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Tapering antipsychotic medication: practical considerations

Published online by Cambridge University Press:  20 September 2021

Mark A. Horowitz*
Affiliation:
Department of Psychiatry, University College London, London, UK Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
Joanna Moncrieff
Affiliation:
Department of Psychiatry, University College London, London, UK Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
Lieuwe de Haan
Affiliation:
Amsterdam UMC, location AMC/Arkin, Amsterdam, Netherlands
Jan P.A.M. Bogers
Affiliation:
Mental Health Organisation Rivierduinen, High Care Clinics, Leiden, The Netherlands
Shiral S. Gangadin
Affiliation:
Department of Biomedical Sciences of Cells and Systems, Rijksuniversiteit Groningen, University Medical Center Groningen, Groningen, Netherlands
Martijn Kikkert
Affiliation:
Research Department, Arkin, Amsterdam, Netherlands
Wim Veling
Affiliation:
Department of Psychiatry, Rijksuniversiteit Groningen, University Medical Center Groningen, Groningen, Netherlands
Iris E. C. Sommer
Affiliation:
Department of Biomedical Sciences of Cells and Systems, Rijksuniversiteit Groningen, University Medical Center Groningen, Groningen, Netherlands Department of Psychiatry, Rijksuniversiteit Groningen, University Medical Center Groningen, Groningen, Netherlands
*
Author for correspondence: Mark A. Horowitz, E-mail: mark_horo@hotmail.com; m.horowitz@ucl.ac.uk

