Early Dose Reduction or Discontinuation vs Maintenance Antipsychotics After First Psychotic Episode Remission

What are the short-term effects and long-term effects of early dose reduction or discontinuation (DRD) compared with maintenance treatment for patients remitted from first-episode psychosis?This randomized clinical trial of 347 patients with first-episode psychosis found no difference in patient-rated functioning between conditions; in the short term, those who received DRD had higher risk of relapse and lower quality of life. From 3 years onwards, DRD showed better researcher-rated functioning, with a similar trend for symptom severity.These findings suggest that because medication was similar from 12 months onwards, better longer-term functioning could reflect the learning experience of a guided tapering attempt, rather than direct medication effects.

Corresponding Author: Iris E. Sommer, MD, PhD, Center for Clinical Neuroscience and Cognition, University Medical Center Groningen, Petrus Campersingel 219, 9713 AP Groningen, the Netherlands (i.e.c.sommer@umcg.nl).

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