Quick answer: Yes. A psychiatric provider licensed in your state can plan and supervise a gradual taper of many psychiatric medications by secure video, the same way they would in an office. A safe taper lowers your dose in small steps over weeks or months, with regular check-ins to catch withdrawal symptoms or signs that your original symptoms are coming back. What you should not do is stop on your own.
Wanting to come off medication is common and completely reasonable. Maybe you have felt well for a long time, side effects bother you, your life has changed, or you simply want to know how you feel without it. Whatever the reason, the way you stop matters as much as the decision itself.
Why you should not stop psychiatric medication suddenly
Your brain adjusts to a medication over time. When the medication is removed too quickly, your body can react before it has time to readjust. With antidepressants, for example, stopping suddenly can bring on withdrawal symptoms such as dizziness, nausea, sleep problems, irritability, anxiety and electric-shock sensations often called “brain zaps.” The NHS advises against stopping antidepressants suddenly and recommends reducing the dose gradually with your doctor’s help (NHS).
Other medications carry their own risks. Stopping a mood stabilizer quickly, for instance, can raise the chance of a mood episode in people with bipolar disorder. That is why a plan made with a prescriber is so important. For more on avoidable missteps, see our post on common mental health medication mistakes.
Can an online provider really manage a taper?
For most non-controlled psychiatric medications, yes. Tapering is mostly about careful planning, small dose changes and close follow-up, and all of that works well over video:
- Evaluation: your provider reviews your history, how long you have been stable and why you want to stop
- A written plan: a schedule of dose reductions, with clear steps and timing
- Prescriptions for each step: new strengths are sent electronically to your pharmacy as you go
- Regular check-ins: short video visits to see how each step feels and adjust if needed
Your provider must be licensed in the state where you are during each visit. A Maryland-licensed provider, for example, can supervise your taper as long as you are in Maryland for every appointment.
When might it be a good time to taper?
There is no single right moment, but these signs suggest it may be worth discussing:
- you have felt well and stable for a sustained period, often at least six months after symptoms improved
- your current life is relatively calm, without a major move, job change, exam or loss on the horizon
- you have support in place, such as friends, family or a therapist
- you understand the signs that would mean slowing down or pausing
It may be better to wait if you are going through a stressful period, your symptoms have only recently improved, or you have had several relapses in the past after stopping.
How a supervised taper usually works
Every taper is personal, but most follow a similar path.
- Talk it through. You and your provider discuss your reasons, your history and any risks. Sometimes the answer is a lower dose rather than stopping completely.
- Make a plan. Your provider sets out a schedule of small reductions. Steps are often spaced a few weeks apart, and the last steps are frequently the smallest.
- Reduce, then watch. After each step you note how you feel. Many people find a simple daily log of mood, sleep and any physical symptoms helpful.
- Check in. Regular follow-ups let your provider review how things are going. Our guide to what happens during a medication management follow-up explains what these visits cover.
- Adjust as needed. If a step feels too hard, your provider may hold the dose for longer, make the next step smaller or go back to the previous dose for a while. This is normal and not a failure.
- Plan for after. Once you have stopped, a final check-in or two helps confirm you are doing well and sets out what to do if symptoms return.
Withdrawal or relapse? How to tell the difference
Feeling unwell during a taper does not always mean your condition is coming back. Knowing the difference helps you and your provider respond the right way.
| Withdrawal (discontinuation) symptoms | Relapse | |
|---|---|---|
| When it starts | Usually within days of a dose change | Usually more gradually, often weeks later |
| What it feels like | Often physical: dizziness, nausea, flu-like feelings, “brain zaps,” vivid dreams | Your original symptoms returning, such as low mood, worry or panic |
| What helps | Often eases if the dose is held or the step is made smaller | May need treatment to be restarted or adjusted |
The two can overlap, so tell your provider about anything new rather than trying to sort it out alone.
Medications that need extra care
- Antidepressants (such as SSRIs and SNRIs): usually tapered gradually; some are more likely than others to cause withdrawal symptoms. Our SSRI vs SNRI guide explains how the two groups differ.
- Mood stabilizers and antipsychotics: often need slow, closely monitored tapers because of the risk of relapse.
- Controlled medications such as benzodiazepines: tapering these needs especially careful medical supervision. Thrive does not prescribe controlled substances, so if you take one, your current prescriber is usually the right person to guide that taper.
Tips for a smoother taper
- Keep your appointments, even when you feel fine
- Take each dose at the same time every day
- Keep a short daily log of mood, sleep and physical symptoms
- Protect your sleep, meals and activity levels
- Limit alcohol, which can worsen mood and anxiety
- Let someone you trust know you are tapering
- Do not split or crush tablets unless your provider or pharmacist says it is safe
If you start to feel unsafe or have thoughts of harming yourself at any point, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.
What if you decide to stay on medication?
Tapering is not the goal for everyone. For some people, staying on medication is the healthiest choice, especially after repeated relapses. That decision is just as valid. If your current medication is not working well or causes side effects, adjusting the dose or trying a different option may be a better next step. Our post on what happens if your medication is not working covers those options.
Tapering with Thrive Telepsychiatry
Thrive Telepsychiatry is a Baltimore-based online practice that has focused on telepsychiatry since 2015. Visits are by secure video with a board-certified psychiatric mental health nurse practitioner licensed in Maryland.
- Supervised tapers: we review your history, build a step-by-step plan and adjust it at regular follow-ups as part of ongoing medication management
- Non-controlled medications only: Thrive does not prescribe controlled substances
- Who we see: teens and adults aged 13 and up who are in Maryland at the time of each visit
- Switching to us first? If you are moving your care to Thrive before tapering, our guide to switching providers without a gap in medication can help
- Cost: $250 for the first one-hour evaluation and $175 for each 30-minute follow-up if you self-pay. Thrive accepts Blue Cross Blue Shield and the Johns Hopkins Hospital Employee Health Plan. See plans and pricing.
When you are ready to talk about your options, you can get started online.
FAQs
How long does it take to taper off psychiatric medication?
It varies. Some tapers take a few weeks, while others take several months. The length depends on the medication, your dose, how long you have taken it and how you respond to each step.
Can I taper off antidepressants on my own?
It is not recommended. Stopping or cutting your dose without a plan raises the risk of withdrawal symptoms and relapse. A provider can set a safe pace and adjust it if needed.
What if withdrawal symptoms are bad?
Tell your provider. They may keep you at your current dose for longer, make the next step smaller or return to the previous dose for a while before trying again.
Will my symptoms come back after I stop?
Some people stay well and some do not. Regular check-ins during and after your taper help you and your provider spot early signs and act quickly if symptoms return.
Can I restart my medication if I need to?
Often, yes. If symptoms return, your provider can talk with you about restarting the medication or trying a different approach.
Does Thrive help with tapering benzodiazepines?
No. Thrive does not prescribe controlled substances, including benzodiazepines. Your current prescriber is usually the best person to supervise that taper.
