Attempting to discontinue antipsychotic medication: Withdrawal methods, relapse and success

• Published in: Psychiatry research 2018-12, Vol.270, p.365-374
• Main Authors: Larsen-Barr, Miriam, Seymour, Fred, Read, John, Gibson, Kerry
• Format: Article
• Language: English
• Subjects: Human rights; Informed choice; Neuroleptic medications; Psychosis treatment; Service user research
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.10.001

•Among 105 people who attempted to stop taking antipsychotic medication, less than half consulted a doctor in preparation and approximately a third used a gradual withdrawal method.•Just over half described successfully stopping and half reported no current use.•Unwanted withdrawal effects were reported by 61.9% of the group and spanned emotional, cognitive, physical, and functional domains.•Withdrawing gradually across more than one month showed significant, positive associations with self-described success and no current use. Few studies explore subjective experiences of attempting to discontinue antipsychotic medication, the withdrawal methods people use, or how their efforts affect their outcomes. People who take antipsychotics for off-label purposes are poorly represented in the literature. This study investigates experiences of attempting to discontinue antipsychotics in a cross-sectional sample and explores potential associations between withdrawal methods, relapse, and success. An anonymous online survey was completed by 105 adults who had taken antipsychotics for any reason and had attempted discontinuation at least once. A mixed methods approach was used to interpret the responses. Just over half (55.2%) described successfully stopping for varying lengths of time. Half (50.5%) reported no current use. People across diagnostic groups reported unwanted withdrawal effects, but these were not universal. Withdrawing gradually across more than one month was positively associated, and relapse was negatively associated with both self-defined successful discontinuation and no current use. Gradual withdrawal was negatively associated with relapse during withdrawal. We conclude it is possible to successfully discontinue antipsychotic medication, relapse during withdrawal presents a major obstacle to successfully stopping AMs, and people who withdraw gradually across more than one month may be more likely to stop and to avoid relapse during withdrawal.