How many beads? Wladimir Bulgar/SPL/Getty

A patient-led movement is helping people taking psychiatric medicines to hack their dosing regimens so they can wean themselves off the drugs without any side effects. Now a Dutch website that sells kits to help people do this is about to launch an English-language site, triggering safety concerns among UK regulators and doctors.

Some people find it impossible to stop taking certain antidepressants and anti-anxiety medicines such as valium because, unless the dose is reduced very gradually, they get severe mental and physical side-effects.

The problem is these medicines aren’t sold in small enough tablets to allow for tapering. This has prompted some people to flout mainstream medical advice and use DIY methods for reducing their doses, such as grinding up tablets and dissolving them in water, or breaking open capsules of tiny beads and counting them out. The UK mental health charity Mind advises people who want to stop taking antidepressants of some techniques to try, but recommends they get advice from their doctor or pharmacist first.


To help people taper their dose more easily, a Dutch medical charity, called Cinderella Therapeutics, together with Maastricht University creates personalised “tapering kits”, with precisely weighed out tablets in labelled packets that gradually reduce over several months. The website recommends people do this under medical supervision and must first receive a doctor’s prescription.

The charity has been sending out such kits since 2014, distributing around 2000 tapering kits for 24 different medications so far. Most of these were for people in the Netherlands, but a few kits have been sent to other countries, including the UK. The website is in Dutch, but an English-language version is being launched next week.

Its actions are legal in the Netherlands, although most medical bodies advise people not to buy medicines over the internet. “Although prescription-only medicines can be imported for personal use, self-medication is potentially risky and we advise against this,” says a spokesperson for the UK’s Medicines & Healthcare Products Regulatory Agency. “We will be contacting our regulatory partners in the Netherlands to make necessary enquiries.”

Withdrawal symptoms

An increasing number of people are taking antidepressants – about 1 in 10 people in the UK, for instance. Many people find antidepressants helpful, and even life-saving, but some struggle to stop taking them when they are ready.

Some people say that when they try to stop, they experience intolerable side effects. A study in New Zealand found that 55 per cent of people got withdrawal symptoms on stopping antidepressants.

“I felt like I had been run over by a bus,” says James Moore, a 46-year-old stay-at-home dad from Rogiet in the UK. He experienced dizziness, nausea and headaches when he stopped taking the antidepressant mirtazapine.

Others who stop taking antidepressants report side effects such as panic attacks or memory and concentration problems. “I know of people who have taken their lives because the withdrawal effects have been so severe,” says Moore, who is now a mental health campaigner.

Information leaflets that the drug manufacturers provide alongside the drug warn of short-term withdrawal effects, and doctors usually advise people to reduce their dose slowly. But even if people do that, once they stop taking the lowest dose of tablet available, some still get problems. Some people are told by their doctors that it is a relapse, even if it might not be.

One solution often proposed is to take one pill every other day, but some common antidepressants such as venlafaxine and paroxetine are broken down by the body within hours, so this method leads to drug levels in the blood fluctuating from one day to the next. Instead, people have begun swapping tips about how to taper their medication online.

Tapering help

Moore tried cutting up his pills into smaller pieces but found the dosing was too variable and his withdrawal symptoms returned. “I was functioning one day and the next I would be in bed,” he says. He is now leading a campaign to make manufacturers make their drugs available in much lower doses.

David Healy, a psychiatrist in Bangor in the UK, says people’s experiences of withdrawing from antidepressants can vary a lot. He helps those with severe symptoms by prescribing liquid formulations of their medicine, which they can measure out in small amounts. These formulations aren’t as widely stocked as their pill equivalents.

Moore has just started a liquid version and has found that his symptoms are less severe. But Healy says most GPs refuse to prescribe such liquids because they are more expensive than the standard pills.

Pharmacist Paul Harder, who makes the tapering kits for Cinderella Therapeutics, says an unpublished survey by the charity found that about 80 per cent of users manage to completely stop taking their medicine. Another 10 per cent reduce it, but the rest return to their original dose. The average time people using the service taper for is two months, he says, but some people take up to seven months.

Tony Kendrick of the University of Southampton in the UK says another option for some people is to switch antidepressants to fluoxetine (Prozac), which is widely available in a liquid formulation. But some people feel they cannot switch.

Kendrick is investigating ways to help doctors tell the difference between antidepressant withdrawal symptoms and signs that a person’s depression or anxiety is returning. Withdrawal symptoms tend to start very quickly, often the first day a dose is missed, and disappear when the person returns to their normal level, he says. “A relapse usually takes weeks or months.”

A spokesperson for the Association of the British Pharmaceutical Industry did not wish to comment.

We have clarified who makes the tapering kits