Mental health

Duration of antipsychotic treatment in individuals with long term and/or recurrent psychotic disorders

Question 4: In individuals with long term and/or recurrent psychotic disorders (including schizophrenia), should individuals be maintained on pharmacotherapy indefinitely or withdrawn from treatment in order to allow for the best outcomes?

Management of psychosis and bipolar disorders

  • Population: adults with chronic and/or recurrent psychotic disorders, including schizophrenia
  • Interventions: antipsychotic treatment discontinuation and placebo
  • Comparison: continuing on antipsychotic treatment
  • Outcomes:
    • symptoms severity
    • prevention of relapses
    • disability and functioning
    • adverse effects of treatment (movement disorders, weight gain)
    • quality of life
    • mortality
    • treatment adherence
    • users' and families' satisfaction with care.

Recommendation(s)

In individuals with long term and/or recurrent psychotic disorders (including schizophrenia), stable for several years on antipsychotic treatment, withdrawal may be considered keeping in mind the increased risk of relapse, possible adverse effects of medicines, and individual preferences in consultation with the family. This decision should be made preferably in consultation with a mental health professional. When medicines are withdrawn, individuals and family members need to be educated to detect early symptoms of relapse, and close clinical monitoring should be done.
Strength of recommendation: STANDARD

Evidence profile

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