Definition of Terms
Acetylcholine: (ah-seat-till-co-leen) A type of neurotransmitter released by all neurons that control the activity of the skeletal muscles, heart beat, some glandular functions, mood, sleep and memory. It is essential to the transmission of brain/spinal-cord messages. See cholinergic.
Addiction: Dependence on a chemical substance to the extent that the physiological and/or psychological need is established. This may be manifested by any combination of the following symptoms: tolerance, preoccupation with obtaining and using the substance, use of the substance despite anticipation of probable adverse consequences, repeated efforts to cut down or control substance use, and withdrawal symptoms when the substance is unavailable or not used.
Adherence: (ad-here-rents) the degree to which the client follows the prescribed course of medication administration. Used as an alternative term to “compliance”, which has overtones of client passivity and obedience, and “noncompliance”, which have overtones of deviancy.
Affect: (aff-fect) Behavior that expresses a subjectively experienced feeling state (emotion); affect is responsive to changing emotional states, whereas mood refers to a pervasive and sustained emotion. Common affects are euphoria, anger, and sadness.
Akathisia: (ack-ka-thees-ya) Complaints of restlessness accompanied by movements such as fidgeting of the legs, rocking from foot to foot, pacing, or inability to sit or stand. Symptoms develop within a few weeks of starting or raising the dose of a neuroleptic medication or of reducing the dose of medication used to treat extrapyramidal symptoms (see extra pyramidal symptoms).
Akinesia: (ack-kin-nees-ya) A state of motor inhibition; reduced voluntary movement.
Alogia: (ah-loge-ya) literally, speechlessness. Most commonly used to refer to the lack of spontaneity in speech and diminished flow of conversation that occurs as negative symptoms in schizophrenia.
Agranulocytosis: (ah-gran-you-low-sigh-toe-sis) A dramatic decrease in the number of infection-fighting white blood cells. Agranulocytosis is a very rare side effect of antipsychotic drugs, most notably of clozapine. Even in the case of clozapine, it is said to afflict only 1-2% of users, and the ill effects of this disease can be reversed if it is identified early, and the drug discontinued.
Amygdala: (ah-mig-dah-lah) In the structure of the brain, part of the basal ganglia. As an important component of the limbic system, it is most consistently linked with emotional reactivity, basic learning and memory processes.
Anhedonia: (an-he-doan-ya) Inability to experience pleasure from activities that usually produce pleasurable feelings.
Anticholinergic (an-tie-koh-lin-urr-jick) (Side) Effects: Adverse effects that result from the suppressive action of certain antipsychotic and antidepressant medications on the action of acetylcholine in the brain and peripheral nervous system. The actual side effects include dry mouth, blurred vision, constipation, and urinary hesitancy.
Antiparkinsonian drugs: (an-tie-park-in-so-nee-an) Pharmacologic agents that reduce Parkinson-like symptoms. In psychiatry, these agents are used to combat the untoward Parkinson-like and extrapyramidal side effects that may be associated with treatment with neuroleptic drugs.
Anxiolytics: Drugs that have an antianxiety effect and are used widely to relieve emotional tension. The most commonly used antianxiety drugs are the benzodiazepines.
Asperger’s disorder: A developmental disorder characterized by gross and sustained impairment in social interaction and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities; occurs in the context of preserved cognitive and language development.
Autism: (aught-tism) A form of developmental disorder in which the subjective predominates and the “me” is favored, sometimes resulting in the exclusion of the “not-me”. The subject is unable to turn his or her energies to outside reality. Introversion and avoidance of contact may be marked; occurs in the context of severely restricted cognitive and language development.
Autonomic (ought-toe-naw-mick) nervoussystem: Regulates the involuntary processes of the internal organs and blood vessels. Many of the functions controlled by the autonomic nervous system are self-regulating or autonomous. It is comprised of two primary subsystems: the sympathetic and parasympathetic systems, which sometimes work in cooperation but other times are antagonistic in their contrasting roles of “arousal” and “rest”.
Avolition A symptom of mental illness that is particularly common in schizophrenia. This symptom is expressed as extreme apathy and loss of normal drive and interest. An avolitional patient often finds it difficult to get started at tasks or, if he begins a task, often gives up before he has finished it.
