Sudden Antipsychotic Withdrawal—Not Low Dose—Leads to Relapse

A new article in Lancet Psychiatry debunks past studies claiming that those on low doses of antipsychotics are more likely to relapse.

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A recent meta-analysis claimed that those on a lower dose of antipsychotics were more likely to relapse than those taking a higher dose. But a new article in Lancet Psychiatry debunks that claim. The original studies almost all began by suddenly dropping the dose of medication that participants were already taking. Thus, the higher rate of relapses was due to abrupt withdrawal, not being on a lower dose.

The new paper was written by well-known psychiatric researchers Mark Horowitz, Robin Murray, and David Taylor.

They write that “of the 24 trials examined, 21 involve switching patients who were already established on a stable dose of medication to lower doses, either abruptly or over a few weeks.”

According to the researchers, it can take “months or years for neuroadaptations to the presence of antipsychotics to resolve.” They give the example of tardive dyskinesia, a severe withdrawal effect that can persist for years after discontinuing the drugs. Because of this, they write, a rapid withdrawal from a high dose of the drug is likely to cause harmful effects that are misclassified as “relapse.”

“The meta-analysis by Højlund and colleagues does not account for the possibility that the process of reducing an antipsychotic dose itself, and not a patient merely being on a lower dose, might affect detected relapse rates,” they write.

The three trials that did not suddenly withdraw patients from a higher dose showed no statistically significant difference in relapse rates between groups. Only the studies that featured abrupt, rapid withdrawal found the supposed effect of increased relapse in the low-dose group.

The researchers also write that future studies should focus on patient-focused outcomes like quality of life and social functioning rather than on small effects on symptom-reduction measures.

This finding aligns with previous research on psychiatric drug withdrawal, which documents a vast array of harmful effects that can last for months or years.

 

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Horowitz, M. A., Murray, R. M., & Taylor, D. (2021). Withdrawal-associated relapse is a potential source of bias. Lancet Psychiatry, 8(9), 747-748. DOI: https://doi.org/10.1016/S2215-0366(21)00250-9 (Link)

13 COMMENTS

  1. If the psychiatrist do not have medicines to give to (or force onto) their patients, then they are not doctors are they?

    To dmschlom
    Everyone is for psychiatry for the fear of the future. The patient is continually drugged for fear of the future. Everyone knows there is no chemical imbalance, virus or bacteria. Controlling the other person but how?

    Insane actions have been with mankind since the start of time and psychiatry and its drugs is the panacea.

    Historical events
    Kill your son because of voices . Binding of Isaac https://en.wikipedia.org/wiki/Binding_of_Isaac
    Kill your wife in anger . Labours of Hercules https://en.wikipedia.org/wiki/Labours_of_Hercules
    Kill your brother .Cain https://en.wikipedia.org/wiki/Cain

    Today all taken care of by magical pills that make people “good” instead of “bad”.

    • Well, I have a rather complex paper trail of evidence on my computer, from when I lived in this lower income black neighborhood of Dorchester, that backs up the contention that large corporations, wishing to make money off of illegally involuntary “Nazi style” medical experiments on marginalized people (e.g., the poor, or black people, etc.), will resort to using both the psychiatric system, crooked cops and mafia connected gangs to accomplish their aims.

      The idea is that, in a neighborhood that is poor enough, the mafia can get away with things and residents there can be intimidated into denying any knowledge or pretending to have witnessed nothing. You will have gangs engage in rather bizarre elaborate “conspiracies” or antics, outside in the neighborhood, playing minds games on and otherwise targetting and hazing a particular victim — often after they have been plied with drugs. Then same individuals will engineer some “incident” that results in police being called, police then go and take the person to a hospital, which may conduct any number of unethical experiments on them (for which they are getting bribed with corporate money, or else maybe some research institution like Harvard got the bribe), and then they will falsify records just right and accuse the victim of suffering “psychosis” (usually drug induced).

      The key thing is, if the victim later on tries to make any accusations, part of their story is going to include the rather fanciful antics of the “mafia” like gangs in their neighborhood, just prior to them being taken to the hospital where bizarre things were done to them. All neighbors will deny responsibility or knowledge, the victim is genuinely going to look like they really did hallucinate the whole thing into existence.

      It’s a very clever cover up.

      I was personally a would-be victim of such a scheme. However, I did a number of things that ensured some of the abuse wouldn’t get covered up. For instance, some of the “Hazing” involved death threats and other bizarre threatening stuff communicated to me online on my computer — which computer hackers from the online server (not in my apt) the communications were going through systematically kept deleting, leaving no evidence I’d been threatened and harassed. I started hitting print screen and saving to microsoft word, systematically capturing those threatening antics, e.g., the threats which would appear in my inbox, and then magically disappear via computer hacker, in a manner intended to make it look like they’d never been sent and I’d just imagined them. In one instance, I had a print screen of a particular folder obviously full of threatening emails — and a minute or two later, a print screen of the same folder, with all the threatening emails gone. And this was a folder where no one, not even me, can delete old messages, they automatically disappear after 30 days and not before. That — and a whole bunch of other things I documented as well — was enough to prove it.

