Dr. Rachael J. Murphy - RiverStep Functional Psychiatry

06/13/2026

People want to come off stimulants for all kinds of reasons. The side effects start to outweigh the benefit - poor sleep, anxiety, headaches, feeling flat or not like yourself. It stops working the way it used to.

Or maybe life shifts, and the circumstances that led to the prescription aren’t there anymore. Maybe you simply don’t like taking a controlled substance indefinitely. Maybe you simply want to know if you need it or not.

Here’s the part that surprises people: stimulants don’t cause the kind of physical dependence we worry about with benzodiazepines, or the withdrawal effects we may even see with other drug classes like antidepressants.

There’s no acute danger in stopping. So you’re often told you can just quit any day you like.

But then the “crash” hits - the flat, foggy stretch as the brain recalibrates.

For those interested in lowering their stimulant dose or eventually discontinuing it: it doesn’t mean white-knuckling through to meet your goals. It’s telling your experiences apart, and that’s exactly what a thoughtful, gradual taper makes possible.

New on the blog: why people stop, what tapering actually means, and how to come off thoughtfully instead of abruptly.

🔗 Link to the blog:

https://www.riverstephealth.com/blog/coming-off-stimulants-what-tapering-actually-means

06/12/2026

www.riverstephealth.com/blog/the-last-milligram-is-the-hardest-what-hyperbolic-tapering-teaches-us-about-stopping-antidepressants

New Blog Post:

Why The Last Milligram is The Hardest

Most people — patients and prescribers alike — assume that the hard part of coming off an antidepressant is the beginning. Cut the big dose, and the small dose left at the end should be a formality. The pharmacology says the opposite. The closer you get to zero, the more carefully you often have...

04/16/2026

The dangers of using antipsychotics like Seroquel and Zyprexa for insomnia. Why off-label prescribing for sleep leads to dependence and tapering issues.

03/03/2026

01/20/2026

Antidepressant continuation and slow tapering with psychological support may reduce relapse risk compared with abrupt discontinuation.

09/30/2025

Anders Sorensen PhD on how to withdraw safely off antidepressants

Book: Crossing Zero: The Art and Science of Coming off - and Staying Off - Psychiatric Drugs https://www.amazon.co.uk/dp/B0FFBDCGP7

08/24/2025

Dr. Anders Sørensen’s “Crossing Zero: The Art and Science of Coming Off Psychiatric Drugs”

Too many patients struggle with withdrawal using inadequate tapering guidelines. The hyperbolic tapering method he explains (based on actual neurobiology) gives us a scientific framework that works.

What’s different:
✓ Trauma-informed approach beyond “just reduce the dose”
✓ Covers major drug classes with specific protocols
✓ Integrates psychological alternatives
✓ Written for patients AND clinicians

This fills the gap between “stay on forever” and “just stop taking it.”

Finally a resource that examines medication’s role AND people’s right to informed discontinuation choices.

Highly recommended! ✨👏🏻