Careful reductions in dosage levels of antipsychotic medications over time improved long-term rates of recovery and functional remission in patients diagnosed with a first-episode psychosis, according to a study led by Lex Wunderink reported in a Supplement of European Psychiatry.
The summary of the study was included in the Supplement as one of the Abstracts of the 23rd European Congress of Psychiatry, which occurred in March of this year. It was a 7-year follow-up by Wunderink and other researchers at the Dutch University Medical Center Groningen on a previous 18-month trial comparing 108 people who’d experienced a first episode of psychosis and were either on maintenance treatment (MT) with antipsychotics or were put into a dose-reduction/discontinuation (DR) program.
The 7-year follow-up involved 103 patients. At 40% compared to 18%, patients in the dose-reduction/discontinuation group showed twice the recovery-rate of maintenance-treatment patients, wrote the authors. “Symptomatic remission-rates were equal (69% and 67%). Better DR recovery-rates were attributable to higher functional remission-rates (46% vs. 20%) in DR.” Relapse rates were initially higher in the dose-reduction/discontinuation group, but after 3 years were nearly the same for both groups.
Dose reduction or discontinuation of antipsychotics during early stages of remitted first-episode psychosis “significantly improved 7-years outcome in terms of recovery and functional remission compared to maintenance treatment,” concluded the authors.
MIA Editors note: Though some of the figures seem slightly different, some MIA readers have pointed out that this appears to be a re-presentation of a study previously published by Wunderink et al in JAMA Psychiatry and reported on by MIA in 2013.
Wunderink, L., R. Nieboer, F. Nienhuis, S. Sytema, and D. Wiersma. “Long Term Recovery Rates in Schizophrenia After Early Antipsychotic Dose Reduction.” European Psychiatry 30 (n.d.): 67. Accessed June 21, 2015. doi:10.1016/S0924-9338(15)30056-0. (Abstract)