A qualitative exploration of family members’ perspectives on reducing and discontinuing antipsychotic medication

Abstract

Background Antipsychotics are routinely prescribed to people diagnosed with schizophrenia or psychosis on a long-term basis. Considerable literature explores service users’ opinions and experiences of antipsychotics, but studies investigating family members’ views are lacking. Aims To explore family members’ perspectives on antipsychotics, particularly their views on long-term use, reduction and discontinuation of antipsychotics. Methods Semi-structured interviews were conducted with 11 family members of people experiencing psychosis. Participants were recruited through community support groups and mental health teams. Interviews were analysed thematically. Results The majority of family members valued antipsychotic medication primarily in supporting what they saw as a fragile stability in the person they cared for. Their views of medication were ambivalent, combining concerns about adverse effects with a belief in the importance of medication due to fears of relapse. They described a need for constant vigilance in relation to medication to ensure it was taken consistently, and often found changes, particularly reduction in medication difficult to contemplate. Conclusions Findings highlight that family members’ attitudes to medication sometimes conflict with those of the people they care for, impacting on their health and the caring relationship. Family members may need more support and could be usefully involved in medication decision-making.