Differences

Last edited on October 10, 2023

This shows you the differences between two versions of the page.

--- meds:antipsychotics:home [on October 10, 2023]
psychdb [Length of Treatment]
+++ meds:antipsychotics:home [on October 10, 2023]
psychdb [Length of Treatment]
@@ Line 99: / Line 99: @@
 Antipsychotics have a relatively quick onset of action and patients begin responding within 1 week.[([[https://www.ncbi.nlm.nih.gov/pubmed/14662555|Agid, O., Kapur, S., Arenovich, T., & Zipursky, R. B. (2003). Delayed-onset hypothesis of antipsychotic action: a hypothesis tested and rejected. Archives of general psychiatry, 60(12), 1228-1235.]])] Patients usually first have improved sleep due to the sedating effects of antipsychotics, followed by decreased anxiety occurs from resolution of the psychotic symptoms. Despite pharmaceutical company marketing, there is no evidence that first and second generation antipsychotics differ in efficacy. The only exception to this is clozapine, which is the gold-standard medication for treatment-resistant schizophrenia, and has the lowest re-hospitalization rate compared to all other antipsychotics.
-w==== Length of Treatment ====
+w
+==== Length of Treatment ====
 <alert type="info" icon="fa fa-book fa-lg fa-fw">
 See also:
@@ Line 111: / Line 112: @@
   * Yet other retrospective studies have shown that more breaks in antipsychotic treatments may result in greater risk of relapse and longer time to remission.[([[https://pubmed.ncbi.nlm.nih.gov/27745754/|Winton-Brown, T. T., Elanjithara, T., Power, P., Coentre, R., Blanco-Polaina, P., & McGuire, P. (2017). Five-fold increased risk of relapse following breaks in antipsychotic treatment of first episode psychosis. Schizophrenia research, 179, 50-56.]])]
   * Practically speaking, however, clinicians and researchers are still unable to discern which populations will do well with an antipsychotic taper, and those who would worsen symptomatically.
-  * More studies are needed to investigate these very important clinical questions.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980442/|Murray, R. M., & Di Forti, M. (2018). Increasing expectations and knowledge require a more subtle use of prophylactic antipsychotics. World Psychiatry, 17(2), 161.]])][([[https://joannamoncrieff.com/2016/03/02/new-research-into-antipsychotic-discontinuation-and-reduction-the-radar-programme/|Dr. Joanna Moncrieff - joannamoncrieff.com]])] Other more recent studies have shown that the risk of relapse after antipsychotic discontinuation does not decrease over time, and that antipsychotic use is associated with increased survival.[([[https://www.ncbi.nlm.nih.gov/pubmed/29621900|Tiihonen, J., Tanskanen, A., & Taipale, H. (2018). 20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia. American Journal of Psychiatry, appi-ajp.]])]
     * The 2023 RADAR Trial found that slow, supported dose reduction of antipsychotics was associated with a higher risk for relapse and did not result in improved social outcomes.[([[https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00258-4/fulltext|Moncrieff, J., Crellin, N., Stansfeld, J., Cooper, R., Marston, L., Freemantle, N., ... & Priebe, S. (2023). Antipsychotic dose reduction and discontinuation versus maintenance treatment in people with schizophrenia and other recurrent psychotic disorders in England (the RADAR trial): an open, parallel-group, randomised controlled trial. The Lancet Psychiatry.]])]
-  * Thus, long-term antipsychotic use for treating first-episode schizophrenia for the majority of patients remains a the most evidence-based practice, as the relapse rates are greater than 80% with medication-discontinuation after several years.
+    * More studies are needed to investigate these very important clinical questions.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980442/|Murray, R. M., & Di Forti, M. (2018). Increasing expectations and knowledge require a more subtle use of prophylactic antipsychotics. World Psychiatry, 17(2), 161.]])][([[https://joannamoncrieff.com/2016/03/02/new-research-into-antipsychotic-discontinuation-and-reduction-the-radar-programme/|Dr. Joanna Moncrieff - joannamoncrieff.com]])] Other more recent studies have shown that the risk of relapse after antipsychotic discontinuation does not decrease over time, and that antipsychotic use is associated with increased survival.[([[https://www.ncbi.nlm.nih.gov/pubmed/29621900|Tiihonen, J., Tanskanen, A., & Taipale, H. (2018). 20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia. American Journal of Psychiatry, appi-ajp.]])]
-    * Relapse involves hospitalization, recurrent psychosis, and significant psychosocial impact, and this needs to be weighed carefully against discontinuation of medication.
+  * Relapse involves hospitalization, recurrent psychosis, and significant psychosocial impact, and this needs to be weighed carefully against discontinuation of medication.
+    * Thus, long-term antipsychotic use for treating first-episode schizophrenia for the majority of patients remains the most evidence-based practice, as the relapse rates are greater than 80% with medication-discontinuation after several years.
 ==== Long-Acting Injectables ====
 <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">