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

antipsychotics discontinuation symptoms meta-analysis systematic review withdrawal symptoms

Journal

Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006

Informations de publication

Date de publication:
2020
Historique:
received: 11 06 2020
accepted: 02 09 2020
entrez: 2 11 2020
pubmed: 3 11 2020
medline: 3 11 2020
Statut: epublish

Résumé

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. 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). 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). We followed guidelines by the Cochrane Collaboration, PRISMA, and MOOSE. 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; 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.

Identifiants

DOI: 10.3389/fpsyt.2020.569912 PMID: 33132934 PMC: PMC7552943
pubmed: 33132934
doi: 10.3389/fpsyt.2020.569912
pmc: PMC7552943
doi:

Types de publication

Systematic Review

Langues

eng

Pagination

569912

Informations de copyright

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

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Auteurs

Lasse Brandt (L)

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.

Tom Bschor (T)

Department of Psychiatry and Psychotherapy, Technical University of Dresden, Dresden, Germany.

Jonathan Henssler (J)

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.

Martin Müller (M)

Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany.

Alkomiet Hasan (A)

Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany.

Andreas Heinz (A)

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.

Stefan Gutwinski (S)

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.

Classifications MeSH