Discontinuation of psychotropic medication : a synthesis of evidence across medication classes
Vinkers, Christiaan H. (Amsterdam UMC. University Medical Center)
Kupka, Ralph W. (Vrije Universiteit Amsterdam)
Penninx, Brenda W. (Vrije Universiteit Amsterdam)
Ruhé, Henricus G. (Radboud University (Nijmegen, Holanda))
van Gaalen, Jakob M. (GGZ inGeest Mental Health Care (Amsterdam, Holanda))
van Haaren, Paul C. F. (Radboud University (Nijmegen, Holanda))
Schellekens, Arnt F. A. (Nijmegen Institute for Scientist Practitioners in Addiction (Holanda))
Jauhar, Sameer (King's College London)
Ramos-Quiroga, Josep Antoni (Universitat Autònoma de Barcelona. Facultat de Medicina)
Vieta, Eduard (Universitat de Barcelona)
Tiihonen, Jari (University of Helsinki)
Veldman, Stijn E. (Radboud University (Nijmegen, Holanda))
Veling, Wim (University of Groningen (Holanda))
Vis, Roeland (St. Antonius Hospital (Nieuwegein/Utrecht, Holanda))
de Wit, Laura E. (St. Antonius Hospital (Nieuwegein/Utrecht, Holanda))
Luykx, Jurjen J (Maastricht University Medical Centre (Maastricht, Països Baixos))

Fecha:	2024
Resumen:	Pharmacotherapy is an effective treatment modality across psychiatric disorders. Nevertheless, many patients discontinue their medication at some point. Evidence-based guidance for patients, clinicians, and policymakers on rational discontinuation strategies is vital to enable the best, personalized treatment for any given patient. Nonetheless, there is a scarcity of guidelines on discontinuation strategies. In this perspective, we therefore summarize and critically appraise the evidence on discontinuation of six major psychotropic medication classes: antidepressants, antipsychotics, benzodiazepines, mood stabilizers, opioids, and stimulants. For each medication class, a wide range of topics pertaining to each of the following questions are discussed: (1) Who can discontinue (e. g. , what are risk factors for relapse?); (2) When to discontinue (e. g. , after 1 year or several years of antidepressant use?); and (3) How to discontinue (e. g. , what's the efficacy of dose reduction compared to full cessation and interventions to mitigate relapse risk?). We thus highlight how comparing the evidence across medication classes can identify knowledge gaps, which may pave the way for more integrated research on discontinuation.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Addiction ; ADHD ; Bipolar disorder ; Depression ; Schizophrenia
Publicado en:	Molecular psychiatry, Vol. 29 (march 2024) , p. 2575-2586, ISSN 1476-5578

DOI: 10.1038/s41380-024-02445-4
PMID: 38503923

12 p, 807.8 KB

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