American author Laura Delano walked away from the treatments that defined her teens and 20s. Now, she’s hoping to create a road map for others to follow, supporting people desperate to taper off, or quit altogether, their psychiatric medications – but some experts disagree with her methods.
Delano is not a doctor: her main qualification is having been “a professional psychiatric patient between 13 and 27”.
During those years, when she attended Harvard and was a nationally ranked squash player, she was prescribed 19 psychiatric medications, often in combinations of three or four at a time. Then she decided to walk away from psychiatric care altogether, a journey she detailed in a memoir, Unshrunk: A Story of Psychiatric Treatment Resistance.
Fourteen years after taking her last psychotropic drug, she projects radiant good health that also serves as her argument – living proof that, all along, her psychiatrists were wrong.
And since then, to the alarm of some physicians, an online DIY subculture focused on quitting psychiatric medications has expanded and begun to mature into a service industry.
The New York Times reports that Delano is a central figure in this shift. From her Connecticut home, she offers coaching to various paying clients. But through Inner Compass Initiative, a non-profit she runs with her husband, Cooper Davis, she hopes to provide support to people interested in reducing or quitting psychiatric medications.
"People are realising they don’t actually need to find a doctor who knows how to do this,” she said. In fact, they may not even need to tell their doctor. “That sounds quite radical,” she added.
“But it’s just been the reality for thousands of people out there who have realised, ‘I have to stop thinking psychiatry will get me out of this situation’.”
Increasingly, many psychiatrists agree that the healthcare system needs to do a better job helping patients get off psychotropic medications when they are ineffective or no longer necessary.
But they also warn that quitting medications without clinical supervision can be dangerous. Severe withdrawal symptoms can occur, and so can a relapse, and it takes expertise to tease them apart.
Psychosis and depression may flare up, and the risk of suicide rises. And for people with the most disabling mental illnesses, like schizophrenia, medication remains the only evidence-based treatment.
“What makes tremendous sense for Laura, and millions of people who are over-diagnosed and over-treated, makes no sense at all for people who can’t get medicine,” said Dr Allen Frances, a professor emeritus of psychiatry at Duke University School of Medicine.
“Laura does not generalise to the person with chronic mental illness who has a clear chance of ending up homeless or in the hospital,” he said. “Those people don’t wind up looking like Laura when they are taken off medication.”
Withdrawal
Peer support around withdrawing from psychiatric medications dates back 25 years, to the early days of digital social networks.
Adele Framer, a retired information architect from San Francisco, discovered such groups in 2005 while enduring a difficult withdrawal from Paxil. At the time, physicians dismissed severe withdrawal as “basically impossible”.
People circulated between the groups, comparing “tapers” in “a viral information-sharing process”, said Framer, who launched her own site, Surviving Antidepressants, in 2011.
Users on her site exchanged highly technical tapering protocols, with dose reductions so tiny that they sometimes required syringes and precision scales.
Dr Mark Horowitz, an Australian psychiatrist, discovered Framer’s site in 2015 and used the peer advice he found to taper off Lexapro himself.
“At that point, I understood who the experts were,” he said. “I have six academic degrees, I have a PhD, I know how antidepressants work, and I was taking advice from retired engineers and housewives on a peer support site to help come off the drugs.”
In recent years, mainstream psychiatry has begun to acknowledge the need for more support for patients getting off medications. This is most visible in Britain, whose health service has updated its guidance for clinicians to acknowledge withdrawal and recommend regular reviews to discontinue unnecessary medications.
In 2024, the Maudsley Prescribing Guidelines in Psychiatry, a respected clinical handbook, issued its first “de-prescribing” volume. Horowitz was one of its authors.
There are early signs of movement in the United States, as well. Dr Jonathan Alpert, chairman of the American Psychiatric Association’s Council on Research, said the group planned to issue its own de-prescribing guide.
The American Society of Clinical Psychopharmacology was also working on a guide to help doctors identify when a medication should be discontinued. “There has never been an incentive in industry to tell people when to stop using their product,” said Dr Joseph Goldberg, the group’s president.
“So it really falls to the non-industry community to ask those questions.”
A success story
Delano entered the conversation in 2010, when she began blogging about her life. She was 27, and attending day treatment at McLean Hospital in Massachusetts. Her platform was Mad in America, a website where former psychiatric patients exchanged stories about their treatment.
