The pandemic has led to a decrease in mental health and an increase in the prescribing of medication for conditions such as stress, insomnia, anxiety and depression. When these drugs are withdrawn or even reduced the symptoms (“discontinuation syndrome”) can be horrendous. Furthermore, many people use opioids, benzodiazepines and other similar substances which can cause tolerance (requiring ever-increasing dosage) and addiction.
There is a simple solution to this problem. These medications could be licensed in 1mg (scored so that they could be cut in half) and 0.25mg quantities. This would allow GPs and pharmacists to a prescribe precise patient-led dosage and enable tailor-made tapering. It would be very easy to do. For example, my own prescription (escitalopram, an SSRI antidepressant) only comes in 20mg, 10mg and 5mg tablets. But the ideal tapering regime requires reductions of no more than 10% at time. And that is 10% of the current dose, not the starting one. So reducing or coming off these drugs is made harder than it needs to be. Homemade solutions (such as splitting pills or diluting in a titration) is messy and imprecise.
(I am aware that some — not all — of these drugs are available in liquid form and in theory that sounds ideal. However I’ve tried the liquid and had a nasty episode: I was on 10mg tablets and so switched to 9 drops (@1mg per drop) then 8, and so on. However, I discovered that taking them on an empty stomach was a very bad idea: I assume that not only was there no pill “filler” to slow the release of the medication but it was also in an alcohol (ethanol) solution making absorption even quicker. So small dose tablets are a much better option.)
A patient could take a combination of smaller denomination tablets to achieve a slow, smooth and steady taper in accurately quantifiable steps. This would also end up saving the NHS money on endless repeat prescriptions.
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