Barriers to stopping neuroleptic (antipsychotic) treatment in people with schizophrenia, psychosis or bipolar disorder

Therapeutic Advances in Psychopharmacology
Joanna MoncrieffMark Abie Horowitz

Abstract

Most guidelines recommend long-term, indefinite neuroleptic (or antipsychotic) treatment for people with schizophrenia, recurrent psychosis or bipolar disorder, on the basis that these medications reduce the chance of relapse. However, neuroleptics have significant adverse effects, including sexual dysfunction, emotional blunting, metabolic disturbance and brain shrinkage, and patients often request to stop them. Evidence for the benefits of long-term treatment is also not as robust as generally thought. Short-term randomised trials show higher rates of relapse among those whose neuroleptic treatment is discontinued compared with those on maintenance treatment, but they are confounded by adverse effects associated with the withdrawal of established medication. Some longer-term studies show possible advantages of medication reduction and discontinuation in terms of improved social functioning and recovery. Therefore, there is a good rationale for supporting patients who wish to stop their medication, especially given the patient choice agenda favoured by The National Institute for Clinical Excellence (NICE). The major barrier to stopping antipsychotics is an understandable fear of relapse among patients, their families and clini...Continue Reading

References

Dec 1, 1991·Archives of General Psychiatry·T SuppesM Tohen
Aug 1, 1972·Psychological Medicine·R L CundallL G Murray
Mar 1, 1995·Archives of General Psychiatry·R J Baldessarini, A C Viguera
Oct 1, 1994·The American Journal of Psychiatry·J D HegartyG Oepen
Jan 1, 1997·Archives of General Psychiatry·A C VigueraM Tohen
Jan 1, 1997·Schizophrenia Bulletin·W S FentonR K Heinssen
Mar 21, 2001·Bipolar Disorders·R J BaldessariniA C Viguera
Aug 28, 2002·The Annals of Pharmacotherapy·Mong-Liang LuWinston W Shen
Apr 1, 1959·The American Journal of Psychiatry·G W BROOKS
Aug 1, 1961·The American Journal of Psychiatry·L N JUDAHO D MURPHREE
Mar 18, 2004·Psychology and Psychotherapy·Rachael CarrickKeith Lloyd
Mar 10, 2005·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Karl-Anton Dorph-PetersenDavid A Lewis
Apr 6, 2005·Archives of General Psychiatry·Jeffrey A LiebermanUNKNOWN HGDH Study Group
Aug 5, 2005·The New England Journal of Medicine·Lars Osterberg, Terrence Blaschke
Feb 3, 2006·History of Psychiatry·Margaret HarrisDavid Healy
May 7, 2009·Current Opinion in Psychiatry·Richard Warner
Jan 22, 2011·Pharmacoepidemiology and Drug Safety·G C AlexanderR S Stafford
Feb 9, 2011·Archives of General Psychiatry·Beng-Choon HoVincent Magnotta
May 13, 2011·International Journal of Qualitative Studies on Health and Well-being·Petra Gunnmo, Helena Fatouros Bergman
Aug 20, 2011·The Annals of Pharmacotherapy·Jessika Roy-DesruisseauxJean-François Trudel
Jan 18, 2013·Journal of the History of the Neurosciences·Joanna Moncrieff
Aug 21, 2013·Journal of Clinical Psychopharmacology·Irene M LakoKatja Taxis
Jul 22, 2014·The British Journal of Clinical Psychology·Andrew I GumleyKevin G Power
Sep 19, 2015·The British Journal of Psychiatry : the Journal of Mental Science·Mao-Sheng RanMeng-Ze Xiang
Mar 18, 2016·Qualitative Health Research·Gabrielle Le GeytGillian Haddock
Mar 10, 2017·Schizophrenia Research·Regitze Sølling WilsMerete Nordentoft
May 6, 2017·The American Journal of Psychiatry·Donald C GoffJeffrey A Lieberman
Apr 7, 2018·The American Journal of Psychiatry·Jari TiihonenHeidi Taipale
Apr 25, 2018·Social Psychiatry and Psychiatric Epidemiology·Miriam Larsen-BarrKerry Gibson
Jun 2, 2018·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Christoph U CorrellJohn M Kane

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Citations

Jan 12, 2021·Thérapie·Louise CartonRomain Guilhaumou
Mar 24, 2021·Schizophrenia Bulletin·Mark Abie HorowitzDavid Taylor
Apr 3, 2021·Therapeutic Advances in Psychopharmacology·Miriam Larsen-Barr, Fred Seymour
Jun 16, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·David RoeYaara Zisman-Ilani
Sep 21, 2021·Psychological Medicine·Mark A HorowitzIris E C Sommer

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