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August 5, 2020

Tapering Antipsychotic Treatment

Author Affiliations
  • 1Division of Psychiatry, University College London, London, United Kingdom
  • 2Goodmayes Hospital, North East London Foundation Trust, Ilford, United Kingdom
  • 3Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
  • 4Department of Pharmacy, South London and Maudsley NHS Foundation Trust, London, United Kingdom
JAMA Psychiatry. 2021;78(2):125-126. doi:10.1001/jamapsychiatry.2020.2166

Antipsychotics are recommended for long-term treatment of schizophrenia because they reduce risk of relapse. However, antipsychotics have many adverse effects, including metabolic complications, tardive dyskinesia, and probable brain volume reduction.1 Patients may ask to reduce or stop their medication or do so abruptly without professional support, sometimes with dire consequences. As there is some evidence that not all patients need lifelong antipsychotic treatment and some may have improved social functioning when taking less or no antipsychotic,1 cautious deprescribing should be a component of high-quality prescribing practice. To our knowledge, there are currently no published guidelines on reduction or cessation of an antipsychotic; we propose principles relevant when deprescribing is thought appropriate.

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