Oct 2, 2018
is: When is the right
time to discontinue an antipsychotic in the treatment of
reviewed the evidence as well as consulting Dr. Ira Glick to help
us answer this question.
Here is the summary of the podcast:
- The APA
guidelines (2004, updated 2009) recommend indefinite antipsychotics
for patients with multiple episodes or two episodes within 5
WFSBP 2013 guidelines recommend antipsychotic maintenance for least
1 year in first-episode psychosis and 2 to 5 years treatment for
- Antipsychotic treatment should be lifelong in
patients with serious suicide attempts, violent behavior and
longer the duration of antipsychotic treatment, the higher the risk
of treatment failure when patients stop.
- Mortality and rehospitalization rates are lower
among patients continuing antipsychotics.
discontinuation paradox could be due to medication-induced build up
of excess of dopamine receptors or supersensitivity