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Effectiveness of antipsychotics used in first-episode psychosis: a naturalistic cohort study

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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 Thompson
Background: 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 Open

ISSN

2056-4724

Publisher

Royal College of Psychiatrists

Issue

5

Volume

2

Page range

323-329

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-10-18

First Open Access (FOA) Date

2016-10-18

First Compliant Deposit (FCD) Date

2016-10-18

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