Symposium Absetzen - Weltpsychiaterkongress Oktober in Berlin
Verfasst: 10.10.2017 12:30
Am 11.10. findet ein Symposium mit Vorträgen zum Thema "Absetzen" statt.
Peter Lehmann und Andreas Heinz zeichnen verantwortlich.
http://www.wpaberlin2017.com/programme/ ... ession/118
Vortragende
Peter C. Gøtzsche, Copenhagen, Denmark
001 –International institute for psychiatric drug withdrawal
In October 2016, eleven people from seven countries that included former patients, psychiatrists, psychologists, therapists and scientists decided to open an International Institute for Psychiatric Drug Withdrawal acknowledging that many millions of patients have become dependent on psychiatric drugs and have difficulty coming off them, which leads to poor long-term outcomes with increasing rates of disability pensions. It is one of the biggest health problems we have but very little is done to help these patients taper off their drugs safely. Unfortunately, some health professionals believe that dependence is only a problem with benzodiazepines although it has been amply documented that this is also a huge problem for other classes of psychiatric drugs, e.g., also for antidepressants and antipsychotics. Research, education, and establishment of withdrawal clinics and helplines are some of the initiatives we will undertake and support worldwide.
http://www.wpaberlin2017.com/programme/ ... stract/100
Tom Bschor, Berlin
002 –Do antidepressants cause dependence? A comparison to benzodiazepines with special regard to withdrawal reactions
Er sagt, es gibt zwar Absetzschwierigkeiten, aber das sei nicht als Abhängigkeit zu betrachten.
Only about 20 years after being introduced into the market, it was widely accepted that benzodiazepines can cause dependence. Besides other symptoms, marked withdrawal reactions, often forcing the individual to re-use the drug, illustrated the addictive power of benzodiazepines. Within the last 20 years, a steep rise in the prescriptions of antidepressants happened. Severe withdrawal reactions occur after cessation of antidepressants as well, frequently, but not only, after the termination of SSRIs. These reactions also hinder attempts to stop the medication. Being of a distinct characteristic, withdrawal symptoms are not simply the return of the pre-treatment depression. One characteristic is their immediate disappearance after re-administration of the antidepressant.
Some experts argue that these withdrawal reactions are indicative of antidepressant dependence. However, dependence is a disease characterized by a set of physical and psychological changes. The following can typically be observed in benzodiazepine-dependent patients, but not in patients on antidepressants: intake to experience an immediate effect; dose-increase, tolerance and intake several times a day; progressive neglect of alternative pleasures or interests because of psychoactive substance use; increased amount of time necessary to obtain or to stockpile the drug; illegal ways of obtaining the drug (hardly any black market for antidepressants exists).
Diagnosing dependence by the occurrence of a withdrawal reaction only would ignore the psychological dimensions of dependence. Hence, antidepressants often cause withdrawal symptoms, but typically not dependence as benzodiazepines do. Antidepressants have a latency of onset of the desired effect, which is usually supposed to be a disadvantage of this class of drug. However, the lack of an immediate effect of antidepressants is probably the most important factor preventing dependency.
http://www.wpaberlin2017.com/programme/ ... stract/101
Volkmar Aderhold, Greifswald
003 –The withdrawal of neuroleptics: When to do so? How? When not to do so? What then?
Early guided withdrawal attempts are beneficial because of the adverse brain changes caused by neuroleptics, and they also serve to achieve the lowest possible dose.<BR>Non-compliance to neuroleptics is consistently high (between 50% and 75%). This is often a reaction to strong side-effects and low efficacy, and tends to result in professionally unguided and often hazardous withdrawal attempts. What is needed, therefore, is the development of a cooperative practice of reduction and withdrawal, so as not to leave affected persons and relatives on their own, exposed to high risk as well as physical and psychological strain. We need multi-professional outpatient teams, including experts by experience/peer professionals, who have the skill to help people to reduce/withdraw, in addition to other effective psychotherapeutic practices.<BR>Positive predictors of successful withdrawal from the few existing studies can help us to judge the feasibility of withdrawal/reduction. Social support is one of the central predictors. In addition, negative predictors, as well as contraindications for withdrawal, can be identified.<BR>Questions that need clarification, as well as advisable steps in preparing a withdrawal attempt, will be presented. Then a procedure for reduction will be outlined, as well as phenomena that may occur when reducing/withdrawing from neuroleptics. Through such a practice we can learn more about the different pharmacological strategies needed for the treatment of the very heterogeneous (in cause and course) syndrome called “schizophrenia,” and develop the best possible cooperation with all those affected.
http://www.wpaberlin2017.com/programme/ ... stract/102
Laura Delano, Medford, MA, USA
004 –Start low, go slow – bridging the divide between the lack of clinical research on safe psychiatric drug withdrawal protocols and the growing evidence base of successful tapering methodologies by users of psychiatric drugs
Users of psychiatric drugs are developing sophisticated tapering protocols that are yielding positive outcomes-including among those who've been on multiple drugs for many years. This presentation will elucidate this growing, rich but largely unrecognized “underground” anecdotal evidence base of tapering methodologies to spark a conversation about how we might bridge the divide between those who have come off psychiatric drugs and helped others do so safely and successfully, and the psychiatric profession.
