MyDeprescriber.com | Podcast Guru

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Coming off psychiatric medication, low and slow. Real stories and plain-English science about coming off psychiatric medication safely, from the team behind MyDeprescriber.com. For people on a taper, the people who love them, and the providers who guide them. Coming off an antidepressant, a benzodiazepine, a sleeping pill or an antipsychotic is a medical process, and most people go into it with less guidance than they had going on. MyDeprescriber.com is the podcast for that gap. Each episode takes one question people actually ask and answers it plainly: Why do the last few milligrams feel harder than the first? What is the difference between withdrawal and relapse, and why do they get confused? What does "low and slow" really mean in practice? What is a hyperbolic taper? When should a taper pause? You will hear from providers trained in deprescribing, from people partway through a taper or on the other side of one, and from the MyDeprescriber team, who read the research so you do not have to. Everything we say is backed by published evidence, and we tell you when the evidence is thin. This show is for three kinds of listeners: people who are tapering or thinking about it, the family and friends supporting them, and clinicians who want to do this well. If that is you, welcome. MyDeprescriber.com is a directory of providers who help people taper psychiatric medication safely, and the home of The Deprescriber's Playbook, a certification course for clinicians. Find a provider near you at mydeprescriber.com/find-a-provider. This podcast is education, not medical advice. Never stop or change a medication without talking to your own provider first.

Recent Episodes

Can you just stop Ambien? What a safe Z-drug taper looks like

Zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata) are labeled for short-term use, often 7 to 35 nights, because the benefit shrinks over weeks and months while the risks creep up. This episode walks through what that means if you have been taking one every night for far longer, and what the 2019 FDA boxed warning for complex sleep behaviors covers. We cover the taper itself: cutting the dose by about 25% every two weeks, a worked zolpidem example from 10 mg down to alternate nights, why the last step is usually the hardest, and why the whole thing often takes 8 to 16 weeks and sometimes six months or more. We also cover rebound insomnia, the short stretch of worse sleep after a cut that usually fades within a week or two, and CBT-I, the structured 4 to 8 session program that is first-line for long-term insomnia. Read the full guide: How to Safely Come Off Z-Drugs. Find a provider trained in deprescribing: mydeprescriber.com/find-a-provider. The hosts of this episode are AI-generated from our written guide. Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.

16 MIN

Oxybutynin, Detrol, Vesicare: how do you come off a bladder pill?

Bladder anticholinergics such as oxybutynin, tolterodine (Detrol) and solifenacin (Vesicare) calm an overactive bladder by blocking acetylcholine. That is also why they can bring dry mouth, constipation, blurry vision, trouble emptying the bladder and mental fog, and why this class gets reviewed rather than renewed year after year. This episode covers what the American Geriatrics Society Beers Criteria says about oxybutynin and the wider antimuscarinic class in older adults, what the research on anticholinergics and dementia does and does not show, and which drugs in a different class work through another receptor. It also covers the practical part: why behavioral steps such as bladder training and pelvic floor exercises come first and need weeks of honest effort, what a planned step-down with your provider can look like, what a short rebound in urgency means, and what tends to improve after stopping. Full guide: How to Safely Come Off Bladder Anticholinergics. Find a provider trained in deprescribing: mydeprescriber.com/find-a-provider. The hosts are AI-generated from the written guide. Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.

25 MIN

What happens if you stop tizanidine suddenly?

Tizanidine (Zanaflex) is a skeletal muscle relaxant prescribed for muscle spasms, cramping and tightness, including in multiple sclerosis and spinal cord injury. It clears quickly, with a half-life of about 2.5 hours, and that fast clearance is part of why stopping it abruptly can go badly. This episode walks through what the written guide covers: the reactions reported after abrupt discontinuation, which are rebound high blood pressure, a fast heart rate, and muscle tone returning, sometimes worse than before, along with tremors, anxiety and headaches, usually within hours to a day or two. It also covers who is most at risk, including people taking around 20 to 28 mg a day, people who have been on it nine weeks or longer, and people also taking an opioid pain medicine, and why older adults clear tizanidine about four times slower than younger people. On pace: the FDA suggests decreasing the dose by 2 mg to 4 mg per day, and real tapers run from a couple of weeks to a month or more depending on the dose and how long the medicine has been taken. Read the full guide: How to Safely Come Off Tizanidine (Zanaflex). To find a clinician trained in deprescribing, see the provider directory. The hosts of this episode are AI-generated from the written guide. Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.

24 MIN

Coming off baclofen: why stopping suddenly is the risk

Baclofen is prescribed for muscle spasticity, often in multiple sclerosis or after a spinal cord injury. This episode walks through what the FDA label says about stopping it: abrupt withdrawal has resulted in hallucinations, seizures, high fever, altered mental status, and rebound spasticity worse than before treatment. We cover why timing matters. Baclofen has a half-life of only about six hours, so a missed dose drops blood levels quickly. We also cover what a taper usually looks like: lowering the daily dose by around 5 to 10 mg every one to two weeks, with smaller steps spread further apart for people on high doses or long-term treatment, and the early signs that the pace is too fast, which are increased spasticity, itching, and tingling of the hands and feet. Read the full guide: How to Safely Come Off Baclofen. To find a provider trained in deprescribing, visit mydeprescriber.com/find-a-provider. The hosts of this episode are AI-generated from the written guide. Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.

17 MIN

Coming off quetiapine for sleep: how slow is slow enough?

Quetiapine (Seroquel) is approved for schizophrenia and bipolar disorder, not for insomnia — yet low doses at bedtime are one of the most common off-label prescriptions people are handed for sleep. This episode walks through what the written guide says about coming off it: why the pace matters, what rebound insomnia is, and what the evidence for sleep actually looks like. We cover the common step-down of 25 to 50 percent every one to two weeks, why the last steps are usually the hardest, and the practical problem of reaching small doses — splitting immediate-release tablets with a pill cutter, using a liquid form, and never crushing extended-release tablets. We also look at the metabolic side of low-dose use, the symptoms that have been linked to stopping rapidly, and why cognitive behavioural therapy for insomnia (CBT-I) is the thing the guide suggests building while the dose comes down. Read the full guide: How to Safely Come Off Quetiapine (Seroquel) for Sleep. Looking for help with a taper? Find a provider trained in deprescribing. The hosts of this episode are AI-generated from the written guide on MyDeprescriber.com. Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.

28 MIN