Can I stop schizophrenia medicines if they have been stable?

Question

Hi doctor,

I’m 25 and was diagnosed with schizophrenia about three years ago after experiencing paranoia and auditory hallucinations. Since starting treatment I have gotten so much better that I have been feeling steady and functioning normally for several months now.

Now that I feel much better, I sometimes wonder if I still need to take medication every day, especially since it sometimes makes me sleepy and less energetic. Should a person with schizophrenia stay on their medication when they feel better? What can happen if treatment stops too soon?

Please help me.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com

Treatment guidelines are different for first episode schizophrenia and multiple episode schizophrenia. The duration of treatment also varies and health agencies have different durations for first-episode schizophrenia.

Most guidelines recommend continuing treatment of first-episode schizophrenia for at least two to three years following complete resolution of the acute episode and stabilisation of symptoms. This is because even if a person feels good there is still a risk of relapse of the illness if medication is stopped too soon.

For those with multiple episodes or ongoing schizophrenia, long-term or lifelong treatment with antipsychotic medication is frequently recommended to reduce the chance of recurrence and maintain daily functioning.

Sometimes the dose of the antipsychotic medication can be gradually reduced under the supervision of a psychiatrist especially if symptoms remain stable for a long period. However, if symptoms such as paranoia, suspiciousness, hearing voices, disturbed sleep or social withdrawal return, the dose may need to be increased again.

Never stop or cut back on medication by yourself, even if your symptoms are under control. Stopping treatment too early or suddenly carries a significant risk of relapse of psychotic symptoms, hospitalisation and development of treatment resistance where medications may not work as effectively in the future.

Thank you.