If you stop antipsychotics suddenly it can cause 'rebound psychosis'. This means that the symptoms of your illness return suddenly, and you may become unwell again. This is also known as 'relapse'. If you or your family or friends think you are becoming unwell again, you should speak to your doctor.
If possible, antipsychotics should be stopped very slowly under close medical observation. Abrupt discontinuation can result in rebound psychosis which can be more severe than before treatment was started.
If drugs are stopped too quickly, people can get withdrawal symptoms (which for antipsychotics can include insomnia, tremors and sometimes psychotic symptoms) or can be de-stabilised by the process of coming off.
The studies in our review (8, 23–26) reported that most withdrawal symptoms started within 4 weeks after abrupt antipsychotic discontinuation and subsided after up to 4 weeks even though certain symptoms such as hyperkinesia may last for months (23).
Antipsychotic drugs can cause various abnormal motor syndromes, but abruptly stopping them has been associated with the seemingly paradoxical development of similar motor syndromes, such as withdrawal dyskinesias, parkinsonian symptoms, dystonias, and neuroleptic malignant syndrome.
CLINICAL MANIFESTATIONS OF ANTIPSYCHOTIC WITHDRAWAL SYNDROME
Cholinergic: Agitation, insomnia, anxiety or depression, dizziness, tachycardia, nausea, diarrhoea, tremors, restlessness, myalgia, paraesthesia, hallucinations, confusion, hypothermia, sweating.
However, some patients are able to sustain a psychosis-free existence after the cessation of antipsychotics. Several studies show that only 25%–55% of patients with schizophrenia who stopped taking antipsychotic medication experienced the relapse of symptoms in the first 6 to 10 months after they stopped taking them.
Many of the side effects of antipsychotic medications are unpleasant and can make it hard for people to stick with medication. Antipsychotics can cause neurological side effects that interfere with normal movements and make it hard to feel calm or experience pleasure.
Previous studies found that the death rate among people with schizophrenia on antipsychotic medications was 30%-50% lower than among those who took a placebo. But most of the studies were shorter than six months, which does not reflect the fact that antipsychotic treatment is often lifelong, the study authors noted.
After symptom remission, continuation of antipsychotic treatment is associated with lower relapse rates and lower symptom severity compared to dose reduction/discontinuation. Therefore, most guidelines recommend continuation of treatment with antipsychotic medication for at least 1 year.
You may find it's possible to manage your symptoms, or to make a full recovery, without medication. If you are taking antipsychotics, you may also want to use other options to support your mental health, as well as your medication.
They can cause movement disorders such as twitching and restlessness, sedation and weight gain, and lead to diabetes.
Neuroleptic malignant syndrome (NMS) NMS is a rare but serious neurological disorder, which means it affects your nervous system. It can happen as a side effect of taking antipsychotics. It may also occur as a withdrawal symptom if you stop taking antipsychotics.
For neurological, neuropsychological, neurophysiological, and metabolic abnormalities of cerebral function, in fact, there is evidence suggesting that antipsychotic medications decrease the abnormalities and return the brain to more normal function.
Specifically, the researchers found that those who stopped taking antipsychotic medication within two years of first taking the drug were almost six times (5.989) more likely to recover from “serious mental illness” and were only 13.4% as likely to be re-hospitalized.
Factor analysis of these items revealed three main effects of antipsychotic medication related to doubt and self-doubt, cognitive and emotional numbing, and social withdrawal. Antipsychotic treatment appears to be connected to a number of negative subjective effects on cognition and emotion.
Formerly known as major tranquilizers and neuroleptics, antipsychotic medications are the main class of drugs used to treat people with schizophrenia. They are also used to treat people with psychosis that occurs in bipolar disorder, depression and Alzheimer's disease.
A doctor cannot force you to get treatment that you don't agree to. A doctor must get your permission before they start any type of treatment. This includes mental health treatment such as counselling, therapy, or medication.
Sometimes psychotic symptoms resolve rapidly and people resume a normal life. Other people take several weeks or even months to recover. Like any major illness, they may want to spend some time recovering and they may wish to use a variety of treatment options.
Some studies suggest that glycine, sarcosine, NAC, several Chinese and ayurvedic herbs, ginkgo biloba, estradiol, and vitamin B6 may be effective for psychotic symptoms when added to antipsychotics (glycine not when added to clozapine).
An episode of psychosis is treatable, and it is possible to recover. It is widely accepted that the earlier people get help the better the outcome. 25% of people who develop psychosis will never have another episode, another 50% may have more than one episode but will be able to live normal lives.
Evidence of the rapidity at which antipsychotics can affect brain volume in humans was recently provided by Tost and associates. These investigators found a significant, reversible decrease in striatal volume in healthy subjects within 2 hours after they were treated intravenously with haloperidol.
Previous research has also shown that the use of antipsychotics may raise the risk of metabolic syndrome in patients with schizophrenia. Metabolic syndrome has, in turn, been associated with heart disease and diabetes.
All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, cardiac arrhythmia, and sudden cardiac death. Primary care physicians should understand the individual adverse effect profiles of these medications.