Literature DB >> 29687219

Attempting to stop antipsychotic medication: success, supports, and efforts to cope.

Miriam Larsen-Barr1,2, Fred Seymour3, John Read4, Kerry Gibson3.   

Abstract

PURPOSE: To explore supports and coping strategies used during attempts to discontinue antipsychotic medication and test for associations with success.
METHOD: 144 people who were taking or had taken antipsychotics completed The Experiences of Antipsychotic Medication Survey. Among them, 105 people had made at least one discontinuation attempt and answered a series of questions about their most recent attempt to stop. Content analysis and Chi-square tests of independence were used to categorise the data and explore associations. Success was defined as stopping all AM use irrespective of the duration of the medication-free period or whether relapse occurred, which were explored separately.
RESULTS: Among the 105 people who had attempted discontinuation, 61.9% described unwanted withdrawal effects and 27.6% of the group described psychotic or manic relapse during the withdrawal period. Within this group 55% described successfully stopping all AM for varying lengths of time, half reported no current use, and half described having some form of professional, family, friend, and/or service user or peer support for their attempt. Having support was positively associated with success and negatively associated with both current use, and relapse during withdrawal. A range of coping efforts were described, but having coping strategies failed to show significant associations with any of the dependent variables explored. Among those who described successfully stopping, some described returning to AM for short periods when needed, while others reported managing well with alternative methods alone.
CONCLUSIONS: Findings cannot be readily generalised due to sampling constraints, but results suggest a wide range of supports and coping strategies may be used when attempting to discontinue antipsychotics. Many people may attempt to discontinue antipsychotics without any support. Those who have support for their attempts may be significantly less likely to relapse during withdrawal and more likely to succeed in their attempt. There is a pressing need for further research in this area.

Entities:  

Keywords:  Antipsychotics; Coping behaviour; Human rights; Medication withdrawal syndromes; Psychoses substance-induced; Social support

Mesh:

Substances:

Year:  2018        PMID: 29687219     DOI: 10.1007/s00127-018-1518-x

Source DB:  PubMed          Journal:  Soc Psychiatry Psychiatr Epidemiol        ISSN: 0933-7954            Impact factor:   4.328


  24 in total

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Authors:  Patrick McGorry; Mario Alvarez-Jimenez; Eoin Killackey
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2.  Predictors of discontinuation of antipsychotic medication and subsequent outcomes in the European First Episode Schizophrenia Trial (EUFEST).

Authors:  Karin Landolt; Wulf Rössler; Vladeta Ajdacic-Gross; Eske M Derks; Jan Libiger; René S Kahn; W Wolfgang Fleischhacker
Journal:  Schizophr Res       Date:  2016-02-26       Impact factor: 4.939

3.  Approach, avoidance, and coping with stress.

Authors:  S Roth; L J Cohen
Journal:  Am Psychol       Date:  1986-07

4.  Neuroleptic withdrawal in schizophrenic patients.

Authors:  R J Baldessarini; A C Viguera
Journal:  Arch Gen Psychiatry       Date:  1995-03

5.  Neuroleptic withdrawal in schizophrenic patients. A review of the literature.

Authors:  P L Gilbert; M J Harris; L A McAdams; D V Jeste
Journal:  Arch Gen Psychiatry       Date:  1995-03

6.  Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial.

Authors:  Lex Wunderink; Roeline M Nieboer; Durk Wiersma; Sjoerd Sytema; Fokko J Nienhuis
Journal:  JAMA Psychiatry       Date:  2013-09       Impact factor: 21.596

7.  Why and how people decide to stop taking prescribed psychiatric medication: exploring the subjective process of choice.

Authors:  David Roe; Hadass Goldblatt; Vered Baloush-Klienman; Margaret Swarbrick; Larry Davidson
Journal:  Psychiatr Rehabil J       Date:  2009

8.  Ambulatory use of olanzapine and risperidone: a population-based study on persistence and the use of concomitant therapy in the treatment of schizophrenia.

Authors:  Dan Cooper; Jocelyne Moisan; Michel Gaudet; Belkacem Abdous; Jean-Pierre Grégoire
Journal:  Can J Psychiatry       Date:  2005-12       Impact factor: 4.356

Review 9.  Risk of symptom recurrence with medication discontinuation in first-episode psychosis: a systematic review.

Authors:  Robert B Zipursky; Natasja M Menezes; David L Streiner
Journal:  Schizophr Res       Date:  2013-08-21       Impact factor: 4.939

10.  Understanding treatment non-adherence in schizophrenia and bipolar disorder: a survey of what service users do and why.

Authors:  Susanne Gibson; Sarah L Brand; Sarah Burt; Zoë V R Boden; Outi Benson
Journal:  BMC Psychiatry       Date:  2013-05-29       Impact factor: 3.630

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Authors:  Joy Llewellyn-Beardsley; Skye Barbic; Stefan Rennick-Egglestone; Fiona Ng; James Roe; Ada Hui; Donna Franklin; Emilia Deakin; Laurie Hare-Duke; Mike Slade
Journal:  J Recovery Ment Health       Date:  2020

2.  Using Open Questions to Understand 650 People's Experiences With Antipsychotic Drugs.

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Journal:  Curr Drug Saf       Date:  2019

4.  Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication.

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Journal:  Ther Adv Psychopharmacol       Date:  2021-01-31

5.  The experiences of 585 people when they tried to withdraw from antipsychotic drugs.

Authors:  John Read
Journal:  Addict Behav Rep       Date:  2022-03-17

Review 6.  Guidelines for Discontinuation of Antipsychotics in Patients Who Recover From First-Episode Schizophrenia Spectrum Disorders: Derived From the Aggregated Opinions of Asian Network of Early Psychosis Experts and Literature Review.

Authors: 
Journal:  Int J Neuropsychopharmacol       Date:  2022-09-28       Impact factor: 5.678

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