Psychopharmacology and Psychiatry Updates

After the Last Dose: Understanding Antipsychotic Discontinuation

10 snips
Mar 2, 2025
Join psychiatrist Oliver Freudenreich, an expert in psychopharmacology from Massachusetts General Hospital, as he sheds light on the complexities of antipsychotic withdrawal. He discusses how psychotic relapse may sometimes be mistaken for withdrawal symptoms. The conversation reveals the common effects of discontinuation, such as insomnia and anxiety, along with risk factors and essential strategies for safe tapering. This insightful dialogue emphasizes the need for careful management and patient communication during this critical transition.
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ANECDOTE

Sarah's Case

  • Sarah, a 32-year-old with schizophrenia stable on quetiapine, wants to stop her medication.
  • This raises questions about managing the transition and differentiating withdrawal from relapse.
INSIGHT

Overlooked Withdrawal

  • Antipsychotic withdrawal is an overlooked area in psychiatry, unlike benzodiazepine or SSRI withdrawal.
  • More research is needed to understand antipsychotic withdrawal syndrome.
INSIGHT

Withdrawal Dyskinesia

  • Withdrawal dyskinesia, a known antipsychotic withdrawal phenomenon, can be severe and last for weeks.
  • It's possibly due to dopamine receptor supersensitivity after dopamine blockade.
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