Axon: (ax-zon) A nerve-fiber projection from the neuron that serves to transmit signals to adjacent neurons. Neurotransmitter substances are contained within an axon. The axon terminal (or end) is also the site of the neurotransmitter release.
Basal ganglia: (baze-zull-gangly-uh) Structures located on both sides of the limbic system, involved in the regulation of movement and in a variety of neuropsychiatric symptoms including dementia, major depression and psychosis. Contains the caudale nucleus, the key area of the brain involved in learning and breaking habits.
Behavioral sensitization: The increasing response of a laboratory animal to repeated administration of the same dose of a stimulant drug. Compare kindling.
Benzodiazepines: (ben-zoe-die-azza-pens) The generic name for a group of drugs that have potent hypnotic, sedative, and anxiolytic action. They are also called anxiolytics or antianxiety drugs.
Beta-blockers: (bay-ta) Refers to a class of drugs that reduces anxiety by blocking the beta receptors in the autonomic nervous system. They block those receptors that stimulate heart beat and those that dilate blood vessels and air channels in the lungs. They are as strong as benzodiazepines, despite the greater dosages needed, and they are not addicting. They are, however, short-acting and do not remain long in the system. They are most effective for specific situations of unmanageable anxiety.
Biological psychiatry: A school of psychiatric thought that emphasizes physical, chemical, and neurological causes of psychiatric illness and treatment approaches.
Catatonic behavior: (catta-tahn-nic) Marked motor abnormalities, generally limited to those occurring as part of a psychotic disorder. This term includes catatonic excitement (apparently purposeless agitation not influenced by external stimuli), stupor (decreased reactivity and fewer spontaneous movements, often with apparent unawareness of the surroundings), negativism (apparent motiveless resistance to instructions or attempts to be moved), posturing (the person’s assuming and maintaining and inappropriate or bizarre stance), rigidity (the person’s maintaining a stance of posture against all efforts to be moved), and waxy flexibility (the person’s limbs can be put into positions that are maintained).
Central nervous system (CNS): The brain and the spinal cord.
Cerebral cortex: (sair-reeb-brul) The upper portion of the brain consisting of layers of neurons and pathways connecting them. The cerebral cortex is divided into four lobes on each side and is the part of the brain responsible for higher order thinking and decision making.
Cerebrospinal fluid (CSF): (sair-rreb-bro-spine-nal) Fluid manufactured in the brain and contained within the brain and spinal cord; it circulates in the central nervous system.
Cholinergic: (coll-lin-nerge-gick) Activated by acetylcholine, this is the part of the autonomic nervous system that controls the life-sustaining organs of the body.
Chronic: Continuing over a long period of time, or recurring frequently. Chronic conditions often begin inconspicuously, and symptoms may be less pronounced than in acute conditions.
Clozapine: (kloh-zah-peen) (Clozaril) An antipsychotic drug found effective in treating severe and persistent schizophrenia. It is not used as a first-line anti-psychotic drug because it produces a small risk of agranulocytosis, a depletion of white blood cells that can be fatal if not monitored. Clozapine has demonstrated effectiveness in treating both the positive and negative symptoms of schizophrenia.
Comorbidity: (coe-more-bid-ditty) The occurrence of two or more disorders at the same time. The disorders may occur independently of each other, or one may occur as a consequence of the other.
Confidentiality: (con-fid-den-she-al-ity) The ethical principle that a physician may not reveal any information disclosed in the course of medical attendance.
Cyclothymic disorder: Refers to frequent episodes of hypomania and mild depression occurring over at least a 2-year period.
Deinstitutionalization: (de-insta-toosh-in-nal-lye-zay-shun) Change in locus of mental health care from traditional, institutional settings to community-based services. Sometimes called trans-institutionalization because it often merely shifts the patients from one institution (the hospital) to another (such as a prison).
Delusion: (dee-lose-yun) A belief that is clearly implausible but compelling and central to an individual’s life.
Dendrite: (den-dright) The short extension of the neuron that is the neuron’s “receiving end” for signals sent from other cells, it is located close to the axons of other cells but separated by a short distance from the synaptic cleft.
