ArticleTherapeutic advances in psychopharmacology2024
Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs.
Article in Therapeutic advances in psychopharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Helping people to discontinue antipsychotics: if, when and how.Schizophrenia (Heidelberg, Germany) · 2025Review
- Correlations between receptor occupancy change and mental state in patients using long-acting injectable antipsychotics: MIDILIA pilot study.BJPsych open · 2025Article
- Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms.Therapeutic advances in psychopharmacology · 2025Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Reducing the dose of psychosis drugs in a gradual hyperbolic manner may minimise withdrawal effects and risk of relapse. There is presently limited guidance on tapering decanoate-based long-acting injectable dopamine antagonists (LIDAs). Objectives: We aimed to apply hyperbolic principles of tapering to the decanoate-based LIDAs flupentixol, zuclopenthixol and haloperidol to develop withdrawal regimens. Design: We used in silico methodology to predict plasma drug levels and D Methods: Existing pharmacokinetic and receptor occupancy data from nuclear neuroimaging studies were used to power modelling. Abrupt discontinuation was examined as a potential strategy, and dose reduction was modelled with pre-defined constraints used in similar work of 10 (fast regimens), 5 (moderate) and 2.5 (slow) percentage points of D Results: Abrupt discontinuation of decanoate-based LIDAs leads to excessive change in D Conclusion: Abrupt cessation of decanoate LIDAs is not consistent with gradual hyperbolic tapering, despite their longer half-lives compared with oral formulations. Reduction to the point of full discontinuation can only be achieved by switching to oral therapy to complete the taper. These results are limited by the in silico and theoretical nature of the study, and there is a need to confirm these findings through real-world observational and interventional studies.
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