ArticleSchizophrenia bulletin2024
Does Slow and Steady Win the Race? Rates of Antipsychotic Discontinuation, Antipsychotic Dose, and Risk of Psychotic Relapse.
Article in Schizophrenia bulletin, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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
8 citing papers in PubMed, 16 citations in OpenAlex.
- Do withdrawal symptoms predict depression relapse after antidepressant cessation?European archives of psychiatry and clinical neuroscience · 2026Trial
- Absolute Receptor Occupancy, Not Rate of Decline, Predicts Relapse.Schizophrenia bulletin · 2026Review
- Not So Hasty: The Effect of Tapering Speed on Relapse May Still Be Important.Schizophrenia bulletin · 2026Article
- Helping people to discontinue antipsychotics: if, when and how.Schizophrenia (Heidelberg, Germany) · 2025Review
- Benefits and risks of antipsychotic discontinuation in people with first and multi-episode psychotic disorders or with schizophrenia: why, when, how and in whom?Schizophrenia (Heidelberg, Germany) · 2025Article
- Successful antipsychotic dose tapering leading to better cognition in patients with remitted psychosis: Results of Guided Antipsychotic Reduction to Reach Minimum Effective Dose (GARMED) trial.Psychological medicine · 2025Article
- 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
- Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs.Therapeutic advances in psychopharmacology · 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
7 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAntipsychotics are recommended for prevention of relapse in schizophrenia. It is unclear whether increased risk of relapse following antipsychotic discontinuation is predominantly associated with an absolute magnitude of dose reduction or rate of antipsychotic reduction. Establishing the responsible mechanism is important because prolonged withdrawal schedules have been suggested to reduce risk of relapse. STUDY
designIndividual patient data from antipsychotic discontinuation studies were obtained. We estimated the occupancy of receptors over time using half-lives and median effective dose ED50 values obtained from pharmacokinetic and receptor occupancy studies. Hazard ratios for relapse events were calculated using Cox proportional hazards models to assess the influence of formulation (oral, 1-monthly, and 3-monthly injections). The change in hazard ratio over time was estimated, and the effect of time-varying covariates was calculated, including rate of occupancy reduction and absolute receptor occupancy. STUDY
resultsFive studies including 1388 participants with schizophrenia were identified (k = 2: oral, k = 2: 1-monthly injection, k = 1: 3-monthly injection). Withdrawal of long-acting injectable medication did not lead to a lower hazard ratio compared with withdrawal of oral medication, and this included the period immediately following randomization. Hazard ratios were not associated with the rate of decline of receptor occupancy; however, they were associated with reduced absolute occupancy in trials of long-acting injections (P = .038).
conclusionsAntipsychotic discontinuation is associated with an increased risk of psychotic relapse, related to receptor occupancy. Although relapse does not appear to be related to the rate of discontinuation, gradual discontinuation strategies may allow for easier antipsychotic reinstatement in case of symptomatic worsening.
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.