After a first episode of psychosis in schizophrenia and related disorders, stopping antipsychotics is considered when the patient has made a full recovery and been well for at least 12 months.
After symptom remission, continuation of antipsychotic treatment is associated with lower relapse rates and lower symptom severity compared to dose reduction/discontinuation. Therefore, most guidelines recommend continuation of treatment with antipsychotic medication for at least 1 year.
Consensus guidelines typically recommend continued antipsychotic medication for 1–2 years, although it has been suggested that treatment discontinuation in the form of targeted intermittent treatment (dose reduction, antipsychotic discontinuation if feasible, and immediate reintroduction if symptoms reemerge) should ...
Symptoms that may be experienced during antipsychotic discontinuation syndrome include: Vomiting, nausea, and/or diarrhea. Difficulty sleeping, restlessness, anxiety, and/or agitation. Dizziness.
If you stop antipsychotics suddenly it can cause 'rebound psychosis'. This means that the symptoms of your illness return suddenly, and you may become unwell again. This is also known as 'relapse'. If you or your family or friends think you are becoming unwell again, you should speak to your doctor.
The reasons people gave for discontinuing their meds included fear of health risks and side effects of long-term use. I am also aware that often psychiatrists offer drugs too quickly, and without also strongly advising the patient concurrently do therapy to help deal with emotional issues.
Antipsychotic drugs are harmful if you do not need them. For someone with dementia, antipsychotic drugs can make everyday activities more difficult. They also have dangerous side effects such as more anxiety, restlessness, loss of hunger or thirst, excessive sleeping and even death.
While not a certainty, long‐term antipsychotic treatment is a very common outcome for people with schizophrenia.
The studies in our review (8, 23–26) reported that most withdrawal symptoms started within 4 weeks after abrupt antipsychotic discontinuation and subsided after up to 4 weeks even though certain symptoms such as hyperkinesia may last for months (23).
"Studies have found that the volume of brain regions changes over a number of days, but this is in one to two hours, and in half that time it bounces back." Within a day, volunteers' brains returned to almost their original size as the effects of the single haloperidol dose subsided.
Prolonged use of antipsychotic medications is viewed as a key factor in treatment for schizophrenia, but there is very little systematic evidence for the long-term benefits of antipsychotics. There is even some longitudinal data suggesting the opposite.
Additionally, psychosocial approaches like family psychoeducation should be combined with pharmacological approaches in early phase of psychosis. Clinicians should monitor the medication adherence in every outpatient visit, and minimum duration of treatment is recommended as three years after remission.
Overall, tardive dyskinesia is the clearest adverse clinical consequence in brain functioning of long‐term antipsychotic treatment, which may be related to dopamine supersensitivity in a subgroup of vulnerable individuals.
Clozapine and olanzapine have the safest therapeutic effect, while the side effect of neutropenia must be controlled by 3 weekly blood controls. If schizophrenia has remitted and if patients show a good compliance, the adverse effects can be controlled.
A person usually begins to feel some improvement within six weeks of starting to take antipsychotic medication. However, it can take several months before they feel the full benefits. It is not possible to predict which medication will work best for a specific person.
All antipsychotics are generally effective, although differences exist in terms of efficacy but also in side effect profile. So far, all antipsychotics block the dopamine-2 (D2) receptor in the brain, including recently available antipsychotics such as lurasidone, cariprazine and brexpiprazole.
How do antipsychotics work? Antipsychotic drugs don't cure psychosis but they can help to reduce and control many psychotic symptoms, including: delusions and hallucinations, such as paranoia and hearing voices.
Ideally, patients who can be maintained on oral antipsychotics should be clinically stable for at least 3 to 6 months after resolution of acute-phase symptoms before a switch to an oral antipsychotic is considered, although this is not always possible.
First, relapse rates are higher than usually recognized when antipsychotics are discontinued, even after a single episode of psychosis. A recent systematic review reported a weighted mean one‐year recurrence rate of 77%, and by two years the risk of recurrence had increased to over 90%3.
More than seventy years after its discovery, lithium remains the most effective medication in all of psychiatry, with a response rate of more than 70% for patients with bipolar disorder. It also has useful applications in the treatment of unipolar depressions.
Formerly known as major tranquilizers and neuroleptics, antipsychotic medications are the main class of drugs used to treat people with schizophrenia. They are also used to treat people with psychosis that occurs in bipolar disorder, depression and Alzheimer's disease.
Lieberman and team looked at clinical trials and neuroscientific data, and they found that the therapeutic benefits of antipsychotic medication far outweigh their side effects.
Medication can help to stabilise your symptoms, so it's possible that your psychotic symptoms may return if you stop taking it. But it's not certain that this will happen. There are several factors that can affect whether you will become ill again.