Zotero Import

PMID- 33754470
OWN - NLM
STAT- MEDLINE
DCOM- 20220311
LR  - 20220721
IS  - 1751-7893 (Electronic)
IS  - 1751-7885 (Print)
IS  - 1751-7885 (Linking)
VI  - 16
IP  - 2
DP  - 2022 Feb
TI  - Medication strategies in first episode psychosis patients: A survey among
      psychiatrists.
PG  - 139-146
LID - 10.1111/eip.13138 [doi]
AB  - AIM: There is an ongoing debate regarding the optimal timing of discontinuation
      of antipsychotic drugs for patients with first episode psychosis. Although most
      guidelines recommend maintenance therapy for at least 1 or 2 years after reaching
      remission, study results indicate that early discontinuation may be beneficial
      for at least a subsample of patients. To date, little is known about which
      medication strategies are applied in patients recovering from a first psychotic
      episode. In this study, we examined the beliefs and practices of clinicians on
      medication discontinuation. METHODS: We performed a survey among 50 experienced
      Dutch psychiatrists to assess how often specific treatment strategies have been
      applied in the past 12 months, as well as their knowledge and expectations with
      respect to medication discontinuation. RESULTS: Psychiatrists estimated that,
      after remission, they continued medication at the same dose for at least 12
      months in 51.2% of cases, continued in a reduced dose in 33.8% of cases and
      discontinued medication in 9.1% of cases after 4.4 months of remission on
      average. Although the medication is discontinued in only a relatively small
      proportion of patients, almost half of all clinicians (45.9%) used this strategy
      at least once in the past 12 months. CONCLUSIONS: There is substantial practice
      variation in antipsychotic medication strategies after remission from a first
      psychotic episode. Future research on long-term effects of early medication
      discontinuation can guide clinicians in making evidence-based decisions when
      treating first-episode patients.
CI  - © 2021 The Authors. Early Intervention in Psychiatry published by John Wiley &
      Sons Australia, Ltd.
FAU - Kikkert, Martijn J
AU  - Kikkert MJ
AUID- ORCID: 0000-0002-9164-7138
AD  - Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Veling, Wim
AU  - Veling W
AD  - Department of Psychiatry, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
FAU - de Haan, Lieuwe
AU  - de Haan L
AD  - Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam,
      The Netherlands.
FAU - Begemann, Marieke J H
AU  - Begemann MJH
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
FAU - de Koning, Mariken
AU  - de Koning M
AD  - Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.
CN  - HAMLETT and OPHELIA Consortium
FAU - Sommer, Iris E
AU  - Sommer IE
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210322
PL  - Australia
TA  - Early Interv Psychiatry
JT  - Early intervention in psychiatry
JID - 101320027
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - *Antipsychotic Agents/therapeutic use
MH  - Humans
MH  - *Psychiatry
MH  - *Psychotic Disorders/drug therapy
MH  - Remission Induction
MH  - Surveys and Questionnaires
PMC - PMC9292219
OTO - NOTNLM
OT  - antipsychotic medication
OT  - discontinuation
OT  - maintenance treatment
OT  - schizophrenia
COIS- The authors declare no conflicts of interest.
FIR - Sommer, Iris
IR  - Sommer I
FIR - de Haan, Lieuwe
IR  - de Haan L
FIR - Veling, Wim
IR  - Veling W
FIR - van Os, Jim
IR  - van Os J
FIR - Smit, Filip
IR  - Smit F
FIR - Begemann, Marieke
IR  - Begemann M
FIR - Schuite-Koops, Sanne
IR  - Schuite-Koops S
FIR - Marcelis, Machteld
IR  - Marcelis M
FIR - Kikkert, Martijn
IR  - Kikkert M
FIR - van Beveren, Nico
IR  - van Beveren N
FIR - Boonstra, Nynke
IR  - Boonstra N
FIR - Rosema, Bram-Sieben
IR  - Rosema BS
FIR - Bakker, P Roberto
IR  - Bakker PR
FIR - Gülöksüz, Sinan
IR  - Gülöksüz S
FIR - Lokkerbol, Joran
IR  - Lokkerbol J
FIR - Brand, Bodyl
IR  - Brand B
FIR - Gangadin, Shiral
IR  - Gangadin S
FIR - Geraets, Chris
IR  - Geraets C
FIR - Van't Hag, Erna
IR  - Van't Hag E
FIR - Oomen, Priscilla
IR  - Oomen P
FIR - Voppel, Alban
IR  - Voppel A
FIR - van Amelsvoort, Therese
IR  - van Amelsvoort T
FIR - Bak, Maarten
IR  - Bak M
FIR - Been, Agaath
IR  - Been A
FIR - van den Bosch, Marinte
IR  - van den Bosch M
FIR - van den Brink, Truus
IR  - van den Brink T
FIR - Faber, Gunnar
IR  - Faber G
FIR - Grootens, Koen
IR  - Grootens K
FIR - de Jonge, Martin
IR  - de Jonge M
FIR - Knegtering, Henderikus
IR  - Knegtering H
FIR - Kurkamp, Jörg
IR  - Kurkamp J
FIR - Mahabir, Amrita
IR  - Mahabir A
FIR - Pijnenborg, Gerdina Hendrika Maria
IR  - Pijnenborg GHM
FIR - Staring, Tonnie
IR  - Staring T
FIR - Vaes, Wiek
IR  - Vaes W
FIR - Veen, Natalie
IR  - Veen N
FIR - Veerman, Selene
IR  - Veerman S
FIR - Wiersma, Sybren
IR  - Wiersma S
EDAT- 2021/03/24 06:00
MHDA- 2022/03/12 06:00
CRDT- 2021/03/23 07:16
PHST- 2021/02/09 00:00 [revised]
PHST- 2020/10/23 00:00 [received]
PHST- 2021/03/06 00:00 [accepted]
PHST- 2021/03/24 06:00 [pubmed]
PHST- 2022/03/12 06:00 [medline]
PHST- 2021/03/23 07:16 [entrez]
AID - EIP13138 [pii]
AID - 10.1111/eip.13138 [doi]
PST - ppublish
SO  - Early Interv Psychiatry. 2022 Feb;16(2):139-146. doi: 10.1111/eip.13138. Epub
      2021 Mar 22.

PMID- 23972821
OWN - NLM
STAT- MEDLINE
DCOM- 20140923
LR  - 20220331
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 152
IP  - 2-3
DP  - 2014 Feb
TI  - Risk of symptom recurrence with medication discontinuation in first-episode
      psychosis: a systematic review.
