Additional information

CRediT contribution statement

Joanna Moncrieff (https://orcid.org/0000-0003-1214-6974): Conceptualisation (lead), Methodology (equal), Investigation (lead), Writing – original draft (equal), Funding acquisition (lead).

Maria Long (https://orcid.org/0000-0002-6920-9676): Investigation (equal), Writing – original draft (equal).

Stefan Priebe (https://orcid.org/0000-0001-9864-3394): Conceptualisation (equal), Methodology (equal), Investigation (equal), Writing – review and editing (equal), Funding acquisition (equal).

Johura Akther-Robertson (https://orcid.org/0009-0007-1720-6215): Investigation (equal), Project administration (equal).

Thomas Barnes (https://orcid.org/0000-0002-2324-656X): Methodology (equal), Funding acquisition (equal).

George Bray (https://orcid.org/0000-0002-7925-3347): Formal analysis (equal).

Ruth Cooper (https://orcid.org/0000-0002-9735-4731): Investigation (equal).

Nadia Crellin (https://orcid.org/0000-0002-9497-5874): Investigation (equal).

Katherine Darton (https://orcid.org/0009-0004-2173-6647): Investigation (equal), Funding acquisition (equal).

Nick Freemantle (https://orcid.org/0000-0001-5807-5740): Conceptualisation (equal), Methodology (equal), Formal analysis (lead 2016–21), Funding acquisition (equal).

Robert Freudenthal (https://orcid.org/0000-0002-4859-9636): Investigation (equal).

Vasiliki Gkofa (https://orcid.org/0000-0003-0096-4451): Investigation (equal).

Lisa Grünwald (https://orcid.org/0000-0002-1205-1732): Investigation (equal).

Zoe Haime (https://orcid.org/0000-0001-6599-2176): Investigation (equal).

Nadia Haynes (https://orcid.org/0009-0003-3123-554X): Investigation (supporting), Project administration (equal), Writing – review and editing (equal).

Robert Horne (https://orcid.org/0000-0002-3068-8438): Methodology (equal), Funding acquisition (equal).

Mark Horowitz (https://orcid.org/0000-0003-1318-2029): Investigation (equal).

Rachael Hunter (https://orcid.org/0000-0002-7447-8934): Methodology (equal), Formal analysis (lead), Supervision (equal), Funding acquisition (equal).

Sonia Johnson (https://orcid.org/0000-0002-7447-8934): Methodology (equal), Funding acquisition (equal).

Lyn Kent (https://orcid.org/0009-0007-5055-0392): Investigation (equal), Funding acquisition (equal).

Glyn Lewis (https://orcid.org/0000-0001-5205-8245): Methodology (equal), Funding acquisition (equal).

Louise Marston (https://orcid.org/0000-0002-9973-1131): Formal analysis (equal).

Nicola Morant (https://orcid.org/0000-0003-4022-8133): Methodology (equal), Formal analysis (Lead), Funding acquisition (equal).

Vanessa Pinfold (https://orcid.org/0000-0003-3007-8805): Investigation (equal), Funding acquisition (equal).

Georgina Ramsay (https://orcid.org/0000-0002-8999-2549): Investigation (equal).

Ruth Smith (https://orcid.org/0000-0003-1330-6669): Investigation (equal), Funding acquisition (equal).

Jacki Stansfeld (https://orcid.org/0000-0002-4491-5523): Investigation (equal).

Thomas Stockmann (https://orcid.org/0000-0001-9954-1234): Investigation (equal).

Victoria Vickerstaff (https://orcid.org/0000-0002-3119-670X): Formal analysis (lead 2021–3), Supervision (equal), Validation (equal).

Acknowledgements

The study team acknowledges the study delivery support given by the NIHR North London Clinical Research Network, NoCLOR and PRIMENT Clinical Trials Unit. We would like to thank the many participants, NHS Trusts, Principal Investigators and all our local collaborators. We are grateful for support from UCLH Biomedical Research Centre.

