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Antipsychotic treatment maintenance reduces risk of relapse in FEP patients

13 Jul 2018

Patients with first-episode psychosis (FEP) may benefit from continuing their antipsychotic treatment, with a recent study showing that treatment maintenance protects against relapse risk, whereas discontinuation for 2 months increases the risk.

Researchers performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing FEP relapse rates between antipsychotic treatment discontinuation and maintenance groups at 1, 2, 3, 6, 9, 12 (primary), and 18–24 months.

A total of 10 RCTs, involving 776 FEP patients with a mean study duration of 18.6 months, were included. Of these, four RCTs had the antipsychotics discontinued abruptly. The remaining six RCTs had treatment ceased after tapering off gradually over several months.

Relapses occurred with significantly greater frequency in the discontinuation group than in the maintenance group. This was true at all time points except at 1 month (2 months: risk ratio [RR], 0.49; 3 months: RR, 0.46; 6 months: RR, 0.55; 9 months: RR, 0.48; 12 months: RR, 0.47; 18–24 months: RR, 0.57).

However, maintenance treatment was associated with a nonsignificant increase in the risk of discontinuation due to adverse events (RR, 2.61).

Although it appears that maintaining antipsychotic treatment is beneficial for preventing relapses for at least 2 years in remitted/stable FEP patients, it remains unclear whether this would be the case for longer than 2 years, researchers said.

There are currently no clinical measures or biomarkers that may facilitate identification of remitted/stable FEP patients who are not at risk of relapse after discontinuation of their antipsychotic treatment, they added. More work is needed to establish these predictive biomarkers to aid in decision-making and a personalized medicine approach.

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Most Read Articles
02 Sep 2018
The combination of maternal pregestational diabetes mellitus plus severe obesity is associated with a heightened risk of several psychiatric and mild neurodevelopmental disorders in offspring compared with either obesity or diabetes alone, a study suggests.
Rachel Soon, 30 Nov 2017

A care management program conducted via telephone for caregivers of patients with Alzheimer’s and other forms of dementia is associated with improved outcomes for both patients and carers, according to a new study in the United States.

07 Sep 2018
Individuals with attention deficiency hyperactivity disorder (ADHD) or anxiety are at greater risk of developing bipolar disorder, according to a study. Moreover, the risk further increases in those who have received diagnoses of both ADHD and anxiety.
Roshini Claire Anthony, 06 Apr 2016
A diagnosis of depression increases the risk of mortality and hospital readmission due to myocardial infarction (MI) in patients with stable coronary artery disease (CAD), according to a Canadian study presented at the recent American College of Cardiology’s 65th Annual Scientific Session in Chicago, Illinois, US.