      In my case, I was experimented on with pharmaceuticals that were not approved of by the FDA. Including — well, I believe the perpetrators have a successful cure for genital herpes they are covering up, in return for bribe money from Big Pharma. Just one example of the kind of corruption that is out there.

      But I do need to note. The threat to fraudulently diagnose victims of crimes “crazy” or with some fabricated mental health diagnosis in order to cover up crimes perpetrated by the mafia is very common. And endemic to psychiatry. Which, by now, is a discipline that networks with other medical industries.

      Actually, in my case, I believe some of the faked diagnoses of me, even while not very credible, were strategically clever enough so as to render my potential testimony against any numbers of criminals “not quite credible enough to indict them.” These criminals — who were mostly drug users doing what they had to do in order to party with cocaine and crystal meth safely — were later blackmailed and forced to submit to unethical nazi style medical experiments done on them, in the arena of computers, robotics and medicine. Testing out such devices on them as robotic rectums intended eventually for elderly incontinent.

      Again, use of the psychiatric system proved to be very advantageous for this kind of plot. The key thing was for medical doctors to tarnish me with bogus psych diagnoses making my testimony just questionable enough so that, if no one else came forward so as to back me up regarding my contentions that I was a victim of certain crimes, no one could be indicted on my testimony alone. And then third parties helped blackmail the perpetrators by waiting in the wings, threatening to come forward in a manner that might bolster my testimony, but agreeing not to do so, if the criminals submitted themselves for medical experiments.

      This is the kind of subtle and sophisticated criminal racketeering that goes on, using psychiatry. But, I mean, with psychiatry being leveraged for the purposes of organized crime in ways as elaborate as THIS, please, how can it possibly be a credible discipline with respect to actually trying to help people with their mental health?

      You simply cannot do good mental healthcare, when a huge portion of psychiatry has been distorted so as to make it useful for criminal racketeering.

  2. Whether one relapses or not is most probably an individual thing; as is withdrawal and even the responses to the side effects of any drug, including psychiatric drugs and thus, the anti-psychotics. It is the fact that each one of us is such a unique individual that has caused the most distress for not only psychiatry, but also traditional medicine and even education, government and most of the institutions that serve people. Many would like to scoff at individualism, but it endemic to all regardless of any other consideration. Unfortunately, many nations either want to supress or deny it in more profound ways than the US. Therefore, I would consider any of these studies somewhat suspect. In my own unique personal experience, I found that an “abrupt withdrawal” was more successful than any other in preventing relapse. However, that could be very dangerous for others. However, when I looked back, I could see how this was appropriate for me. As earlier, I went “cold turkey” from alcohol and never looked back. There have been other things I have gone “cold turkey” from and never went back. Of course, there are some things I have been unable to wean myself from… Some of it is due to my personal determination and some of it is due to my memory of what that “whatever” did to my brain/body. The question is how is anyone to know what to do has to what is best for them; since obviously psychiatry, like so many other institutions and other entities, refuse to acknowledge the unique individuaity of each person; seeing them only as a member of a particular, prescribed group, whatever group that might be. Thank you.

  3. I think we should attend to the subject at hand, whiich is the possible relapse of anti-psychotic drug use. Like illegal drugs, at times, one’s environment may be part of the cause, however, there is so much more at play here that needs to be understood. We can spend all day and night discussing how terrible life is and the hand of cards we think we have been dealt, but it does not help the cause of freeing people from the use of anti-psychotics and other psychiatric. But, in the end, it will still boil down to the individual and his or her determination to remain psychiatric drug free. In most cases that means walking away from psychiatry all together, including therapy. It may also mean finding a place to live that assists one in being and feeling safe from the evils of psychiatry. We must always remember it is psychiatry that is the evil, not even its stepsister, psychology, can come close. Why is psychiatry, the evil, because it is, to be blount, diabolical (devil-inspired.) So, the first step is to just say no to psychiatry and leave the extra, possibly disgusting “fluff” behind. Thank you.

  4. I’ve seen a paper on low dose “antipsychotic” prescribing at 200mg chloropromazine per day where none of the people “relapsed”. This makes sense to me, as – if the people were to start feeling uncomfortable, they could UP the dose slightly, or reduce the dose again, and remain OK.

    I cut down to 25mg of Mellaril similar to 25mg Chloropromazine/day in a period of 6 years (1984 to 1990) – from 25mg / month of Modecate Depot (“suitable” for “schizophrenia”). And have remained well since.