PG  - 408-14
LID - S0920-9964(13)00436-2 [pii]
LID - 10.1016/j.schres.2013.08.001 [doi]
AB  - The large majority of individuals with a first episode of schizophrenia will
      experience a remission of symptoms within their first year of treatment. It is
      not clear how long treatment with antipsychotic medications should be continued
      in this situation. The possibility that a percentage of patients may not require
      ongoing treatment and may be unnecessarily exposed to the long-term risks of
      antipsychotic medications has led to the development of a number of studies to
      address this question. We carried out a systematic review to determine the risk
      of experiencing a recurrence of psychotic symptoms in individuals who have
      discontinued antipsychotic medications after achieving symptomatic remission from
      a first episode of non-affective psychosis (FEP). Six studies were identified
      that met our criteria and these reported a weighted mean one-year recurrence rate
      of 77% following discontinuation of antipsychotic medication. By two years, the
      risk of recurrence had increased to over 90%. By comparison, we estimated the
      one-year recurrence rate for patients who continued antipsychotic medication to
      be 3%. These findings suggest that in the absence of uncertainty about the
      diagnosis or concerns about the contribution of medication side effects to
      problems with health or functioning, a trial off of antipsychotic medications is
      associated with a very high risk of symptom recurrence and should thus not be
      recommended.
CI  - © 2013 Elsevier B.V. All rights reserved.
FAU - Zipursky, Robert B
AU  - Zipursky RB
AD  - Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote
      School of Medicine, McMaster University, St. Joseph's Healthcare Hamilton, 100
      West 5th Street, Hamilton, Ontario L8N 3K7, Canada. Electronic address:
      [email protected].
FAU - Menezes, Natasja M
AU  - Menezes NM
AD  - Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote
      School of Medicine, McMaster University, St. Joseph's Healthcare Hamilton, 100
      West 5th Street, Hamilton, Ontario L8N 3K7, Canada. Electronic address:
      [email protected].
FAU - Streiner, David L
AU  - Streiner DL
AD  - Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote
      School of Medicine, McMaster University, St. Joseph's Healthcare Hamilton, 100
      West 5th Street, Hamilton, Ontario L8N 3K7, Canada; Department of Psychiatry,
      Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic
      address: [email protected].
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20130821
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/*therapeutic use
MH  - Humans
MH  - Psychotic Disorders/*diagnosis/*drug therapy
MH  - Recurrence
OTO - NOTNLM
OT  - Antipsychotic
OT  - Discontinuation
OT  - First episode psychosis
OT  - Recurrence
OT  - Relapse
OT  - Schizophrenia
OT  - Withdrawal
EDAT- 2013/08/27 06:00
MHDA- 2014/09/24 06:00
CRDT- 2013/08/27 06:00
PHST- 2012/12/19 00:00 [received]
PHST- 2013/07/29 00:00 [revised]
PHST- 2013/08/01 00:00 [accepted]
PHST- 2013/08/27 06:00 [entrez]
PHST- 2013/08/27 06:00 [pubmed]
PHST- 2014/09/24 06:00 [medline]
AID - S0920-9964(13)00436-2 [pii]
AID - 10.1016/j.schres.2013.08.001 [doi]
PST - ppublish
SO  - Schizophr Res. 2014 Feb;152(2-3):408-14. doi: 10.1016/j.schres.2013.08.001. Epub
      2013 Aug 21.

PMID- 35041015
OWN - NLM
STAT- MEDLINE
DCOM- 20220704
LR  - 20220705
IS  - 1433-9285 (Electronic)
IS  - 0933-7954 (Linking)
VI  - 57
IP  - 7
DP  - 2022 Jul
TI  - An observational study of antipsychotic medication discontinuation in
      first-episode psychosis: clinical and functional outcomes.
PG  - 1329-1340
LID - 10.1007/s00127-022-02230-0 [doi]
AB  - PURPOSE: To study the impact of supervised antipsychotic medication
      discontinuation on clinical and functional outcomes in first-episode psychosis
      (FEP) in two different cultural environments. METHOD: FEP patients(N = 253),
      treated in two early intervention services (Montreal, Canada and Chennai, India)
      for 2 years, were assessed for medication use, positive and negative symptom
      remission and social-occupational functioning at regular intervals. RESULTS:
      Between months 4 and 24 of treatment, 107 patients discontinued medication
      ('Off'group) as compared to 146 who stayed on medication ('On'group). Medication
      discontinuation was higher in Chennai as compared to Montreal (n = 80, 49.07% vs
      n = 27, 16.87%; χ(2) 37.80, p < 0.001), with no difference in time to
      discontinuation [Means(SDs) = 10.64(6.82) and 10.04(5.43), respectively,
      p = 0.71). At month 24 (N = 235), there were no differences in the rate of
      positive symptom remission between the on and Off groups (81.5 vs 88.0%,
      respectively) at both sites. The rate of negative symptom remission was lower
      among patients in the On compared to the Off group (63.2 vs 87.9%, respectively,
      χ(2) = 17.91, p < 0.001), but only in Montreal (55.4% vs 80.0%, respectively,
      χ(2) = 4.12, p < 0.05). Social and Occupational Functioning Assessment Scale
      scores were equally high in both Off and On medication groups in Chennai [Means
      (SDs) = 79.43(12.95) and 73.59(17.63), respectively] but higher in the Off
      compared to the On group in Montreal Means (SDs) = 77.47(14.97) and 64.94(19.02),
      respectively; Time × site interaction F = 3.96(1,217), p < 0.05]. Medication
      status (On-Off) had no impact on the outcomes, independent of other variables
      known to influence outcomes. CONCLUSION: Certain cultural environments and
      patient characteristics may facilitate supervised discontinuation of
      antipsychotic medication following treatment of an FEP without negative
      consequences.
CI  - © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
FAU - Malla, Ashok
AU  - Malla A
AUID- ORCID: 0000-0002-5863-4191
AD  - Department of Psychiatry, McGill University, Office: 29-1110, ACCESS Pavilion,
      6625 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada. [email protected].
