Keks Nicholas, Schwartz Darren, Hope Judy
Centre for Mental Health Education and Research, Delmont Private Hospital, Glen Iris, Victoria.
Monash University, Clayton, Victoria.
Aust Prescr. 2019 Oct;42(5):152-157. doi: 10.18773/austprescr.2019.052. Epub 2019 Oct 1.
In general, specialist advice should be sought when stopping or switching antipsychotics While antipsychotics are often needed long term, there are circumstances when clinicians, patients and families should reconsider the benefits versus the harms of continuing treatment Withdrawal syndromes, relapse and rebound can occur if antipsychotics are discontinued, especially if they are stopped abruptly. Generally, they should be reduced and stopped slowly, ideally over weeks to months Relapse of psychosis and exacerbation occur in most patients with psychotic disorders, occasionally with drastic consequences. Sometimes this occurs many months after stopping antipsychotics Switching from one antipsychotic to another is frequently indicated due to an inadequate treatment response or unacceptable adverse effects. It should be carried out cautiously and under close observation
一般来说,在停用或更换抗精神病药物时应寻求专科医生的建议。虽然抗精神病药物通常需要长期使用,但在某些情况下,临床医生、患者及其家属应重新考虑继续治疗的利弊。如果停用抗精神病药物,尤其是突然停药,可能会出现戒断综合征、复发和反跳现象。一般来说,应缓慢减量并停药,理想情况下在数周至数月内完成。大多数患有精神障碍的患者会出现精神病复发和病情加重的情况,偶尔会产生严重后果。有时这种情况会在停用抗精神病药物数月后发生。由于治疗反应不佳或出现不可接受的不良反应,经常需要从一种抗精神病药物换用另一种。换药应谨慎进行,并密切观察。