Larsen-Barr Miriam, Seymour Fred
School of Psychology, The University of Auckland, Auckland, New Zealand.
Ther Adv Psychopharmacol. 2021 Jan 31;11:2045125321989133. doi: 10.1177/2045125321989133. eCollection 2021.
It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this.
A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process.
Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25-25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by 'understanding myself and my needs', 'finding what works for me' and 'connecting with support'. Sub-themes expand on the way in which they did this. For example, 'finding what works for me' included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences.
This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.
众所周知，尝试停用抗精神病药物可能是一个充满波折的过程，复发风险很高，这常常导致人们重新服药。尽管如此，仍有一群人似乎能够成功停药。对于人们是如何做到这一点的，我们知之甚少。
通过一项匿名在线调查招募了一个便利样本，这些成年人已停用抗精神病药物一年多，参与半结构化访谈，该调查研究了新西兰的抗精神病药物使用经历。主题分析探讨了参与者对他们在停药过程中和停药后维持自身健康所做努力的描述。
在自愿参与的7名女性中，6人报告被诊断为双相情感障碍，1人报告被诊断为强迫症和抑郁症。这些女性报告成功停用抗精神病药物达1.25至25年；6人采用了逐渐停药的方法，并在准备和应对停药过程中得到了支持。参与者将健康定义为管理所面临任何困难影响的能力，而非完全预防这些困难的能力，并将其视为一个随时间演变的过程。他们描述了通过“了解自己和自己的需求”、“找到适合自己的方法”以及“寻求支持”来管理停药过程并在之后维持自身健康。子主题详细阐述了他们做到这一点的方式。例如，“找到适合自己的方法”包括使用一系列策略来灵活满足自身需求、践行接纳、依靠毅力和好奇心以及创造积极的生活体验。
这是一项小型定性研究，结果应谨慎解读。该样本表明，经历躁狂和精神病发作的人有可能成功停用抗精神病药物，并安全应对停药过程中出现的任何症状或之后出现的其他生活压力源所带来的影响。研究结果表明，内在资源和系统性因素在尝试停药的人群所观察到的结果中发挥着作用，而过度关注避免复发可能对这些努力产生适得其反的效果。专业人员在促进改变方面可以发挥重要作用。
