ReviewTherapeutic advances in psychopharmacology2020
Barriers to stopping neuroleptic (antipsychotic) treatment in people with schizophrenia, psychosis or bipolar disorder.
Review in Therapeutic advances in psychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Non-verbal behaviours as predictors for treatment response in patients with depression or schizophrenia: a systematic review.Frontiers in psychiatry · 2025Pooled it
- Are People Worse Off in a Mental Health Treatment Paradigm Where Medication Is Deemphasised? A Naturalistic Noninferiority Trial of an Initiative to Improve Patient Choice.The International journal of social psychiatry · 2026Article
- [Labor inclusion and medicalization: neuroleptics as actants in the experiences of workers diagnosed with schizophrenia in Chile].Salud colectiva · 2026Article
- Helping people to discontinue antipsychotics: if, when and how.Schizophrenia (Heidelberg, Germany) · 2025Review
- 'I Wish It Were More Often Told to People Before They Are Prescribed These Medications How Hard It Is to Get Off Them': A Qualitative Descriptive Analysis of Free-Text Responses to a Survey on Reducing and Stopping Psychiatric Medication.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Lived experiences of caregivers with a family member living with a severe mental health condition in South Africa.BMC psychiatry · 2025Article
- The Association Between Psychotropic Medication Use and Gait and Mobility Impairment in Community-Dwelling Older People: Data From The Irish Longitudinal Study on Ageing (TILDA).The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Combination of Two Long-Acting Antipsychotics in Schizophrenia Spectrum Disorders: A Systematic Review.Brain sciences · 2024Review
- Experiences of reduction and discontinuation of antipsychotics: a qualitative investigation within the RADAR trial.EClinicalMedicine · 2023Article
- Review
- The place of long-acting injectable antipsychotics in the treatment of schizophrenia.Therapeutic advances in psychopharmacology · 2023Article
- The human neurosecretome: extracellular vesicles and particles (EVPs) of the brain for intercellular communication, therapy, and liquid-biopsy applications.Frontiers in molecular biosciences · 2023Review
- The experiences of 585 people when they tried to withdraw from antipsychotic drugs.Addictive behaviors reports · 2022Article
- Confounding of Antipsychotic Discontinuation Studies by Withdrawal-Related Relapse.Schizophrenia bulletin · 2022Article
- Priorities for future research on reducing and stopping psychiatric medicines using a James Lind Alliance priority setting partnership: The PROTECT study protocol.HRB open research · 2022Article
- A Method for Tapering Antipsychotic Treatment That May Minimize the Risk of Relapse.Schizophrenia bulletin · 2021Article
- Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication.Therapeutic advances in psychopharmacology · 2021Article
- Clozapine discontinuation withdrawal symptoms in schizophrenia.Therapeutic advances in psychopharmacology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most guidelines recommend long-term, indefinite neuroleptic (or antipsychotic) treatment for people with schizophrenia, recurrent psychosis or bipolar disorder, on the basis that these medications reduce the chance of relapse. However, neuroleptics have significant adverse effects, including sexual dysfunction, emotional blunting, metabolic disturbance and brain shrinkage, and patients often request to stop them. Evidence for the benefits of long-term treatment is also not as robust as generally thought. Short-term randomised trials show higher rates of relapse among those whose neuroleptic treatment is discontinued compared with those on maintenance treatment, but they are confounded by adverse effects associated with the withdrawal of established medication. Some longer-term studies show possible advantages of medication reduction and discontinuation in terms of improved social functioning and recovery. Therefore, there is a good rationale for supporting patients who wish to stop their medication, especially given the patient choice agenda favoured by The National Institute for Clinical Excellence (NICE). The major barrier to stopping antipsychotics is an understandable fear of relapse among patients, their families and clinicians. Institutional structures also prioritise short-term stability over possible long-term improvements. The risk of relapse may be mitigated by more gradual reduction of medication, but further research is needed on this. Psychosocial support for patients during the process of reducing medication may also be useful, particularly to enhance coping skills. Guidelines to summarise evidence on ways to reduce medication would be useful. Many patients want to try and stop neuroleptic medication for good reasons, and psychiatrists can help to make this a realistic option by supporting people to do it as safely as possible, with the best chance of a positive outcome.
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