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Cited by 246Schizophrenia research and treatmentBipolar Disorder and TreatmentMental Health and Psychiatry

The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index.

Clinical Risk Following Abrupt and Gradual Withdrawal of Maintenance Neuroleptic Treatment

Viguera, Adele C.·1997·Archives of General Psychiatry
DOI 10.1001/archpsyc.1997.01830130055011
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Abstract

BACKGROUND: Abrupt discontinuation of long-term psychotropic medication can be followed by a high risk of early relapse. This study aimed to quantify the relapse risk over time in patients with schizophrenia following discontinuation of maintenance neuroleptic treatment. METHODS: Data on the timing of relapses in patients with schizophrenia after withdrawal from neuroleptic therapy were located by a computerized literature search, combined with new data, and evaluated by survival analysis. RESULTS: Data were found for 1210 schizophrenic subjects: 1006 (795 inpatients and 211 outpatients) were withdrawn abruptly from oral neuroleptic therapy, and 204 discontinued treatment gradually (> or = 3 weeks) or stopped treatment with depot neuroleptic drugs. After abrupt discontinuation of oral medication, the risk of relapse reached 50% within 30 weeks, with remarkably little additional risk thereafter to 3.7 years; inpatients relapsed more rapidly than did outpatients (10 vs 18 weeks to a 25% relapse risk). In studies including subjects whose drug therapy was withdrawn abruptly (n = 49) vs gradually (n = 58), relapse was earlier after abrupt discontinuation (25% risk in 6 vs 10 weeks), with a persistent difference for at least 6 months. CONCLUSIONS: The relapse risk was high within 6 months of discontinuing oral neuroleptic therapy, particularly in hospitalized patients. Most patients who remained stable for 6 months continued to do so for long periods without medication, indicating clinical heterogeneity. Drug-withdrawal stressors, related to long-term pharmacodynamic adaptations, are implicated. Since the risk was lower after gradually discontinuing oral neuroleptic therapy or stopping depot injections, early relapse may be spared by a slow removal of drugs.

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Crossref · 10.1001/archpsyc.1997.01830130055011

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Metadata

Authors
Viguera, A. C.
Affiliations
Harvard University (US)
Corresponding author
Viguera, Adele C.
ORCID
Viguera, Adele C.
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
1997-01-01
Volume
54
Issue
1
Pages
49
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.1997.01830130055011
OpenAlex
W2153434361
Cited by
246
References
49
Citations by year
2026: 1 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 10 · 2019: 10 · 2018: 10 · 2017: 6 · 2016: 6 · 2015: 14 · 2014: 8 · 2013: 13 · 2012: 14
FWCI
7.81
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5k05mh047370-25)
  • National Institute of Mental Health (P01MH031154, MH-31154, MH47370)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, neuroleptic withdrawal, abrupt discontinuation, relapse risk, long-term antipsychotic treatment, depot neuroleptics
MeSH terms
Administration, Oral, Ambulatory Care, Delayed-Action Preparations, Drug Administration Schedule, Female, Follow-Up Studies, Hospitalization, Humans, Injections, Intramuscular, Male, Recurrence, Risk Factors, Schizophrenia, Schizophrenic Psychology, Substance Withdrawal Syndrome, Antipsychotic Agents, Survival Analysis

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