I came across the following at Rufus Mays' website and thought it was worthy of sharing.
Quote:
Potential adverse effects upon withdrawal of atypical neuroleptic
The body will always try to maintain itself in a state of optimal conditions for cell functioning. Therefore if a drug is introduced that blocks a specific signal or function the body will try to compensate for this. So, if an atypical neuroleptic blocks dopamine receptors, the cell on which the receptors are located will sense that it is not receiving as many signals from the dopamine receptors as it used to. In the long term, the cell will respond by producing more receptors, in an attempt to get the level of dopamine receptor signalling it is used to.
As well as producing increased numbers of dopamine receptors, the sensitivity of the dopamine receptors is increased. If an individual then decided to abruptly discontinue taking the atypical neuroleptic, the dopamine receptors would no longer be blocked and fully exposed. So should anything potentially exciting or stimulating happen, dopamine would be released and bind to the increased numbers of extra sensitive receptors, leading to increased dopamine transmission, over and above what would have occured before the atypicals were introduced. In this scenario, some individuals develop 'psychotic' symptoms, due to over flooding of dopamine receptors, which may be interpreted as a 'relapse'.
The development of psychotic symptoms when there is excess dopamine transmission (as may occur in abrupt withdrawal) may lead some individuals to believe that increased dopamine signalling may have been responsible for the psychotic experiences an individual initially had when the drugs were first prescribed. However, individuals who had no psychiatric history have been given a course of neuroleptic treatment, and when the neuroleptics were abruptly withdrawn some of these individuals developed 'psychotic' symptoms.
Source: comingoff.com
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I've come across that information before and feel that this fellow actually explained the process a little more clearly...
Quote:
This biological mechanism is somewhat well understood now. The antipsychotics profoundly block dopamine receptors. They block 70-90 percent of the dopamine receptors in the brain. In return, the brain sprouts about 50 percent extra dopamine receptors. It tries to become extra sensitive.
So in essence you've created an imbalance in the dopamine system in the brain. It's almost like, on one hand, you've got the accelerator down -- that's the extra dopamine receptors. And the drug is the brake trying to block this. But if you release that brake, if you abruptly go off the drugs, you now do have a dopamine system that's overactive. You have too many dopamine receptors. And what happens? People that go abruptly off of the drug, do tend to have severe relapses.
Source: An Interview With Robert Whitaker
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This is one of the reasons it can be so important to reduce slowly. Also, if you do have a worsening of symptoms it can be helpful to consider that it may be temporary. This is also why it's important to develop some non-medicinal approaches to coping with symptoms.
By the way, if anyone finds this information to be alarming, do bear in mind that for those who are moving toward full recovery, withdrawing from medication will occur at some point. The old face of schizophrenia might have been a paradigm of chronicity and a life-time of maintenance medication; the new face of schizophrenia is recovery. For many people, their recovery will include coming off medication.
There will be many others whose recovery includes medication but these individuals may find they're able to maintain daily function and control symptoms at a lower dose. It may be a taboo subject in some areas but usually, no laws are being broken when people attempt to find what works best
for them.
See also: The Dopamine Hypothesis