Which Medications Should Never Be Stopped Abruptly?

When a doctor prescribes a medication, they provide instructions on what dose, how often, and how long you should take it. Yet, surveys show that approximately one-third of Americans stop taking a prescription medication without consulting their doctor. The reasons include prohibitive cost, intolerable side effects, feeling better, or feeling like the prescription drug is not working.

However, some medications should never be stopped abruptly without talking to a doctor. Doing so can lead to withdrawal symptoms, worsening health conditions, hospitalization, and even death.

This article will list some medications you should not discontinue abruptly without talking to your doctor.

Blood Thinners

Blood thinners are medications that treat or prevent blood clots from forming. They are often used for long-term treatment in atrial fibrillation (A-Fib) patients who are at high risk of stroke or heart attack or those with artificial heart valves. If you suddenly stop a blood thinner without your doctor’s knowledge, you are putting yourself at risk of stroke and heart attack.

Blood Pressure Medications

Medications such as beta-blockers that treat high blood pressure should not be stopped suddenly. These medications not only lower blood pressure but also reduce your heart rate. Abrupt discontinuation of blood pressure medications like a beta-blocker can lead to rebound hypertension and a rapid heartbeat, which can put you at risk of stroke, certain heart diseases, or even heart attack.

Antidepressants and Anti-Anxiety Drugs

Certain medications used to treat severe anxiety and depression should not be quit cold turkey. Long-term use of these drugs can lead to psychological dependence on them, and abruptly stopping them can cause you to experience withdrawal symptoms. Withdrawal reactions may include symptoms similar to alcohol withdrawal, headaches, nausea, abdominal pain, lightheadedness, sleep problems, and seizures. Abrupt discontinuation of antidepressant medications like selective serotonin reuptake inhibitors (SSRIs) can also trigger a worsening or relapse of depression and anxiety.

Anti-Seizure Medications

If you stop taking a medication that helps control seizures, it can lead to an increased risk of more severe and/or more frequent seizures. Abruptly discontinuing anti-seizure medications can also lead to withdrawal symptoms such as confusion, disorientation, and agitation. Always talk to your doctor before you stop taking medication prescribed to control seizures.

Sleeping Pills

Medications such as benzodiazepines (Xanax, Valium) are sometimes prescribed for short-term treatment of insomnia. Sudden withdrawal from these medications can lead to rebound insomnia and withdrawal symptoms such as restlessness and anxiety. The best way to stop taking benzodiazepine sedatives or sleeping pills is to gradually reduce the dose over a period of several weeks under the guidance of a healthcare provider.

Thyroid Medications

Doctors may prescribe medications to treat an overactive or underactive thyroid gland. If you suddenly stop taking these drugs, you can experience undesirable and dangerous adverse effects. For patients with an underactive thyroid, abrupt discontinuation of thyroid medication can cause myxedema coma, severe hypothyroidism that can cause altered mental status, low body temperature, and other complications. For those with overactive thyroid, a thyroid storm can happen due to stopping thyroid medication. Thyroid medications need to be slowly tapered. Your doctor may advise you to take a lower dose for about a week before stopping the drug.

Proton Pump Inhibitors

Proton pump inhibitors (PPIs) are used to relieve symptoms of heartburn, acid reflux, and gastroesophageal reflux disease (GERD) and treat stomach ulcers. If you stop taking proton pump inhibitors suddenly, it can lead to a rebound effect with an increase in stomach acid secretion. This can cause worsening acid reflux symptoms such as regurgitation, indigestion, causing upper belly pain, bloating, and nausea. The longer you have been on a PPI, the higher the risks are for rebound acid reflux. Ask your doctor how to taper off a PPI to avoid worsening symptoms.

Glaucoma Eye Drops

Eye drops for glaucoma help reduce intraocular pressure (the pressure inside the eye). The right treatment for glaucoma usually requires the daily application of eye drops. If you stop the eye drop abruptly, it can increase eye pressure, permanently damaging the optic nerve and leading to irreversible blindness. Always talk to your doctor before you stop using the medicine for glaucoma. If you have intolerable side effects or problems with the costs for eye drops, talk to your doctor about alternatives.

Steroids

Cortisol is a natural steroid hormone in the body that is made by the adrenal glands. Doctors prescribe steroid medications like prednisone to treat acute illnesses because of their anti-inflammatory effects. However, when you take steroid medications, especially at high doses or for a long time, the adrenal glands slow down the production of the natural steroid hormone. When you stop taking the steroid medication, it takes the adrenal glands 1-2 weeks to return to making the natural hormone. That’s why people who suddenly stopped taking steroid medicines can experience low steroid hormone levels with adverse effects such as weakness, nausea, vomiting, diarrhea, and abdominal pain.

Opioid Pain Medicine

Hydrocodone, oxycodone, fentanyl, morphine, and other combination products such as Percocet (oxycodone/acetaminophen) and Norco (hydrocodone/acetaminophen) are opioid pain medicines; they are used to treat moderate to severe pain. Stopping these medicines cold turkey, especially if you have been on them for a long time or at higher doses, can lead to severe withdrawal symptoms, including generalized pain, restlessness, anxiety, and an upset stomach. Opioid pain medicines should be reduced at a gradual rate under the guidance of a doctor.

Antibiotics

Antibiotics are one of the drug classes that, often, patients do not complete the whole course that is prescribed. When someone has an infection, their symptoms typically improve after 3 to 4 days of taking antibiotics. The return of energy and fever resolve makes people think there is no need for antibiotics. However, not finishing the entire course of antibiotics may allow some bacteria to survive and worsen the infection. Then this resistant strain of bacteria will lead to the ineffectiveness of the antibiotics designed to kill them. Therefore, you must complete the entire course of antibiotics prescribed to you even when you start to feel better. If you experience side effects from the antibiotics, you should discuss them with your doctor before discontinuing the antibiotic on your own.

Medication Safety Tips

Always talk to your doctor before discontinuing medication, including prescription medicines and over-the-counter products.
Ask your doctor if it is safe to stop taking a particular drug when you feel better.
If it is not safe to stop suddenly, make sure you understand how to gradually reduce the medication safely.
Learn about the withdrawal reactions and side effects of stopping a medicine cold turkey. Contact your doctor if you experience any of these signs and symptoms.

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