| Autor: |
de Haan L; Amsterdam UMC, locatie AMC, afd. Psychiatrie, Amsterdam.; Contact: l.dehaan@amsterdamumc.nl., Gangadin SS; UMC Groningen, afd. Psychiatrie, Groningen., de Beer F; UMC Groningen, afd. Psychiatrie, Groningen., Djordjevic M; UMC Groningen, afd. Psychiatrie, Groningen., Begemann MJH; UMC Groningen, afd. Psychiatrie, Groningen., Sommer IEC; UMC Groningen, afd. Psychiatrie, Groningen. |
| Jazyk: |
Dutch; Flemish |
| Zdroj: |
Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2023 Dec 21; Vol. 168. Date of Electronic Publication: 2023 Dec 21. |
| Abstrakt: |
In this paper we discuss the risks and benefits of discontinuing antipsychotic medication within one year after remission of a first episode of psychosis. We start with a fictional case report of a 21-year-old man, who was diagnosed with schizophreniform disorder four months earlier. While symptoms responded well to a daily dose of 10 mg ariprazole, he experienced side effects (tiredness and mild hypersomnia). Three months after symptom remission, he expressed the wish to discontinue his medication. How should psychiatrists respond to his wish? To answer that, we briefly summarize relevant evidence and discuss arguments for the different therapeutic approaches, i.e., maintaining vs. tapering antipsychotic medication, based on specific patient characteristics. Recommendations from the current Dutch guidelines are complemented with personal experience and considerations in finding the optimal balance between side effects, relapse risk, stigma and acceptance of mental health problems, while incorporating the principles of shared decision-making. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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