Mental health service users experiences of medication discontinuation: a systematic review of qualitative studies

Abstract

Background: The use of psychotropic medication is often the first line of treatment for people with mental distress. However, many service users discontinue their prescribed medication, and little is known about their experiences or the reasons why they choose to stop taking medication.Aim: The aim of this review is to synthesize research literature focused on the experiences of people who decided to discontinue taking medication for their mental health problem.Methods: A systematic review of qualitative studies was conducted. Data bases were searched for qualitative research which explored participants' motivations for discontinuing medication and their experiences of the process.Results: Six themes were identified: 1) Taking medications: a loss of autonomy, 2) Discontinuing medication: a thought-out process, 3) Factors influencing the decision to discontinue medication, 4) Discontinuing medication: experiences of the process, 5) Outcomes of discontinuing medication, 6) Managing mental distress in the absence of medication. Conclusion:Service providers need to be aware that for some service user's psychotropic medication is not deemed a suitable treatment approach. Those who wish to discontinue medication need to be supported in the context of positive, therapeutic risk where their mental and physical health can be monitored and the likelihood of success increased.

Community‐based counselling for benzodiazepine withdrawal: A mixed‐methods study of client outcomes

“…This client‐centred approach can be contrasted with the reticence and barriers that have characterised the attitudes of health professionals to deprescribing (Anderson et al, 2014; Porath‐Waller et al, 2015). Further, a lack of control and agency has been noted as an important factor in adults unilaterally discontinuing their psychiatric medications (Keogh et al, 2021) and the lack of involvement in medication decision‐making has been found to be a challenge for young people with a mental illness (McMillan et al, 2020). More generally, favourable outcomes for collaborative models involving shared decision‐making have also been found for pluralistic models of counselling for young people with substance use (Joyce et al, 2022).…”

Mobile phone applications to support psychotropic tapering: a scoping review protocol

“…Additionally, the use of psychotropic medication can lead to the development of physiological dependence with long-term use and withdrawal symptoms on discontinuation, which may ultimately play a role in extending their duration of use, even for those who have recovered during drug therapy or for whom there is no longer a valid indication to continue it 17 . Some service users decide to discontinue psychotropic medication to recapture lost personal autonomy, to live a life free of medication and, in some cases, because these medications have failed to manage the person's distressful experience and symptoms 18 . However, these individuals have reported challenges in accessing professional support and having their autonomy and choice respected 18,19 .…”

“…Some service users decide to discontinue psychotropic medication to recapture lost personal autonomy, to live a life free of medication and, in some cases, because these medications have failed to manage the person's distressful experience and symptoms 18 . However, these individuals have reported challenges in accessing professional support and having their autonomy and choice respected 18,19 .…”

Mobile phone applications to support psychotropic tapering: a scoping review protocol

“…Additionally, the use of psychotropic medication can lead to the development of physiological dependence with long-term use and withdrawal symptoms on discontinuation, which may ultimately play a role in extending their duration of use, even for those who have recovered during drug therapy or for whom there is no longer a valid indication to continue it 21 . Some service users decide to discontinue psychotropic medication to recapture lost personal autonomy, to live a life free of medication and, in some cases, because these medications have failed to manage the person’s distressful experience and symptoms 22 . However, these individuals have reported challenges in accessing professional support and having their autonomy and choice respected 22 , 23 .…”

“…Some service users decide to discontinue psychotropic medication to recapture lost personal autonomy, to live a life free of medication and, in some cases, because these medications have failed to manage the person’s distressful experience and symptoms 22 . However, these individuals have reported challenges in accessing professional support and having their autonomy and choice respected 22 , 23 .…”