Lived Experience Advisory Group members

Karl Willetts, Jonny Benjamin, Sandra Jayacodi and Martina Pavlikova.

Programme Steering Committee members

Tom Craig, Lex Wunderink, Nils Mulder, Richard Emsley and Maurice Arbuthnot.

Independent Data Safety Monitoring Board

Victoria Cornelius, Derek Tracey, Fiona Gaughran and Prisha Shah.

Patient data statement

This work uses data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it is important that there are safeguards to make sure that they are stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation.

Data-sharing statement

Deidentified participant data and a data dictionary will be made publicly available after publication through University College London’s data repository (www.ucl.ac.uk/library/open-science-research-support/research-data-management/ucl-research-data-repository) according to NIHR policy. All data requests should be submitted to the corresponding author for consideration.

Ethics statement

The recruitment study (WP1a) and focus group study included in WP1b were approved by the East of Scotland Research Ethics Service (REC reference: 15/ES/0163) on 24 September 2015.

The trial and qualitative substudies (WP2 and WP3) received ethical approval from Brent Research Ethics Committee on 27 October 2016 (reference is 16/LO/1507). It was registered with the International Standard Randomised Controlled Trials register on 7 February 2017 (registration number: ISRCTN90298520) and with ClinicalTrials.gov on 18 June 2018.

Information governance statement

University College London (UCL) is committed to handling all personal information in line with the UK Data Protection Act (2018) and the General Data Protection Regulation (EU GDPR) 2016/679. This ensures that all personal data is processed lawfully, fairly and transparently. Under the Data Protection legislation, UCL is the Data Controller, and you can find out more about how we handle personal data, including how to exercise your individual rights and the contact details for our Data Protection Officer here: data-protection@ucl.ac.uk.

Disclosure of interests

Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, are available in the toolkit on the NIHR Journals Library report publication page at https://doi.org/10.3310/GJJM0506.

Primary conflicts of interest: Joanna Moncrieff has grants from NIHR (NIHR203294; RP-PG-1214-20004) and is a co-applicant on grants from the Medical Research Future Fund (MRFF) in Australia. She receives royalties from six books about psychiatric drugs; she has received lecture fees from Alberta Psychiatric Association, British Psychological Association, Universite de Sherbrooke, Case Western Reserve University and University of Basal. She is cochair person of the Critical Psychiatry Network and a board member of the Council for Evidence-based Psychiatry (both unpaid roles). Stefan Priebe has grants from NIHR (NIHR203294; NIHR 201680; NIHR 201707) and was a member of the HTA MPOH panel from 1 January 2014 to 31 May 2018. Thomas Barnes is joint head of the Prescribing Observatory for Mental Health, Royal College of Psychiatrists. Ruth Cooper has undertaken paid consultancy work for the All Party Parliamentary Group for Prescribed Drug Dependence, is a member of the Advisory Board for the PARTANE Study (Participatory Design of a Systematic Review on Tapering Neuroleptics in People with Schizophrenia-related disorders) (a paid role) and is an unpaid Board Member of the International Institute for Psychiatric Drug Withdrawal (IIPDW). Nick Freemantle has grants from NIHR (CTU-56), Medical Research Council, Cure Parkinson’s Trust and the EU. He has received consulting fees from ALK, Sanofi Avantis, Gedeo Richter, Abbott, Galderma, Astra Zeneca, Ipsen, Vertex, Thea, Novo Nordisk, Aimmune, speaker fees from Abbott Singapore and had been paid to sit on a data safety monitoring or advisory board by Orion. Mark Horowitz is co-applicant on grants from the Medical Research Future Fund (MRFF) in Australia; he has received consulting fees from Outro Health, a digital clinic aimed to support people to stop unnecessary antidepressants, lecture fees from NHS Trusts for grand rounds presentations, Salomon’s University and University of Washington. He sits on the DSMB of the RELEASE trial in Australia and is a cofounder of Outro Health. He is a member of the Critical Psychiatry Network and is an associate of the International Institute of Psychiatric Drug Withdrawal (both unpaid roles). Sonia Johnson has grants from NIHR (PR-PRU-0916-22003; RP-PG-0615-20021; NIHR206807) and UKRI. She is chair of programme advisory committees for two studies funded through NIHR Programme Grants and has acted as a paid reviewer of grant applications for programmes on social interventions for Austrian foundation – Wiener Wissenschafts-, Forschungs- und Technologiefonds (WWTF) | Vienna Science and Technology Fund. Glyn Lewis has grants from NIHR (NIHR134074; NIHR153131; RP-PG-1214-20004) and is chair of an NIHR funded trial steering committee. All other authors declare no competing interests.

