帮助人们停止服用抗精神病药物:如果,何时以及如何
Joanna Moncrieff1,2, Mark Abie Horowitz3,4
1Division of Psychiatry, University College London, London, UK. j.moncrieff@ucl.ac.uk.
Schizophrenia (Heidelberg, Germany)
|December 17, 2025
概括
许多患者可能不需要终身抗精神病治疗. 逐渐减少可以降低戒断风险并改善社会功能,但复发仍然是可能的.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 临床心理学 临床心理学
背景情况:
- 主流观点是,在多次精神病发作后,终身使用抗精神病治疗.
- 有证据表明,抗精神病药物的益处可能被高估,而戒断可能会导致不良影响,包括复发.
- 目前关于逐步降低抗精神病药物的实用试验产生了混合的结果.
研究的目的:
- 批判性地评估终身抗精神病治疗的必要性.
- 探索成功停止抗精神病药物的潜力.
- 在长期使用抗精神病药物方面作出以患者为中心的决策.
主要方法:
- 对抗精神病药物治疗和停止治疗的现有文献和实用试验的审查.
- 在停止抗精神病药物后,影响复发和社会功能因素的分析.
- 检查拟议的逐步逐渐减少策略,例如过度缩减 (每月5-10%).
主要成果:
- 并非所有停止抗精神病药物的患者都会复发.
- 逐渐减少可能会改善长期的社会功能,尽管复发风险仍然存在.
- 没有一致的预测因素可以确定适合成功停止抗精神病药物治疗的患者.
结论:
- 强制终身抗精神病治疗的假设需要重新评估.
- 应该更广泛地考虑和提供逐步,个性化的逐渐缩减策略.
- 由于戒断风险和潜在的不良影响,建议尽量减少长期抗精神病药物暴露.
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