Harm Reduction Guide To Coming Off Psychiatric Drugs by The Icarus Project

Harm Reduction Guide to Coming Off Psychiatric Drugs

by The Icarus Project Author

Created by the Icarus Project and the Freedom Center (A Massachusetts mental health advocacy group), this is a guide to the realities of psychiatric drug use, including long-term side effects, how they work, and what they do to your brain. It includes info on mood stabilizers, anti-psychotics, anti-depressants, anti-anxiety drugs, risks, benefits, wellness tools, withdrawal, detailed Resource section, information for people staying on their medications, and much more. A harm reduction approach means not being pro- or anti-medication, but supporting people to make their own decisions balancing the risks and benefits involved. Written by Will Hall, with a 14-member health professional advisory board providing research assistance and 24 other collaborators involved in developing and editing. The guide has photographs and art throughout, and a beautiful original cover painting by Jacks McNamara. Check out one person's experience here.

Comments & Reviews


As the Harm Reduction Guide to Coming Off Psychiatric Drugs says,

"This guide brings together the best information we’ve discovered and lessons we’ve learned at The Icarus Project and Freedom Center. It is not intended to persuade anyone to stop taking psychiatric medications, but instead aims to educate people about their options if they decide to explore going off. In a culture polarized between the pro-medication propaganda of pharmaceutical companies on the one hand, and the anti-medication agenda of some activists on the other, we offer a harm reduction approach to help people make their own decisions. We also present ideas and information for people who decide to stay on or reduce their medications...

"It’s easy to fall into absolutist thinking when it comes to psychiatric drugs. Pro-drug advocates focus on the risks of extreme emotional states, while anti-drug advocates focus on the risks of taking drugs. But it is the belief of this guide, and the philosophy of our pro-choice work at the Freedom Center and the Icarus Project, that either-or thinking around drugs is a big part of the problem."

In working on psychiatric medication issues over the past 8 years I've seen again and again how emotionally upsetting and controversial these issues can be. Strong feelings, either pro-drugs or anti-drugs, are common, and can stifle conversation and dialog. Mental health gets pushed under the rug and left up to doctors, and pharmaceutical companies, to deal with. We're trying to open up the conversation, and create respectful listening spaces where we can share information and learn how to take care of each other better. Sometimes that means dealing with strong emotions and criticism. I believe the zine, DIY, and anti-authoritarian communities are ready for open dialog on difficult topics: our wellness and our lives can depend on it.

This guide is available as a free download if anyone would like to read it for yourselves before purchasing a copy; and it's also available in spanish. Just go to this link:

It used to be that whenever someone would talk about improving wages or working conditions and try to organize a union, they would be immediately labeled as a communist. Today anyone who dissents from US foreign policy risks getting labeled a terrorist. Are the same prejudice at work whenever anyone who criticizes pharmaceutical companies is labeled as anti-medication and a member of a cult?

Creating a balanced way to talk about psychiatric drugs is not easy, but the feedback from the Guide has been extremely positive. It has supporters across the spectrum of people who take medications every day and people who don't take any medications, and it has critics across the same spectrum, people who only want their own pro- or anti- point of view represented. If you are looking to have your own bias confirmed, the Guide is probably not for you. If you're looking to join a thoughtful discussion with a lot of grey areas and room for learning, please be part of the growing community that is embracing a harm reduction approach to psychiatric drugs and using this Guide as a tool.

As far as the specific challenges to the integrity of the Guide's research, I welcome anyone to offer details of what specific facts or research they consider inaccurate, just email me at will(at)theicarusproject (dot) net. We are putting together a second edition of the Guide, and any improvements and corrections are welcome. The current edition was carefully edited by a large collaborative effort of more than 30 people, including 18 health care practitioners, and the research is solid and relies on reputable scholarly sources, as well as MIND, the leading mainstream mental health charity in the UK.

The Guide makes it clear that support, including a doctor's support, is often much better than going alone. Not always but often. It also recognizes that sometimes doctors don't have a clue about what they are doing and can harm their patients. While some may find it reassuring to hear they should only do something with their doctor's approval, that can be a very risky policy. A hundred years of abusive and inept psychiatric practice has proven that. The UK charity MIND even changed their official policy, and no longer make a blanket recommendation to only go off medications with your doctor's approval (you can read the full MIND report on coming off medications by following the link in the Guide). In a an anti-authoritarian movement it should be clear how foolhardy it is to assume anyone has the answers just because they've got a degree and a white coat. Especially when the medical profession is so deeply corrupted by pharmaceutical profiteering.

