Maintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis: randomised controlled trial

Objective To study rates of relapse in remitted patients with first episode psychosis who either continued or discontinued antipsychotic drugs after at least one year of maintenance treatment.Design 12 month randomised, double blind, placebo controlled trial.Setting Early psychosis outpatient clinic...

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Bibliographic Details
Published in:BMJ 2010-08, Vol.341 (7770), p.435-435
Main Authors: Chen, Eric Y H, Hui, Christy L M, Lam, May M L, Chiu, Cindy P Y, Law, C W, Chung, Dicky W S, Tso, Steve, Pang, Edwin P F, Chan, K T, Wong, Y C, Mo, Flora Y M, Chan, Kathy P M, Yao, T J, Hung, S F, Honer, William G
Format: Article
Language:English
Subjects:
Antipsychotic Agents - therapeutic use
Antipsychotic drugs
Antipsychotics
Chronic illnesses
Clinical trials
Clinical Trials (Epidemiology)
Dibenzothiazepines - therapeutic use
Discontinued
Double-Blind Method
Drug development
Drugs: Psychiatry
Epidemiology
Evidence-based medicine
Female
First time
Hallucinations
High functioning
Humans
Male
Medical treatment
Patients
Placebos
Psychiatry
Psychosis
Psychotherapy
Psychotic Disorders (Incl Schizophrenia)
Psychotic Disorders - drug therapy
Psychotropic drugs
Quetiapine
Quetiapine Fumarate
Recurrence
Relapse
Schizophrenia
Substance abuse treatment
Survival analysis
Symptoms
Time Factors
Treatment Outcome
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Summary:Objective To study rates of relapse in remitted patients with first episode psychosis who either continued or discontinued antipsychotic drugs after at least one year of maintenance treatment.Design 12 month randomised, double blind, placebo controlled trial.Setting Early psychosis outpatient clinics in Hong Kong.Participants 178 patients with first episode psychosis who had received at least one year of antipsychotic drug treatment between September 2003 and July 2006 and had no positive symptoms of psychosis.Interventions Patients received either maintenance treatment with quetiapine (400 mg/day) or placebo and were followed up for the next 12 months or until a relapse occurred.Main outcome measure Relapse assessed monthly and defined as re-emergence of psychotic symptoms (delusions, conceptual disorganisation, hallucinations, suspiciousness, and unusual thought content) according to predefined thresholds.Results 178 patients were randomised (89 to quetiapine and 89 to placebo). The Kaplan-Meier estimate of the risk of relapse at 12 months was 41% (95% confidence interval 29% to 53%) for the quetiapine group and 79% (68% to 90%) for the placebo group (P
ISSN:0959-8138
0959-8146
0959-535X
1468-5833
1756-1833
DOI:10.1136/bmj.c4024