Abstract
In recent years, an increasing number of case reports on psychiatric drug
withdrawal have emerged, offering detailed clinical insights and valuable
real-world evidence on the withdrawal process. The objective of this review was
to evaluate the strategies and management for withdrawing psychiatric drugs, as
detailed in case reports and series. A systematic review of case reports and
series published between 2013 and 2023 was conducted to capture the latest
trends in psychiatric drug withdrawal. Cases were identified following the
PRISMA guidelines by searching electronic databases Medline and Scopus. Finally,
47 case reports and series were included. The primary reason for drug withdrawal
was attributed to the emergence of adverse events, followed by medication
dependence or abuse, and clinical decision-making or symptom resolution. Gradual
reduction of doses was implemented through various management approaches as the
primary strategy for drug withdrawal, and drug substitution emerged as the
second most employed strategy. Also, patients were mostly undergoing
polypharmacy. Favorable treatment outcomes were reported in the majority of
cases, suggesting that psychiatric drug withdrawal is feasible – though quite
challenging in some situations. However, the remarkably low number of
unsuccessful cases may create a misleading impression of the significant
difficulty associated with withdrawing psychiatric drugs.
Keywords
drug tapering - dose reduction - drug therapy - psychoactive drug - drug withdrawal
symptoms
