Maintence therapy with quetiapine following first episode psychosis

January 01, 0001

Maintence therapy with quetiapine following first episode psychosis

This group of Hong Kong and Canadian researchers studied continued maintenance therapy in patients following first episode psychosis after symptoms had remitted for at least one year with pharmacotherapy. They performed a one year randomized, double blind, placebo controlled trial in outpatient clinics in Hong Kong recruiting patients with first episode psychosis who had received at least one year of antipsychotic drug treatment and had no positive symptoms of psychosis (n=178). Participants were randomized to either maintenance treatment with quetiapine (400 mg/day) or placebo. They were followed monthly for the next 12 months or until a relapse occurred.

The researchers report: "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% for the quetiapine group and 79% for the placebo group. Although quetiapine was generally well tolerated, the rate of discontinuation due to adverse or serious adverse events was greater in the quetiapine group (18%, 16/89) than in the placebo group (8%, 7/89) (relative risk 2.29).

The researchers concluded: "In a group of asymptomatic patients with first episode psychosis and at least one year of previous antipsychotic drug treatment, maintenance treatment with quetiapine compared with placebo resulted in a substantially lower rate of relapse during the following year."

This study finds good evidence for continued maintenance therapy following first episode of pyschosis when initial pharmacotherapy is successful

For the full abstract, click here.

BMJ 341:c4024, 19 August 2010
© 2010 Chen et al.
Maintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis- randomised controlled trial. Eric Y H Chen, Christy L M Hui, May M L La, et al. Correspondence to E Y H Chen: [email protected]

Category: P. Psychological. Keywords: quetiapine, psychosis, maintenance, relapse, remittance, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 7 September 2010

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