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Effectiveness of antipsychotics used in first-episode psychosis: a naturalistic cohort study
journal contribution
posted on 2023-06-09, 03:35 authored by Richard Whale, Michael Harris, Gail Kavanagh, Vijitha Wickramasinghe, Chris JonesChris Jones, Steven Marwaha, Ketan Jethwa, Nirmalan Ayadurai, Andrew ThompsonBackground: One year of antipsychotic treatment from symptom remission is recommended following a first episode of psychosis (FEP). Aims: To investigate the effectiveness of commonly used antipsychotic medications in FEP. Method: A retrospective cohort study of naturalistic treatment of patients (N=460) accepted by FEP services across seven UK sites. Treatment initiation to all-cause discontinuation determined from case files. Results: Risk of treatment discontinuation is greatest within 3 months of treatment initiation. Risperidone had longest median survival time. No significant differences were observed in time to discontinuation between commonly used antipsychotics on multivariable Cox regression analysis. Poor adherence and efficacy failure were the most common reasons for discontinuation. Conclusions: Effectiveness differences appear not to be a current reason for antipsychotic choice in FEP. Adherence strategies and weighing up likely adverse effects should be the clinical focus.
History
Publication status
- Published
File Version
- Published version
Journal
BJPsych OpenISSN
2056-4724Publisher
Royal College of PsychiatristsExternal DOI
Issue
5Volume
2Page range
323-329Department affiliated with
- Primary Care and Public Health Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2016-10-18First Open Access (FOA) Date
2016-10-18First Compliant Deposit (FCD) Date
2016-10-18Usage metrics
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