Attempting to stop antipsychotic medication: success, supports, and efforts to cope

作者：Larsen Barr Miriam^*; Seymour Fred; Read John; Gibson Kerry

来源：Social Psychiatry and Psychiatric Epidemiology, 2018, 53(7): 745-756.

DOI：10.1007/s00127-018-1518-x

• Antipsychotics
• Medication withdrawal syndromes
• Psychoses substance-induced
• Human rights
• Social support
• Coping behaviour

To explore supports and coping strategies used during attempts to discontinue antipsychotic medication and test for associations with success.
144 people who were taking or had taken antipsychotics completed The Experiences of Antipsychotic Medication Survey. Among them, 105 people had made at least one discontinuation attempt and answered a series of questions about their most recent attempt to stop. Content analysis and Chi-square tests of independence were used to categorise the data and explore associations. Success was defined as stopping all AM use irrespective of the duration of the medication-free period or whether relapse occurred, which were explored separately.
Among the 105 people who had attempted discontinuation, 61.9% described unwanted withdrawal effects and 27.6% of the group described psychotic or manic relapse during the withdrawal period. Within this group 55% described successfully stopping all AM for varying lengths of time, half reported no current use, and half described having some form of professional, family, friend, and/or service user or peer support for their attempt. Having support was positively associated with success and negatively associated with both current use, and relapse during withdrawal. A range of coping efforts were described, but having coping strategies failed to show significant associations with any of the dependent variables explored. Among those who described successfully stopping, some described returning to AM for short periods when needed, while others reported managing well with alternative methods alone.
Findings cannot be readily generalised due to sampling constraints, but results suggest a wide range of supports and coping strategies may be used when attempting to discontinue antipsychotics. Many people may attempt to discontinue antipsychotics without any support. Those who have support for their attempts may be significantly less likely to relapse during withdrawal and more likely to succeed in their attempt. There is a pressing need for further research in this area.

• 出版日期2018-7