Adams et al. 2017 U.K. [68] | Case study | n: 1 age: 30 gender: male ethnicity: not reported ID = mild | Community | Intervention: Two psychotropic medicines and a beta blocker were deprescribed separately Medication: olanzapine, carbamazepine, propranolol Duration: 2 years Length of follow up: ongoing; 2 years from when deprescribing process began | Discontinuation or reduction of dose of psychotropic medicines General wellbeing Weight | Olanzapine and carbamazepine were stopped Propranolol was reduced and deprescribing process ongoing. He is less tired, more alert, and better able to express himself. He has expanded his activities and increased his access to the community. He can cope better with changes to his routine. His behaviours are well managed by the behavioural strategies in place, and he has now been discharged by the psychiatrist to the GP. Weight reduced form 82 kg to 56 kg which was within recommended BMI |
Bastiampillai et al. 2014 Australia [69] | Case study | n: 1 age: 28 gender: male ethnicity: not reported ID = moderate | Inpatient | Intervention: Following warning from CSM in UK, thioridazine withdrawn and patient changed to risperidone. Medication: risperidone Duration: not reported Length of follow up: not reported | Behaviour and mental health symptomatology | Delusions and hallucinations reported within 2 weeks of stopping Thioridazine, hospitalised for 2 ½ years, unresponsive to several other Antipsychotics, prescribed clozapine and went into remission |
Brahm et al. 2009 USA [70] | Case study | n: 1 age: 53 gender: male ethnicity: white ID = moderate | Inpatient | Intervention: deprescribing Medication: ziprasidone Duration: Not reported Length of follow up: Not reported | Episodes of inappropriate sexual behaviour | Episodes of inappropriate sexual behaviour increased from 2 to 3 per month prior to discontinuation to 21 episodes the following month post discontinuation |
Branford D 2019 U.K. [14] | Case studies ×  3 | 1. n: 1 age: 35 gender: male ethnicity: not reported ID = not reported 2. n: 1 age: not reported gender: not reported ethnicity: not reported ID = not reported 3. n: 1 age: not reported gender: male ethnicity: not reported ID = not reported | 1. Community 2. Community 3. Community |  | 1. Successful discontinuation, quality of life observations 2. Successful discontinuation 3. Successful discontinuation, quality of life observations | 1. Antipsychotic discontinued post discontinuation he was more lively, wanting to go on more outings and tackle new activities. Staff aware to offer active support to meet his needs and his grabbing behaviours are understood. 2. Chlorpromazine discontinued 3. Antipsychotic discontinued Patient is now reported to be very positive. He enjoys walks, his self-confidence has gone up and his life is changing. He is cooking for himself and is keen to find work. |
Connor 1998 USA [71] | Case study | n: 1 age: 11 gender: not reported ethnicity: not reported ID = moderate | Community | Intervention: deprescribing Medication: thioridazine Duration: 3 weeks Length of follow up: 12 weeks | AIMS | Within 1 week of discontinuation patient developed new onset multiple involuntary movements consisting of jaw grinding, oral dyskinesias, bilateral hand rolling, vermiform tongue movements. and bilateral choreiform movements of his digits. When methylphenidate that was being co prescribed was also discontinued the movement disorder resolved. |
Dillon 1990 USA [72] | Case study | n: 1 age: 7 yrs. 11 months gender: male ethnicity: not reported ID = borderline | Community | Intervention: deprescribing Medication: clonidine Duration: 4 weeks Length of follow up: not reported | Adverse behaviours | When withdrawn from clonidine over 4 weeks multiple self-destructive behaviours involving the theme of suffocation were reported |
Faisal et al. 2021 Ireland [73] | Case study | n:1 age:13 gender: female ethnicity: not reported ID = moderate | Community | Intervention: deprescribing Medication: risperidone Duration: unclear Length of follow up: unclear | Overall clinical presentation, BFCRS | In first week following risperidone discontinuation nursing staff observed gradual change in behaviour, insomnia, increased salivation, mutism, echopraxia, immobility. Catatonic symptoms occurred over 8 weeks following discontinuation followed by admission to paediatric high dependency unit. Responded to im lorazepam, Resolution of catatonic symptoms after 7 weeks in hospital |
Ghaziuddin et al. 1990 USA [74] | Case study | n: 1 age: 34 gender: female ethnicity: not reported ID = moderate | Inpatient | Intervention: deprescribing Medication: diazepam Duration: 6 weeks Length of follow up: 6 months | Challenging behaviour mental health symptomatology dose of medication | 10 days after discontinuation of diazepam resembling mania reported. Improvement noted when diazepam represcribed. |
Lee et al. 2019 U.K. [75] | Case study | n: 1 age: early 40s gender: female ethnicity: not reported ID = moderate | Community | Intervention: Flexible medication reduction in collaboration with PBS framework Involving an initial 25% reduction with further changes dictated by behavioural data, the impact of any side effects, the opinions of care staff and of family members Medication: risperidone Duration: 6 months Length of follow up: not reported | Dose of medication challenging behaviour | Reduction slowed down in response to increase in grabbing behaviours. Risperidone stopped PBS supported medication reduction reduced challenging behaviour |
McLennan 2019 Canada [76] | Case study | n: 1 age: 15 gender: male ethnicity: white ID = moderate | Community | Intervention: deprescribing 6 psychotropic medicines, Medication: quetiapine, lamotrigine, clonidine, olanzapine, sertraline, and ziprasidone Duration: whole process over approx.18 months Length of follow up: not reported | Number of medicines stopped | Quetiapine, lamotrigine, clonidine, olanzapine, sertraline successfully discontinued ziprasidone added trazadone prn added for sleep ziprasidone associated with unsuccessful attempt to deprescribe |