Depersonalization: (dee-person-nal-eye-zay-shun) Feelings of unreality or strangeness concerning either the environment, the self, or both. This is characteristic of depersonalization disorder and may also occur in schizotypal personality disorder, schizophrenia, and in those persons experiencing overwhelming anxiety, stress or fatigue.
Depression: An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Depression, Bipolar: Formerly called manic- depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder involves cycles of depression and elation or mania. Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, you can have any or all of the symptoms of a depressive disorder. When in the manic cycle, any or all symptoms listed under mania may be experienced. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, unwise business or financial decisions may be made when an individual is in a manic phase. Bipolar disorder is often a chronic recurring condition.
Derealization: (dee-ree-al-eye-zay-shun) A feeling of estrangement or detachment from one’s environment. May be accompanied by depersonalization.
Detoxification: (dee-tox-see-fih-cay-shun) The process of providing medical care during the removal of depedence-producing substances from the body so that withdrawal symptoms are minimized and physiological function is safely restored. Treatment includes medication, rest, diet, fluids, and nursing care.
Dexamethasone - suppression text (DST): (deck-sah-meth-tha-zone) A test of hormone function sometimes used as a diagnostic tool in depression. In healthy individuals, the administration of dexamethasone suppresses the concentration of cortisol in the blood. Approximately 40-50% of persons diagnosed with major depression have an abnormal DST in that they do not suppress cortisol in response to dexamethasone.
Differential diagnosis: The consideration of which of two or more diseases with similar symptoms the patient suffers from.
Dopamine: (dope-pah-meen) A neurotransmitter, which regulates movement, mood and motivation. There are 3 major pathways in the brain’s dopamine system: 1) mesocortical: emotion, motivation, cognition; 2) mesolimbic: feelings, emotions, psychosis; 3) nigostriatal: planned and voluntary coordination of movement.
Dopamine hypothesis: A theory that attempts to explain the pathogenesis of schizophrenia and other psychotic states as due to excesses in dopamine activity in various areas of the brain. The theory is, in part, based on biological observations that the antipsychotic properties of specific drugs may be related to their ability to block the action of dopamine, and the opposite effects of stimulants that increase the action of dopamine.
DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, 1994. The American Psychiatric Association’s official classification of mental disorders.
Dual diagnosis: The co-occurrence within one’s lifetime of a psychiatric disorder and a substance use disorder. Comorbidity is the preferred term.
Dyskinesia: (disc-kin-nees-yah) Any disturbance of movement. It may also be induced by medication.
Dystonia: (diss-tony-yah) Abnormal positioning or spasm of the muscles of the head, neck, limbs, or trunk; the dystonia develops within a few days of starting or raising the dose of a neuroleptic medication, because of dysfunction of the extrapyramidal system.
Efficacy: (effi-ka-see) Effectiveness of a drug as a therapeutic agent, particularly over long-term use.
Electroconvulsive therapy (ECT): Use of electric currents, with anesthetics and muscle relaxants, applied briefly to one or both sides of the brain. Most effective in severe depression.
Electroencephalograph: (en-ceff-loe-graff) An instrument for measuring electrical waves generated by neurons in the brain.
Endocrine disorders: (end-doe-crin) Disturbances of the function of the ductless glands that may be metabolic in origin and may be associated with or aggravated by emotional factors, producing mental and behavioral disturbances in addition to physical signs.
Of particular significance in psychiatry is the hypothalamic-pituitary-adrenal (HPA) axis, consisting of a self-regulating circle of neurohormones released from the hypothalamus and stimulating the release of hormones from the pituitary. These in turn stimulate hormone secretion in target organs (thyroid, adrenal, and gonads). The HPA axis is involved in the regulation of sexual activity, thirst and hunger behaviors, sleep, learning and memory, and perhaps in antidepressant activity.
Epilepsy: (ep-pih-lep-see) A neurological disorder characterized by periodic motor and sensory seizures, sometimes accompanied by alternations of consciousness.
Euphoria: (you-for-ree-ya) An exaggerated feeling of physical and emotional well-being.
Euthymic (you-thigh-mick) mood state: A generally positive mood state, or state of emotional wellness, marked by the absence of chronic or serious mood disorders, which might affect social functioning negatively.
