The Lancet Psychiatry
Fecha de publicación: October 2020
Autores: Helene Speyer, Marieke Begemann, Nikolai Albert, Amber Weller, Merete Nordentoft, Wim Veling
Background: There is a pressing need for knowledge about the effects of discontinuing antipsychotic medication in patients with remitted psychosis. Patients usually ask how long they will have to continue, and many stop taking medication, hoping that they can manage without it. As health-care professionals, we are responsible for providing evidence-based counselling for the initiation and discontinuation of medication, to help patients make informed choices. However, the two randomised trials that have compared a maintenance strategy with an early dose reduction strategy after remission in patients with first-episode psychosis, have reported contradictory results. The Dutch MESIFOS study found that more patients achieved long term functional remission in the group who were assigned to early discontinuation of antipsychotic medication after 6 months of remission, compared with those who were assigned to maintenance treatment. However, a recent study from Hong Kong did not replicate this finding in a larger sample.