FAU - Iyer, Srividya N
AU  - Iyer SN
AUID- ORCID: 0000-0001-5367-9086
AD  - Department of Psychiatry, McGill University, Office: 29-1110, ACCESS Pavilion,
      6625 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
AD  - Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas
      Mental Health University Institute, Montreal, Canada.
FAU - Joober, Ridha
AU  - Joober R
AUID- ORCID: 0000-0003-3492-807X
AD  - Department of Psychiatry, McGill University, Office: 29-1110, ACCESS Pavilion,
      6625 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
AD  - Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas
      Mental Health University Institute, Montreal, Canada.
FAU - Rangaswamy, Thara
AU  - Rangaswamy T
AUID- ORCID: 0000-0001-6813-066X
AD  - Schizophrenia Research Foundation (SCARF), Chennai, India.
FAU - Ramachandran, Padmavati
AU  - Ramachandran P
AUID- ORCID: 0000-0002-0380-8617
AD  - Schizophrenia Research Foundation (SCARF), Chennai, India.
FAU - Schmitz, Norbert
AU  - Schmitz N
AUID- ORCID: 0000-0001-7777-6323
AD  - Department of Psychiatry, McGill University, Office: 29-1110, ACCESS Pavilion,
      6625 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
FAU - Taksal, Aarati
AU  - Taksal A
AUID- ORCID: 0000-0003-4125-7585
AD  - Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas
      Mental Health University Institute, Montreal, Canada.
FAU - Mohan, Greeshma
AU  - Mohan G
AUID- ORCID: 0000-0002-6322-5413
AD  - Schizophrenia Research Foundation (SCARF), Chennai, India.
FAU - Margolese, Howard C
AU  - Margolese HC
AD  - Department of Psychiatry, McGill University, Office: 29-1110, ACCESS Pavilion,
      6625 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
AD  - Prevention and Early Intervention Program for Psychosis, McGill University Health
      Centre, Montreal, Canada.
LA  - eng
GR  - 5R01MH093303-05/foundation for the national institutes of health/
PT  - Journal Article
PT  - Observational Study
DEP - 20220118
PL  - Germany
TA  - Soc Psychiatry Psychiatr Epidemiol
JT  - Social psychiatry and psychiatric epidemiology
JID - 8804358
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - *Antipsychotic Agents/therapeutic use
MH  - Humans
MH  - India
MH  - *Psychotic Disorders/therapy
MH  - Remission Induction
MH  - Social Adjustment
OTO - NOTNLM
OT  - Adherence
OT  - Canada
OT  - Early intervention in psychosis
OT  - FEP
OT  - India
OT  - Medication discontinuation
OT  - Remission
EDAT- 2022/01/19 06:00
MHDA- 2022/07/06 06:00
CRDT- 2022/01/18 12:34
PHST- 2021/07/28 00:00 [received]
PHST- 2022/01/06 00:00 [accepted]
PHST- 2022/01/19 06:00 [pubmed]
PHST- 2022/07/06 06:00 [medline]
PHST- 2022/01/18 12:34 [entrez]
AID - 10.1007/s00127-022-02230-0 [pii]
AID - 10.1007/s00127-022-02230-0 [doi]
PST - ppublish
SO  - Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1329-1340. doi:
      10.1007/s00127-022-02230-0. Epub 2022 Jan 18.

PMID- 30058834
OWN - NLM
STAT- MEDLINE
DCOM- 20191014
LR  - 20191014
IS  - 1440-1614 (Electronic)
IS  - 0004-8674 (Linking)
VI  - 52
IP  - 9
DP  - 2018 Sep
TI  - Medication discontinuation in first episode psychosis: thinking about the offset
      of psychotic disorders.
PG  - 819-821
LID - 10.1177/0004867418790087 [doi]
FAU - Galletly, Cherrie
AU  - Galletly C
AD  - 1 Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia.
AD  - 2 Ramsay Health Care (SA) Mental Health, Adelaide, SA, Australia.
AD  - 3 Northern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia.
FAU - Suetani, Shuichi
AU  - Suetani S
AD  - 4 Queensland Centre for Mental Health Research and The Park Centre for Mental
      Health, Wacol, QLD, Australia.
AD  - 5 Queensland Brain Institute, The University of Queensland, St Lucia, QLD,
      Australia.
AD  - 6 Psychosis Academic Clinical Unit, Metro South Addiction and Mental Health
      Services, Brisbane, QLD, Australia.
FAU - Dark, Frances
AU  - Dark F
AD  - 6 Psychosis Academic Clinical Unit, Metro South Addiction and Mental Health
      Services, Brisbane, QLD, Australia.
AD  - 7 Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health
      Services, Brisbane, QLD, Australia.
LA  - eng
PT  - Editorial
DEP - 20180730
PL  - England
TA  - Aust N Z J Psychiatry
JT  - The Australian and New Zealand journal of psychiatry
JID - 0111052
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/*therapeutic use
MH  - Humans
MH  - Practice Guidelines as Topic
MH  - Psychotic Disorders/*drug therapy
MH  - Time Factors
MH  - *Withholding Treatment
EDAT- 2018/07/31 06:00
MHDA- 2019/10/15 06:00
CRDT- 2018/07/31 06:00
PHST- 2018/07/31 06:00 [pubmed]
PHST- 2019/10/15 06:00 [medline]
PHST- 2018/07/31 06:00 [entrez]
AID - 10.1177/0004867418790087 [doi]
PST - ppublish
SO  - Aust N Z J Psychiatry. 2018 Sep;52(9):819-821. doi: 10.1177/0004867418790087.
      Epub 2018 Jul 30.

PMID- 32115314
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 225
DP  - 2020 Nov
TI  - Perspective on medication decisions following remission from first-episode
      psychosis.
PG  - 82-89
LID - S0920-9964(20)30083-9 [pii]
LID - 10.1016/j.schres.2020.02.007 [doi]
AB  - While antipsychotics (APs) could provide rapid relief of positive symptoms in
      psychotic disorders, their usage is often associated with side effects, stigma
      and inconveniences. For these and other reasons, many psychosis patients,
      particularly those of first-episode psychosis (FEP) in remission, wish to
      discontinue maintenance treatment. The current review aims to discuss the
      strategies of AP treatment following remission from FEP, with particular emphasis
      on the evaluation of outcomes following AP discontinuation. Upon review of
      relevant literature, three potential strategies are put forth for
      treatment-responsive, remitted FEP patients: a) life-long maintenance treatment,
      b) AP discontinuation during second year of treatment, or c) AP discontinuation
      after three years of treatment. In theory, the first strategy presents the safest
      option for maximal symptom control. However, a rigorous RCT indicates that if AP
      discontinuation is to be attempted, the third strategy best prevents poor
      long-term clinical outcomes. Further data is needed to address the costs and
      benefits of each treatment strategy, compare AP-free patients with those on
      different types of APs, as well as explore even longer-term outcomes.
