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‘Deprescribing’ antipsychotics in schizophrenia: witless and dangerous?: COMMENTARY ON… DEPRESCRIBING ANTIPSYCHOTICS

  • Ann Mortimer (a1)
Summary

‘Deprescribing’ here comprises arguments against treating patients who have been psychotic beyond first episode. Nevertheless, four out of five patients relapse, compared with only two of five still taking medication. However, much first-episode psychosis is not schizophrenia, but persistent substance-induced psychotic disorder. Virtually nothing is known about factors which facilitate this in the minority who develop it, nor how to decide if the patient will relapse off medication. Patients who are well, stable and tolerating minimal doses of medication should be the first to suggest that they try to do without it, not us.

DECLARATION OF INTEREST

A.M. has worked with pharmaceutical companies regarding the introduction of atypical antipsychotic treatments for schizophrenia, received research funding and spoken at conferences.

Copyright
Corresponding author
Correspondence Ann Mortimer, NAViGO House, 3–7 Brighowgate, Grimsby DN32 0QE, UK. Email: ann.mortimer@nhs.net
References
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Chen, EHY, Lam, MML, Chiu, CPY, et al. (2010) Maintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis: randomised controlled trial. BMJ, 341: c4024.
Gupta, S, Cahill, JD, Miller, R (2018) Deprescribing antipsychotics: a guide for clinicians. BJPsych Advances, 24(5): 295302.
Mortimer, A (2015) Early intervention in psychosis: another triumph of hope over experience? Progress in Neurology and Psychiatry, 19(3): 10–4.
Niemi-Pynttar, JA, Sund, R, Putkonen, H, et al. (2013) Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. Journal of Clinical Psychiatry, 74(1): 94–9.
O'Donoghue, B, Lyne, J, Renwick, L (2012) A descriptive study of ‘non cases’ and referral-rates to an early intervention for psychosis service. Early Interventions in Psychiatry, 6(3): 276–82.
Shrek (2001) produced by PDI/Dreamworks, USA. Directed by Andrew Adamson and Vicky Jenson. [Film].
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BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
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‘Deprescribing’ antipsychotics in schizophrenia: witless and dangerous?: COMMENTARY ON… DEPRESCRIBING ANTIPSYCHOTICS

  • Ann Mortimer (a1)
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