    I used Straightforward “Psychotherapy” as well, to deal with my Neuroleptic Withdrawal High Anxiety. If I hadn’t the “High Anxiety” would have Overwhelmed me.

  5. In my own case in 1983 when I attempted (with permission) to Abruptly Withdraw from my Modecate Depot Injection – I experienced 4 hospitalizations in 5 months, 1 Suicide Attempt and I near Suicide Attempt.

    The reason I wanted to get off the Neuroleptic Depot Medication was because it was disabling me – and my Psychiatlist was interpreting my Disability as Mental Illness.

    • WE NEED TO COME OUT OF THE DARK AGES
      With the length of time “Antipsychotic” Drugs have been around – at least 60 years – a person might think that the extremely important recent research conducted by – Doctors Murray, Horowitz, Taylor, Moncrieff (to name a few) – had already been done in the 1960s.

    • Now in my case, well I really do suffer from ADHD and a tendency towards anxiety, but that is all. And so does my twin brother. We were given fake diagnoses and lied to by doctors at Harvard who wanted to conduct unethical medical experiments on us — and it’s a long complex story.

      However, eventually — well, the sickening part of it was to conduct a series of horrific crimes perpetrated by the mafia, cover these crimes up, and then fraudulently portray the very severe PTSD and trauma as spontaneously appearing symptoms of schizophrenia — and they hoped they would be able to claim no one had done anything to us.

      I was legally savvy. My twin brother wasn’t and I couldn’t get him to listen to me about the importance of keeping paper trails. Anyway, I kept paper trails and took them to a lawyer and they proved the abuse badly enough so people were willing to admit that I’d been abused and my then fragile mental state (not what I started out with, what the perpetrators caused in me by what they did) was the result of abuse and very serious crimes. Actually, I even had physical damage from some pretty undeniable rapes, it was that bad. As well as clear cut brain damage.

      However, had I not gotten a lawyer at the right time, they would have declared it all schizophrenic — and then if you put someone suffering from that kind of PTSD on anti-psychotics, it inhibits the part of the brain that might have the capacity to recover on its own.

      They know that too, and the sickening part of psychiatry is how often they will misdiagnose trauma, and how much they know if such a misdiagnosis leads to an anti-psychotic, they can use the anti-psychotic to permanently incapacitate an abused and exploited victim. And, yes, they do this fully knowing what they are doing, it’s that evil.

      Actually, in my case, it wasn’t just trauma trauma. I had head trauma inflicted which, again, makes it even harder for the brain to re-develop the connections it must develop to overcome PTSD. And would have made an anti-psychotic even more debilitating and detrimental to my recovery.

      But that is all theoretical. And that is all the danger I knew about, hence my rigorous keeping of paper trails and legal savvy I used to protect myself from that.

      However, even after getting the attorney, I was still in a very debilitated state of mind. Terrible PTSD which could easily look like schizophrenia if you didn’t know what had happened to me.

      The one thing that worked the best for my recovery was outdoor exercise and mountain climbing. For some reason, exercise combined with exposure to nature — which stimulates the olfactory sense, biggest interface between one’s environment and the brain — helped my brain overcome those ingrained “ruts” I was stuck in with PTSD. And stimulated it to grow new and more positive connections.

      Actually, there was a study done on elderly people which shows OUTDOOR walking — but not indoor exercises — stimulates the brain to grow more brain cells and make more connections.

      https://www.nytimes.com/2021/07/14/well/move/exercise-walking-brain-memory.html?smid=url-share

      I am certain that overcoming PTSD — but also probably overcoming other issues like schizophrenia — is best done by stimulating the brain to grow more brain cells like this. And I speak of this as a victim of trauma and ptsd and brain damage leading to certain cognitive impairments. Mountain climbing outdoors IS like a drug that impacts one’s brain. Also, the environment one does it in counts too. Higher altitude mountains with lots of cold running water crashing over rocky streams has a better or at least different impact compared to hotter, lower altitude and more “stagnant” air environments.

      Hiking the white mountains of New Hampshire will have a different impact from hiking short rolling hills in areas of New England near sea level, even though both are good.

      Anti-psychotics does the exact opposite of grow brain cells. It causes brain shrinkage. It’s the exact opposite of the right thing to do. They act as enablers. This is as bad as ancient rome prescribing lead poisoning to the upper middle class.

      Actually, part of the unethical experiments I was forced to endure involved many years of excruciating physical pain due to an untreated muscle spasm, which even when treated caused me a neurological pain syndrome that is hard to recover from and hard to shake off.

      I now, occasionally, have fake pain in certain spots, that my brain neurologically “creates” — or gets fooled into thinking is real — that is a result of me having spent 25 years in untreated excruciating pain. Fibromyalgia is what it’s sometimes called. However, most people with fibromyalgia were born with it whereas I had it programmed in me due to a horrendous experience that’s almost unheard of.

