Comparing Apples to Oranges Obscures Tortoises Beating Hares: The Relationship Between Rate of Antipsychotic Tapering and Relapse

Abstract

I was intrigued to see McCutcheon et al.’s analysis of paliperidone discontinuation studies purporting to demonstrate that the rate of reduction of antipsychotics has no bearing on risk of relapse. This result is perplexing as it would logically follow that abrupt stoppage would be as safe as slow tapering. This appears counter-intuitive and contrary to findings that more gradual tapering leads to lesser overall relapse rates than more rapid reduction for many psychiatric drugs, such as antidepressants, and lithium.