Copyright and credit statement

Every effort has been made to obtain the necessary permissions for reproduction, to credit original sources appropriately and to respect copyright requirements. However, despite our diligence, we acknowledge the possibility of unintentional omissions or errors and we welcome notifications of any concerns regarding copyright or permissions.

Publications

Cooper RE, Hanratty É, Morant N, Moncrieff J. Mental health professionals’ views and experiences of antipsychotic reduction and discontinuation. PLOS ONE 2019;14:e0218711. https://doi.org/10.1371/journal.pone.0218711

Moncrieff J, Lewis G, Freemantle N, Johnson S, Barnes TRE, Morant N, et al. Randomised controlled trial of gradual antipsychotic reduction and discontinuation in people with schizophrenia and related disorders: the RADAR trial (Research into Antipsychotic Discontinuation and Reduction). BMJ Open 2019;9:e030912. https://doi.org/10.1136/bmjopen-2019-030912

Moncrieff J, Crellin NE, Long MA, Cooper RE, Stockmann T. Definitions of relapse in trials comparing antipsychotic maintenance with discontinuation or reduction for schizophrenia spectrum disorders: a systematic review. Schizophr Res 2020;225:47–54. https://doi.org/10.1016/j.schres.2019.08.035

Freudenthal R, Marston L, Stansfeld JL, Priebe S, Moncrieff J. How do participants in clinical trials compare with other patients with schizophrenia? Contemp Clin Trials Commun 2021;22:100803. https://doi.org/10.1016/j.conctc.2021.100803

Crellin NE, Priebe S, Morant N, Lewis G, Freemantle N, Johnson S, et al. An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders. BMC Psychiatry 2022;22:185. https://doi.org/10.1186/s12888-022-03822-5

Ramsay G, Haime Z, Crellin NE, Stansfeld JL, Priebe S, Long M, Moncrieff J. Recruitment to a trial of antipsychotic reduction: impact of an acceptability study. BMC Med Res Methodol 2023;23:78. https://doi.org/10.1186/s12874-023-01881-0

Moncrieff J, Crellin N, Stansfeld J, Cooper R, Marston L, Freemantle N, et al. Randomised controlled trial of antipsychotic dose reduction and discontinuation versus maintenance treatment in people with schizophrenia and other recurrent psychotic disorders in England (the RADAR trial). Lancet Psychiatry 2023;10:848–59. https://doi.org/10.1016/S2215-0366(23)00258-4

Morant N, Long M, Jayacodi S, Cooper R, Akther-Robertson J, Stansfeld J, et al. Experiences of reduction and discontinuation of antipsychotics: a qualitative investigation within the ‘RADAR’ trial. eClinicalMedicine 2023;64:102135. https://doi.org/10.1016/j.eclinm.2023.102135

Bray G, Moncrieff J, Priebe S, Marston L, Lewis G, Haynes N, et al. Cost-utility analysis of antipsychotic discontinuation and reduction in patients with long-term schizophrenia and psychosis in English Mental Health Trusts: the RADAR Study. Value Health 2025;28:358–67. https://doi.org/10.1016/j.jval.2024.07.017