Sometimes the problem begins only when you STOP taking the drug. In one of the most serious cases, a hospice nurse told me of a terrifying first episode of mania that began shortly after she stopped taking an antidepressant drug. It was so severe she ended up in a locked psychiatric ward.

This is also a drug hazard that can be minimized with careful management. (See below)

Withdrawal effects are most common among all drugs that target the central nervous system. This includes tranquilizers, painkillers with narcotics,amphetamines and other stimulants, nicotine, and many drugs for depression.

What happens is that the body slowly adapts or adjusts to the chemical intrusion of the drug, trying to nullify its effects. When the drug is suddenly withdrawn it disrupts the nervous system until it can readjust to a "drug free"world.

Rebound effects are a form of withdrawal effect that tricks many people into believing they can't do without a drug. When the drug is withdrawn, the original problem returns, but the symptoms are often more severe than at the start. The classic case are the sleep medications such as Halcion and Restoril. Not only do they become less effectivive over time as the body adjusts to the chemical intrusion, stopping can cause rebound insomnia.

Some drugs for high blood pressure, notably beta blockers, can sometimes cause rebound hypertension that can be hazardous.

Drugs for depression are advertised as "not habit forming" but most of them do cause withdrawal symptoms and need to be tapered off carefully. There is no good scientific data, but andecdotal reports single out Paxil and Effexor for problems with withdrawal symptoms.

The basic solution is to taper off these drugs slowly. It's best to work with a doctor familar with withdrawal problems, and this step is essential for some psychiatric drugs.

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