Questions & Answers on Psychiatric Medications

Tadao Ogura, M.D.


How Long Will I Have to Stay On Psychiatric Medications?

How long you must stay on your medications will depend on the type of the disorder you are suffering from and its severity.

According to many recent studies, the relapse rate goes down the longer a patient remains in remission. For example, the relapse rate after discontinuing psychiatric medications for depression is about 75% after one year of medication treatment. Many "experts" used to recommend that you should take medications for three to six months. Now, they recommend two years or longer after being stabilized.

For some conditions, such as Schizophrenia or Bipolar I Disorders, medications may need to be taken indefinitely, since the brain dysfunctions associated with these conditions are often more resistant to stabilization or "healing." However, I have seen a few "chronic schizophrenics" who spent most of their lives in mental institutions but have become symptom-free and completely "normal" without any medications in their old age! Again, "we are not created equal" and each case is different.

As noted earlier, in general, psychiatric medications do not directly cure psychiatric disorders, but help improve or compensate for brain dysfunctions. Nevertheless, our brains seem to try to heal themselves or, at least, compensate for the disordered states to a point where medications become unnecessary. Nevertheless, there are cases in which the medication becomes a permanent, or semi-permanent, necessity.

In my personal experience with the few thousand patients I have treated so far, about one third of patients with Major Depressive Disorders, Anxiety Disorders, Bipolar II Disorders, and Obsessive-Compulsive Disorders were able to "graduate" from their medications in two to five years. In cases of Bipolar I Disorders and Schizophrenia patients, they needed to be on their medications for many more years and often for life.

We do not know precisely what happens to the brain with or without medications, however, we can safely say that, in the majority of cases, medications facilitate or accelerate the self-healing processes of the brain, provided the medications are a "good match" to the patients' bodies.

It may be frustrating or disappointing for some of you to find out that you may have to stay on a medication for a long time or even "forever." But, since the majority of psychiatric disorders are also physical illnesses, it's actually not that surprising that these disorders may require long-term medications. However, think about the benefits, or the positive side of things. With the right medications, you are able to lead happier, more productive, perhaps even longer lives. That's not too different from why we take vitamin supplements every day.

The most important thing to remember, however, is never to go off your medication without consulting your doctor first. If you are feeling "great," you should not mistake it as proof that you do not need the medication any more. Always check with your doctor, and listen to your doctor's advice. If the medications are helping you, going off them may suddenly may put you back to where you started from or even make your condition much more severe than before.

All too often, I have seen patients who decided to stop their medications because they were feeling better. It never seemed to occur to them that they are feeling better because of the medications. Rather they seemed to think, "I did it on my own." I do not know why people think that they can get away with taking such risks with their health, but no one should make decisions without consulting a doctor on any medication.


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