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Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis
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Thompso, Andrew D., Singh, Swaran P. and Birchwood, M. J. (2016) Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis. Early Intervention in Psychiatry, 10 (4). pp. 355-361. doi:10.1111/eip.12244 ISSN 1751-7885.
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Official URL: http://dx.doi.org/10.1111/eip.12244
Abstract
Aims
Discontinuation of antipsychotics following remission in first episode psychosis (FEP) is a contentious area of practice. We aimed to investigate the views of early psychosis clinicians on this important clinical question.
Methods
We designed an 11 question online survey on medication discontinuation following remission of symptoms in FEP. The questionnaire was distributed to early intervention team workers in England and Wales via members of the National Early Psychosis Network who were requested to distribute it to their teams.
Results
We received 172 questionnaire responses; 37% were nurses, 33% doctors, 11% psychologists and 19% were other allied health professionals. The average years of experience in psychiatry was 16.9. 75.4% of respondents thought that greater than 60% of patients would like to be considered for guided medication reduction/discontinuation. Only 31.4% of respondents said that medication should be continued for over a year following remission. 61.4% of respondents felt that the quality of life of individuals was better in those who stop medication following remission. There was a significant difference in the response of professional groups to this question. 82.6% of respondents said they would be happy to support their patients in participating in a randomized trial of graded antipsychotic reduction/discontinuation versus maintenance medication.
Conclusions
The views of clinicians regarding prophylactic antipsychotic medication following remission in FEP are much less conservative than those in current guidelines; concern was expressed by many about the impact of antipsychotic medication on quality of life. A randomized trial of maintenance antipsychotic medication versus graded reduction/discontinuation is feasible and has considerable clinician support.
| Item Type: | Journal Article | ||||||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Psychoses--Treatment, Antipsychotic drugs | ||||||||||
| Journal or Publication Title: | Early Intervention in Psychiatry | ||||||||||
| Publisher: | Wiley-Blackwell Publishing Asia | ||||||||||
| ISSN: | 1751-7885 | ||||||||||
| Official Date: | August 2016 | ||||||||||
| Dates: |
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| Volume: | 10 | ||||||||||
| Number: | 4 | ||||||||||
| Page Range: | pp. 355-361 | ||||||||||
| DOI: | 10.1111/eip.12244 | ||||||||||
| Status: | Peer Reviewed | ||||||||||
| Publication Status: | Published | ||||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) |
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