Abstract

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Type
Commentary
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Begemann, M. J. H., Thompson, I. A., Veling, W., Gangadin, S. S., Geraets, C. N. W., van ‘t Hag, E., … Sommer, I. E. C. (2020). To continue or not to continue? Antipsychotic medication maintenance versus dose-reduction/discontinuation in first episode psychosis: HAMLETT, a pragmatic multicenter single-blind randomized controlled trial. Trials, 21(1), 147. https://doi.org/10.1186/s13063-019-3822-5CrossRefGoogle ScholarPubMed
Bjornestad, J., Lavik, K. O., Davidson, L., Hjeltnes, A., Moltu, C., & Veseth, M. (2019). Antipsychotic treatment – a systematic literature review and meta-analysis of qualitative studies. Journal of Mental Health, 0(0), 111. https://doi.org/10.1080/09638237.2019.1581352Google Scholar
Bogers, J. P. A. M., Hambarian, G., Michiels, M., Vermeulen, J., & de Haan, L. (2020). Risk factors for psychotic relapse after dose reduction or discontinuation of antipsychotics in patients with chronic schizophrenia: A systematic review and meta-analysis. Schizophrenia Bulletin Open, 1(1), 112. https://doi.org/10.1093/schizbullopen/sgaa002.CrossRefGoogle Scholar
Borison, R. L., Diamond, B. I., Sinha, D., Gupta, R. P., & Ajiboye, P. A. (1988). Clozapine withdrawal rebound psychosis. Psychopharmacology Bulletin, 24(2), 260263. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3212159Google ScholarPubMed
Bowtell, M., Eaton, S., Thien, K., Bardell-Williams, M., Downey, L., Ratheesh, A., … O'Donoghue, B. (2018). Rates and predictors of relapse following discontinuation of antipsychotic medication after a first episode of psychosis. Schizophrenia Research, 195(13–14), 231236. https://doi.org/10.1016/j.schres.2017.10.030CrossRefGoogle ScholarPubMed
Cooper, R. E., Laxhman, N., Crellin, N., Moncrieff, J., & Priebe, S. (2019). Psychosocial interventions for people with schizophrenia or psychosis on minimal or no antipsychotic medication: A systematic review. Schizophrenia Research, 225, 1530. https://doi.org/10.1016/j.schres.2019.05.020.CrossRefGoogle ScholarPubMed
Cosci, F., & Chouinard, G. (2020). Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications. Psychotherapy and Psychosomatics, 89(5), 283306. https://doi.org/10.1159/000506868CrossRefGoogle ScholarPubMed
Horowitz, M. A., Jauhar, S., Natesan, S., Murray, R. M., & Taylor, D. M. (2021). A method for tapering antipsychotic treatment that may minimize the risk of relapse. Schizophrenia Bulletin, 47(4), 11161129.CrossRefGoogle ScholarPubMed
Horowitz, M. A., Murray, R. M., & Taylor, D. (2020). Tapering antipsychotic treatment. JAMA Psychiatry, 78(2), 125126. https://doi.org/10.1001/jamapsychiatry.2020.2166.CrossRefGoogle Scholar
Kahn, R. S., Winter van Rossum, I., Leucht, S., McGuire, P., Lewis, S. W., Leboyer, M., … Sommer, I. E. (2018). Amisulpride and olanzapine followed by open-label treatment with clozapine in first-episode schizophrenia and schizophreniform disorder (OPTiMiSE): A three-phase switching study. The Lancet. Psychiatry, 5(10), 797807. https://doi.org/10.1016/S2215-0366(18)30252-9CrossRefGoogle ScholarPubMed
Leucht, S., Tardy, M., Komossa, K., Heres, S., Kissling, W., Salanti, G., & Davis, J. M. (2012). Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: A systematic review and meta-analysis. The Lancet, 379(9831), 20632071. https://doi.org/10.1016/S0140-6736(12)60239-6CrossRefGoogle ScholarPubMed
Moncrieff, J., Gupta, S., & Horowitz, M. A. (2020). Barriers to stopping neuroleptic (antipsychotic) treatment in people with schizophrenia, psychosis or bipolar disorder. Therapeutic Advances in Psychopharmacology, 10, 110. https://doi.org/10.1177/2045125320937910.CrossRefGoogle ScholarPubMed
Moncrieff, J., Lewis, G., Freemantle, N., Johnson, S., Barnes, T. R. E., Morant, N., … Priebe, S. (2019). Randomised controlled trial of gradual antipsychotic reduction and discontinuation in people with schizophrenia and related disorders: The RADAR trial (Research into Antipsychotic Discontinuation and Reduction). BMJ Open, 9(11), e030912. https://doi.org/10.1136/bmjopen-2019-030912CrossRefGoogle Scholar
Pitschel-Walz, G., Leucht, S., Bäuml, J., Kissling, W., & Engel, R. R. (2001). The effect of family interventions on relapse and rehospitalization in schizophrenia – A meta-analysis. Schizophrenia Bulletin, 27(1), 7392. https://doi.org/10.1093/oxfordjournals.schbul.a006861CrossRefGoogle ScholarPubMed
Read, J., & Williams, J. (2019). Positive and negative effects of antipsychotic medication: An international online survey of 832 recipients. Current Drug Safety, 14(3), 173181. https://doi.org/http://dx.doi.org/10.2174/1574886314666190301152734.CrossRefGoogle ScholarPubMed
Shimomura, Y., Kikuchi, Y., Suzuki, T., Uchida, H., Mimura, M., & Takeuchi, H. (2020). Antipsychotic treatment in the maintenance phase of schizophrenia: An updated systematic review of the guidelines and algorithms. Schizophrenia Research, 215, 816. https://doi.org/https://doi.org/10.1016/j.schres.2019.09.013CrossRefGoogle ScholarPubMed
Sommer, I. E. C., Oomen, P. P., & Hasan, A. (2019). Maintenance treatment for patients with a first psychotic episode. Current Opinion in Psychiatry, 32(3), 147156. https://doi.org/10.1097/YCO.0000000000000494CrossRefGoogle ScholarPubMed
Thompson, A., Singh, S., & Birchwood, M. (2016). Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis. Early Intervention in Psychiatry, 10(4), 355361. https://doi.org/10.1111/eip.12244CrossRefGoogle ScholarPubMed
Thompson, J., Stansfeld, J. L., Cooper, R. E., Morant, N., Crellin, N. E., & Moncrieff, J. (2020). Experiences of taking neuroleptic medication and impacts on symptoms, sense of self and agency: A systematic review and thematic synthesis of qualitative data. Social Psychiatry and Psychiatric Epidemiology, 55(2), 151164. https://doi.org/10.1007/s00127-019-01819-2CrossRefGoogle ScholarPubMed
Verghese, C., DeLeon, J., Nair, C., & Simpson, G. M. (1996). Clozapine withdrawal effects and receptor profiles of typical and atypical neuroleptics. Biological Psychiatry, 39(2), 135138. https://doi.org/10.1016/0006-3223(95)00215-4CrossRefGoogle ScholarPubMed
Weller, A., Gleeson, J., Alvarez-Jimenez, M., McGorry, P., Nelson, B., Allott, K., … Killackey, E. (2019). Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: Study protocol. Early Intervention in Psychiatry, 13(6), 13451356. https://doi.org/10.1111/eip.12769CrossRefGoogle ScholarPubMed
Wunderink, L. (2018). Who needs antipsychotic maintenance treatment and who does not? Our need to profile and personalize the treatment of first episode psychosis. Schizophrenia Research, 197, 6566. https://doi.org/10.1016/j.schres.2017.11.007CrossRefGoogle ScholarPubMed
Wunderink, L., Nieboer, R. M., Wiersma, D., Sytema, S., & Nienhuis, F. J. (2013). Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry, 70(9), 913920. https://doi.org/10.1001/jamapsychiatry.2013.19CrossRefGoogle ScholarPubMed