When someone takes antipsychotic medication inconsistently—coming on and off it without medical guidance—it can seriously destabilize their brain chemistry and emotional state. Here’s what typically happens:

1. Neurotransmitter disruption
Antipsychotics work by balancing dopamine (and often serotonin). When the medication is suddenly stopped, dopamine activity can rebound, sometimes leading to agitation, paranoia, or mood swings. Restarting the medication again can shock the system, because the brain is trying to readjust to suppressed dopamine.

2. Mood instability

• While on medication: emotions may feel blunted or steadier, depending on the drug.
• When abruptly stopping: anxiety, irritability, depression, or intense highs and lows can appear quickly. Some people also experience withdrawal symptoms—insomnia, nausea, restlessness—which worsen mood.

3. Behavioural changes

• Coming off medication too quickly can trigger aggression, impulsivity, suspiciousness, or disorganized behaviour. In severe cases, psychotic symptoms (hallucinations, delusions) can return suddenly and more intensely than before (this is called “rebound psychosis”).
• Going back on medication without guidance can cause side effects to feel stronger than before—such as sedation, sexual dysfunction, or emotional flattening—making the person more likely to stop again. This cycle can create a pattern of instability.

4. Relationship and safety impact
For partners, family, or colleagues, this inconsistency can feel like walking on eggshells—never knowing which version of the person will show up. Mood swings, unpredictable behaviour, or bursts of aggression often strain trust and emotional safety in relationships.

5. Long-term consequences
Repeatedly coming on and off medication can make symptoms harder to manage in the future, reduce the effectiveness of treatment, and increase the risk of hospitalization. It can also heighten vulnerability to depression, self-harm, or substance misuse.

👉 This is why psychiatrists stress consistency and slow, supervised changes. The brain needs time to recalibrate safely.