Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series
Abstract Background 80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-024-05699-y |
| _version_ | 1797233403266859008 |
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| author | Sofie Norlin Mølgaard Mette Ødegaard Nielsen Kickan Roed Jimmi Nielsen |
| author_facet | Sofie Norlin Mølgaard Mette Ødegaard Nielsen Kickan Roed Jimmi Nielsen |
| author_sort | Sofie Norlin Mølgaard |
| collection | DOAJ |
| description | Abstract Background 80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient’s feeling of autonomy and psychiatric rehabilitation. Case presentation We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders– 10th Edition codes F20.0–5, F20.7–9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down. Conclusions Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse. Impact and implications Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery. |
| first_indexed | 2024-04-24T16:15:37Z |
| format | Article |
| id | doaj.art-8a9e189244e1464b984eec0958506856 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-24T16:15:37Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-8a9e189244e1464b984eec09585068562024-03-31T11:28:20ZengBMCBMC Psychiatry1471-244X2024-03-012411810.1186/s12888-024-05699-yClinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case seriesSofie Norlin Mølgaard0Mette Ødegaard Nielsen1Kickan Roed2Jimmi Nielsen3Mental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophreniaMental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophreniaMental Health Centre Glostrup, Copenhagen University Hospital– Mental Health Services CPH, Centre for Applied Research in Mental Health CareMental Health Center Glostrup, Copenhagen University Hospital, Unit for complicated schizophreniaAbstract Background 80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient’s feeling of autonomy and psychiatric rehabilitation. Case presentation We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders– 10th Edition codes F20.0–5, F20.7–9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down. Conclusions Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse. Impact and implications Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.https://doi.org/10.1186/s12888-024-05699-ySchizophreniaAntipsychotic medicationDose reductionTaperingRecoveryRelapse |
| spellingShingle | Sofie Norlin Mølgaard Mette Ødegaard Nielsen Kickan Roed Jimmi Nielsen Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series BMC Psychiatry Schizophrenia Antipsychotic medication Dose reduction Tapering Recovery Relapse |
| title | Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series |
| title_full | Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series |
| title_fullStr | Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series |
| title_full_unstemmed | Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series |
| title_short | Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series |
| title_sort | clinical experiences of guided tapering of antipsychotics for patients with schizophrenia a case series |
| topic | Schizophrenia Antipsychotic medication Dose reduction Tapering Recovery Relapse |
| url | https://doi.org/10.1186/s12888-024-05699-y |
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