Can Antipsychotic Doses Be Reduced Safely?
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- Опубликовано: 10 фев 2025
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In this Quick Take, Dr. Oliver Freudenreich discusses the findings of the RADAR study, a clinical antipsychotic dose reduction trial for schizophrenia. The study found that although dose reduction or discontinuation of antipsychotics did not improve psychosocial function, it did double the relapse risk in patients with remitting, relapsing psychotic illness.
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They need to do 5, 7, 10, 15, 20, 25, and 30 year follow ups. Robert Whitaker reports antipsychotics work better compared to non drug treatment for first 4 years. After that the general trend starts to slowly reverse itself overtime.
There are several psychological and natural therapies plus spiritual practices that have shown themselves to be helpful for psychosis including social support and meaningful work. Add these interventions into the non drug treatment group and things start to look alot more promising for them.
The fact of doing RADAR changed practice more than the results. The results show that gradual reduction of neuroleptics still increases the risk of relapse, as much as abrupt discontinuation. But doing the trial highlighted that neuroleptics are harmful and unpleasant drugs and that people should have a choice and the option to try and reduce or stop if they want to (as long as risks are not very high). And the majority of those who reduced or stopped did not relapse. Numbers were small but this shows relapse is not inevitable. But relapse is a risk and people need to know this as part of making informed decisions about their medication.
Well done