CI  - Copyright © 2020 Elsevier B.V. All rights reserved.
FAU - Hui, Christy L M
AU  - Hui CLM
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China. Electronic
      address: [email protected].
FAU - Lam, Bertha S T
AU  - Lam BST
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China.
FAU - Lee, Edwin H M
AU  - Lee EHM
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China.
FAU - Chan, Sherry K W
AU  - Chan SKW
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key
      Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong,
      China.
FAU - Chang, W C
AU  - Chang WC
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key
      Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong,
      China.
FAU - Suen, Y N
AU  - Suen YN
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China.
FAU - Chen, Eric Y H
AU  - Chen EYH
AD  - Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key
      Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong,
      China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20200227
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - *Antipsychotic Agents/therapeutic use
MH  - Humans
MH  - *Psychotic Disorders/drug therapy
OTO - NOTNLM
OT  - Discontinuation
OT  - Long-term outcome
OT  - Maintenance treatment
OT  - Psychosis
OT  - Remission
OT  - Schizophrenia
COIS- Declaration of competing interest E.Y.H.C. reports having received speaker
      honoraria from Otsuka and DSK BioPharma; received research funding from Otsuka;
      participated in paid advisory boards for Jansen and DSK BioPharma; received
      funding to attend conferences from Otsuka and DSK BioPharma. The remaining
      authors declare no competing interests.
EDAT- 2020/03/03 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/03/03 06:00
PHST- 2020/01/03 00:00 [received]
PHST- 2020/02/13 00:00 [revised]
PHST- 2020/02/15 00:00 [accepted]
PHST- 2020/03/03 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/03/03 06:00 [entrez]
AID - S0920-9964(20)30083-9 [pii]
AID - 10.1016/j.schres.2020.02.007 [doi]
PST - ppublish
SO  - Schizophr Res. 2020 Nov;225:82-89. doi: 10.1016/j.schres.2020.02.007. Epub 2020
      Feb 27.

PMID- 35261544
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220310
IS  - 1176-6328 (Print)
IS  - 1178-2021 (Electronic)
IS  - 1176-6328 (Linking)
VI  - 18
DP  - 2022
TI  - Discontinuing Antipsychotic Medication After Remission from First-Episode
      Psychosis: A Survey of Psychiatrists' Attitudes in Taiwan.
PG  - 465-475
LID - 10.2147/NDT.S339866 [doi]
AB  - BACKGROUND: Patients in remission after first-episode psychosis are inclined to
      discontinue antipsychotic treatment, which may lead to higher risk of relapse and
      unfavorable outcomes. Paradoxically, also there are evidences suggesting that
      certain patients may stay well in drug-free condition. Psychiatrists' views
      towards this dilemma might affect their approaches to these patients, and
      discrepant attitudes are noted between Western and Asian clinicians. This study
      aimed to examine psychiatrists' attitudes about discontinuing antipsychotic
      medications after remission from first-episode psychosis. METHODS: Psychiatrists
      were recruited for this study using convenience sampling. A cross-sectional
      survey was conducted using a set of questionnaires comprising nine items for
      attitudes toward medication discontinuation, six vignettes for probing
      psychiatrists' practice in designated clinical scenarios, and a list of criteria
      that may affect their responses. RESULTS: Responses were provided by 118
      psychiatrists, two-thirds men, mean age 39.8 ± 10.1 years and mean experience
      12.7 ± 9.7 years. Half of the participants endorsed that fewer than 20% of the
      remitted patients should stop medication completely; the majority advised that an
      observation period of 1 year or longer is necessary while discontinuing
      medication. The majority would not initiate discussion with patients about
      discontinuing medication. Responding to two case vignettes, those who endorsed
      that more patients could stop antipsychotics were also more inclined to discuss
      it with patients, but not consistently in response to the other four case
      vignettes. Taiwan psychiatrists expressed a wide range of decision-making
      considerations for discontinuing antipsychotics. CONCLUSION: The majority of
      Taiwan psychiatrists thought it was not feasible to stop medications completely
      but were willing to consider this option. Once being presented with actual
      clinical scenarios, many participants hesitated to discontinue antipsychotic
      medications for various reasons. The proactive attitude of psychiatrists towards
      conducting clinical trials to test the feasibility of medication discontinuation
      may help to provide better reference for this clinical dilemma.
CI  - © 2022 Yen et al.
FAU - Yen, Ko
AU  - Yen K
AUID- ORCID: 0000-0003-3527-5189
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
FAU - Liu, Chen-Chung
AU  - Liu CC
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
AD  - Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch,
      Hsin-Chu, Taiwan.
FAU - Lin, Yi-Ting
AU  - Lin YT
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Chien, Yi-Ling
AU  - Chien YL
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Hsieh, Ming H
AU  - Hsieh MH
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Liu, Chih-Min
AU  - Liu CM
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Hwang, Tzung-Jeng
AU  - Hwang TJ
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Liao, Wei-Hsiang
AU  - Liao WH
AUID- ORCID: 0000-0003-0132-6435
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
FAU - Hwu, Hai-Gwo
AU  - Hwu HG
AUID- ORCID: 0000-0002-2582-2807
AD  - Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
AD  - Department of Psychiatry, College of Medicine, National Taiwan University,
      Taipei, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20220301
PL  - New Zealand
TA  - Neuropsychiatr Dis Treat
JT  - Neuropsychiatric disease and treatment
JID - 101240304
PMC - PMC8898187
OTO - NOTNLM
OT  - antipsychotics
OT  - attitude
OT  - discontinuation
OT  - first-episode psychosis
OT  - questionnaire
OT  - remission
COIS- All authors declare no conflicts of interest.