On her blog, Delano described the shadow plot of her psychiatric treatment.
In ninth grade, she was diagnosed with bipolar disorder and prescribed Depakote and Prozac. In college, her pharmacologists added Ambien and Provigil. Over the years, this list expanded, but she still seemed to be getting worse. Four times she was so desperate that she checked herself into psychiatric hospitals. At 25, she attempted at suicide.
Then, at 27, she picked up a book by journalist Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, in which the writer proposed that the increasing use of psychotropic medications was responsible for the rise in psychiatric disorders.
In scientific journals, reviewers dismissed his analysis as polemical, cherry-picking data to support a broad, oversimplified argument.
But for Delano, it was an epiphany. “I’d been confronted with something I’d never considered,” she writes in Unshrunk. “What if it wasn’t treatment-resistant mental illness that had been sending me into the depths of despair and dysfunction, but the treatment itself?”
She quit five drugs over the next six months, under the guidance of a psychopharmacologist. She describes a brutal withdrawal, complete with constipation, diarrhoea, aches, spasms and insomnia, but she was “ready to stop being a psychiatric patient”, she said.
Born in 1983, five years before Prozac entered the market, Delano was part of the first large wave of Americans to be prescribed medications in their teens. Many readers recognised, in her blog entries, elements of their own stories – how a diagnosis had become part of their identities, how a single prescription had expanded into a cocktail.
She also provided something the ex-patient community had lacked: an aspirational model.
Her life had clearly flourished after quitting her medications. In 2019 she married Davis, whom she met in the ex-patient movement, and they have two sons.
Kennedy to probe threat
And a watershed moment arrived last month, when Health Secretary Robert F Kennedy Jr. announced that the “Make America Healthy Again” commission would examine the “threat” posed by antidepressants and stimulants.
Kennedy has long expressed scepticism about psychiatric medications; in his confirmation hearings, he suggested that selective serotonin reuptake inhibitors, or SSRIs, have contributed to a rise in school shootings, and can be harder to quit than heroin.
There is no evidence to back up either of these statements. But Davis agreed.
“He might be the only person in the room who gets how serious it can be,” he said.
Delano and Davis both offer coaching, but what excites them more is the membership community hosted by their non-profit, Inner Compass Initiative, which, links up members via livestreams, Zoom gatherings and a private social network.
They dream of a national “de-prescribing” network along the lines of Alcoholics Anonymous, said Davis, who became the group's executive director this year.
Delano assures readers she is not “anti-medication” or “anti-psychiatry”. “I am neither of these things,” she writes. “I know that many people feel helped by psychiatric drugs, especially when they’re used in the short term.”
Still, there is no mistaking the bedrock of mistrust underlying her project. “I feel for psychiatry,” she said. “It’s a big ask we’re putting on them, to basically step back and consider that their entire paradigm of care is inadvertently causing harm to people.”
An echo chamber
The rollout of Kennedy’s agenda has raised hopes throughout “critical psychiatry” and "anti-psychiatry"” communities that their critiques will, for the first time, be taken seriously.
Some in the medical world fear this augurs a deepening mistrust in science. And it is true – the written resources Inner Compass provides are overwhelmingly negative about every major class of psychiatric medications, which remain the only evidence-based treatment for severe mental illnesses.
A section on antipsychotics, for instance, cites studies that purport to show that people who take them fare worse than people who never take them or stop them. (This is misleading; people do not take them unless they have severe symptoms.) A section on antidepressants cites a study suggesting they cause people to commit acts of violence. (The study was criticised for distorting its findings.)
Alpert, who is also chairman of psychiatry and behavioural sciences at Montefiore Einstein, reviewed Inner Compass’ resources and described them as “biased” and “frightening”.
He said online peer communities risk becoming “echo chambers”, since they tend to attract people who have had bad experiences with medical treatment.
Because quitting psychiatric medications can be so risky, he said, a pervasive mistrust of medical care could have serious consequences.
“What happens when people taper off their medications because of an echo chamber, and they’re more suicidal, or they get more psychotic, and they need to be hospitalised, or they lose their job?” he said. “Who cares about those people?”
The New York Times article – Leading a Movement Away from Psychiatric Medication (Restricted access)
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