Neuroleptic withdrawal in schizophrenic patients: A review of the literature

P. L. Gilbert; M. J. Harris; L. A. McAdams; D. V. Jeste; R. J. Baldessarini; A. C. Viguera; W. T. Carpenter; C. A. Tamminga; J. F. Greden; R. Tandon; H. Y. Meltzer; K. H. Nuechterlein; M. J. Gitlin; K. L. Subotnik; R. J. Wyatt

doi:10.1001/archpsyc.1995.03950150005001

Neuroleptic withdrawal in schizophrenic patients: A review of the literature

P. L. Gilbert, M. J. Harris, L. A. McAdams, D. V. Jeste, R. J. Baldessarini, A. C. Viguera, W. T. Carpenter, C. A. Tamminga, J. F. Greden, R. Tandon, H. Y. Meltzer, K. H. Nuechterlein, M. J. Gitlin, K. L. Subotnik, R. J. Wyatt

Research output: Contribution to journal › Review article › peer-review

422 Scopus citations

Abstract

In the treatment of chronic schizophrenia, there are risks associated with both neuroleptic maintenance (eg, tardive dyskinesia) and neuroleptic withdrawal (eg, psychotic exacerbation or relapse). We reviewed 66 studies on neuroleptic withdrawal involving 4365 patients with schizophrenia. The mean cumulative relapse rate was 53% in patients withdrawn from neuroleptic therapy and 16% in those maintained on neuroleptic therapy over a mean follow-up period of 9.7 months. The relapse rate was positively associated with length of follow-up. Predictors of relapse reported in individual studies included younger age, higher baseline neuroleptic dosage, and shorter length of hospitalization. Adverse effects of neuroleptic withdrawal other than relapse were usually mild and transient. The risk-benefit ratio of neuroleptic maintenance vs withdrawal should be assessed carefully in individual patients. A slow taper to the lowest effective dosage may be the preferred strategy in many patients.

Original language	English (US)
Pages (from-to)	173-212
Number of pages	40
Journal	Archives of General Psychiatry
Volume	52
Issue number	3
DOIs	https://doi.org/10.1001/archpsyc.1995.03950150005001
State	Published - 1995

ASJC Scopus subject areas

Arts and Humanities (miscellaneous)
Psychiatry and Mental health

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Gilbert, P. L., Harris, M. J., McAdams, L. A., Jeste, D. V., Baldessarini, R. J., Viguera, A. C., Carpenter, W. T., Tamminga, C. A., Greden, J. F., Tandon, R., Meltzer, H. Y., Nuechterlein, K. H., Gitlin, M. J., Subotnik, K. L., & Wyatt, R. J. (1995). Neuroleptic withdrawal in schizophrenic patients: A review of the literature. Archives of General Psychiatry, 52(3), 173-212. https://doi.org/10.1001/archpsyc.1995.03950150005001

Gilbert, PL, Harris, MJ, McAdams, LA, Jeste, DV, Baldessarini, RJ, Viguera, AC, Carpenter, WT, Tamminga, CA, Greden, JF, Tandon, R, Meltzer, HY, Nuechterlein, KH, Gitlin, MJ, Subotnik, KL & Wyatt, RJ 1995, 'Neuroleptic withdrawal in schizophrenic patients: A review of the literature', Archives of General Psychiatry, vol. 52, no. 3, pp. 173-212. https://doi.org/10.1001/archpsyc.1995.03950150005001

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abstract = "In the treatment of chronic schizophrenia, there are risks associated with both neuroleptic maintenance (eg, tardive dyskinesia) and neuroleptic withdrawal (eg, psychotic exacerbation or relapse). We reviewed 66 studies on neuroleptic withdrawal involving 4365 patients with schizophrenia. The mean cumulative relapse rate was 53% in patients withdrawn from neuroleptic therapy and 16% in those maintained on neuroleptic therapy over a mean follow-up period of 9.7 months. The relapse rate was positively associated with length of follow-up. Predictors of relapse reported in individual studies included younger age, higher baseline neuroleptic dosage, and shorter length of hospitalization. Adverse effects of neuroleptic withdrawal other than relapse were usually mild and transient. The risk-benefit ratio of neuroleptic maintenance vs withdrawal should be assessed carefully in individual patients. A slow taper to the lowest effective dosage may be the preferred strategy in many patients.",

author = "Gilbert, {P. L.} and Harris, {M. J.} and McAdams, {L. A.} and Jeste, {D. V.} and Baldessarini, {R. J.} and Viguera, {A. C.} and Carpenter, {W. T.} and Tamminga, {C. A.} and Greden, {J. F.} and R. Tandon and Meltzer, {H. Y.} and Nuechterlein, {K. H.} and Gitlin, {M. J.} and Subotnik, {K. L.} and Wyatt, {R. J.}",

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AU - Viguera, A. C.

AU - Carpenter, W. T.

AU - Tamminga, C. A.

AU - Greden, J. F.

AU - Tandon, R.

AU - Meltzer, H. Y.

AU - Nuechterlein, K. H.

AU - Gitlin, M. J.

AU - Subotnik, K. L.

AU - Wyatt, R. J.

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Neuroleptic withdrawal in schizophrenic patients: A review of the literature

Abstract

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