{"id":3859,"date":"2026-01-24T10:55:13","date_gmt":"2026-01-24T07:55:13","guid":{"rendered":"https:\/\/psychiatry-cy.com\/?p=3859"},"modified":"2026-01-24T11:20:20","modified_gmt":"2026-01-24T08:20:20","slug":"stopping-antipsychotic-medication-what-patients-families-and-clinicians-need-to-know","status":"publish","type":"post","link":"https:\/\/psychiatry-cy.com\/el\/stopping-antipsychotic-medication-what-patients-families-and-clinicians-need-to-know\/","title":{"rendered":"Stopping Antipsychotic Medication: What Patients, Families, and Clinicians Need to Know"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Many patients and families ask an important and understandable question:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cNow that I\u2019m feeling better, do I really need to stay on antipsychotic medication?\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This article explains the benefits, risks, and clinical reasoning behind continuing or, in rare cases, carefully reducing or discontinuing antipsychotic medication, based on the most recent scientific evidence and international guidelines.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Key Scientific Publication Discussed<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Correll, C. U., Rubio, J. M., &amp; Kane, J. M. (2025)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Title: Benefits and risks of antipsychotic discontinuation in people with first and multi-episode psychotic disorders or with schizophrenia: why, when, how and in whom?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Journal: Schizophrenia (Nature Portfolio)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Volume: 11<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Article number: 151<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Publication date: 17 December 2025<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Access: Open access<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This paper represents one of the most up-to-date expert reviews on antipsychotic discontinuation and is highly relevant to everyday clinical practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Why This Topic Matters<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Antipsychotic medications are one of the most effective treatments in psychiatry for preventing relapse in psychotic disorders. At the same time, they can cause side effects that understandably make some patients want to stop treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The challenge is balancing:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">quality of life today with long-term mental health stability<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What the Evidence Clearly Shows<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1. Stopping Antipsychotics Greatly Increases Relapse Risk<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">According to Correll et al. (2025) and multiple large studies:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">People who stop antipsychotic medication have a much higher risk of relapse<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Relapse often occurs within months<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Relapse may require hospitalization and can disrupt work, relationships, and independence<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Importantly, each relapse may make future episodes harder to treat.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>First Episode Psychosis vs Schizophrenia: Why the Approach Differs<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">First Episode Psychosis (FEP)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients experiencing a first psychotic episode often:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>recover well<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>regain full functioning<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>feel \u201cback to normal\u201d<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Because of this, early discontinuation is sometimes requested.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What guidelines and evidence say:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NICE (UK) and APA (USA) recommend continuing antipsychotics for at least 1\u20132 years after remission<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Stopping earlier significantly increases relapse risk<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There is no reliable way to predict who will remain well off medication<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Clinical approach:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medication should usually be continued, but at the lowest effective dose, with regular review and shared decision-making.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Schizophrenia and Multi-Episode Psychotic Disorders<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For individuals with:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">a diagnosis of schizophrenia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">more than one psychotic episode<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">previous relapses after stopping medication<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The evidence is much clearer:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Long-term or lifelong maintenance treatment is often necessary<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Discontinuation carries a high risk of relapse and long-term functional decline<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most international guidelines strongly advise against routine discontinuation<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u00a0Clinical approach:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Focus on dose optimization, side-effect management, and quality of life, rather than stopping treatment altogether.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What About Side Effects?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Side effects are real and must be taken seriously. These may include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>weight gain<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>fatigue<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>emotional blunting<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>metabolic changes<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">However, the key message from Correll et al. (2025) and major guidelines is:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Side effects should usually be managed by adjusting treatment \u2014 not by stopping it abruptly.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Options often include:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>lowering the dose<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>switching to a different medication<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>treating side effects directly<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>lifestyle and metabolic monitoring<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>When Might Discontinuation Be Considered? (Exceptional Cases)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The paper emphasizes that complete discontinuation should be rare, but may be considered when all of the following apply:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>sustained remission for a significant period<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>strong insight and engagement in care<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>minimal or no substance use<\/li>\n\n\n\n<li>stable housing and psychosocial support<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>significant side-effect burden despite optimized treatment<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>full understanding and acceptance of relapse risk<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Even in these cases:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>reduction must be very gradual<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>monitoring must be frequent<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>a clear relapse action plan must be in place<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Abrupt stopping is strongly discouraged.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Why Taking This Risk Is Sometimes Discussed<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In carefully selected individuals, clinicians may explore dose reduction or discontinuation to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>improve quality of life<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>reduce long-term physical health risks<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>respect patient autonomy within safe limits<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">However, this is a shared medical decision, not a routine recommendation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key Messages for Patients and Families<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Feeling well does not mean the illness has disappeared<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Medication often prevents relapse, even when symptoms are quiet<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Relapse can be more damaging than staying on medication<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Any change should be slow, planned, and supervised<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Staying on medication is not a failure \u2014 it is often a sign of good self-care<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Clinical Bottom Line<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Based on:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Correll et al. (2025)<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>NICE guidelines<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>APA guidelines<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>and decades of clinical evidence<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Antipsychotic maintenance treatment remains the safest option for most people with psychotic disorders.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Discontinuation should be:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>rare<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>individualized<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>carefully monitored<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>and never abrupt<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key References<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Correll CU, Rubio JM, Kane JM.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Benefits and risks of antipsychotic discontinuation in people with first and multi-episode psychotic disorders or with schizophrenia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Schizophrenia. 2025;11:151.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">National Institute for Health and Care Excellence (NICE).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Psychosis and schizophrenia in adults: prevention and management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NICE Guideline CG178.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">American Psychiatric Association (APA).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice Guideline for the Treatment of Patients With Schizophrenia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3rd Edition.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Leucht S et al.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Relapse prevention in schizophrenia with antipsychotic maintenance treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Lancet.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Many patients and families ask an important and understandable question: \u201cNow that I\u2019m feeling better, do I really need to stay on antipsychotic medication?\u201d This article explains the benefits, risks, and clinical reasoning behind continuing or, in rare cases, carefully reducing or discontinuing antipsychotic medication, based on the most recent scientific evidence and international guidelines.&hellip;<\/p>\n","protected":false},"author":2,"featured_media":3857,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rs_blank_template":"","rs_page_bg_color":"","slide_template_v7":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[139],"tags":[],"class_list":["post-3859","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-antipsychotic-el","entry","has-media"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/psychiatry-cy.com\/wp-content\/uploads\/2026\/01\/file-20230106-15-l496tm.avif","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p87S9d-10f","_links":{"self":[{"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/posts\/3859","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/comments?post=3859"}],"version-history":[{"count":0,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/posts\/3859\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/media\/3857"}],"wp:attachment":[{"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/media?parent=3859"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/categories?post=3859"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/psychiatry-cy.com\/el\/wp-json\/wp\/v2\/tags?post=3859"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}