November 19, 2013 by Sandra Steingard, MD
Tapering Neuroleptics: Two Year Results
As I have described previously, I have been tracking my experience with tapering neuroleptic drugs in my clinical practice. With all of the people I see who are stable on a particular dose of a neuroleptic drug, I discuss the risks of long-term use of these drugs. We also discuss the potential benefits. This conversation varies from person to person. We take into account what has happened in the past, how he is doing now, and what she has to lose if her past problems were to re-emerge. If a person wants to taper, I suggest slow reduction; 25-30% every 3-6 months. I keep track of who chooses to taper and who does not. I now have a colleague who is doing the same in her practice. Together, we are following 112 individuals. We presented our data in a poster presentation at the Institute of Psychiatric Services in October, 2013.
September 9, 2013 by Sandra Steingard, MD
Taking Anti-Psychotics When You Are Not Psychotic
In brief, the Wunderink study uses a randomized control design and found that, in adults diagnosed with a psychotic disorder, continuous use of neuroleptics was associated with worse functional outcomes than intermittent use. Higher doses were associated with worse outcomes than lower ones.
These days, neuroleptic drugs are widely promoted to treat depression and they are often used “off-label” to treat behavioral problems in children. They are among the most widely prescribed drugs; given the theory that “schizophrenia” affects 1% of the population, it is clear that many individuals – adults and children – who do not have this diagnosis are prescribed these drugs.
Is the Wunderink study relevant to those who do not experience psychosis?