Medication reduction and discontinuation for schizophrenia

  Patients with schizophrenia often fail to adhere to their medication after their symptoms have disappeared, leading to relapse and resulting in prolonged treatment. When exactly can medication be stopped and reduced?  Patients with schizophrenia need a full course of treatment and a full range of treatment, continuous medication and psychosocial interventions.  ①Acute treatment: alleviate the main symptoms, adequate drug treatment, the course of treatment for at least 4-6 weeks; ②Recovery (consolidation) treatment: prevent the relapse of the alleviated symptoms, using the original effective drugs and doses to continue treatment, the course of treatment for at least 3-6 months; ③Maintenance (recovery) treatment: maintain the stability of the disease, to prevent the relapse of the disease, adhere to drug treatment, according to individual conditions to determine the maintenance drug dose, the course of treatment for not less than 2-5 years. The dose is generally one-half to two-thirds of the original treatment amount. Many scholars have suggested that long-term maintenance treatment should be given to those who have relapsed after stopping medication. For patients who are refractory, have severe suicidal attempts or violent aggressive behavior, continuous maintenance therapy is recommended. In conclusion, the dose and duration of maintenance therapy should be individualized and related to the duration of illness, relapse history, severity of illness, degree of remission, environment, pre-morbid personality, and dose and duration of previous medication, which need to be considered together.  ④If the medication is discontinued, the disease needs to be closely observed and medication should be resumed as soon as possible if there is a precursor of relapse.