You should never stop taking antipsychotic medication without discussing it with your doctor or healthcare team. But there are a number of reasons why your doctor may decide to switch to a different antipsychotic medication:
- Some of your symptoms haven’t improved, despite taking your antipsychotic medication continuously as prescribed.
- Your antipsychotic medication has unacceptable side effects that haven’t gotten better over time.
- You have a relapse of severe positive symptoms, such as delusions or hallucinations, despite taking your antipsychotic medication continuously as prescribed.
Different antipsychotic medications have different effects (and different side effects). What happens depends on the reason for switching, which antipsychotic medication you’re switching from, and which antipsychotic medication you’re switching to.
If you’re stable and switching to improve positive symptoms, such as delusions or hallucinations, or negative symptoms, such as apathy, difficulties talking, or withdrawing from social situations and relationships, your doctor will switch your antipsychotic medication to a different one that can control those symptoms better. If you’re stable and switching because of side effects, your doctor will follow guidelines and switch your antipsychotic medication to a different antipsychotic medication that is less likely to produce those side effects.
In both these cases, the switch needs to be done slowly over a period of weeks or more with a crossover period, where the dose of the antipsychotic medication you’re switching from is gradually reduced to avoid any rebound effects, while the dose of the antipsychotic medication you’re switching to, is gradually increased. (You also may need to take other medications temporarily during this period.)
If you’re switching because you have a relapse of severe positive symptoms despite taking your antipsychotic medication continuously, your doctor may switch your antipsychotic medication more quickly.
Whatever the scenario, it’s important to carefully follow the directions given for switching to avoid side effects or a worsening of your condition, and your doctor or healthcare team will monitor your progress.
Fagiolini A. Roundtable discussion. Advances in schizophrenia, Rome 2021.
