Cautions Against the Use of Antipsychotic Medication for Treatment of Dementia

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

Download Full-text

Are Patients With Schizophrenia Better Off With Lifetime Antipsychotic Medication?

Journal of Clinical Psychopharmacology ◽

10.1097/jcp.0000000000001171 ◽

2020 ◽

Vol 40 (2) ◽

pp. 145-148

Author(s):

Ira D. Glick ◽

Daisy Zamora ◽

John M. Davis ◽

Uma Suryadevara ◽

Andrea Goldenson ◽

...

Keyword(s):

Antipsychotic Medication

Download Full-text

Multimodal meta-analysis of structural and functional brain changes in first episode psychosis and the effects of antipsychotic medication

Neuroscience & Biobehavioral Reviews ◽

10.1016/j.neubiorev.2012.07.012 ◽

2012 ◽

Vol 36 (10) ◽

pp. 2325-2333 ◽

Cited By ~ 173

Author(s):

J. Radua ◽

S. Borgwardt ◽

A. Crescini ◽

D. Mataix-Cols ◽

A. Meyer-Lindenberg ◽

...

Keyword(s):

Antipsychotic Medication ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Functional Brain ◽

Episode Psychosis ◽

Brain Changes

Download Full-text

Antipsychotic Medication Adherence Scale (AMAS): Development and preliminary psychometric properties

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.658 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s258-s259

Author(s):

M.J. Martins ◽

A.T. Pereira ◽

C.B. Carvalho ◽

P. Castilho ◽

A.C. Lopes ◽

...

Keyword(s):

Medication Adherence ◽

Psychometric Properties ◽

Antipsychotic Medication ◽

Convergent Validity ◽

Rating Scale ◽

Statistical Analysis Plan ◽

Different Types ◽

Adherence Scale ◽

Relevant Variables ◽

Competing Interest

IntroductionAlthough being highly consensual that antipsychotic adherence is an important outcome predictor in psychosis, existing reviews have found mean rates of adherence around 40–60%. Several aspects, such as patient-related, medication-related, environmental-related variables have been described as important predictors.AimsThis study aim is to develop, administer and present preliminary psychometric properties of a new scale for antipsychotic medication adherence that includes different types of predictors (clinical, psychosocial, and practical among others).MethodsThe “AMAS” was developed by a multidisciplinary team and was based on recent research on factors influencing antipsychotic adherence. The scale evolved from multiple drafts and experts were contacted in order to improve the final version. Over 50 patients with a diagnosis of a psychotic-spectrum disorder taking antipsychotic medication will be assessed with the “AMAS” and the Medication Adherence Rating Scale. Additionally, each patient's psychiatrist will fill in a form with demographic and clinical variables (such as type of symptoms, previous adherence problems, current adherence, insight and other relevant variables).ResultsThis is an ongoing study and the sample is still being collected (scheduled finish date: February/2016). Our statistical analysis’ plan includes: reliability analysis (Chronbach's alpha, alpha if item deleted, inter item correlations and covariances and item-total correlations); validity (convergent validity); factorial analysis.ConclusionsIt is hypothesized that the “AMAS” will be a practical, reliable and valid unidimentional instrument with clinical utility assessing adherence to antipsychotics. The “AMAS” can be also useful in assessing intervention targets (e.g. psychoterapeutical, psychoeducational) to enhance adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text