Deprescribing antipsychotics in adults with psychotic disorders – a literature review

Abstract

Despite evidence of adverse effects, continuous antipsychotic maintenance treatment is still often the preferred intervention for people with a long-term psychotic disorder. Antipsychotic treatment should be discussed with patients and the option of deprescribing should be explored. There is, however, a lack of guidance on antipsychotic deprescribing as well as a conflict in mental health services between recovery-oriented practice, which promotes collaboration and patient choice, and the more traditional approach of promoting adherence to the clinician’s recommendation. The author conducted a literature review to gather clinical and academic perspectives on antipsychotic deprescribing in adults with a psychotic disorder in the context of recovery-oriented practice. Findings suggest that the adverse effects of long-term antipsychotic use are such that deprescribing should be considered, the challenge for nurses being to find a balance between patient autonomy and risk mitigation.