PDF(Pubmed)
Abstract：
BACKGROUND: 80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient\'s feeling of autonomy and psychiatric rehabilitation.
METHODS: We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders- 10th Edition codes F20.0-5, F20.7-9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down.
CONCLUSIONS: Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse.
UNASSIGNED: Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.
METHODS: We present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders- 10th Edition codes F20.0-5, F20.7-9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down.
CONCLUSIONS: Reducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse.
UNASSIGNED: Some patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.
摘要：
背景：80％的患者将有关治疗方案的信息视为康复的重要组成部分，此外，有精神病发作史的患者感到被排除在抗精神病药物治疗的决策之外，最重要的是，精神卫生工作人员倾向于不愿意支持精神分裂症患者的共同决策和药物逐渐减少。本病例系列旨在证明抗精神病药物的逐渐减少，以及引导逐渐减少如何影响患者的自主性和精神康复。
方法：我们介绍了6名诊断为精神分裂症的患者（国际精神和行为障碍分类-第10版代码F20.0-5，F20.7-9），他们在我们的诊所接受了专业指导的逐渐减少。该诊所旨在指导患者在安全的环境中确定最低剂量的抗精神病药物，以最大程度地减少严重复发的风险。两名患者完全停止了抗精神病药物治疗，两个人在逐渐缩小期间复发，一个人选择以低剂量停止渐缩，和一名患有难治性精神分裂症的患者，它仍在逐渐缩小。
结论：减少抗精神病药物剂量可提高某些患者的情绪意识（n=4），帮助他们制定更好的策略来应对压力并增加康复感。在逐渐减少的过程中，患者感受到了更大的自主权和赋权感，即使停药是不可能的。提高患者的意识和在复发期间的早期干预可以防止严重复发。
■一些精神分裂症患者可能过度用药，导致不必要的副作用和减少用药的愿望。我们研究中的患者说明了与患者共同进行的抗精神病药物的指导逐渐减少如何改善情绪意识并制定有效的症状管理策略。这反过来可能会导致更大的赋权和认同感，并赋予生活更多的意义，支持个人康复的经验。
方法：我们介绍了6名诊断为精神分裂症的患者（国际精神和行为障碍分类-第10版代码F20.0-5，F20.7-9），他们在我们的诊所接受了专业指导的逐渐减少。该诊所旨在指导患者在安全的环境中确定最低剂量的抗精神病药物，以最大程度地减少严重复发的风险。两名患者完全停止了抗精神病药物治疗，两个人在逐渐缩小期间复发，一个人选择以低剂量停止渐缩，和一名患有难治性精神分裂症的患者，它仍在逐渐缩小。
结论：减少抗精神病药物剂量可提高某些患者的情绪意识（n=4），帮助他们制定更好的策略来应对压力并增加康复感。在逐渐减少的过程中，患者感受到了更大的自主权和赋权感，即使停药是不可能的。提高患者的意识和在复发期间的早期干预可以防止严重复发。
■一些精神分裂症患者可能过度用药，导致不必要的副作用和减少用药的愿望。我们研究中的患者说明了与患者共同进行的抗精神病药物的指导逐渐减少如何改善情绪意识并制定有效的症状管理策略。这反过来可能会导致更大的赋权和认同感，并赋予生活更多的意义，支持个人康复的经验。
