Stopping a medication? Check first, quit safer

You may have many reasons why you'd like to stop taking a certain medication. Maybe it's causing unwanted side effects, you don't think it's working, you feel that you've healed and no longer need it, or you can't afford it. That doesn't mean it's safe to quit a drug cold turkey. Abruptly stopping a medication can be risky and even life-threatening.

Rebound effects

Many medications work by blocking or activating certain body chemicals or processes. When you stop taking a drug suddenly, symptoms or problems that were controlled can return with a vengeance — meaning they might be worse than they were before treatment. That's called a rebound effect.

"Two prime examples are medications used to treat high blood pressure. If you decide to stop taking the alpha blocker clonidine [Catapres], your blood pressure might increase considerably. Abruptly stopping a beta blocker might cause your heart rate to rise rapidly, which might result in chest pain or even a heart attack," says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Other drugs with potential rebound effects include proton-pump inhibitors, such as omeprazole (Prilosec), used to treat heartburn; the sleep medication zolpidem (Ambien), if it's stopped abruptly after long-term use; and the over-the-counter nasal decongestant spray oxymetazoline (Afrin), if it's been taken for more than three days.

Withdrawal symptoms

Sometimes quitting a drug is a shock to your body. As it adjusts, you might experience symptoms that are mild or moderate — such as mood changes, insomnia, nausea, diarrhea, muscle pain, or changes in appetite. In some cases, symptoms can be severe: hallucinations, delirium, seizures, or suicidal thoughts. "Symptoms tend to be more severe and last longer — more than a few days — if you've been taking higher doses for a long period of time," Doyle Petrongolo says.

Medications that can cause withdrawal symptoms are often those that affect the brain and nervous system: prescription painkillers such as oxycodone (OxyContin) or hydromorphone (Dilaudid); antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclics; anti-anxiety medications such as benzodiazepines; nerve pain medications such as gabapentin (Neurontin); and antipsychotic medications.

Talk to your doctor

Consult with your doctor before quitting a drug. "If you feel you no longer need it, ask if the doctor agrees. You could have a false sense that you've healed, while in reality you're better only because you've been taking your pills," Doyle Petrongolo says. "If you're experiencing side effects from a medication, or you don't feel it's effective, there might be something else you can take."

If you're having difficulty paying for your medication, Doyle Petrongolo recommends asking your doctor if it's possible to prescribe a more affordable alternative. Or ask your pharmacist about ways to reduce drug costs, such as using drug discount cards or applying for a manufacturer's patient assistance program. "We have a number of strategies we can share with clients and programs we can direct them to," Doyle Petrongolo says.

If you'd still like to quit a medication, do so only with your doctor's guidance (see "Tapering off a drug"). Until you get that information, don't stop taking any prescribed drug.

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