EDAT- 2022/03/10 06:00
MHDA- 2022/03/10 06:01
CRDT- 2022/03/09 08:43
PHST- 2021/09/28 00:00 [received]
PHST- 2021/12/26 00:00 [accepted]
PHST- 2022/03/09 08:43 [entrez]
PHST- 2022/03/10 06:00 [pubmed]
PHST- 2022/03/10 06:01 [medline]
AID - 339866 [pii]
AID - 10.2147/NDT.S339866 [doi]
PST - epublish
SO  - Neuropsychiatr Dis Treat. 2022 Mar 1;18:465-475. doi: 10.2147/NDT.S339866.
      eCollection 2022.

PMID- 29706449
OWN - NLM
STAT- MEDLINE
DCOM- 20190520
LR  - 20190520
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 201
DP  - 2018 Nov
TI  - Predictors of 'all-cause discontinuation' of initial oral antipsychotic
      medication in first episode psychosis.
PG  - 287-293
LID - S0920-9964(18)30240-8 [pii]
LID - 10.1016/j.schres.2018.04.027 [doi]
AB  - INTRODUCTION: Discontinuation of the initial oral antipsychotic prescribed for a
      first episode of psychosis (FEP) can derail outcome. Our objective was to examine
      the rate of and time to all-cause discontinuation of the first antipsychotic
      prescribed and the factors influencing such discontinuation. METHODS: In a sample
      of 390 FEP patients, we estimated the rate of and time to discontinuation of the
      initial antipsychotic over a one-year period. The effects of a number of putative
      predictors of discontinuation were estimated using regression analyses. RESULTS:
      Rate of discontinuation of the first antipsychotic was 72%, with no difference
      between the 3 investigated antipsychotics (olanzapine (73%), risperidone (68%)
      and aripiprazole (75%)), (χ(2) (2) = 1.89, p = 0.388). Mean time to
      discontinuation was 7.2 (4.6) months and was not different among the three
      antipsychotics (Log-rank χ(2) (2) = 0.257, p = 0.879). Binary logistic regression
      showed that higher positive and negative symptoms remission and baseline
      functioning were associated with lower rates of discontinuation (Nagelkerke
      R(2) = 0.36, χ(2) (10) = 66.9, p < 0.001). Multiple linear regression showed the
      same predictors, in addition to male gender and less weight gain per month of
      exposure to the initial antipsychotic, to be associated with longer time to
      discontinuation (adjusted R(2) = 0.336, F (9, 219) = 13.8, p < 0.001).
      CONCLUSION: Discontinuation of the initial antipsychotic is a major concern in
      the course of treating FEP. Symptom relief, better functioning and lower side
      effects appear to be the major factors associated with continuing an
      antipsychotic medication.
CI  - Copyright © 2018 Elsevier B.V. All rights reserved.
FAU - Mustafa, Sally
AU  - Mustafa S
AD  - Douglas Mental Health University Institute, Montreal, QC, Canada.
FAU - Joober, Ridha
AU  - Joober R
AD  - Department of Psychiatry, McGill University, Montréal, QC, Canada; Douglas Mental
      Health University Institute, Montreal, QC, Canada.
FAU - Lepage, Martin
AU  - Lepage M
AD  - Department of Psychiatry, McGill University, Montréal, QC, Canada; Douglas Mental
      Health University Institute, Montreal, QC, Canada.
FAU - Iyer, Srividya
AU  - Iyer S
AD  - Department of Psychiatry, McGill University, Montréal, QC, Canada; Douglas Mental
      Health University Institute, Montreal, QC, Canada.
FAU - Shah, Jai
AU  - Shah J
AD  - Department of Psychiatry, McGill University, Montréal, QC, Canada; Douglas Mental
      Health University Institute, Montreal, QC, Canada.
FAU - Malla, Ashok
AU  - Malla A
AD  - Department of Psychiatry, McGill University, Montréal, QC, Canada; Douglas Mental
      Health University Institute, Montreal, QC, Canada. Electronic address:
      [email protected].
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20180426
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Administration, Oral
MH  - Antipsychotic Agents/*administration & dosage/adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Patient Acceptance of Health Care/psychology
MH  - Prognosis
MH  - Prospective Studies
MH  - Psychotic Disorders/diagnosis/*drug therapy/psychology
MH  - Remission Induction
MH  - Weight Gain/drug effects
MH  - Young Adult
OTO - NOTNLM
OT  - Baseline functioning
OT  - Discontinuation
OT  - Initial antipsychotic
OT  - Remission
OT  - Weight gain
EDAT- 2018/05/01 06:00
MHDA- 2019/05/21 06:00
CRDT- 2018/05/01 06:00
PHST- 2017/08/22 00:00 [received]
PHST- 2018/01/08 00:00 [revised]
PHST- 2018/04/14 00:00 [accepted]
PHST- 2018/05/01 06:00 [pubmed]
PHST- 2019/05/21 06:00 [medline]
PHST- 2018/05/01 06:00 [entrez]
AID - S0920-9964(18)30240-8 [pii]
AID - 10.1016/j.schres.2018.04.027 [doi]
PST - ppublish
SO  - Schizophr Res. 2018 Nov;201:287-293. doi: 10.1016/j.schres.2018.04.027. Epub 2018
      Apr 26.

PMID- 32033579
OWN - NLM
STAT- MEDLINE
DCOM- 20201123
LR  - 20220412
IS  - 1745-6215 (Electronic)
IS  - 1745-6215 (Linking)
VI  - 21
IP  - 1
DP  - 2020 Feb 7
TI  - To continue or not to continue? Antipsychotic medication maintenance versus
      dose-reduction/discontinuation in first episode psychosis: HAMLETT, a pragmatic
      multicenter single-blind randomized controlled trial.