Extra pyramidal symptoms (EPS): (peer-ram-ih-dahl) A variety of signs and symptoms, including muscular rigidity, tremors, drooling, shuffling gait (parkinsonism); restlessness (akathisia); peculiar involuntary postures (dystonia); motor inertia (akinesia); and many other neurological disturbances. Results from dysfunction of the extrapyramidal system. May occur as a side effect of certain psychotropic drugs, particularly neuroleptics.
GABA: (gab-ah) (gama aminobutyric acid) An amino acid and neurotransmitter, found throughout the central nervous system, that has a vital dampening effect on the excitability of nerve cells.
Genes: Located at various points along the chromosomes, genes are bits of deoxyribonucleic acid (DNA) that carry the hereditary code. It is estimated that the human has approximately 100,000 genes, known collectively as the genome.
Glial cells: (glee-yal) “Glue cells”. Glial cells are small neurons that are specialized to provide nourishment and support for the command neurons located in gray matter regions such as the cortex or the basal ganglia.
Glutamate: (glute-tah-mate) A neurotransmitter; an amino acid governing much of human thought and emotion, regulating systems involved in cognitive and higher mental functions (memory, learning, sensory reception, information processing). Glutamate serves as the brains major excitatory neurotransmitter, causing neurons to “fire” rather than cease firing. Glutamate is also the sole source of GABA, the predominant inhibitory transmitter in the CNS.
Grandiosity: (gran-dee-oss-city) Exaggerated belief or claims of one’s importance of identity, often manifested by delusions of great wealth, power, or fame.
Hallucinations: (hah-loo-sin-nay-shuns) False perceptions that are heard, seen, tasted, smelled or felt.
Hippocampus: (hip-poe-camp-us) A nucleus in the brain crucial to learning and long-term memory; part of the limbic system.
Hypertensive crisis: Sudden and sometimes fatal rise in blood pressure; it may occur as a result of combining monoamine oxidase inhibitors and tyramine in food, or over-the-counter medications (e.g., cough remedies and nose drops).
Hypothalamus: (hype-poe-thall-uh-muss) The complex brain structure composed of many nuclei with various functions. It is the head ganglion of the autonomic nervous system and is involved in the control of heat regulation; heart rate, blood pressure, and respiration; sexual activity; water, fat, and carbohydrate metabolism; digestion, appetite, and body weight; wakefulness; fight or flight response; and rage.
Iatrogenic: (ee-yat-tro-gen-ic) Harmful effects presumed to be caused (inadvertently) by the treatment itself.
Illusion: A misperception of a real external stimulus.
Insomnia: Inability to fall asleep (also called initial insomnia); or stay asleep (also called middle insomnia) or waking up too early (also called terminal insomnia or early morning wakening).
Kindling: (kin-dling) The creation of seizures in an area of the brain by subjecting it to repeated, low level electrical stimulation; eventually the area becomes so sensitive that seizures will occur spontaneously, with no electrical stimulus.
Labile: (lay-bile) Rapidly shifting mood; unstable.
Limbic system: A network of structures in the forebrain (including the hippocampus, amygdala, thalamus, hypothalamus) that work to regulate human emotions such as fear, anger, depression, excitement and certain aspects of movement; regulates emotion, memory, arousal, cognition.
Lithium: Used in the treatment of acute mania and as a maintenance medication to help reduce the duration, intensity and frequency of bipolar disorder. There is a narrow band of effective dosage above which toxicity occurs and below which there is no effect; can also cause fetal damage.
Maintenance drug therapy: Continuing a therapeutic drug after it has reached its maximum efficacy, and at a minimum effective level to prevent an early relapse or a later recurrence of illness.
Manic depression: Alternating moods of abnormal highs (mania) and lows (depression). Called bipolar disease because of the swings between these opposing poles in mood.
Mental illness: A brain dysfunction. Afflicts millions of people in the United States. Often strikes young people in their most productive years. Includes schizophrenias, major depression and bi-polar illnesses (manic depression), which have definite biological components. Includes disturbed thinking, feeling and behavior affecting the whole person. Devastates caring families emotionally, physically, and financially. Can improve with proper treatment, rehabilitation and support.
