Withdrawing from antipsychotics may require months or even years, and patients need to gradually reduce to very low doses, according to a new analysis led by University College London (UCL) and King’s College London academics. The review, published online on March 23, 2021 in Schizophrenia Bulletin, is believed to be the first-ever scientific paper outlining how exactly antipsychotic medication should be reduced in order to minimize both withdrawal effects and the risk of relapse. The open-access article is titled “A Method for Tapering Antipsychotic Treatment That May Minimize the Risk of Relapse” (https://academic.oup.com/schizophreniabulletin/advance-article/doi/10.1093/schbul/sbab017/6178746?searchresult=1). Withdrawal symptoms can be severe, and may include psychotic symptoms similar to the underlying condition, which can result in patients being advised to remain on the medication indefinitely, even though the new symptoms might have been avoidable with a carefully-managed withdrawal. The review’s lead author Dr. Mark Horowitz (UCL Psychiatry) said: “Surprisingly, there are no published guidelines on how to come off antipsychotics. From my own experience I know how hard it can be to wean off psychiatric medications--so we set out to write guidance on how to withdraw safely from antipsychotics. Stopping medications is an important part of the job of a psychiatrist, yet it has received relatively little attention.” Antipsychotics are one of the fastest growing classes of drugs being prescribed in England (https://nhsbsa-opendata.s3-eu-west-2.amazonaws.com/mh-annual-narrative-final.html), growing from 660,000 people (9.4 million prescriptions) in 2015/2016 to 750,000 people in 2019/2020.
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