatched to spread all over the Internet. Unfortunately, it doesn’t work for bipolar disorder or, in fact, for most disorders. Even when changing medications, which should only be done under the supervision of a qualified doctor, going off cold turkey is dangerous. There has been increasing publicity, yes, also on the Internet, about withdrawing suddenly from SSRI antidepressants. They’ve even got a name for it. It’s Serotonin Withdrawal Syndrome. But sometimes, there are no immediate symptoms. Right now I am on a medication which is causing difficult side effects. The psychiatrist with whom I spoke while getting a second opinion after seeing the incompetent doc, agrees that it would be a good idea to slowly titrate down off of this med and go onto another one which does not have some of the undesirable side effects that I have been experiencing. Because some of the side effects are uncomfortable, it is very tempting for me to stop the medication altogether. But long years of experience have taught me that it isn’t worth it, that I could end up back in the hospital or dead. No thanks. I’ll struggle with feeling bad, gaining weight after I’ve tried so hard and lost so much, feeling that drugged, “hungover” feeling, until I can get on the medication that is shown not to cause weight gain and doesn’t have some of the other side effects associated with some of the other meds in that class that I have been on. (Don’t ask. I’m deliberately avoiding naming specific medications because I don’t need to in order to get my point across. I know how good it can sometimes feel to be full of energy, to stay up for days, to get tons of work done, to feel at the peak of performance, to be more creative, to lose the social reticence and become the life of the party. But I know the crashes. I know the depths of despair and darkness, a darkness far more palpable and powerful than physical darkness, that can result from going off meds. We can’t always avoid the highs and lows. But if we go off meds, our chances of getting into major depression, major mania, psychotic episodes and suicide are far greater. Is it really worth it to take that chance?

I had a friend who did it. He was bipolar and stable for awhile. He went off meds and started taking St. John’s Wert. For two years he didn’t have an episode. Then, he disappeared. Several months later, after having plunged into a deep depression, he committed suicide. He was young. He wasn’t stupid. But he thought he could beat the bipolar without meds. Wrong. It just doesn’t work.

The problem with a lot of information on the Internet is that there is a grain of truth in there somewhere but it has been so twisted that whatever small amount of truth may have once been there is gone and has been obscured by deception and outright lies. The “medication holiday” was actually done as a treatment for Parkinson’s Disease. I know a man who had severe Parkinson’s. He was on tons of meds. Sometimes, he’d be taking meds every fifteen to thirty minutes. They gave him some measure of control over his symptoms. But eventually, there were so many meds and they’d start failing to work and then the doctors weren’t sure which meds to discontinue and which to keep. It was a real mess.

Enter the “medication holiday”. But, it was done in a hospital under doctor supervision and it wasn’t for bipolar. The patient’s had their systems cleansed totally of the meds and then new meds were gradually introduced until the correct regimen was found. It is rather analogous to what happens when one is trying to determine exactly what specific foods someone is allergic to. Sometimes, a person, or an animal, is put on a very basic diet of something pretty neutral, then foods are gradually added back. This is not a perfect analogy; analogies seldom are. But, first, I don’t even know if this “medication holiday” treatment is still being done in the case of those with severe Parkinson’s Disease and even if it is and even if it works for that, that doesn’t mean it works for bipolar or other psychiatric disorders. There is overwhelming evidence that going off meds for someone who is bipolar is like playing with fire. Please, please, if you don’t do it for yourselves, do it for people you care about. My friend committed suicide. That is a final act. You can’t take it back. It is devastating to family and friends who care. If an irresponsible health professional is telling you to do that, refuse. If you can’t get prescriptions written for your meds, go to another doctor. Another thing, if meds are so outrageously expensive (and some of mine are) and are not covered by insurance and you don’t have money in any kind of account, investments, or other assetts, like equity from your home, there are still alternatives.Although many drug companies have cut back on or discontinued the special programs they used to have to give free or low-cost drugs to low-income people because they figure they can be covered under the MEDICARE Part D provision, there are still options. I don’t have all the answers. I know that when I got married and moved to where my husband lived, to a state that is, sadly, well known for being near the bottom of the country when it comes to mental health care, when I knew I would no longer be eligible for MEDICAID, I was really scared. Since I’ve been here, I’ve had to spend money I thought I wouldn’t have to get decent care. Going into this outpatient program proved once again that even if I have to make some sacrifices, it’s worth it to get better quality care. I wish it wasn’t like that. I wish there was a way, an easy answer. It’s different for everyone. It just breaks my heart to hear of people having to take less of their meds in order to feed their families. I’m not saying it’s easy. But sometimes I have had to swallow my pride and take food and other aid from places like the Salvation Army, churches, shelters etc. I’ve been homeless. I’ve had to deal with all kinds of organizations. Sometimes I have had to accept what was probably not the best care but at least I got on meds and sometimes, even in the state hospital, I got put on meds that helped me get out of an episode. I hate state hospitals. There’s one in my city. I never want to be there. But please, do what you need to do (hopefully, short of breaking the law), to get on the meds you need. Other things are important too. Getting good sleep, eating as healthy a diet as possible, exercise (you don’t have to pay for a gym membership to do it either and if you’re eating fast food or junk food you’re not really saving, you’re paying a price that doesn’t show on the bill. It’s the price of possible later medical problems, like high cholesterol, diabetes, heart disease, etc. Even the salads aren’t always that nutritious, especially if they’re using iceberg lettuce as most of the fillers.