http://www.wpaberlin2017.com/programme/ ... stract/103
Peter Lehmann und Andreas Heinz zeichnen verantwortlich.
http://www.wpaberlin2017.com/programme/ ... ession/118
Vortragende
Peter C. Gøtzsche, Copenhagen, Denmark
001 –International institute for psychiatric drug withdrawal
In October 2016, eleven people from seven countries that included former patients, psychiatrists, psychologists, therapists and scientists decided to open an International Institute for Psychiatric Drug Withdrawal acknowledging that many millions of patients have become dependent on psychiatric drugs and have difficulty coming off them, which leads to poor long-term outcomes with increasing rates of disability pensions. It is one of the biggest health problems we have but very little is done to help these patients taper off their drugs safely. Unfortunately, some health professionals believe that dependence is only a problem with benzodiazepines although it has been amply documented that this is also a huge problem for other classes of psychiatric drugs, e.g., also for antidepressants and antipsychotics. Research, education, and establishment of withdrawal clinics and helplines are some of the initiatives we will undertake and support worldwide.
http://www.wpaberlin2017.com/programme/ ... stract/100
Tom Bschor, Berlin
002 –Do antidepressants cause dependence? A comparison to benzodiazepines with special regard to withdrawal reactions
Er sagt, es gibt zwar Absetzschwierigkeiten, aber das sei nicht als Abhängigkeit zu betrachten.
Only about 20 years after being introduced into the market, it was widely accepted that benzodiazepines can cause dependence. Besides other symptoms, marked withdrawal reactions, often forcing the individual to re-use the drug, illustrated the addictive power of benzodiazepines. Within the last 20 years, a steep rise in the prescriptions of antidepressants happened. Severe withdrawal reactions occur after cessation of antidepressants as well, frequently, but not only, after the termination of SSRIs. These reactions also hinder attempts to stop the medication. Being of a distinct characteristic, withdrawal symptoms are not simply the return of the pre-treatment depression. One characteristic is their immediate disappearance after re-administration of the antidepressant.
Some experts argue that these withdrawal reactions are indicative of antidepressant dependence. However, dependence is a disease characterized by a set of physical and psychological changes. The following can typically be observed in benzodiazepine-dependent patients, but not in patients on antidepressants: intake to experience an immediate effect; dose-increase, tolerance and intake several times a day; progressive neglect of alternative pleasures or interests because of psychoactive substance use; increased amount of time necessary to obtain or to stockpile the drug; illegal ways of obtaining the drug (hardly any black market for antidepressants exists).
Diagnosing dependence by the occurrence of a withdrawal reaction only would ignore the psychological dimensions of dependence. Hence, antidepressants often cause withdrawal symptoms, but typically not dependence as benzodiazepines do. Antidepressants have a latency of onset of the desired effect, which is usually supposed to be a disadvantage of this class of drug. However, the lack of an immediate effect of antidepressants is probably the most important factor preventing dependency.
http://www.wpaberlin2017.com/programme/ ... stract/101
Volkmar Aderhold, Greifswald
003 –The withdrawal of neuroleptics: When to do so? How? When not to do so? What then?
Early guided withdrawal attempts are beneficial because of the adverse brain changes caused by neuroleptics, and they also serve to achieve the lowest possible dose.<BR>Non-compliance to neuroleptics is consistently high (between 50% and 75%). This is often a reaction to strong side-effects and low efficacy, and tends to result in professionally unguided and often hazardous withdrawal attempts. What is needed, therefore, is the development of a cooperative practice of reduction and withdrawal, so as not to leave affected persons and relatives on their own, exposed to high risk as well as physical and psychological strain. We need multi-professional outpatient teams, including experts by experience/peer professionals, who have the skill to help people to reduce/withdraw, in addition to other effective psychotherapeutic practices.<BR>Positive predictors of successful withdrawal from the few existing studies can help us to judge the feasibility of withdrawal/reduction. Social support is one of the central predictors. In addition, negative predictors, as well as contraindications for withdrawal, can be identified.<BR>Questions that need clarification, as well as advisable steps in preparing a withdrawal attempt, will be presented. Then a procedure for reduction will be outlined, as well as phenomena that may occur when reducing/withdrawing from neuroleptics. Through such a practice we can learn more about the different pharmacological strategies needed for the treatment of the very heterogeneous (in cause and course) syndrome called “schizophrenia,” and develop the best possible cooperation with all those affected.
http://www.wpaberlin2017.com/programme/ ... stract/102
Laura Delano, Medford, MA, USA
004 –Start low, go slow – bridging the divide between the lack of clinical research on safe psychiatric drug withdrawal protocols and the growing evidence base of successful tapering methodologies by users of psychiatric drugs
Users of psychiatric drugs are developing sophisticated tapering protocols that are yielding positive outcomes-including among those who've been on multiple drugs for many years. This presentation will elucidate this growing, rich but largely unrecognized “underground” anecdotal evidence base of tapering methodologies to spark a conversation about how we might bridge the divide between those who have come off psychiatric drugs and helped others do so safely and successfully, and the psychiatric profession.
http://www.wpaberlin2017.com/programme/ ... stract/103