Medical effects of abrupt neuroleptic withdrawal (original) (raw)

Abrupt withdrawal of neuroleptics is often associated with symptoms such as headache, insomnia, nausea, and vomiting. Do these symptoms exceed base rates? Are prewithdrawal dosage and type of neuroleptic significant? Are the concurrent administration and/or withdrawal of AP drugs necessary for the production of these withdrawal symptoms? The literature in the area is reviewed to indicate current status of these issues. Also, prewithdrawal and postwithdrawal symptom data are presented from a withdrawal study of 56 chronic schizophrenic patients.

Postwithdrawal symptom rates (38%) significantly exceeded base rates for the total group and for subgroups withdrawn from neuroleptics only and from neuroleptics and AP drugs. Other studies2,3,5,8 have found incidences of 60% and higher. A relationship between neuroleptic dosage and withdrawal symptoms was not found, as was also the case in one prior study.3 We did not establish a relationship between neuroleptic type and withdrawal symptoms, but the studies2,3,5,8 showing the highest incidences of withdrawal symptoms used particularly autonomic neuroleptics (especially aliphatics). Although nonautonomic neuroleptics (piperazines and butyrophenones) alone can lead to withdrawal symptoms, they appear to do so mostly when AP drugs are concomitantly being taken and are withdrawn. The clinical implications of these findings are discussed.