Motivations for and Experiences With Antipsychotic Tapering Among Patients With Schizophrenia Seeking Guided Dose Reduction

作者：Alexander Nøstdal, Rikke Hilker, Jimmi Nielsen, Mette Ødegaard Nielsen · 发表于：Psychiatric Services · 年份：2024 · DOI：10.1176/appi.ps.20230641 · 被引用次数：6 · 研究领域：Schizophrenia research and treatment、Healthcare Decision-Making and Restraints、Mental Health and Psychiatry

OBJECTIVE: Over time, most patients with schizophrenia wish to reduce or discontinue their antipsychotic medication treatment. In Denmark, a specialized government-funded outpatient clinic was established to offer guided antipsychotic dose reduction. This study aimed to provide data on motivations for and previous experiences with antipsychotic tapering among patients attending the clinic. METHODS: Patients completed an open-ended survey on their motivations for discontinuing or tapering antipsychotic medication and recorded their expectations about these outcomes. They also provided information on previous experiences with discontinuing medication and their level of symptoms, functioning, and side effects. RESULTS: The survey was completed by 76 (86%) of 88 patients. The main motivations for discontinuing antipsychotics were adverse effects (71%) and uncertainty about the necessity of taking antipsychotics (29%). Other factors included concerns about long-term effects, disagreeing with the diagnosis, experiencing an insufficient effect, and feeling stigmatized by taking medication. Previous experience with discontinuation of antipsychotics was reported by 42 patients, of whom 23 reported relapse as the outcome. Most patients believed they could succeed in dose reduction (N=73 of 75, 97%) or discontinuation (N=62 of 75, 83%). CONCLUSIONS: Motivational factors reported for professionally guided antipsychotic dose reduction align with previous studies examining patients choosin...