A rating scale to inform successful discontinuation of antipsychotics and antidepressants

Abstract

Practitioners lack guidance on how to support discontinuation of psychotropic medication. An understanding of what constitutes discontinuation success that encompasses the patients’ perspective could advance knowledge in this clinically relevant area. Here, we report the development and validation of a scale to assess subjective discontinuation success. Participants who attempted discontinuing antidepressants and/or antipsychotics during the past 5 years (n = 396) completed a questionnaire on subjective discontinuation success (Discontinuation Success Scale, DSS) developed in consultation with people with lived experience of discontinuation. Construct validity was tested by exploratory and confirmatory factor analysis. Criterion validity was tested by assessing DSS-scores’ associations with objective success (i.e., full cessation, reduced dose) in combination with scoring above a predefined criterion on the Well-Being Index. Factor analyses yielded a three-dimensional scale reflecting subjective discontinuation success, positive effects, and negative effects of discontinuation. A 24-item DSS demonstrated sufficient model fit for the participants discontinuing antidepressants or antipsychotics, respectively. Significant associations with objective success and well-being were found. Participants who had achieved full cessation and scored high on well-being reached the highest DSS scores. The DSS is a viable tool for future research aimed at identifying predictors of discontinuation success in order to inform recommendations related to discontinuation.