      Anyway, what I suffer from now are what could be described as pain hallucinations. E.g., the same pain that used to be in my upper back left shoulder blade area will remap itself to different parts of my body, which then will sometimes “feel” like they are in the same pain I used to have before.

      The moment I was informed it was a pain syndrome and not real injuries in those spots, I instantly started to “mind over matter” start to will the pain away and mentally take control over the pain and start training myself into mentally reducing it. That went on for awhile during a two year haitus from mountain climbing. And I improved the pain somewhat. Then I start regularly mountain climbing in New Hampshire again — and the mountain climbing itself DRASTICALLY reduced the pain.

      I can say, the mountain climbing stimulates your brain into “re-evaluating” what IS reality and what ISN’T reality. Re-evaluating the “pain” it was wrongly feeling into “not-pain.” But I think PTSD is the same way, and likely schizophrenia probably is too. As well as depression. Your brain can do re-processing of stuff. Re-programming of stuff. Somehow, it is stimulated to automatically do it much more in an environment involving outdoor exercise in nature. And I think, if it were researched better, we would learn why.

      My gut feeling tells me, your brain is sensitive to what you are breathing in, the olfactory sense, as well as the exercise and the exertion. But olfactory stimulation in the absence of exercise and exertion won’t work. I just know it’s the combination that does it. Also, mountain climbing involves exercise on un-even terrain — not the monotonous “same movement all the time” repetition of a gym treadmill, which also means your whole entire nervous system is being stimulated and exercised as you mountain climb. Forcing your brain to be “there.” Monotonous treadmill — your brain can fall asleep while you do that. It’s not the same.

      Thinking of evolution, our brains developed in environments where, when we trekked long distance through unfamiliar territories, our brains had to be on the look out for dangerous predators or other dangers. Schizophrenia and ptsd are diseases related to paranoia and the sensing of danger. Maybe our brains were developed so we “need” some amount of the conditions associated with real danger in our lives, or it’s like — I once heard about how people, if put in sensory deprivation chambers for too long, will start to hallucinate. Maybe modern day civilized life is, to some people, too much like a sensory deprivation chamber.

  6. In my case, as regards withdrawal, I mostly “toughed it out.” After my nearly comatose state which put me in the hospital, the “doctors” abruptly withdrew all drugs from me, which included two anti-psychotics, valium and two SSRIS. I remained on lithium. For two years after that and through several doctors, they tried and failed a few different anti-psychotics including seroquel and zyprexa. Basically, they were useless and caused very uncomfortable side effects. I still remained on lithium. I, then, became concerned that I had lithium toxicity as I had been on lithium on and off for over twenty years. Finally, I got to the point that I could no longer take any pills and every pill I took, I basically threw up, including lithium. I noticed that after a night or so of no pills, I felt better like I was “clean” inside. This was how I felt after a horrible reaction to alcohol which caused me to stop drinking some years earlier. I told this, the psychiatrist and that I did not want to take any moredrug; so the psychiatrist, who in her idiocracy, persisted in writing me a prescription for lithium as a protection. I never saw that psychiatrist again or went back to that clinic. I walked away. I still had to go through “withdrawal” which at times was excruciating, but I “toughed” it out and I, personally, am a better person for it. However, I would not suggest or advocate this for anyone. How one withdraws from any drug or drugs is a uniquely personal decision that should be tailored to each person’s unique health needs. But, as usual, almost all these decisions are left not up to the patient, but to some doctor or maybe another health provider who may or not have the best interest of the individual at heart. Thank you.

  7. The brain can not be forced what it can or should not do; either uniquely and individually or on a total human level. This is true for non-human creatures, too. When the brain is forced into such situations, there is damage from slight to major. Psychiatric drugs, psychadelic drugs, and even some other drugs will do that. Synthetic drugs are especially suspect. Of course, any kind of trauma to the brain can affect it and that includes exterior trauma, such as sports injury or car accident or interior trauma such as illness or a trumatic incident in one’s life. However, as far as interior trauma goes, what is traumatic for one person may not be traumatic for another person. Such that, if you are lousy, say in math and take an accounting job that can induce trauma. We also know war and natural disasters do cause brain-damaging trauma. And, of course, nutrition and diet affects the brain and again that is highly unique to each person. Also, there are some people who are more highly sensitive to their environment than other people and there are other people who thrive on risk and sensation. The 90s were supposed to be “The Decade of the Brain.” But, we failed on this one. We forgot to guide people to learn to take care of their brain; to listen to its needs and to find a way to spend more of their time using their God-given strengths and less of their time trying to do the impossible; making their weaknesses into their strengths. We need to take care of our brains as if they are our children; with kindness, gentleness and patience and we need to listen to our brains as if they were a wise parent or grandparent. If these “analogies” don’t fit you, please fill in the blank with what works for you. Thank you.

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