Metabolite: (meh-tab-boe-lite) A compound that results from the chemical breakdown of a neurotransmitter in the space between nerve cells (synapse).
Neuroleptic: (nur-ro-lep-tik) Referring to a specific effect of a pharmacologic agent on the nervous system; specifically a drug whose principal effect is on psychomotor activity.
Neurons: (nurr-ronz) Nerve cells which carry information processing in the brain.
Neuroscience: The study of brain function, the neural substrates of behavior and how the nervous system is affected by disease.
Neurotransmitter: A chemical found in the nerve cells that acts as a “neuro-messenger” by carrying electrical impulses between neurons.
Norepinephrine: (nor-reppin-nef-frin) A type of neurotransmitter secreted by the adrenal glands in response to arousal-provoking events such as stress. It influences mood, emotional behavior, alertness, anxiety and tension.
Nucleus: In the minute structure of a typical cell, the nucleus is a denser body in its midst. It represents the directive center of most cellular activities, governing the process of cell division and hereditary transmission.
Orthostatic hypotension: (or-thoe-stat-tic high-poe-ten-shun) A drop in blood pressure resulting in a dizzy or faint feeling that is produced after suddenly sitting up or standing up. Many psychiatric drugs cause orthostatic hypotension. It can be a serious side effect in elderly patients.
Paranoia: (parra-noy-yah) A feeling or state in which someone believes others are trying to harm them when this is absolutely untrue.
Parietal lobe: (purr-eye-it-ahl) A physically distinct area of the cerebral cortex responsible for the intellectual processing of sensory information (visual, tactile, auditory) and responsible for verbal and visual-spatial processing.
Parkinsonian effects: (park-in-so-nee-an) Drug-induced effects resulting from an antipsychotic medications that mirror classical Parkinson’s disease symptoms, such as reduction in motor abilities and coordination, shuffling gait, drooling, muscle rigidity, and tremors. Ordinarily the effect occurs within 5 to 90 days of drug initiation.
Peptides, neuropeptides: Chemicals, including some hormones, which act as messengers in the brain and modulate the activity of many other neurotransmitters.
Pretrial phase: (pro-dro-mull) The phase during which a deteriorating state of health is recognized that later culminates in full-blown illness. During the deterioration phase, there are subtle warning signs of the impending illness, such as withdrawal, bizarre thoughts, or other behaviors recognized as precursors of a psychotic episode.
Prophylactic: A treatment or medication used to protect against the onset, or recurrence of a disease or disorder.
Psychomotor agitation: (adge-jih-tay-shun) Excessive motor activity, usually nonpurposeful and associated with internal tension. Examples include inability to sit still, fidgeting, pacing, wringing of hands, and pulling of cloths.
Psychopharmacology: (sigh-coe-far-muh-coll-oh-gee) The study of the action of drugs that affect thinking, emotion and behavior; the branch of medicine that specializes in medications to treat mental illnesses.
Psychosis: (sigh-coe-siss) A mental state characterized by extreme impairment of the sufferer’s perception of reality, including hallucinations, delusions, incoherence and bizarre behavior.
Psychotropic drugs: (sigh-coe-trope-pic) Drugs that alter psychological functioning and/or mood, thoughts, motor abilities, balance, movement, and coordination.
Receptor/receptor molecule: Protein molecules embedded in the wall of nerve cells that bind neurotransmitters. Each receptor binds a specific neurotransmitter, thereby turning a particular biochemical or cellular mechanism on or off. Receptors are generally found in the dendrite and cell body of neurons.
Refractory: (ree-fract-tree) Non-response to the known therapeutic effect of a drug or course of drug treatment; or, non-response due to increased tolerance to a drug over time. See treatment resistance.
Rehabilitation: In psychiatry, the methods and techniques used to achieve maximum functioning and optimum adjustment for the patient and to prevent relapses or recurrences of illness; sometimes termed tertiary prevention.
Reuptake: (ree-up-take) Removal of a neurotransmitter from the synapse by the neuron that released it; reabsorption.
