"All roads lead to medication?" Qualitative responses from an Australian first-person survey of antipsychotic discontinuation.

Objective: The purpose of the survey was to better understand the experiences of people who attempt antipsychotic discontinuation.

Method: A multiple-choice and short-answer survey was distributed in 2011-2012 to potential participants involved in participating organizations. Respondents were asked about past discontinuation events, including decision negotiation and withdrawal experience. This article thematically analyses their free-text responses.

Results: There were 98 valid surveys returned. Respondents highlighted the roles of the therapeutic alliance and health and illness explanatory models in understanding the context of discontinuation. Reported impacts of discontinuation were mixed and complex. Withdrawal syndromes were described by over half of the participants. Of the 98 respondents, 21 reported remaining antipsychotic-free at the time of survey completion.

Conclusions And Implications For Practice: Participant accounts highlight the importance of context and relationships in their thinking about antipsychotic discontinuation. Although results cannot necessarily be generalized, participant descriptions of withdrawal syndromes suggest there may be a need to improve education, monitoring, and support strategies for some people during discontinuation. Shifting toward a more collaborative, transparent, and service-user-driven approach to discontinuation may help to mitigate some of the negative discontinuation impacts identified. The polarized discontinuation outcomes described highlight the individuality of every participant's recovery journey and the need to avoid generalizing about the role of antipsychotics in care.