Display options
Cite
Brandt L, Bschor T, Henssler J, et al. Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis. Front Psychiatry. 2020;11:569912doi: 10.3389/fpsyt.2020.569912.
Brandt, L., Bschor, T., Henssler, J., Müller, M., Hasan, A., Heinz, A., & Gutwinski, S. (2020). Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis. Frontiers in psychiatry, 11569912. https://doi.org/10.3389/fpsyt.2020.569912
Brandt, Lasse, et al. "Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis." Frontiers in psychiatry vol. 11 (2020): 569912. doi: https://doi.org/10.3389/fpsyt.2020.569912
Brandt L, Bschor T, Henssler J, Müller M, Hasan A, Heinz A, Gutwinski S. Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis. Front Psychiatry. 2020 Sep 29;11:569912. doi: 10.3389/fpsyt.2020.569912. eCollection 2020. PMID: 33132934; PMCID: PMC7552943.
Copy Download .nbib Format: NLM
Share it on

Front Psychiatry. 2020 Sep 29;11:569912. doi: 10.3389/fpsyt.2020.569912. eCollection 2020.

Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis.

Frontiers in psychiatry

Lasse Brandt, Tom Bschor, Jonathan Henssler, Martin Müller, Alkomiet Hasan, Andreas Heinz, Stefan Gutwinski

Affiliations

  1. Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
  2. Department of Psychiatry and Psychotherapy, Technical University of Dresden, Dresden, Germany.
  3. Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  4. Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany.
  5. Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany.
  6. Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany.

PMID: 33132934 PMCID: PMC7552943 DOI: 10.3389/fpsyt.2020.569912

Abstract

OBJECTIVE: Avoiding withdrawal symptoms following antipsychotic discontinuation is an important factor when planning a safe therapy. We performed a systematic review and meta-analysis concerning occurrence of withdrawal symptoms after discontinuation of antipsychotics.

DATA SOURCES: We searched the databases CENTRAL, Pubmed, and EMBASE with no restriction to the beginning of the searched time period and until October 1, 2019 (PROSPERO registration no. CRD42019119148).

STUDY SELECTION: Of the 18,043 screened studies, controlled and cohort trials that assessed withdrawal symptoms after discontinuation of oral antipsychotics were included in the random-effects model. Studies that did not implement placebo substitution were excluded from analyses. The primary outcome was the proportion of individuals with withdrawal symptoms after antipsychotic discontinuation. We compared a control group with continued antipsychotic treatment in the assessment of odds ratio and number needed to harm (NNH).

DATA EXTRACTION: We followed guidelines by the Cochrane Collaboration, PRISMA, and MOOSE.

RESULTS: Five studies with a total of 261 individuals were included. The primary outcome, proportion of individuals with withdrawal symptoms after antipsychotic discontinuation, was 0.53 (95% CI, 0.37-0.70;

CONCLUSION: Withdrawal symptoms appear to occur frequently after abrupt discontinuation of an oral antipsychotic. The lack of randomized controlled trials with low risk of bias on antipsychotic withdrawal symptoms highlights the need for further research.

Copyright © 2020 Brandt, Bschor, Henssler, Müller, Hasan, Heinz and Gutwinski.

Keywords: antipsychotics; discontinuation symptoms; meta-analysis; systematic review; withdrawal symptoms

References

  1. Ann Intern Med. 2009 Aug 18;151(4):264-9, W64 - PubMed
  2. Schizophr Bull. 1996;22(4):591-5 - PubMed
  3. World J Biol Psychiatry. 2013 Feb;14(1):2-44 - PubMed
  4. Addict Biol. 2020 Mar;25(2):e12735 - PubMed
  5. Ther Adv Psychopharmacol. 2016 Apr;6(2):145-6 - PubMed
  6. Am Rev Respir Dis. 1960 Apr;81:562-6 - PubMed
  7. J Clin Psychiatry. 2018 Jun 19;79(4): - PubMed
  8. Dtsch Arztebl Int. 2019 May 17;116(20):355-361 - PubMed
  9. BMJ. 2011 Oct 18;343:d5928 - PubMed
  10. Am J Med. 1987 Jan;82(1):17-9 - PubMed
  11. J Autism Child Schizophr. 1973 Jul-Sep;3(3):247-53 - PubMed
  12. Aging Ment Health. 2013;17(1):125-32 - PubMed
  13. Lancet. 2019 Sep 14;394(10202):939-951 - PubMed
  14. Compr Psychiatry. 1976 Mar-Apr;17(2):285-94 - PubMed
  15. Am J Psychiatry. 1959 Apr;115(10):931-2 - PubMed
  16. Biol Psychiatry. 1993 Jun 1-15;33(11-12):829-35 - PubMed
  17. Nervenarzt. 1967 Apr;38(4):170-4 - PubMed
  18. Schizophr Res. 1993 Oct;10(3):267-71 - PubMed
  19. J Pharmacol Exp Ther. 2011 Nov;339(2):324-8 - PubMed
  20. Compr Psychiatry. 1966 Dec;7(6):501-9 - PubMed
  21. Psychother Psychosom. 2017;86(4):189-219 - PubMed
  22. Br J Psychiatry. 2017 Sep;211(3):127-129 - PubMed
  23. Lancet. 2012 Jun 2;379(9831):2063-71 - PubMed
  24. Am J Psychiatry. 1966 Aug;123(2):221-6 - PubMed
  25. J Am Geriatr Soc. 2004 Oct;52(10):1737-43 - PubMed
  26. J Clin Psychopharmacol. 1999 Oct;19(5):435-43 - PubMed
  27. Biol Psychiatry. 1989 Jan;25(1):75-86 - PubMed
  28. J Clin Psychiatry. 1998 Sep;59(9):472-7 - PubMed
  29. CNS Drugs. 2013 Jul;27(7):545-72 - PubMed
  30. JAMA. 2000 Apr 19;283(15):2008-12 - PubMed
  31. J Psychopharmacol. 2016 Aug;30(8):749-70 - PubMed
  32. Eur Psychiatry. 2010 Jun;25 Suppl 2:S12-21 - PubMed
  33. Br J Clin Pharmacol. 1976 Feb;3(1):157-63 - PubMed
  34. Arzneimittelforschung. 1970 Jul;20(7):890-3 - PubMed
  35. Lancet Psychiatry. 2019 Jun;6(6):538-546 - PubMed
  36. BMJ. 2011 Jul 22;343:d4002 - PubMed

Publication Types