Withdrawal of chronic chlorpromazine medication: an experimental analysis.

Doctors took five adults with intellectual disability off the antipsychotic drug chlorpromazine. They watched each person for four weeks, then put the drug back, then took it away again — an ABAB design.

Staff recorded problem behavior, self-care, and social acts every day. No one knew when the pills were real or placebo.

Going off the drug helped some people and hurt others. One woman talked more and hit herself less without chlorpromazine. Two men became more aggressive and needed the drug again.

The team saw no single pattern. Each adult reacted differently, so the drug stayed only for those who got worse without it.

Lawer et al. (2009) later gave risperidone, haloperidol, or placebo to similar adults. Pills cost more yet worked no better than placebo, updating Reberg et al. (1979) with stronger controls and cost data.

Thillainathan et al. (2024) replaced drugs with a full ABA program in a specialty home. Most residents cut severe behavior without meds, showing behavioral care can extend beyond the pill trials of the 1970s.

Green et al. (1987) used the same ABAB setup to test naltrexone for self-injury and saw no change, matching the mixed, person-to-person picture first seen here.

If you serve adults who have taken antipsychotics for years, do not assume they still need them. Run brief, data-rich withdrawal probes while tracking daily behavior and side effects. Pair the trial with ABA skills teaching so gains made off medication can last. Share graphs with the medical team to decide drug need case-by-case.