Antipsychotic Prophylaxis after First Psychotic Episode: How Long?

Once in a while some really clinical relevant results in research is published. Picture this: first time psychoses, recovered with antipsychotics. Still stable after one year. Should we discontinue the antipsychotic medication? Nope, discontinuation of the antipsychotic in first time psychotic patients after one year increases the risk of relapse.

After one year patients were gradually withdrawn from medication (n=11) and 9 patients continued their antipsychotic regimen. Due to the amount of patients relapsing after discontinuation the tial was ended prematurely.

During the trial it appeared that, in contrast with continuation, gradual withdrawal from antipsychotic medication was almost invariably followed by relapse leading to reinstatement of antipsychotic therapy. Further randomisation to discontinuation was therefore considered unethical and recruitment was terminated prematurely

You can read the publication here: Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients: results from an aborted randomised trial and mini meta-analysis. It’s the second chapter of the PhD thesis of Geartsje Boonstra. In conclusion small but excellent and clinical relevant research, not only statistically significant.

Boonstra, G., Burger, H., Grobbee, D., & Kahn, R. (2010). Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients: Results from an aborted randomised trial International Journal of Psychiatry in Clinical Practice, 1-7 DOI: 10.3109/13651501.2010.534801