PG  - 147
LID - 10.1186/s13063-019-3822-5 [doi]
LID - 147
AB  - BACKGROUND: Antipsychotic medication is effective for symptomatic treatment in
      schizophrenia-spectrum disorders. After symptom remission, continuation of
      antipsychotic treatment is associated with lower relapse rates and lower symptom
      severity compared to dose reduction/discontinuation. Therefore, most guidelines
      recommend continuation of treatment with antipsychotic medication for at least 1
      year. Recently, however, these guidelines have been questioned as one study has
      shown that more patients achieved long-term functional remission in an early
      discontinuation condition-a finding that was not replicated in another recently
      published long-term study. METHODS/DESIGN: The HAMLETT (Handling Antipsychotic
      Medication Long-term Evaluation of Targeted Treatment) study is a multicenter
      pragmatic single-blind randomized controlled trial in two parallel conditions
      (1:1) investigating the effects of continuation versus
      dose-reduction/discontinuation of antipsychotic medication after remission of a
      first episode of psychosis (FEP) on personal and social functioning, psychotic
      symptom severity, and health-related quality of life. In total 512 participants
      will be included, aged between 16 and 60 years, in symptomatic remission from a
      FEP for 3-6 months, and for whom psychosis was not associated with severe or
      life-threatening self-harm or violence. Recruitment will take place at 24 Dutch
      sites. Patients are randomized (1:1) to: continuation of antipsychotic medication
      until at least 1 year after remission (original dose allowing a maximum reduction
      of 25%, or another antipsychotic drug in similar dose range); or gradual dose
      reduction till eventual discontinuation of antipsychotics according to a tapering
      schedule. If signs of relapse occur in this arm, medication dose can be increased
      again. Measurements are conducted at baseline, at 3, and 6 months post-baseline,
      and yearly during a follow-up period of 4 years. DISCUSSION: The HAMLETT study
      will offer evidence to guide patients and clinicians regarding questions
      concerning optimal treatment duration and when to taper off medication after
      remission of a FEP. Moreover, it may provide patient characteristics associated
      with safe dose reduction with a minimal risk of relapse. TRIAL STATUS: Protocol
      version 1.3, October 2018. The study is active and currently recruiting patients
      (since September 2017), with the first 200 participants by the end of 2019. We
      anticipate completing recruitment in 2022 and final assessments (including
      follow-up 3.5 years after phase one) in 2026. TRIAL REGISTRATION: European
      Clinical Trials Database, EudraCT number 2017-002406-12. Registered 7 June 2017.
FAU - Begemann, Marieke J H
AU  - Begemann MJH
AUID- ORCID: 0000-0001-6448-2799
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands. [email protected].
FAU - Thompson, Ilse A
AU  - Thompson IA
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
FAU - Veling, Wim
AU  - Veling W
AD  - Department of Psychiatry, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
FAU - Gangadin, Shiral S
AU  - Gangadin SS
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
AD  - Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center
      Utrecht, Utrecht, The Netherlands.
FAU - Geraets, Chris N W
AU  - Geraets CNW
AD  - Department of Psychiatry, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
FAU - van 't Hag, Erna
AU  - van 't Hag E
AD  - Department of Psychiatry, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
FAU - Müller-Kuperus, Sanne J
AU  - Müller-Kuperus SJ
AD  - Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center
      Utrecht, Utrecht, The Netherlands.
FAU - Oomen, Priscilla P
AU  - Oomen PP
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
FAU - Voppel, Alban E
AU  - Voppel AE
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
FAU - van der Gaag, Mark
AU  - van der Gaag M
AD  - Parnassia Psychiatric Institute, The Hague, The Netherlands.
AD  - Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
FAU - Kikkert, Martijn J
AU  - Kikkert MJ
AD  - Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Van Os, Jim
AU  - Van Os J
AD  - Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center
      Utrecht, Utrecht, The Netherlands.
AD  - Department of Psychiatry and Neuropsychology, School for Mental Health and
      Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The
      Netherlands.
AD  - Department of Psychosis Studies, Institute of Psychiatry, Psychology &
      Neuroscience, King's College London, London, UK.
FAU - Smit, H Filip E
AU  - Smit HFE
AD  - Department of Epidemiology and Biostatistics, Amsterdam Public Health Research
      Institute, VU University Medical Center, Amsterdam, The Netherlands.
AD  - Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public
      Health Research Institute, VU University Medical Center, Amsterdam, The
      Netherlands.
AD  - Centre of Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental
      Health), Utrecht, The Netherlands.
FAU - Knegtering, Rikus H
AU  - Knegtering RH
AD  - Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands.
AD  - Rob Giel Research Center, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
FAU - Wiersma, Sybren
AU  - Wiersma S
AD  - Early Intervention Psychosis Team, GGZ inGeest Specialized Mental Health Care,
      Hoofddorp, The Netherlands.
FAU - Stouten, Luyken H
AU  - Stouten LH
AD  - Centre for Early Psychosis, Parnassia Psychiatric Institute, The Hague, The
      Netherlands.
FAU - Gijsman, Harm J
AU  - Gijsman HJ
AD  - Program for Psychosis & Severe Mental Illness, Pro Persona Mental Health,
      Wolfheze, The Netherlands.
FAU - Wunderink, Lex
AU  - Wunderink L
AD  - Department of Psychiatry, University of Groningen, University Medical Center
      Groningen, Groningen, The Netherlands.
AD  - Department of Education and Research, Friesland Mental Health Care Services,
      Leeuwarden, The Netherlands.
FAU - Staring, Anton B P
AU  - Staring ABP
AD  - Department ABC, Altrecht Psychiatric Institute, Utrecht, The Netherlands.
FAU - Veerman, Selene R T
AU  - Veerman SRT
AD  - Community Mental Health, Mental Health Service Noord-Holland Noord, Alkmaar, The
      Netherlands.
FAU - Mahabir, Amrita G S
AU  - Mahabir AGS
AD  - Early Psychosis Team, GGNet, Apeldoorn, The Netherlands.
FAU - Kurkamp, Jörg
AU  - Kurkamp J
AD  - Center for Youth with Psychosis, Mediant ABC Twente, Enschede, The Netherlands.
FAU - Pijnenborg, Gerdina H M
AU  - Pijnenborg GHM
AD  - Department of Psychotic Disorders, GGZ-Drenthe, Assen, The Netherlands.
FAU - Veen, Natalie D
AU  - Veen ND
AD  - GGZ Delfland, Delfland Institute for Mental Health Care, Delft, The Netherlands.
FAU - Marcelis, Machteld
AU  - Marcelis M
AD  - Department of Psychiatry and Neuropsychology, School for Mental Health and
      Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The
      Netherlands.
AD  - Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands.
FAU - Grootens, Koen P
AU  - Grootens KP
AD  - Reinier van Arkel Institute for Mental Health Care, 's Hertogenbosch, The
      Netherlands.
AD  - Radboud University Medical Centre, Nijmegen, The Netherlands.
