Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership
- PMID: 39500611
- PMCID: PMC11552588
- DOI: 10.1136/bmjopen-2024-088266
Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership
Abstract
Objective: The objective of this study is to identify the top 10 research priorities on reducing and stopping psychiatric medication that reflect the perspectives and unmet needs of three key stakeholder groups (people with lived experience, family members/carers/supporters and healthcare professionals).
Methods: A priority-setting partnership was conducted using the James Lind Alliance's seven-step process. This involved (1) creating an international Steering Group of key stakeholder representatives and (2) identifying potential partners; (3) gathering stakeholders' uncertainties about reducing and stopping psychiatric medication using an online survey and summarising the survey responses; (4) checking the summary questions against existing evidence and verifying uncertainties; (5) shortlisting the questions using a second online survey; (6) determining the top 10 research questions through a prioritisation workshop; and (7) disseminating the results.
Results: A total of 3635 questions were collected in the initial survey from 884 respondents of which 32 questions were verified as uncertainties. These questions were then ranked in a second online survey by 526 respondents and the findings discussed in a final prioritisation workshop by 30 participants to produce the final top 10 list of research questions. These questions cover a range of areas including the most effective ways of safely reducing/stopping psychiatric medication and providing support to individuals undergoing the discontinuation process, as well as the best ways to educate healthcare professionals on this topic.
Conclusion: The top 10 list of research priorities was produced through extensive engagement with key stakeholders and highlights important uncertainties and gaps in the existing evidence base that need to be addressed by future research.
Keywords: Anxiety disorders; Depression & mood disorders; PSYCHIATRY; Schizophrenia & psychotic disorders.
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: Cathal Cadogan (CC) sits on the Board of Directors for the Alliance for Benzodiazepine Best Practices; a not-for-profit organisation with the mission to inform evidence-based improvements in the use of benzodiazepines and Z-drugs. Anne Cody (AC) works at the Health Research Board, who part-funded the process The grant did not contain any expectation or condition of being included in the Steering Group. Adele Framer (AF) is the founder of SurvivingAntidepressants.org which is an online community of volunteers providing peer support for tapering all psychiatric drugs and their withdrawal syndromes. AF sit on the Board of Directors for International Institute for Psychiatric Drug Withdrawal a not-for-profit organisation which supports research and practice-based knowledge that will facilitate safe reduction of and withdrawal from psychiatric drugs and is President of the Psychotropic Deprescribing Council. Mark Horowitz (MH) is a collaborating investigator on the RELEASE and RELEASE+ trials in Australia evaluating hyperbolic tapering of antidepressants against tapering as usual. MH has received honoraria for lectures about deprescribing from several NHS Trusts, and universities in the US and the UK. MH is a co-founder of and consultant to Outro Health digital clinic which aims to help patients in the US to help stop no longer needed antidepressant treatment. Christy Huff (CH) is the Medical Director of the Benzodiazepine Information Coalition, a not-for-profit organisation with the mission of educating about the potential adverse effects of benzodiazepines taken as prescribed. Nicole Lamberson (NL) is a Medical Board Member of the Benzodiazepine Information Coalition, a not-for-profit organisation with the mission of educating about the potential adverse effects of benzodiazepines taken as prescribed. NL is cofounder of the Inner Compass Initiative's The Withdrawal Project, a not-for-profit organisation which seeks to help people make more informed choices about psychiatric diagnoses and drugs and build community with like-minded others thinking critically about today's mental health industry. NL is an Associate Member of the International Institute for Psychiatric Drug Withdrawal, a not-for-profit organisation which supports research and practice-based knowledge that will facilitate safe reduction of and withdrawal from psychiatric drugs. Luke Montagu (LM) is cofounder of the Council for Evidence-based Psychiatry which seeks to communicate evidence of the potentially harmful effects of psychiatric drugs to the people and institutions in the UK that can make a difference. All other authors declare no competing interests.
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