Tapering antipsychotic treatment
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Hyperbolic tapering has been adopted by NICE guidelines for several other classes of drugs including opioids and antidepressants, and suggested for higher risk patients in antidepressant tapering guidelines in Australia and Canada.
“Hyperbolic tapering has been adopted by the NICE guidelines for several other classes of drugs including opioids and antidepressants, and suggested for higher risk patients in antidepressant tapering guidelines in Australia and Canada, based on the biological plausibility of this approach and emerging empirical evidence(Horowitz & Wilcock, 2022; Horowitz et al., 2021; Horowitz & Taylor, 2021; Jauc”
From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Horowitz & Taylor, 2021
Slow tapering allows neuroadaptations to resolve in step with reduced receptor activation.
“Slow tapering allows neuroadaptations to resolve in step with reduced receptor activation (Ashton, 2005; Horowitz & Taylor, 2021).”
From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Horowitz & Taylor, 2021
Gradually reducing GABA-A receptor modulation by benzodiazepines minimizes disturbance to homeostatic balance achieved at steady-state dosing and thus withdrawal symptoms.
“The rationale for tapering is that gradually reducing GABA-A receptor modulation by benzodiazepines minimizes disturbance to homeostatic balance achieved at steady-state dosing and thus withdrawal symptoms.”
From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Horowitz & Taylor, 2021
Cites
Howes, O. D., Kambeitz, J., Kim, E., Stahl, D., Slifstein, M., Abi-Dargham, A., & Kapur, S. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2012.169 · Cited by 967 · see citing works
Leucht, S., Tardy, M., Komossa, K., Heres, S., Kissling, W., Salanti, G., & Davis, J. M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60239-6 · Cited by 931 · see citing works
Comparing rat’s to human’s age: How old is my rat in people years?
Quinn, R. (2005) · Nutrition · doi:10.1016/j.nut.2005.04.002 · Cited by 682 · see citing works
Dose-response meta-analysis of antipsychotic drugs for acute schizophrenia
Leucht, S., Crippa, A., Siafis, S., Patel, M. X., Orsini, N., & Davis, J. M. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2019.19010034 · Cited by 301 · see citing works
Clinical risk following abrupt and gradual withdrawal of maintenance neuroleptic treatment
Viguera, A. C. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830130055011 · Cited by 246 · see citing works
Should psychiatrists be more cautious about the long-term prophylactic use of antipsychotics?
Murray, R. M., Quattrone, D., Natesan, S., van Os, J., Nordentoft, M., Howes, O., Di Forti, M., & Taylor, D. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.182683 · Cited by 244 · see citing works
Self-citationWunderink, L., Nienhuis, F. J., Sytema, S., Slooff, C. J., Knegtering, R., & Wiersma, D. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0502 · Cited by 234 · see citing works
Estimating Dopamine D2 Receptor Occupancy for Doses of 8 Antipsychotics: A Meta-Analysis
Lako, I. M., van den Heuvel, E. R., Knegtering, H., Bruggeman, R., & Taxis, K. (2013) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182983ffa · Cited by 125 · see citing works
Joyce, J. N. (2001) · Synapse · doi:10.1002/syn.1035 · Cited by 47 · see citing works
抗精神病薬8剤の用量に対するドーパミンD 2 受容体占有率の推定: メタ分析
Irene, M. L., Edwin, R. V. D. H., Knegtering, H., Bruggeman, R., & Katja, T. (2013) · Journal of Clinical Psychopharmacology · Cited by 44 · see citing works
Azimzadeh, M., & Azimzadeh, M. (2006) · Synapse · doi:10.1002/(issn)1098-2396 · Cited by 42 · see citing works
Huhn, M., Leucht, C., Rothe, P., Dold, M., Heres, S., Bornschein, S., Schneider-Axmann, T., Hasan, A., & Leucht, S. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-020-01109-y · Cited by 38 · see citing works
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A Method for Tapering Antipsychotic Treatment That May Minimize the Risk of Relapse
Horowitz, M. A., Jauhar, S., Natesan, S., Murray, R. M., & Taylor, D. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbab017 · Cited by 157 · see citing works
Self-citationHow to reduce and stop psychiatric medication
Horowitz, M. A., & Taylor, D. (2022) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.10.001 · Cited by 26 · see citing works
Self-citationEserian, J. K., Blanco, V. P., Mercuri, L. P., Matos, J. D. R., & Galduróz, J. C. F. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115537 · Cited by 15 · see citing works
O’Neill, J. R., Taylor, D. M., & Horowitz, M. A. (2023) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253231198463 · Cited by 12 · see citing works
Self-citationO’Neill, J. R., Taylor, D. M., & Horowitz, M. A. (2024) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253241272790 · Cited by 7 · see citing works
Self-citationAbie Horowitz, M., Framer, A., Strang, J., & Taylor, D. (2025) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253251371504
Self-citationPharmacological principles for safe benzodiazepine and Z-drug dose reduction
Horowitz, M., Lamberson, N., Brandt, J., Framer, A., Shapiro, B., Sørensen, A., Cadogan, C., Ritvo, A., & Taylor, D. (2026) · Psychological Medicine · doi:10.1017/s0033291726104887
“…higher risk patients in antidepressant tapering guidelines in Australia and Canada, based on the biological plausibility of this approach and emerging empirical evidence(Horowitz & Wilcock, 2022; Horowitz et al., 2021; Horowitz & Taylor, 2021; Jauca, n.d.; NICE, 2022; Therapeutic Guidelines, 2025).”
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- Authors
- Horowitz, M. A., Murray, R. M., & Taylor, D.
- Affiliations
- North East London NHS Foundation Trust (GB)
- King's College London (GB)
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2021-02-01
- Volume
- 78
- Issue
- 2
- Pages
- 125
- ISSN
- 2168-622X (ISSN-L)
- OpenAlex
- W3047096426
- Cited by
- 49
- References
- 12
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 5 · 2022: 4 · 2021: 20 · 2020: 2
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2020-18-022)
- 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 › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- antipsychotic tapering, antipsychotic discontinuation, schizophrenia, psychosis, relapse prevention
- MeSH terms
- Drug Tapering, Humans, Schizophrenia, Antipsychotic Agents
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