You say “schizophrenia” and I say “psychosis”: Just tell me when I can come off this medication

Zipursky, Robert B.; Odejayi, Gbolahan; Agid, Ofer; Remington, Gary

doi:10.1016/j.schres.2020.02.009

Cited by 15 publications

(4 citation statements)

References 49 publications

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“…Antipsychotic medication is considered the primary treatment for people with a diagnosis of schizophrenia and related disorders across the world [ 1 – 4 ]. It is effective in reducing acute symptoms [ 5 ] and long-term antipsychotic medication is recommended for people with recurrent episodes on the basis of evidence that continuous antipsychotic treatment reduces the risk of relapse compared to discontinuation [ 6 , 7 ]. However, the adverse effects of these drugs are often serious and disabling, including diabetes, tardive dyskinesia, heart disease, sedation, emotional blunting, akathisia and sexual dysfunction [ 8 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

et al. 2022

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Background Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients’ views about continuing or discontinuing antipsychotic treatment. Aims To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support. Methods We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken. Results We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction. Conclusions This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued.

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Section: Introductionmentioning

confidence: 99%

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

et al. 2022

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“…Such patients who represent one in five real-world patients need to be represented in scientific studies for better ecological validity. Future science in schizophrenia should also focus on uniformity of assessment measures evaluating and reporting core outcomes ( Campana et al, 2021 ; Woods et al, 2021b ; Zipursky et al, 2020 ).…”

Section: In the Near Futurementioning

confidence: 99%

A redux of schizophrenia research in 2021

Suhas

Mehta

2022

Schizophrenia Research

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“…

Dear editorBased on a comprehensive literature review, Zipursky et al address the challenge of advising patients with sustained remission from a first episode of psychosis over risks and benefits of medication discontinuation (Zipursky et al, 2020). A strong statement is made on the need to continue antipsychotic medication in the long term for those with a confirmed diagnosis of schizophrenia or schizoaffective disorder.

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confidence: 99%

“…However, we do acknowledge that cost-effectiveness of this type of continuous CBT follow-up remains to be demonstrated. Zipursky et al (2020) recognize that a minority of patients diagnosed with a first episode of schizophrenia will be able to sustain remission without antipsychotic medication. However, they fail to identify supportive psychosocial interventions that we consider fundamental to this aim, especially in first-episode psychosis.…”

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confidence: 99%

Could CBT sustain long-term remission without antipsychotic medication in schizophrenia?

Castelnovo

Aquilino²,

Parabiaghi³

et al. 2020

Schizophrenia Research

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You say “schizophrenia” and I say “psychosis”: Just tell me when I can come off this medication

Cited by 15 publications

References 49 publications

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

A redux of schizophrenia research in 2021

Could CBT sustain long-term remission without antipsychotic medication in schizophrenia?

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