Antipsychotics

Explains what antipsychotics are used for, how the medication works, possible side effects and information about withdrawal.

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Can I come off antipsychotics?

Some doctors may suggest that once you’re on these drugs, you need to stay on them for some time – or indefinitely. Many people do remain on them for a long time, and you might feel that this is the right choice for you. However, if you have been taking antipsychotics for some time and have been well, you may want to stop and see if you can cope successfully in other ways.

For ideas on how you could manage your symptoms without medication, see our page on alternatives to antipsychotics. For more information on withdrawal, see our pages on coming off psychiatric drugs.

"I feel so much better being off – less drugged up and more alive."

How easy is it to come off these drugs?

If you have been taking antipsychotics for some time (a year or more), it can be quite difficult to come off them. Some people may be able to stop without problems but others can have great difficulty. As a rule:

You will need to come off slowly and gradually by reducing your daily dose over a perod of weeks or months. On the whole, the longer you have been taking a drug for, the longer it's likely to take you to come off it.
Avoid stopping suddenly – if you come off too quickly you are much more likely to have a relapse of your psychotic symptoms or to develop tardive psychosis.
Get support from people close to you. Ideally this will include support from your GP or your psychiatrist as well as friends, family and peer support from other people who've had similar experiences and can relate to what you're going through.

What if my doctor doesn't want me to come off my medication?

Unfortunately a lot of people find that their doctors are not very supportive of their decision to come off antipsychotics, and don't offer as much help as they would like. But it's important to remember that taking medication is your choice. You have the right to try coming off if you want to – and to change your mind.

For guidance on giving yourself the best chance of coming off safely and successfully, see our pages on coming off psychiatric drugs.

"I took myself off and found I could feel emotions again, which was scary, but worth it."

When's the best time to try coming off?

There's no universal 'best time' to try coming off antipsychotics – everyone's different, and there are all sorts of different factors that might affect your chance of success. But when considering when would be best for you, it might be helpful to think about the following:

What else is going on in your life right now? If you're under lots of extra stresses from other life problems (such as moving house, financial worries or concerns about your family) how might this affect your ability to cope?
Would you prefer to feel relaxed and unburdened, so you're able to pay close attention to how you're feeling day to day, or would you find it easier to be busy so you're distracted by focussing on other things?
Have you got a support group nearby or other people in your life who can help you if you start to find withdrawal difficult?
If you've tried to come off your medication before but have not been able to manage it, what factors might have played a part then? Can you avoid or minimise them when you try again?

Remember: whenever you decide to try coming off, it is always important to withdraw slowly and safely. It might take a long time, or you might find that you become comfortable on a lower dose and decide not to come off completely. The main thing is that you find a way to manage your symptoms that works for you.

"I came off them too fast and I wasn't physically or mentally ready for that. [I think] it's really important to make sure you come off them really slowly and under the watchful eye of a professional."

Will my psychotic symptoms come back?

Medication can help to stabilise your symptoms, so it's possible that your psychotic symptoms may return if you stop taking it – but it's not certain. There are many other factors that can influence your chance of becoming ill again besides taking medication. For example:

while on medication you may have received other forms of treatment such as talking treatments and arts therapies that have helped you discover and practice new ways to cope
you may have been able to make changes in your life since your last episode that mean you are less likely to become ill again
if your friends and family are supportive of your decision to try coming off, this can also reduce your risk of relapsing

Some psychiatrists believe that people with a diagnosis of schizophrenia who remain on antipsychotics for a number of years have fewer relapses than those who are not on antipsychotics. However, not all psychiatrists agree with this – and a lot people with a diagnosis of schizophrenia don't find it to be true for them personally.

Remember: you are much more likely to have a relapse if you try to come off your medication too quickly.

"Trying to come off was exhausting – my mood swings came back with a vengeance. Felt like I'd totally lost it again."

What withdrawal symptoms might I get?

The main withdrawal symptoms associated with antipsychotics are:

abnormal skin sensations
aching muscles
anxiety
diarrhoea
dizziness and vertigo
feeling too hot or too cold
feeling withdrawn socially
headaches
loss of appetite
mood disturbances
nausea (feeling sick)
neuroleptic malignant syndrome
restlessness, agitation and irritability
runny nose
shaking
insomnia (inability to sleep)
sweating
tardive dyskinesia
tardive psychosis
vomiting (being sick)

Unfortunately there's no evidence on how common these withdrawal symptoms are, so there's no way to know how likely you are to get any of them.

For information on withdrawal symptoms of a particular drug, you can look it up in our antipsychotics A-Z.

"I was on a very small dose so I found it easy to stop – no side effects. My energy levels are back, but I have noticed I'm not sleeping as much and I'm a bit edgy, so I'm monitoring myself closely using a sleep and mood journal."