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Conference Paper: A double-blind randomized placebo-controlled study of relapse prevention in remitted first-episode psychosis patients following one year of maintenance therapy

TitleA double-blind randomized placebo-controlled study of relapse prevention in remitted first-episode psychosis patients following one year of maintenance therapy
Authors
Issue Date2008
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schres
Citation
The 14th Biennial Winter Workshop on Schizophrenia and Bipolar Disorders, Montreux, Switzerland, 3-7 February 2008. In Schizophrenia Research, 2008, v. 98 suppl., p. 11-12 How to Cite?
AbstractBackground: Currently, there is no consensus regarding how long antipsychotics medication should be continued following a first/single psychotic episode. Long-term maintenance therapy carries side-effects and may not be necessary for some patients. Clinically, patients often request discontinuation after a period of remission. This is one of the first double-blind randomized-controlled studies designed to address the issue. Methods: Patients with DSM-IV schizophrenia and related psychoses (excluding substance induced psychosis) who remitted well following a first/single-episode and had remained well on maintenance medication for 1 year were randomized to receive either maintenance therapy with quetiapine (400 mg/day), or placebo for 12 months. Relapse was defined by the presence of (i) an increase in at least one of the following Positive and Negative Syndrome Scale (PANSS) psychotic symptom items to a threshold score (delusion, hallucinatory behaviour, conceptual disorganization, unusual thought content, suspiciousness); (ii) Clinical Global Impression (CGI) Severity of Illness 3 or above and (iii) CGI Improvement 5 or above. Results: 178 patients were randomized. 144 patients completed the study (80.9%). The relapse rate was 35% (31/89) for the maintenance group and 66% (59/89) for the placebo group (log-rank test, χ2 = 15.858, p < 0.001). Relapse was not related to age or gender. Other significant predictors of relapse include medication status, pre-morbid schizotypal traits, verbal memory and soft neurological signs. Conclusions: This study provides new data for relapse risks in remitted first-episode psychosis patients following 1 year of maintenance therapy. There is a substantial risk of relapse if medication is discontinued. Maintenance medication halves relapse rate. On the other hand, 34% of patients discontinued medication and remained well. Explorations of potential predictors of relapse may help further to estimate risks so that an informed decision about medication discontinuation can be made. Acknowledgement: This study was supported by an investigator-initiated study award from AstraZeneca and the Research Grants Council, Hong Kong (Project number: 765505).
Persistent Identifierhttp://hdl.handle.net/10722/81581
ISSN
2015 Impact Factor: 4.453
2015 SCImago Journal Rankings: 2.304

 

DC FieldValueLanguage
dc.contributor.authorChen, EYHen_HK
dc.contributor.authorHui, CLMen_HK
dc.contributor.authorLam, Men_HK
dc.contributor.authorLaw, CWen_HK
dc.contributor.authorChiu, CPYen_HK
dc.contributor.authorChung, DWSen_HK
dc.contributor.authorTso, Sen_HK
dc.contributor.authorPang, EPFen_HK
dc.contributor.authorChan, KTen_HK
dc.contributor.authorWong, YCen_HK
dc.contributor.authorMo, Fen_HK
dc.contributor.authorChan, KPMen_HK
dc.contributor.authorHung, SFen_HK
dc.contributor.authorHoner, WGen_HK
dc.date.accessioned2010-09-06T08:19:31Z-
dc.date.available2010-09-06T08:19:31Z-
dc.date.issued2008en_HK
dc.identifier.citationThe 14th Biennial Winter Workshop on Schizophrenia and Bipolar Disorders, Montreux, Switzerland, 3-7 February 2008. In Schizophrenia Research, 2008, v. 98 suppl., p. 11-12en_HK
dc.identifier.issn0920-9964en_HK
dc.identifier.urihttp://hdl.handle.net/10722/81581-
dc.description.abstractBackground: Currently, there is no consensus regarding how long antipsychotics medication should be continued following a first/single psychotic episode. Long-term maintenance therapy carries side-effects and may not be necessary for some patients. Clinically, patients often request discontinuation after a period of remission. This is one of the first double-blind randomized-controlled studies designed to address the issue. Methods: Patients with DSM-IV schizophrenia and related psychoses (excluding substance induced psychosis) who remitted well following a first/single-episode and had remained well on maintenance medication for 1 year were randomized to receive either maintenance therapy with quetiapine (400 mg/day), or placebo for 12 months. Relapse was defined by the presence of (i) an increase in at least one of the following Positive and Negative Syndrome Scale (PANSS) psychotic symptom items to a threshold score (delusion, hallucinatory behaviour, conceptual disorganization, unusual thought content, suspiciousness); (ii) Clinical Global Impression (CGI) Severity of Illness 3 or above and (iii) CGI Improvement 5 or above. Results: 178 patients were randomized. 144 patients completed the study (80.9%). The relapse rate was 35% (31/89) for the maintenance group and 66% (59/89) for the placebo group (log-rank test, χ2 = 15.858, p < 0.001). Relapse was not related to age or gender. Other significant predictors of relapse include medication status, pre-morbid schizotypal traits, verbal memory and soft neurological signs. Conclusions: This study provides new data for relapse risks in remitted first-episode psychosis patients following 1 year of maintenance therapy. There is a substantial risk of relapse if medication is discontinued. Maintenance medication halves relapse rate. On the other hand, 34% of patients discontinued medication and remained well. Explorations of potential predictors of relapse may help further to estimate risks so that an informed decision about medication discontinuation can be made. Acknowledgement: This study was supported by an investigator-initiated study award from AstraZeneca and the Research Grants Council, Hong Kong (Project number: 765505).-
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schresen_HK
dc.relation.ispartofSchizophrenia Researchen_HK
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Schizophrenia Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Schizophrenia Research, [VOL 98, ISSUE Supplement, 2008] DOI 10.1016/j.schres.2007.12.020en_HK
dc.titleA double-blind randomized placebo-controlled study of relapse prevention in remitted first-episode psychosis patients following one year of maintenance therapyen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailChen, EYH: eyhchen@hku.hken_HK
dc.identifier.emailHui, CLM: h0007716@graduate.hku.hken_HK
dc.identifier.emailLaw, CW: lawcw@HKUCC.hku.hken_HK
dc.identifier.emailChiu, CPY: chiupyc@hkucc.hku.hk, cindychiu@gmail.comen_HK
dc.identifier.authorityChen, EYH=rp00392en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.schres.2007.12.020-
dc.identifier.hkuros142218en_HK
dc.identifier.hkuros143561-
dc.identifier.volume98-
dc.identifier.issuesuppl.-
dc.identifier.spage11-
dc.identifier.epage12-
dc.publisher.placeNetherlands-

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