Now, I know we don’t all have the luxury of eating organic food. I wish I did. Some things are just too expensive. If you’re in a city with decent public transit, it’s better to take it than spend money on gas that could go toward meds. Therapy is important too. But if I had to choose, and I know it’s about more than just meds, I’d put therapy on hold or give up other things, like maybe TV (I don’t have cable), computers, (though I realize they are important and there’s an awful lot of available online support and you do too if you’re reading this), but sometimes I’ve had to get the budget down to bare essentials. I didn’t have a computer until I got married. Prior to my marriage, I literally had no money for anything but basic necessities. I had a roof over my head and clothes on my back and food to eat, though not always what I wanted. I was thankful. Marriage was an unexpected bonus. I figured I’d be single for the rest of my life. When my husband first knew me, he tried to get me to get off my psych meds. Granted, I was able to get off one of them and later make some other changes. But I couldn’t just go off meds. I needed them. I didn’t like it and neither did he. He wasn’t used to that. I’m glad it never came to having to make a choice between him and the meds. that would have been tough! (lol) But honestly, maybe I’m being a little melodramatic but it’s only to stress the importance of keeping on meds and definitely not taking a “medication holiday”. If you do, you may never take a real holiday again.

Hi David,

Its me again. I dont know where that first comment came from? Moderation what? Any way, I was wondering what you do to keep people ON their medication? My friend does not live with me anymore, ( I dont need any more Broken things or torn up plants ). So I am in the dark about that!!!!!
Thanks again,
Dianne

I worked with a Dr. that quit taking her medications and did not let anyone know, she had a husband and three teenage girls, she went to take the dog for a walk one evening while her entire family was at home.
The dog came back by itself, with no leash, which made her husband wonder, when he went out on the back deck to look for his wife, she had hung herself with the dogleash.
Her daughters and husband will never get that image out of their minds.
Not only is it stupid to stop taking your meds, IT IS SELFISH!!!!!!!!

Hi David

I”ve been on medication now for 18 years and had an E.C.T. My medication have been changed almost every year. The reason being is that the effect of the medication wears of although I am on my meds I still experience depression and manic episodes while using it regularly. The fact is that I experience both episodes and it really confuses me. The psychiatrist that I visit currently don’t have an idea on which medication next as I have been on all of them and after a year or two the medication must be changed again. This is all very depressing, but I always find a solution to the problem. Since last week I have experience that I am losing it again and I sometimes feel like giving up, but you have changed my life by sitting here chatting to someone that understand how I feel make a difference. I have many a time tried to give up on meds, and survived two tempted suicides. I would like to reach out to people with BPD. PLEASE DO NOT EVEN TRY TO GIVE UP ON YOUR MEDS not for a friend or family members it is your life and yours alone. KEEP UP WITH YOUR MEDS AND STAY ALIVE.
THANK YOU DAVE FOR YOUR INSPIRATION!!!

I completely agree that medication holidays are not good. I had a therapist suggest it once 8 years ago to me but it sounded nuts even then and I wasn’t near stable.
I have been off my meds twice in the last year but not by my choice. The first was last fall when I was hospitalized with Sepsis. I was admitted through ER and was very sick. I had a temperature and was vomiting. Sepsis kills most of the time. It is a serious infection caused by staph that caused the body to shut down and go into organ failure. It was treated with very strong IV antibiotics for 3 days, then 2 weeks of strong oral antibiotics. I was off my meds while in the hospital due to possible interactions between the meds. It was no bp meds and live or bp meds and die. Some choice, eh?
I was off my meds for almost a week. First because nothing, not even water would stay down and then in the hospital – on the contageous floor to no less. When I found out where I was I had to laugh. I was the youngest one on the ward by 40 years – I was in a hospital primarily for older people. As a result I plunged into a deep depression. Some was from not being on my meds and some from circumstances in my life. The doctor I see wanted to hospitalize me. It was mid-December by them. My other birthday – as an adopted child I have 2 birthdays, when I was born and 7 months later when my parents got me – was that weekend. I promised that if I was still so depressed on Monday that I would go to the hospital on Monday. I stayed the weekend with my mom and by Monday I was feeling a bit better.
Then a month ago I ran out of meds for 2 weeks. Not my fault – really! To deal with most of the reasons causing the depression I moved to India to be with my husband. My doctor in the States, swore I could get all my meds here in India. She was born and raised here and visits every year. I was given 3 months supply so I wouldn’t run out before I could find more and another doctor. Well, since I was very stable when I left she said she would still prescribe my meds because sometimes up to 60% of meds sold here in India are counterfit. Which could make me very ill.
Since I am on SSI, I can only see the county doctor I’m assigned to. There are 2 doctors in my clinic and my case worker is NOT allowed to speak to him – no matter what the crisis. Real good, eh? Anyways, my doctor was on vacation for 6 weeks in central India of all places. I was out of refills and could not get refills. My meds are not available here – my husband looked in almost every pharmacy in the city. He is the sweetest man. Well by the time my came back from vacation, refilled and my mom was able to send my meds – I was 2 weeks without. It almost cost me my marriage. I started spiraling into rage and depression that a month later am just starting to come out of.
And I never strive to be normal. Normal is simply a town in Illinois or a setting on the wash machine.

is there any way i can ask you questions im a single mom of 3 with bipolar and really no income to speak of. all i have for support is a mom with bipolar as well and she has no insurance to get help either and she lives with the rest of my family dont want any thing to do with us.noone to talk to.

Hi David

I do not wish to receive any more emails from you. It is clogging up my inbox at work.

Thank you for understanding

Regards

Deonette