Whale, Richard, Harris, Michael, Kavanagh, Gail, Wickramasinghe, Vijitha , Jones, Christopher I., Marwaha, Steven, Jethwa, Ketan, Ayadurai, Nirmalan and Thompson, Andrew David (2016) Effectiveness of antipsychotics used in first-episode psychosis : a naturalistic cohort study. BJ Psych Open, 2 (5). pp. 323-329. bjporcpsych002766.. doi:doi: 10.1192/bjpo.bp.116.002766

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Abstract

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.
Declaration of interest
R.W., A.T. and S.M. have received research grant, speaker honoraria and conference attendance funding from all companies marketing antipsychotics.
Copyright and usage
© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Item Type:	Journal Article
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Risperidone, Antipsychotic drugs, Psychoses -- Treatment
Journal or Publication Title:	BJ Psych Open
Publisher:	Royal College of Psychiatrists
ISSN:	2056-4724
Official Date:	September 2016
Dates:	Date Event September 2016 Published 10 October 2016 Available 12 September 2016 Accepted 29 January 2016 Submitted
Volume:	2
Number:	5
Page Range:	pp. 323-329
Article Number:	bjporcpsych002766.
DOI:	doi: 10.1192/bjpo.bp.116.002766
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access

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