School of Psychology, The University of Auckland, Auckland, New Zealand.
Waitemata District Health Board, CAMHS West, Private Bag 93 115, Henderson, Auckland, 0612, New Zealand.
Soc Psychiatry Psychiatr Epidemiol. 2018 Jul;53(7):745-756. doi: 10.1007/s00127-018-1518-x. Epub 2018 Apr 23.
To explore supports and coping strategies used during attempts to discontinue antipsychotic medication and test for associations with success.
144 people who were taking or had taken antipsychotics completed The Experiences of Antipsychotic Medication Survey. Among them, 105 people had made at least one discontinuation attempt and answered a series of questions about their most recent attempt to stop. Content analysis and Chi-square tests of independence were used to categorise the data and explore associations. Success was defined as stopping all AM use irrespective of the duration of the medication-free period or whether relapse occurred, which were explored separately.
Among the 105 people who had attempted discontinuation, 61.9% described unwanted withdrawal effects and 27.6% of the group described psychotic or manic relapse during the withdrawal period. Within this group 55% described successfully stopping all AM for varying lengths of time, half reported no current use, and half described having some form of professional, family, friend, and/or service user or peer support for their attempt. Having support was positively associated with success and negatively associated with both current use, and relapse during withdrawal. A range of coping efforts were described, but having coping strategies failed to show significant associations with any of the dependent variables explored. Among those who described successfully stopping, some described returning to AM for short periods when needed, while others reported managing well with alternative methods alone.
Findings cannot be readily generalised due to sampling constraints, but results suggest a wide range of supports and coping strategies may be used when attempting to discontinue antipsychotics. Many people may attempt to discontinue antipsychotics without any support. Those who have support for their attempts may be significantly less likely to relapse during withdrawal and more likely to succeed in their attempt. There is a pressing need for further research in this area.
探索在尝试停用抗精神病药物时使用的支持和应对策略，并检验其与成功的关联。
144 名正在服用或曾服用过抗精神病药物的人完成了《抗精神病药物使用体验调查》。其中，105 人至少尝试过一次停药，并回答了一系列关于他们最近停药尝试的问题。采用内容分析法和卡方独立性检验对数据进行分类，并探讨关联。成功定义为停止所有抗精神病药物的使用，无论无药期的持续时间长短或是否复发，这两者将分别进行探讨。
在 105 名尝试停药的人中，61.9%的人描述了不想要的戒断效应，27.6%的人在停药期间出现了精神病或躁狂复发。在这一组中，55%的人描述了成功地停止了所有抗精神病药物的使用，时间长短不一，一半的人报告目前没有使用，一半的人描述他们在尝试停药时得到了专业人士、家人、朋友、服务使用者或同伴的某种形式的支持。获得支持与成功呈正相关，与当前使用和停药期间复发呈负相关。描述了一系列应对策略，但应对策略与所探讨的任何依赖变量均无显著关联。在那些成功停药的人中，一些人在需要时短时间内重新使用抗精神病药物，而另一些人则仅用其他方法成功地管理。
由于抽样限制，研究结果不能轻易推广，但结果表明，在尝试停用抗精神病药物时，可能会使用广泛的支持和应对策略。许多人可能在没有任何支持的情况下尝试停用抗精神病药物。那些在尝试停药时有支持的人在停药期间复发的可能性较小，成功的可能性较大。因此，该领域迫切需要进一步的研究。
