Are antipsychotics addictive?

Antipsychotics are the frontline treatment for psychotic disorders, such as schizophrenia, and are proven to be effective at managing their symptoms. While they are most commonly used to treat psychotic disorders, they can also be used to treat various other mental health conditions, such as bipolar disorder and major depressive disorder.

Amid the benefits they offer, a pertinent question arises: Do antipsychotics bear the capacity for addiction?

Can antipsychotics cause dependence?

Antipsychotic medications are not generally considered to be addictive in the same way that substances like opioids, benzodiazepines, or stimulants can be.

Opioids, benzodiazepines, or stimulants carry a risk for addiction because these drugs produce strong feelings of euphoria, powerful urges to continue using the drug and a need to increase dosage to achieve the desired effect. However, antipsychotics do not elicit these feelings and are thus not considered addictive. ^[1]

While antipsychotics are not typically associated with the intense euphoria or cravings that characterize addictive substances, some individuals may develop physical dependence on them.

What is antipsychotic dependence?

Antipsychotic dependence refers to a situation where an individual becomes reliant on antipsychotic medications to manage their symptoms, maintain stability, or function in their daily life.

Over time, some individuals may develop tolerance to the effects of antipsychotic medications, requiring higher doses to achieve the same level of symptom control. This can contribute to a sense of dependence on higher doses for symptom management.

Abruptly stopping antipsychotic medications, especially after long-term use, can lead to withdrawal symptoms and a return of symptoms. This can make individuals feel reliant on the medication to prevent the discomfort associated with withdrawal.

For individuals who are concerned about antipsychotic dependence, open communication with their healthcare provider is crucial. Adjustments to medication regimens should be discussed and decided upon collaboratively after considering the individual’s specific needs, response to treatment, and overall well-being.

How do you cut down or stop taking antipsychotics?

Whether you want to cut down your dosage or stop taking antipsychotics completely the same principle applies, take it slow. A sudden reduction in dosage or stopping cold turkey increases the risk of both psychotic symptoms coming back and the onset of unpleasant withdrawal symptoms. ^[1]

The first step is to ask yourself if this the right moment to stop taking antipsychotics. Consider whether you can manage the consequences, and if you feel supported by your family, friends, or partner. ^[1]

If the answer is yes, then talk to your prescribing healthcare provider. They will assess your current condition, medication history, and overall health to determine if it’s appropriate to reduce or discontinue the medication.

Explain to your healthcare provider why you are considering reducing or stopping the medication. They can help you evaluate the potential benefits and risks of making this change.

If your doctor determines that it’s safe to proceed, they will likely recommend a gradual tapering schedule – usually by about 10% at a time with two to three weeks between each reduction. ^[2] Tapering involves reducing the dosage of the medication slowly over a period of time, usually several months. This helps minimize the risk of withdrawal symptoms and symptom recurrence.

During the tapering process, closely monitor your symptoms. If you notice any changes in your mental health or any new symptoms emerging, communicate them to your doctor. Maintain regular appointments with your healthcare provider while tapering off the medication. This allows them to assess your progress, adjust the tapering schedule if necessary, and provide support as needed. ^[1]