Antipsychotic Withdrawal Syndrome – Understanding the Hyperbolic Curve and Tapering Antipsychotic Treatment to Reduce the Risk of Relapse
We previously covered antidepressant withdrawal. Antipsychotic withdrawal can pose similar challenges. Despite the challenges and a serious risk of relapse, there are no clear guidelines on managing antipsychotic discontinuation and dose reduction. [Shimomura et al. 2020]
- First-line treatment for psychotic disorders remains drugs with antagonist properties at dopamine D2 receptors.
- Long-term continuous therapy with antipsychotics upregulates D2 receptors, and when treatment is abruptly stopped, receptor supersensitivity can manifest.
- Notably, this can result in movement disorders (i.e., tardive dyskinesia [TD]) and supersensitivity psychosis. [Miller and Chouinard 1993]
Abruptly stopping antipsychotic therapy comes with a high risk of withdrawal symptoms that include a variety of somatic, motor, and psychological symptoms. [Chouinard et al. 2017]