An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

TY - JOUR

T1 - An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

AU - Crellin, Nadia E

AU - Priebe, Stefan

AU - Morant, Nicola

AU - Lewis, Glyn

AU - Freemantle, Nick

AU - Johnson, Sonia

AU - Horne, Rob

AU - Pinfold, Vanessa

AU - Kent, Lyn

AU - Smith, Ruth

AU - Darton, Katherine

AU - Cooper, Ruth E

AU - Long, Maria

AU - Thompson, Jemima

AU - Gruenwald, Lisa

AU - Freudenthal, Robert

AU - Stansfeld, Jacki L

AU - Moncrieff, Joanna

N1 - Funding Information: This article presents independent research funded by the United Kingdom’s National Institute for Health Research (NIHR) (project number: RP-PG-0514-20004). The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health. Funding Information: This research was sponsored by North East London NHS Foundation Trust. The Research into Antipsychotic Discontinuation and Reduction (RADAR) research team acknowledges the support of the National Institute for Health Research Clinical Research Network, and Priment Clinical Trials Unit. The research team also thank the RADAR Lived Experience Advisory Panel (LEAP) for their support. The authors would also like to thank Zoe Haime, Georgina Buswell for their help with some of the analysis, and Éanna Hanratty for his support with data collection. Publisher Copyright: © 2022, The Author(s).

PY - 2022/12

Y1 - 2022/12

N2 - BACKGROUND: Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients' views about continuing or discontinuing antipsychotic treatment.AIMS: To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support.METHODS: We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken.RESULTS: We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction.CONCLUSIONS: This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued.

AB - BACKGROUND: Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients' views about continuing or discontinuing antipsychotic treatment.AIMS: To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support.METHODS: We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken.RESULTS: We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction.CONCLUSIONS: This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued.

KW - Antipsychotic Agents/therapeutic use

KW - Drug-Related Side Effects and Adverse Reactions

KW - Humans

KW - Psychotic Disorders/drug therapy

KW - Recurrence

KW - Schizophrenia/chemically induced

KW - Withholding Treatment

UR - http://www.scopus.com/inward/record.url?scp=85126275158&partnerID=8YFLogxK

U2 - 10.1186/s12888-022-03822-5

DO - 10.1186/s12888-022-03822-5

M3 - Article

C2 - 35291964

SN - 1471-244X

VL - 22

SP - 185

JO - BMC Psychiatry

JF - BMC Psychiatry

IS - 1

M1 - 185

ER -