SynthesisSchizophrenia bulletin2023
Risk Factors for Psychotic Relapse After Dose Reduction or Discontinuation of Antipsychotics in Patients With Chronic Schizophrenia. A Meta-Analysis of Randomized Controlled Trials.
Synthesis in Schizophrenia bulletin, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Risk Factors for Psychotic Relapse After Dose Reduction or Discontinuation of Antipsychotics in Patients With Chronic Schizophrenia. A Meta-Analysis of Randomized Controlled Trials.Schizophrenia bulletin · 2023Pooled it
- The association between relapse and the outcome of schizophrenia and recurrent psychotic disorders.The British journal of psychiatry : the journal of mental science · 2025Trial
- Efficacy and Safety of Roluperidone for the Treatment of Negative Symptoms of Schizophrenia.Schizophrenia bulletin · 2022Trial
- [Reduction and discontinuation of antipsychotic drugs in outpatient practice: perspectives of psychiatrists].Der Nervenarzt · 2026Article
- Clozapine Dose Reduction in Remitted Patients With Treatment-Resistant Schizophrenia: A Case Series.Schizophrenia bulletin · 2026Article
- Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) therapy for voice hearers: systematic review and meta-analysis.BJPsych open · 2026Review
- Not So Hasty: The Effect of Tapering Speed on Relapse May Still Be Important.Schizophrenia bulletin · 2026Article
- Absolute Receptor Occupancy, Not Rate of Decline, Predicts Relapse.Schizophrenia bulletin · 2026Review
- Dose reduction and discontinuation of antipsychotics in psychotic disorders: a systematic review of qualitative studies and meta-synthesis.Schizophrenia (Heidelberg, Germany) · 2026Review
- Antipsychotic Discontinuation and Re-initiation in Pregnant Women With Schizophrenia: A Retrospective Cohort Study From South Korea.Schizophrenia bulletin · 2026Article
- Tai chi in mental health interventions: a narrative review comparing its role with pharmacotherapy and psychotherapy.Frontiers in psychology · 2026Review
- Antipsychotic treatment in schizophrenia: balancing relapse prevention and functional recovery.Schizophrenia (Heidelberg, Germany) · 2025Article
- Helping people to discontinue antipsychotics: if, when and how.Schizophrenia (Heidelberg, Germany) · 2025Review
- Risk of relapse during tapering of antipsychotic medication after a first psychotic episode: association with D2 receptor affinity but not with tapering speed.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- Comparison of Negative Symptom Network Structures Between Patients With Early and Chronic Schizophrenia: A Network and Exploratory Graph Analysis.Schizophrenia bulletin · 2025Article
- Discontinuation of psychotropic medication: a synthesis of evidence across medication classes.Molecular psychiatry · 2024Review
- Does Slow and Steady Win the Race? Rates of Antipsychotic Discontinuation, Antipsychotic Dose, and Risk of Psychotic Relapse.Schizophrenia bulletin · 2024Article
- Long-Acting Injectable Second-Generation Antipsychotics in Seriously Ill Patients with Schizophrenia: Doses, Plasma Levels, and Treatment Outcomes.Biomedicines · 2024Article
- Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs.Therapeutic advances in psychopharmacology · 2024Article
- Targeted Treatment of Schizophrenia Symptoms as They Manifest, or Continuous Treatment to Reduce the Risk of Psychosis Recurrence.Schizophrenia bulletin · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and hypothesisAlthough maintenance treatment with antipsychotics protects against psychotic relapse, high doses may hamper recovery. Therefore, dose reduction or discontinuation may be considered in patients with chronic schizophrenia. Here, we identified risk factors for psychotic relapse when doses are reduced. STUDY
designWe systematically searched MEDLINE, EMBASE, and PsycINFO from January 1950 through January 2021 and reviewed randomized controlled trials (RCTs) that reported relapse rates after antipsychotic dose reduction or discontinuation in patients with chronic schizophrenia. We calculated relative risks (RRs) with 95% confidence intervals (CIs) per person-year and sought to identify potential risk factors for relapse. The study is registered with PROSPERO (CRD42017058296). STUDY
resultsForty-seven RCTs (54 patient cohorts, 1746 person-years) were included. The RR for psychotic relapse with dose reduction/discontinuation versus maintenance treatment was 2.3 per person-year (95% CI: 1.9 to 2.8). The RR was higher with antipsychotic discontinuation, dose reduction to less than 3-5 mg haloperidol equivalent (HE), or relatively rapid dose reduction (<10 weeks). The RR was lower with long-acting injectable agents versus oral antipsychotic dose reduction. Other factors that increased the risk of psychotic relapse were younger age and short follow-up time.
conclusionsClinicians should take several risk factors for psychotic relapse into account when considering dose reduction in patients with chronic schizophrenia. Studies of a relatively fast reduction in antipsychotic dose support a minimum dose of 3-5 mg HE. However, if the dose is tapered more gradually, relapses related to medication withdrawal might be avoided, possibly enabling lower-end doses to be achieved.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.