Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review

Craig Karson,1 Ruth A Duffy,2 Anna Eramo,3 Anna-Greta Nylander,4 Steve J Offord5 1CNK Consultants, Delray Beach, FL, 2Medical Affairs – Neuroscience, Otsuka America Pharmaceutical, Inc., Princeton, NJ, 3Medical Affairs & Phase IV Clinical Affairs, Lundbeck LLC, Deerfield, IL, USA;...

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Autores principales:	Karson C, Duffy RA, Eramo A, Nylander AG, Offord SJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	cognition first-episode psychosis long-term outcome relapse remission schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ed9f8cc055374076827f5e2c74dd0a90
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spelling	oai:doaj.org-article:ed9f8cc055374076827f5e2c74dd0a902021-12-02T02:00:09ZLong-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review1178-2021https://doaj.org/article/ed9f8cc055374076827f5e2c74dd0a902016-01-01T00:00:00Zhttps://www.dovepress.com/long-term-outcomes-of-antipsychotic-treatment-in-patients-with-first-e-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Craig Karson,1 Ruth A Duffy,2 Anna Eramo,3 Anna-Greta Nylander,4 Steve J Offord5 1CNK Consultants, Delray Beach, FL, 2Medical Affairs – Neuroscience, Otsuka America Pharmaceutical, Inc., Princeton, NJ, 3Medical Affairs & Phase IV Clinical Affairs, Lundbeck LLC, Deerfield, IL, USA; 4Medical Affairs Aripiprazole, H Lundbeck A/S, Valby, Denmark; 5Medical Affairs, Otsuka America Pharmaceutical, Inc., Princeton, NJ, USA Background: Treatment during first-episode psychosis (FEP) or early schizophrenia may affect the rates of relapse and remission, as well as cognitive functioning, over time. Prolonged duration of psychosis is associated with a poor prognosis, but the effects of treatment in patients with FEP or early schizophrenia on the long-term outcomes are not well defined. Objective: To understand the long-term effects of treatment with antipsychotic agents on remission, relapse, and cognition in patients with FEP or early schizophrenia. Methods: Using PubMed and Scopus databases, a systematic review was undertaken of articles published between January 1, 2000, and May 20, 2015, that reported randomized and nonrandomized prospective clinical trials on the long-term effects of oral or long-acting injectable antipsychotics on measures of relapse, remission, or cognition in patients with FEP or early schizophrenia. For comparative purposes, trials reporting the effects of later intervention with antipsychotics in patients with longer disease history were also evaluated. Titles, abstracts, and full-text articles were independently screened for eligibility by all the authors based on the predefined criteria. Results: Nineteen studies met inclusion criteria: 13 reported long-term outcomes of relapse, remission, or cognition following antipsychotic treatment in patients with FEP and six reported on patients with a longer disease history. Antipsychotic treatment in patients with FEP produced high rates of remission in the year following treatment initiation, and untreated FEP reduced the odds of later achieving remission. Maintenance therapy was more effective than treatment discontinuation or intermittent/guided discontinuation in preventing relapse. Initiating antipsychotic treatment in patients with FEP also produced sustained cognitive improvement for up to 2 years. Antipsychotic therapy also reduced the risk or rate of relapse in patients with a longer disease history, with outcomes in one study favoring a long-acting injectable formulation over an oral antipsychotic. Conclusion: Treatment of patients with FEP is associated with benefits in the long-term outcomes of remission, relapse, and cognition. More long-term studies of treatment in patients with FEP are needed to confirm these findings. Keywords: cognition, first-episode psychosis, long-term outcome, relapse, remission, schizophreniaKarson CDuffy RAEramo ANylander AGOfford SJDove Medical Pressarticlecognitionfirst-episode psychosislong-term outcomerelapseremissionschizophreniaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 57-67 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	cognition first-episode psychosis long-term outcome relapse remission schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	cognition first-episode psychosis long-term outcome relapse remission schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Karson C Duffy RA Eramo A Nylander AG Offord SJ Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
description	Craig Karson,1 Ruth A Duffy,2 Anna Eramo,3 Anna-Greta Nylander,4 Steve J Offord5 1CNK Consultants, Delray Beach, FL, 2Medical Affairs – Neuroscience, Otsuka America Pharmaceutical, Inc., Princeton, NJ, 3Medical Affairs & Phase IV Clinical Affairs, Lundbeck LLC, Deerfield, IL, USA; 4Medical Affairs Aripiprazole, H Lundbeck A/S, Valby, Denmark; 5Medical Affairs, Otsuka America Pharmaceutical, Inc., Princeton, NJ, USA Background: Treatment during first-episode psychosis (FEP) or early schizophrenia may affect the rates of relapse and remission, as well as cognitive functioning, over time. Prolonged duration of psychosis is associated with a poor prognosis, but the effects of treatment in patients with FEP or early schizophrenia on the long-term outcomes are not well defined. Objective: To understand the long-term effects of treatment with antipsychotic agents on remission, relapse, and cognition in patients with FEP or early schizophrenia. Methods: Using PubMed and Scopus databases, a systematic review was undertaken of articles published between January 1, 2000, and May 20, 2015, that reported randomized and nonrandomized prospective clinical trials on the long-term effects of oral or long-acting injectable antipsychotics on measures of relapse, remission, or cognition in patients with FEP or early schizophrenia. For comparative purposes, trials reporting the effects of later intervention with antipsychotics in patients with longer disease history were also evaluated. Titles, abstracts, and full-text articles were independently screened for eligibility by all the authors based on the predefined criteria. Results: Nineteen studies met inclusion criteria: 13 reported long-term outcomes of relapse, remission, or cognition following antipsychotic treatment in patients with FEP and six reported on patients with a longer disease history. Antipsychotic treatment in patients with FEP produced high rates of remission in the year following treatment initiation, and untreated FEP reduced the odds of later achieving remission. Maintenance therapy was more effective than treatment discontinuation or intermittent/guided discontinuation in preventing relapse. Initiating antipsychotic treatment in patients with FEP also produced sustained cognitive improvement for up to 2 years. Antipsychotic therapy also reduced the risk or rate of relapse in patients with a longer disease history, with outcomes in one study favoring a long-acting injectable formulation over an oral antipsychotic. Conclusion: Treatment of patients with FEP is associated with benefits in the long-term outcomes of remission, relapse, and cognition. More long-term studies of treatment in patients with FEP are needed to confirm these findings. Keywords: cognition, first-episode psychosis, long-term outcome, relapse, remission, schizophrenia
format	article
author	Karson C Duffy RA Eramo A Nylander AG Offord SJ
author_facet	Karson C Duffy RA Eramo A Nylander AG Offord SJ
author_sort	Karson C
title	Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
title_short	Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
title_full	Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
title_fullStr	Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
title_full_unstemmed	Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
title_sort	long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/ed9f8cc055374076827f5e2c74dd0a90
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Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia: a systematic review

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