Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem

Medical Hypotheses
Joanna Moncrieff

Abstract

In this paper, I argue that the problems that occur after discontinuation or reduction of long-term psychiatric drug treatment may be caused by the process of drug withdrawal itself, rather than representing the course of the underlying illness. Adverse effects induced by discontinuation of psychiatric medication include: (1) a somatic discontinuation syndrome that includes psychological symptoms which may be mistaken for relapse, (2) a rapid onset psychotic reaction after withdrawal of both conventional neuroleptic drugs and some atypicals, notably clozapine (sometimes referred to as supersensitivity psychosis), (3) a psychological reaction to withdrawal, which may be mistaken for relapse or may itself precipitate relapse, (4) a genuine relapse of the underlying condition precipitated by the process of withdrawal. The implications of these effects include the possibility that much of the research on maintenance treatment is flawed and that the recurrent nature of psychiatric conditions may sometimes be iatrogenic. If withdrawal induced adverse effects could be effectively managed, the success of drug discontinuation might be much greater than usually assumed and might outweigh the disadvantages of continued treatment.

References

Nov 1, 1978·The American Journal of Psychiatry·G GardosD Tarsy
Dec 15, 1978·Psychopharmacology·P Muller, P Seeman
Jan 1, 1977·The American Journal of Psychiatry·W T CarpenterJ S Strauss
Apr 1, 1992·The Journal of Nervous and Mental Disease·B KirkpatrickR W Buchanan
Jan 1, 1991·Journal of Substance Abuse Treatment·H Ashton
Dec 1, 1991·Archives of General Psychiatry·T SuppesM Tohen
Sep 11, 1990·The American Journal of Psychiatry·W T CarpenterR W Buchanan
Jan 1, 1987·International Clinical Psychopharmacology·S C DilsaverR M Snider
Mar 1, 1995·Archives of General Psychiatry·R J Baldessarini, A C Viguera
Jun 1, 1993·Archives of General Psychiatry·G L FaeddaM Tohen
Jan 1, 1997·Archives of General Psychiatry·A C VigueraM Tohen
Apr 29, 1998·Harvard Review of Psychiatry·A C VigueraJ Friedberg
Mar 5, 1999·Journal of Psychopharmacology·R Tranter, D Healy
May 6, 1999·Psychopharmacology·A J GoudieC Cavanagh
Apr 19, 2000·Journal of Clinical Psychopharmacology·M Bauer, S Döpfmer
Mar 21, 2001·Bipolar Disorders·R J BaldessariniA C Viguera
Aug 2, 2001·The American Journal of Psychiatry·G L FaeddaR J Baldessarini
Jul 5, 2002·Psychotherapy and Psychosomatics·Ross J BaldessariniAdele C Viguera
Jan 17, 2004·Acta Psychiatrica Scandinavica·J CavanaghG M Goodwin
Jun 23, 2004·Journal of Clinical Psychopharmacology·John M Davis, Nancy Chen
Jul 16, 2005·BMJ : British Medical Journal·Joanna Moncrieff, Irving Kirsch
May 27, 2006·PLoS Medicine·Joanna Moncrieff, David Cohen

❮ Previous
Next ❯

Citations

Feb 18, 2009·The Australian and New Zealand Journal of Psychiatry·Paul Schimmel
Feb 23, 2008·BioPsychoSocial Medicine·Donald BakalJeffrey Schaefer
Mar 7, 2014·Journal of Psychoactive Drugs·Joanna MoncrieffSally Porter
Jun 26, 2007·Current Medical Research and Opinion·Gary SullivanDavid Taylor
Jan 21, 2016·Case Reports in Psychiatry·Tarek ShahrourTaoufik Alsaadi
Oct 10, 2014·Journal of Psychiatric and Mental Health Nursing·C SalomonS Elsom
Nov 30, 2011·International Journal of Psychiatry in Clinical Practice·F KapsaliC Papageorgiou
Oct 6, 2016·International Journal of Mental Health Nursing·Irshad AhmadInayat Shah
May 14, 2011·The Australian and New Zealand Journal of Psychiatry·Sudhir KumarAshutosh Singh
Jun 26, 2017·Psychotherapy and Psychosomatics·Guy ChouinardMasaomi Iyo
Oct 11, 2017·Journal of Clinical Psychopharmacology·Praveen NavkhareSahoo Saddichha
Feb 29, 2016·Pharmacological Reports : PR·Grzegorz CessakEwa Bałkowiec-Iskra
Jun 1, 2017·NPJ Schizophrenia·Robin Emsley
Oct 15, 2020·Psychological Medicine·Robert Whitaker
Mar 24, 2021·Early Intervention in Psychiatry·Martijn J KikkertIris E Sommer
Apr 3, 2021·Therapeutic Advances in Psychopharmacology·Miriam Larsen-Barr, Fred Seymour
Mar 21, 2019·Psychotherapy and Psychosomatics·Alexander M Récalt, David Cohen
Mar 30, 2019·Psychotherapy and Psychosomatics·David Cohen, Alexander Recalt

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here