Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia- a case series.

Journal: BMC psychiatry

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophrenia, Glostrup, Denmark. Sofie.norlin.moelgaard@regionh.dk. Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophrenia, Glostrup, Denmark. Mental Health Centre Glostrup, Copenhagen University Hospital- Mental Health Services CPH, Centre for Applied Research in Mental Health Care, Glostrup, Denmark.

Abstract summary 

80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient's feeling of autonomy and psychiatric rehabilitation.We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders- 10th Edition codes F20.0-5, F20.7-9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down.Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse.Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.

Authors & Co-authors:  Mølgaard Nielsen Roed Nielsen

Study Outcome 

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Citations :  Jibson MD, Waltham M, Marder S, UpToDAte. 2022. Second-generation antipsychotic medications: Pharmacology, administration, and side effects. Available from: https://www.uptodate.com/contents/second-generation-antipsychotic-medications-pharmacology-administration-and-side-effects.
Authors :  4
Identifiers
Doi : 240
SSN : 1471-244X
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Antipsychotic medication;Dose reduction;Recovery;Relapse;Schizophrenia;Tapering
Study Design
Study Approach
Country of Study
Publication Country
England