New paper in Therapeutic Advances in Psychopharmacology with David Taylor & Mark Horowitz Prolonging the interval between depot antipsychotics may allow potential for tapering. Peak rate of D2 occ change from abruptly stopping depots may explain withdrawal effects / symptom relapse journals.sagepub.com/doi/10.1177/20…

Proposing a method for the safe discontinuation of antipsychotic long-acting injections. journals.sagepub.com/doi/10.1177/20…

Great paper by James O'Neill crunching the numbers about what constitutes slow hyperbolic tapering for antipsychotic depots. Punchline: stopping abruptly not slow enough (not 'self tapering'), likely needs stepping down dose and then to orals to stop at a slow enough rate.

Excited to be at #RCPsychNYAutumn today, with what looks to be a fascinating & engaging psychopharmacology-focussed programme RCPsych Northern & Yorkshire Royal College of Psychiatrists

🥶 Light work

After 3 years of work with David Taylor and many other psychiatrists, pharmacists and patient experts I am happy to see The Maudsley Deprescribing Guidelines get a publication date amzn.to/3tTQq9s (UK) amzn.to/40o3wrI (US)

Apologies, yesterday I mixed up the links for the Maudsley Deprescribing Guidelines. US: amzn.to/3tTQq9s UK: amzn.to/40o3wrI It will be published in 2 volumes: the second volume on mood stabilisers, stimulants, antipsychotics and opioids in 2025.

In summary, this model suggests a novel use of LAIs by extending the interval between their dosing to implement dose reduction whilst observing the principles of gradual hyperbolic reduction outlined previously. journals.sagepub.com/doi/10.1177/20…

The Maudsley Deprescribing Guidelines is available in the UK amzn.to/40o3wrI, US amzn.to/3tTQq9s, Australia bit.ly/3OKZ9m7 Canada bit.ly/3uB4Zj9and elsewhere around the world (also at other booksellers).

James O'Neill Agree. There's a brilliant paper on this that explains with crystal clarity that abruptly stopping antipsychotics produces much faster changes than you would think journals.sagepub.com/doi/10.1177/20…

Dear NHS Knowledge for Healthcare, any chance the new Maudsley Deprescribing Guidelines could be added to your excellent eBook collection alongside the Maudsley Prescribing Guidelines? Lots of HCPs would be delighted to have access to this new resource.

Congratulations to our very own Chris Lawrence and team on their new publication on optimal doses for medications for psychosis. Read all about it here: journals.sagepub.com/doi/10.1177/02… Southern Health NHS Foundation Trust

Prof Taylor from King's College London recommends that antidepressants are regularly reviewed and, if no longer necessary, tapered in a manner proportional to their current dose (so that reductions get smaller and smaller in size as the total dose gets smaller). #RCPSychIC 2024

How to make small doses for antidepressant tapering by Mark Horowitz. Important not to skip doses. He doesn’t think it is worth switching to fluoxetine. #RCPsychIC

Glad to have had the opportunity to talk at the conference about deprescribing to a packed room (a friend of mine was turned away at the door!) and many thoughtful and engaged questions. Thanks to David Taylor and Robin Murray for chairing

Thanks to Psychiatric Times for writing about our recent paper in Journal of Psychopharmacology on what clinicians should consider when increasing the dose of antipsychotics Adam Jameson Sam McLean Chris Lawrence psychiatrictimes.com/view/analysis-…

Clinically useful paper led by James O'Neill looking at how to hyperbolically taper decanoate antipsychotic depots. Abrupt stopping likely not sufficiently slow enough taper for many patients, requires switching to orals bit.ly/3BbaDew with @ David Taylor