Antipsychotic drugs antipsychotics discontinuation trials

Combining an FGA and an SGA and combining different SGAs have been suggested, but no data exist to support or refute these strategies. If a series of antipsychotic monotherapies fails, a time-limited combination trial may be attempted. If there is no improvement within 6 to 12 weeks, one of the drugs should be tapered and discontinued. 

In an open trial of antipsychotics for outpatients with BPD, Teicher and colleagues ( 243) noted that sustained melancholic depression developed in three patients, necessitating removal from the trial and treatment with antidepressants. In this context, Gardner and Cowdry (248) also reported that melancholia developed in three patients on CBZ, necessitating drug discontinuance and treatment for depression. Flence, clinicians should anticipate that severe depression can develop in some patients with BPD and be prepared to treat with antidepressants. 

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