Schizophrenia: One of several brain diseases whose symptoms that may include loss of personality (flat affect), agitation, catatonia, confusion, psychosis, unusual behavior, and withdrawal. The illness usually begins in early adulthood. The causes of schizophrenia are not yet fully known. Schizophrenia is not caused by poor parenting practices. A variant version of a gene called COMT has been found to increase the risk for developing schizophrenia. The normal version of the COMT gene helps process dopamine, a brain chemical. The variant version of the COMT gene is less active in this regard. Other genes and environmental factors may well be involved in schizophrenia.
Serotonin: (sair-ah-tone-in) A type of neurotransmitter that affects sensory processes, muscular activity, and cognition. It is a factor in states of consciousness, basic bodily functions, complex sensory and motor activities, and mood. Serotonin is thought to be implicated in mood disorders, aggression, and schizophrenia. Fluoxetine (Prozac) and clozapine (Clozaril) are thought to be significant effects of the serotonergic systems (those that produce serotonin).
Side effect: A drug response that accompanies the principal response for which a medication is taken. Most side effects are undesirable yet cause only minor disturbances; others may cause serious problems.
Sign: Objective evidence of disease or disorder. See also symptom.
Substance abuse: A maladaptive pattern of psychoactive substance use indicated by either: 1) continued use despite knowing that it causes or exacerbates a persistent or recurrent social, occupational, psychological, or physical problem, or 2) recurrent use in situations in which it creates a physical hazard (such as driving when intoxicated). Abuse refers to relatively mild, transient symptoms. Compare substance dependence.
Substance dependence: Impaired control over use of a psychoactive substance and continued use of the substance despite adverse consequences. Dependence can include physiological tolerance to a substance and is more serious and persistent than substance abuse.
Supportive psychotherapy: A treatment technique that helps a patient reduce stress and cope with his or her disorder without probing disturbing thoughts or emotions.
Sympathetic nervous systems: (simm-pah-thet-tic) The part of the autonomic nervous system that responds to dangerous or threatening situations by preparing a person physiologically for “fight or flight”.
Symptom: A specific manifestation of a patient’s condition indicative of an abnormal physical or mental state; a subjective perception of illness.
Synapse: (sin-naps) The gap between the membrane of one nerve cell and the membrane of another. The synapse is the space through which the nerve impulse is passed chemically or electrically, from one nerve to another.
Syndrome: (sin-drome) A configuration of symptoms that occur together and constitute a recognizable condition.
Tachycardia: (tack-ah-card-ee-ah) Unusually rapid heart beat (greater than 100 beats per minute) that may result from the side effects of antidepressants acting on the autonomic nervous system. It is a form of heart arrhythmia.
Tapering: The process of slowly decreasing the dose of medication over several days or weeks until the medication is completely discontinued. This is done to reduce or avoid withdrawal symptoms.
Tardive dyskinesia: (tar-div-disk-kin-nees-ya) A side-effect of traditional antipsychotic drugs. This side-effect, which involved abnormal involuntary movements of the face, tongue, mouth, fingers, upper and lower limbs, and occasionally the entire body, usually appears after taking the drug for some time and occurs in at least a mild form in 25 to 40 percent of patient on antipsychotic agents. Tardive dyskinesia may be severe or irreversible in 5 to 10 percent of cases.
Tolerance: The reduced responsiveness of the body to a drug as a function of reduced sensitivity of the nerve receptors over time.
Toxicity: (tox-sis-city) The capacity of a drug to damage body tissue or seriously impair body functions.
Tranquilizer: A drug that decreases anxiety and agitation. Preferred terms are antianxiety and antipsychotic drugs.
Treatment resistant: Lack of response to a specific therapy that would ordinarily be expected to be effective. The patient who does not respond to the usual dosage of a drug but does respond to a higher dosage is often termed a “relative resister”. Absolute resistance refers to the patient who fails to respond to any dosage of the drug. See refractory.
Tremor: (trem-mur) A trembling or shaking of the body or any of its parts. It may be induced by medication.
Withdrawal: A pathological retreat from people or the world of reality, often seen in schizophrenia.
Withdrawal symptoms: New symptoms that arise because a drug is discontinued. These almost always go away within two weeks of drug discontinuation. Tapering a drug rather than abruptly discontinuing it reduces and sometimes even eliminates withdrawal symptoms.