Antipsychotics: Starting and stopping antipsychotics

^{From: Understanding psychiatric medications: Antipsychotics - Information for consumers, families and friends (© 2009 CAMH)}

How long should I take antipsychotics?

If you take antipsychotics for psychosis, how long you take them depends on what the psychosis is related to and how many episodes you have experienced. In some situations, you may only need to take this medication until the symptoms of psychosis are relieved. In others, antipsychotics may be used over a longer term to help prevent further episodes.

When starting a new antipsychotic as a long-term treatment, you should take that drug for at least a month before deciding whether or not it is working for you.

Are antipsychotics addictive?

Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Antipsychotics do not have these effects.

Antipsychotics do, however, have one thing in common with some addictive drugs—they can cause withdrawal effects when you stop taking them, especially if you stop suddenly. These effects can include nausea, vomiting, diarrhea and stomach pain, dizziness and shakiness. When the time comes to cut down or stop taking the drug, cutting back gradually helps to reduce withdrawal effects.

How do I cut down or stop taking antipsychotics?

Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. A sudden change in your dose greatly increases the risk that psychotic symptoms will return or become more intense.

The first step is to ask yourself if this is the right time. Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends?

If you think you’re ready, talk to your doctor. If your doctor doesn’t agree, find out why. If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion.

If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually—usually by about 10 per cent at a time—with at least two to three weeks between each reduction. This process of cutting back can take several months. Using a pill cutter or a liquid form of your medication can help you to cut your dose down in small amounts.

If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time.

As you cut down, if you start to feel unwell, let your doctor know. He or she can help you determine whether you are experiencing withdrawal effects or signs that symptoms are returning. You may want to go back up with your dose. Find the dose that works best for you.

Contents:

• Introduction
• Do I need treatment?
• What do antipsychotics do?
• Side-effects
• Types of antipsychotics
• Starting and stopping antipsychotics
• Antipsychotics, other drugs and driving
• Antipsychotics, sexuality and pregnancy
• Is age an issue?
• Where can I get more information about antipsychotics?
• How can I find treatment or a support group?

• Print
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