FAU - Faber, Gunnar
AU  - Faber G
AD  - Yulius, Mental Health Institute, Dordrecht, The Netherlands.
FAU - van Beveren, Nico J
AU  - van Beveren NJ
AD  - Antes Center for Mental Health Care, Rotterdam, The Netherlands.
AD  - Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
AD  - Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
FAU - Been, Agaath
AU  - Been A
AD  - Center for Developmental Disorders, Dimence Institute for Mental Health,
      Deventer, The Netherlands.
FAU - van den Brink, Truus
AU  - van den Brink T
AD  - Early Intervention Team, GGZ Centraal, Amersfoort, The Netherlands.
FAU - Bak, Maarten
AU  - Bak M
AD  - Department of Psychiatry and Neuropsychology, School for Mental Health and
      Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The
      Netherlands.
AD  - Mondriaan Mental Health Care, Heerlen, The Netherlands.
FAU - van Amelsvoort, Therese A M J
AU  - van Amelsvoort TAMJ
AD  - Department of Psychiatry and Neuropsychology, School for Mental Health and
      Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The
      Netherlands.
AD  - Mondriaan Mental Health Care, Heerlen, The Netherlands.
FAU - Ruissen, Andrea
AU  - Ruissen A
AD  - Emergis, Kenniscentrum, Goes, The Netherlands.
FAU - Blanke, Christine
AU  - Blanke C
AD  - Anoiksis, University Medical Center Utrecht, Utrecht, The Netherlands.
FAU - Groen, Karin
AU  - Groen K
AD  - MIND Ypsilon, Organization of Relatives and Carers of People with a Vulnerability
      to Psychosis, The Hague, The Netherlands.
FAU - de Haan, Lieuwe
AU  - de Haan L
AD  - Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam,
      The Netherlands.
FAU - Sommer, Iris E C
AU  - Sommer IEC
AD  - Department of Biomedical Sciences of Cells & Systems, Cognitive Neurosciences,
      University of Groningen, University Medical Center Groningen (UMCG), Groningen,
      The Netherlands.
LA  - eng
GR  - 80-84800-98-41015/ZonMw/
PT  - Clinical Trial Protocol
PT  - Journal Article
DEP - 20200207
PL  - England
TA  - Trials
JT  - Trials
JID - 101263253
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antipsychotic Agents/*administration & dosage/standards
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Practice Guidelines as Topic
MH  - Pragmatic Clinical Trials as Topic
MH  - Psychotic Disorders/diagnosis/*drug therapy
MH  - Quality of Life
MH  - Remission Induction/methods
MH  - Severity of Illness Index
MH  - Single-Blind Method
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC7006112
OTO - NOTNLM
OT  - Antipsychotic medication, first episode psychosis
OT  - Discontinuation
OT  - Maintenance
OT  - Randomized controlled trial
OT  - Tapering, global functioning
OT  - Treatment
COIS- The authors declare that they have no competing interests.
EDAT- 2020/02/09 06:00
MHDA- 2020/11/24 06:00
CRDT- 2020/02/09 06:00
PHST- 2019/04/04 00:00 [received]
PHST- 2019/10/22 00:00 [accepted]
PHST- 2020/02/09 06:00 [entrez]
PHST- 2020/02/09 06:00 [pubmed]
PHST- 2020/11/24 06:00 [medline]
AID - 10.1186/s13063-019-3822-5 [pii]
AID - 3822 [pii]
AID - 10.1186/s13063-019-3822-5 [doi]
PST - epublish
SO  - Trials. 2020 Feb 7;21(1):147. doi: 10.1186/s13063-019-3822-5.

PMID- 18832960
OWN - NLM
STAT- MEDLINE
DCOM- 20090317
LR  - 20220310
IS  - 1538-1145 (Electronic)
IS  - 1527-4160 (Linking)
VI  - 14
IP  - 5
DP  - 2008 Sep
TI  - A review of second-generation antipsychotic discontinuation in first-episode
      psychosis.
PG  - 289-300
LID - 10.1097/01.pra.0000336756.65308.83 [doi]
AB  - "All-causes discontinuation" refers to discontinuation of treatment for any
      reason, and adherence to medication is an important component of this measure.
      Two recent landmark studies suggest that adherence is a major issue in patients
      with first-episode psychosis (FEP) right from the onset of treatment. In this
      review, the incidence, reasons for, and clinical outcomes of medication
      discontinuation in FEP are considered. More than 40% of patients with FEP
      discontinue medication during the first 9 months of treatment, at which point the
      chances of relapse increase dramatically. Findings concerning predictors of
      medication discontinuation in this patient population that have been replicated
      in more than one study include severity of psychopathology, lack of insight into
      illness, negative attitudes towards medications, comorbid substance use, and
      medication side effects. Interventions that have the potential to decrease
      discontinuation rates in patients with psychotic disorders include orally
      disintegrating tablets, long-acting injectable drugs, cognitive-behavioral
      therapy, compliance therapy, family support/intervention, and peer support,
      although these strategies have largely been unexplored in FEP. In addition to the
      question of medication discontinuation in the acute treatment of FEP, another
      important issue is how long patients with FEP should be treated with
      antipsychotics once they have achieved remission; unfortunately, little evidence
      is available to guide the decision as to whether medication should be
      discontinued or maintenance treatment provided in this situation. Studies are
      therefore needed to identify predictors of patients with remitted FEP who are
      less likely to relapse when medication is discontinued. Taken together, the
      findings presented in this article underscore the importance of addressing issues
      related to medication discontinuation as a means of preventing long-term
      morbidity and enhancing remission and functional recovery in FEP.
FAU - Miller, Brian J
AU  - Miller BJ
AD  - Department of Psychiatry and Health Behavior, Medical College of Georgia,
      Augusta, GA 30912, USA. [email protected]
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Psychiatr Pract
JT  - Journal of psychiatric practice
JID - 100901141
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/*therapeutic use
MH  - Cognitive Behavioral Therapy
MH  - Family Therapy
MH  - Humans
MH  - Incidence
MH  - *Psychotic Disorders/epidemiology/psychology/therapy
MH  - Remission Induction
MH  - Severity of Illness Index
MH  - Social Support
MH  - Withholding Treatment/*statistics & numerical data
RF  - 77
EDAT- 2008/10/04 09:00
MHDA- 2009/03/18 09:00
CRDT- 2008/10/04 09:00
PHST- 2008/10/04 09:00 [pubmed]
PHST- 2009/03/18 09:00 [medline]
PHST- 2008/10/04 09:00 [entrez]
AID - 00131746-200809000-00005 [pii]
AID - 10.1097/01.pra.0000336756.65308.83 [doi]
PST - ppublish
SO  - J Psychiatr Pract. 2008 Sep;14(5):289-300. doi:
      10.1097/01.pra.0000336756.65308.83.

