Gaebel, Wolfgang, Riesbeck, Mathias, Woelwer, Wolfgang, Klimke, Ansgar ORCID: 0000-0002-1160-5270, Eickhoff, Matthias, von Wilmsdorff, Martina, de Millas, Walter, Maier, Wolfgang, Ruhrmann, Stephan ORCID: 0000-0002-6022-2364, Falkai, Peter ORCID: 0000-0003-2873-8667, Sauer, Heinrich, Schmitt, Andrea ORCID: 0000-0002-5426-4023, Riedel, Michael, Klingberg, Stefan ORCID: 0000-0001-8081-7181 and Moeller, Hans-Juergen (2016). Predictors for symptom re-exacerbation after targeted stepwise drug discontinuation in first-episode schizophrenia Results of the first-episode study within the German research network on schizophrenia. Schizophr. Res., 170 (1). S. 168 - 177. AMSTERDAM: ELSEVIER. ISSN 1573-2509

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Abstract

Background: After a first episode in schizophrenia guidelines recommend antipsychotic maintenance treatment (MT) for at least 1 year. Recent RCTs on subsequent targeted intermittent treatment (IT) after stepwise drug discontinuation yielded noticeably higher relapse rates than during MT also in first-episode patients. Nevertheless, about 50% of patients remain stable under IT. Given the potential adverse effects of antipsychotics and the preference of many patients to discontinue drugs, valid predictors for the feasibility of IT are urgently needed to support decision making. Methods: Based on a one-year RCT phase comparing MT with IT in first-episode patients after 1 year of MT, conducted within the German Research Network on Schizophrenia (GRNS), predictors for deterioration under IT in 19 feasible patients were identified by logistic regression analysis. Results: Deterioration occurred in 10 patients (52.6%). Univariate analyses indicated a lower PANSS positive score after acute treatment as well as after one year of MT as significant predictors; in multivariate logistic regression, in addition to the lower PANSS positive score after acute treatment, reaching enduring remission and having had a deterioration both during MT evolved as significant predictors and indicate a higher risk for deterioration. Conclusions: Although limited by the small sample size, our findings suggest that patients who show a favorable response and full and enduring symptom remission during antipsychotic treatment, as well as those with marked deterioration despite MT should rather be recommended to remain on treatment because they are at higher risk for symptom re-exacerbation after (stepwise) drug discontinuation. (C) 2015 Elsevier B.V. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gaebel, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riesbeck, MathiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Woelwer, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klimke, AnsgarUNSPECIFIEDorcid.org/0000-0002-1160-5270UNSPECIFIED
Eickhoff, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Wilmsdorff, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Millas, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maier, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruhrmann, StephanUNSPECIFIEDorcid.org/0000-0002-6022-2364UNSPECIFIED
Falkai, PeterUNSPECIFIEDorcid.org/0000-0003-2873-8667UNSPECIFIED
Sauer, HeinrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitt, AndreaUNSPECIFIEDorcid.org/0000-0002-5426-4023UNSPECIFIED
Riedel, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klingberg, StefanUNSPECIFIEDorcid.org/0000-0001-8081-7181UNSPECIFIED
Moeller, Hans-JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-293411
DOI: 10.1016/j.schres.2015.10.024
Journal or Publication Title: Schizophr. Res.
Volume: 170
Number: 1
Page Range: S. 168 - 177
Date: 2016
Publisher: ELSEVIER
Place of Publication: AMSTERDAM
ISSN: 1573-2509
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RANDOMIZED CONTROLLED-TRIAL; DEPRESSION RATING-SCALE; MAINTENANCE TREATMENT; MEDICATION DISCONTINUATION; SUPERSENSITIVITY PSYCHOSIS; RELAPSE; RISPERIDONE; HALOPERIDOL; REMISSION; COSTMultiple languages
PsychiatryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/29341

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