Discussion
psychotic, schizophrenia
This study is one of the few to depict dose-tapering trajectories for stable patients receiving antipsychotic maintenance treatment [Even though the algorithm in this study guided clinicians to taper antipsychotics very slowly and in a hyperbolic manner as suggested previously [The relatively low relapse rate of this cohort, not higher than their maintenance counterparts [Although only a small number of patients experienced relapse during dose tapering, several factors for precaution were identified. In addition to the diagnosis of schizophrenia, a well-known risk factor of relapse [As the sample size of each subgroup is small and not feasible for sophisticated statistical analyses, this study was more exploratory than confirmatory, so several limitations must be addressed. First, most participants were cooperative with this delicate tapering procedure, implying that they were in a better position to anticipate a good individual prognosis, thus the results may not be generalizable to patients who were not able to follow the guided processes reliably. Second, most patients had more than one psychotic episode, a condition in which most guidelines do not usually recommend discontinuing antipsychotic medications [Echoing the advocacy of Marder and Zito: “We encourage a sense of curiosity about the possibility of dose reduction and discontinuation in appropriate patients.” [