COPYRIGHT 2006 Canadian Medical Association
The psychopharmacology of major psychiatric disorders involves the principle of optimal treatment, which includes appropriate drug selection, correct dosing, recognition and management of side effects, and appropriate duration of treatment. There is a substantial literature to support evidence-based decisions for all of these components of treatment in most major psychiatric syndromes. Less attention has been focused on drug discontinuation, especially in an era when longer-term treatment is recommended for most mood, anxiety and psychotic disorders. However, the rate and method of drug discontinuation can affect the course and prognosis of both mood and psychotic disorders. This is particularly relevant given the recommended use of relatively brief antidepressant treatment in bipolar disorder and the intermittent use of antipsychotic drugs in both mood and psychotic disorders. Moreover, up to 50% of patients will not comply with their prescription medication and will discontinue their drug treatments of their own accord. (1)
Analogous observations have been made in bipolar disorder and schizophrenia concerning drug discontinuation. Several studies have shown that discontinuation of lithium maintenance treatment in patients with bipolar disorder whose condition has been stabilized leads to...
Professional journal covering clinical and biological psychiatry and neuroscience.
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