Beyond Clinical Remission in First Episode Psychosis: Thoughts on Antipsychotic Maintenance vs. Guided Discontinuation in the Functional Recovery Era

M Alvarez-Jimenez; B O’Donoghue; A Thompson; JF Gleeson; S Bendall; C Gonzalez-Blanch; E Killackey; L Wunderink; PD McGorry

Journal article

Beyond Clinical Remission in First Episode Psychosis: Thoughts on Antipsychotic Maintenance vs. Guided Discontinuation in the Functional Recovery Era

M Alvarez-Jimenez, B O’Donoghue, A Thompson, JF Gleeson, S Bendall, C Gonzalez-Blanch, E Killackey, L Wunderink, PD McGorry

CNS Drugs | ADIS INT LTD | Published : 2016

DOI: 10.1007/s40263-016-0331-x

Abstract

Treatment guidelines for first episode psychosis (FEP) recommend at least 1 year of antipsychotic treatment following remission; however, in light of some recent research and the preference of some individuals to discontinue their medication sooner, this recommendation can be questioned. The aim of this article is to appraise the current discontinuation studies given our views on how this field should progress. We conducted a review of randomized controlled trials investigating dose-reduction/medication discontinuation compared with treatment maintenance in clinically remitted FEP patients. Seven trials were identified, and these reported a higher rate of relapse in the dose reduction or dis..

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University of Melbourne Researchers

Mario Alvarez-Jimenez Author

Brian O'Donoghue Author

Andrew Thompson Author

Sarah Bendall Author

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Grants

Funding Acknowledgements

Dr M Alvarez-Jimenez is supported by the CR Roper Fellowship, Faculty of Medicine, Dentistry, and Health Science, the University of Melbourne, Australia, and a Career Development Fellowship from the National Health and Medical Research Council of Australia. Professor PD McGorry is supported by a Research Fellowship from the National Health and Medical Research Council of Australia. Assistant Professor E Killackey is supported by a Career Development Fellowship from the National Health and Medical Research Council of Australia. Dr. S Bendall is supported by an Early Career Research Fellowship from the National Health and Medical Research Council of Australia. In addition, support was provided by the Australian Government and the Colonial Foundation to Orygen, The National Centre of Excellence in Youth Mental Health. The sponsors did not participate in the design or conduct of this review; in the collection, management, analysis, or interpretation of data; in the writing of the manuscript; or in the preparation, review, approval, or decision to submit this manuscript for publication.