A Method for Tapering Antipsychotic Treatment That May Minimize the Risk of Relapse
This article explores what is known about reducing and discontinuing antipsychotics, including withdrawal syndromes, and puts forward some principles for reducing and discontinuing antipsychotics in a manner that minimizes the risk of relapse.
Source:
Schizophrenia Bulletin
SPS commentary:
The authors suggest that when antipsychotics are reduced, it should be done gradually (over months or years), and that tapering regimens should aim to reduce D2 receptor antagonism in a linear fashion and with adequate time provided in between dose reductions to allow adaptation to lower doses of the drug. Examples are given for haloperidol, risperidone, olanzapine, clozapine, quetiapine and amisulpride. Final doses before complete cessation may need to be as small as 1/40th a therapeutic dose to prevent a large decrease in D2 blockade when stopped. They say their hypothesis needs to be tested in further tapering trials of antipsychotics, and that formal guidelines in this area are required.