And contrary to what the authors implied in their article, the study they cited
+(2) and another meta-analysis of neuroleptic withdrawal
+(3,
+4) actually show that abrupt withdrawal increases the probability of recurrence of psychotic symptoms. In that light, the "rapid and severe deterioration" of symptoms that followed drug discontinuation in 26% of their subjects points to a withdrawal reaction, as psychotic relapses rarely occur during the first weeks of withdrawal
+(5). Withdrawal reactions appear to be especially common when atypical neuroleptics are abruptly withdrawn
+(6,
+7). Until the authors provide additional data (e.g., on concomitant medications prescribed and withdrawn, on withdrawal-emergent extrapyramidal symptoms, on speed of response to reinstitution of neuroleptics), their study underscores the clinical need for gradual, patient-centered drug withdrawal and the scientific need to distinguish between neuroleptic withdrawal reactions and psychotic relapses.