PMID- 35935409
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220809
IS  - 1664-0640 (Print)
IS  - 1664-0640 (Electronic)
IS  - 1664-0640 (Linking)
VI  - 13
DP  - 2022
TI  - Tapered discontinuation vs. maintenance therapy of antipsychotic medication in
      patients with first-episode schizophrenia: Obstacles, findings, and lessons
      learned in the terminated randomized clinical trial TAILOR.
PG  - 910703
LID - 10.3389/fpsyt.2022.910703 [doi]
LID - 910703
AB  - AIM: Evidence is insufficient regarding the consequences of discontinuing vs.
      maintaining antipsychotic medication in patients with first-episode
      schizophrenia. Our aim was to examine tapered discontinuation vs. maintenance
      treatment regarding remission of psychotic symptoms and impact on other areas.
      METHODS: Patients included had a diagnosis of schizophrenia, were treated with
      antipsychotic medication, and were in remission of psychotic symptoms.
      Participants were randomized to tapered discontinuation or maintenance treatment
      with antipsychotic medication. Assessments were undertaken at baseline and after
      1-year. The primary outcome was remission of psychotic symptoms without
      antipsychotic medication. RESULTS: The trial was terminated due to insufficient
      recruitment. In total, 29 participants were included: 14 in the
      tapering/discontinuation group and 15 in the maintenance group. Adherence to
      maintenance treatment was poor. At 1-year follow-up, remission of psychotic
      symptoms without antipsychotic medication for 3 months was observed in five
      participants in the tapering/discontinuation group and two in the maintenance
      group. CONCLUSION: Due to insufficient recruitment this study does not provide a
      conclusion on whether unfavorable outcomes or advantages follow tapering of
      antipsychotic medication. Recruitment and adherence to maintenance treatment
      encountered obstacles. Based on experiences from this trial, we discussed
      alternative study designs as consistent evidence is still needed on whether to
      continue or discontinue antipsychotic medication in remitted patients with
      first-episode schizophrenia. CLINICAL TRIAL REGISTRATION:
      https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-000565-23/DK, EU
      Clinical Trials Register-EudraCT no. 2016-000565-23.
CI  - Copyright © 2022 Stürup, Hjorthøj, Albert, Dolmer, Birk, Ebdrup, Eplov, Jensen,
      Vernal, Speyer, Mors and Nordentoft.
FAU - Stürup, Anne Emilie
AU  - Stürup AE
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
FAU - Hjorthøj, Carsten
AU  - Hjorthøj C
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
AD  - Section of Epidemiology, Department of Public Health, University of Copenhagen,
      Copenhagen, Denmark.
FAU - Albert, Nikolai
AU  - Albert N
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
AD  - Psychiatry Øst, Region Sjælland, Roskilde, Denmark.
FAU - Dolmer, Signe
AU  - Dolmer S
AD  - Psychosis Research Unit, Department of Clinical Medicine, Aarhus University
      Hospital, Aarhus, Denmark.
FAU - Birk, Merete
AU  - Birk M
AD  - Psychosis Research Unit, Department of Clinical Medicine, Aarhus University
      Hospital, Aarhus, Denmark.
FAU - Ebdrup, Bjørn H
AU  - Ebdrup BH
AD  - Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre
      Glostrup, University of Copenhagen, Glostrup, Denmark.
AD  - Department of Clinical Medicine, Faculty of Health and Medical Sciences,
      University of Copenhagen, Copenhagen, Denmark.
FAU - Eplov, Lene Falgaard
AU  - Eplov LF
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
FAU - Jensen, Heidi
AU  - Jensen H
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
FAU - Vernal, Ditte Lammers
AU  - Vernal DL
AD  - Unit for Psychiatric Research, Psychiatry, Department of Clinical Medicine,
      Aalborg University Hospital, Aalborg University, Aalborg, Denmark.
FAU - Speyer, Helene
AU  - Speyer H
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
FAU - Mors, Ole
AU  - Mors O
AD  - Psychosis Research Unit, Department of Clinical Medicine, Aarhus University
      Hospital, Aarhus, Denmark.
FAU - Nordentoft, Merete
AU  - Nordentoft M
AD  - Copenhagen Research Center for Mental Health (CORE), Mental Health Center
      Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20220722
PL  - Switzerland
TA  - Front Psychiatry
JT  - Frontiers in psychiatry
JID - 101545006
PMC - PMC9355082
OTO - NOTNLM
OT  - antipsychotics
OT  - design
OT  - discontinuation
OT  - first-episode schizophrenia
OT  - maintenance
OT  - relapse
OT  - remission
OT  - tapering
COIS- BE is part of the Advisory Board of Eli Lilly Denmark A/S, Janssen-Cilag,
      Lundbeck Pharma A/S, and Takeda Pharmaceutical Company Ltd; and has received
      lecture fees from Bristol-Myers Squibb, Otsuka Pharma Scandinavia AB, Eli Lilly
      Company, Boehringer Ingelheim Denmark A/S, and Lundbeck Pharma A/S. DV has
      received speaking fees from Lundbeck. The remaining authors declare that the
      research was conducted in the absence of any commercial or financial
      relationships that could be construed as a potential conflict of interest.
EDAT- 2022/08/09 06:00
MHDA- 2022/08/09 06:01
CRDT- 2022/08/08 03:31
PHST- 2022/04/01 00:00 [received]
PHST- 2022/06/30 00:00 [accepted]
PHST- 2022/08/08 03:31 [entrez]
PHST- 2022/08/09 06:00 [pubmed]
PHST- 2022/08/09 06:01 [medline]
AID - 10.3389/fpsyt.2022.910703 [doi]
PST - epublish
SO  - Front Psychiatry. 2022 Jul 22;13:910703. doi: 10.3389/fpsyt.2022.910703.
      eCollection 2022.