Some other quotes from the Guide should make it clear this is a pro-choice, harm reduction approach that welcomes all decisions about taking meds, based on honest informed consent about medication risks and benefits:

"Applying harm reduction philosophy to mental health is a new but growing concept. It means recognizing that people are already taking psychiatric drugs, and already trying to come off them. It encourages examining all the different kinds of risks involved: the harm from emotional crisis that goes along with experiences labeled mental disorders, as well as the harm from treatments to deal with these experiences, such as psychiatric drugs, diagnostic labels, and hospitalization. Making harm reduction decisions means looking carefully at the risks of all sides of the equation: honesty about what help drugs might offer for a life that feels out of control, honesty about how harmful those same drugs might be, and honesty about options and alternatives. Any decisions may involve a process of experimen­tation and learning, including learning from your own mistakes. Harm reduction accepts all this, believing that the essence of any healthy life is the capacity to be empowered.

"Principles of This Guide: Choice: Psychiatric medications affect the most intimate aspects of mind and consciousness. We have the right to self-determination: to define our experiences as we want, seek out practitioners we trust, and discontinue treatments that aren’t working for us. We don’t judge others for taking or not taking psychiatric drugs: we respect individual autonomy. When people have difficulty expressing themselves or being understood by others, they deserve accommodation, supported decision-making, and patience from caring advocates, according to the principle of “first do no harm” and the least intrusion possible. No one should be forced to take psychi­atric drugs against their will.

"The decision to take or not take psychiatric drugs should be based on the usefulness of the drug to the person who needs help relative to the risks involved.

"Making a decision about coming off psychiatric drugs means evaluating as best you can the risks and benefits involved, including important information missing or suppressed from most mainstream accounts. Some risks may be worth taking, some risks may not be worth taking, but all risks should be taken into consideration. Because each person is different and drug effects can vary widely, the uncertainty involved should be met with your own best judgment and observations of how your body and mind are responding.

"You may decide that, given the degree of crisis you are facing and the obstacles to workable alterna­tives, you want to continue psychiatric medication. It may still be a good idea to take a harm reduction approach. You can make whatever changes to improve the quality of your life, and work to minimize the risk or harm associated with the medications you are taking.

Plan Support: Get help if you can. Working with a doctor or health care practitioner who is on your side can make a huge difference. Have supportive friends and family, and get help making your plan.


Simply put: Scientology is 100% against drugs: Icarus and Survivors are pro-choice, arming folks with the information they need for reducing and eliminating drugs if someone chooses to do so. Given the coercion of psychiatry, they are quite aware of coercive tactics and try not to reproduce them in their politics.


What power does a book have to blackmail you, emotionally or otherwise? I don’t understand elle36's comment at all. While I haven’t used the advice in this book personally, I’ve recommended it to many people who have found it to be
indispensable. As far as I know, it’s the only book of its kind and that’s why people seek it out. I’ve been a part of the Icarus Project for the last
year in a half and I’ve found many people who are open-minded and compassionate towards the particulars of my situation, not dogmatic or
bullying as the last comment suggests. I’ve found a community of people who are committed to mental health and wellness as defined by those of us who have been labeled and otherwise maligned by our normalcy-obsessed culture.
I’ve met zero Scientologists or otherwise creepy cult-like individuals or ties to that ilk. (I can’t find anything on the site with ties to them,
either, WTF?) I know Will Hall, one of the editors / contributors to this book personally and he is the last person on earth who would ever pressure
someone to make any choice about taking or not taking meds. The whole point is informed *choice*- did elle36 even read the book??


What elle36 says is completely ludicrous.

The guide is deeply respectful of people's individual process and is not in the least bit coercive. I found it to be an extremely non-judgmental approach that offers guidance SHOULD someone CHOOSE to come off drugs. That is something we do not find in the typical psychiatrists office where we are indeed routinely met with coercion and no options other than medications.

At no time is it recommended that people work without a professional helping them.

Freedom Center nor Icarus have no ties to Scientology whatsoever. This is the way anyone who is threatened by someone who questions established psychiatry is criticized when the attacker does not have solid arguments against the critics.

Call them a Scientologist and they hope that will scare people away. It's a wimpy way to make an argument.

This guide presents a very solid start to a process that should involve a great deal of research and care to ones body mind and spirit. The reader is pointed in the direction to start this process.


This publication may be startling to the most trusting of us because it is so well researched, referenced and peer-reviewed. I found it surprising how it has a strong point of view based on experience and still advocates caution, such as a patient working with a doctor before making any medication changes. For those moving towards a drug free life it is a breath of fresh air and for many, I am sure, a ray of hope. Hardly a revolutionary position, getting me off drugs eventually would be the goal of any physician I'd want to visit.


A coercive way of emotionally blackmailing you into getting off your meds if you do suffer mental illness. This propaganda is a disservice to the zine community and the community at large, arguing against the effectiveness of drugs and suggesting one is weaker for taking them. It's completely irresponsible in basically advocating people disregard their medical professional's advice and weaning themselves off drugs without doctor supervision. Furthermore this organisation has links to scientology - they cite heaps of scientology lit at the back. 'Breakfast at twilight 2' zine (through paper trail distro) rips this publication apart & its authors brilliantly. You've been warned!!!!