Early intervention services, patterns of prescription and rates of discontinuation of antipsychotic treatment in first-episode psychosis


Por: Catalan, A, Garcia, L, Sanchez-Alonso, S, Gil, P, Diaz-Marsa, M, Olivares, J, Rivera-Baltanas, T, Perez-Martin, J, Torres, M, Ovejero, S, Tost, M, Berge, D, Rodriguez, A and Labad, J

Publicada: 1 dic 2021 Ahead of Print: 1 dic 2020
Resumen:
Aims: Non-compliance is still an important problem in psychotic patients. Although antipsychotic (AP) treatment leads to a decrease in psychotic relapses, there are no clear recommendations about how long treatment should be maintained after first-episode psychosis (FEP) and no indication of the rates and causes of treatment withdrawal in this group. Methods: We evaluated a large sample of patients with FEP for 2 years to compare the time to all-cause treatment discontinuation of AP drugs and the time to the first relapse. We collected the sociodemographic and psychopathological characteristics of the sample. The number of relapses was also recorded. Results: A total of 310 FEP patients were assessed across seven early intervention teams (mean age = 30.2 years; SD = 11.2). The most prevalent diagnosis at baseline was psychotic disorder not otherwise specified (36.1%), and the most commonly used APs were risperidone (26.5%) and olanzapine (18.7%). A lack of efficacy was the most frequent reason for the withdrawal of the first AP prescribed, followed by non-compliance. There were no differences in the relapse rates between different APs. Patients treated with long-acting injectable (LAI) APs presented less disengagement from services than patients treated with oral APs. Conclusions: Although there were no differences between the different APs in terms of relapse rates, LAIs had higher retention rates than oral APs in early intervention services. Compliance is still an important issue in Psychiatry, so clinicians should use different strategies to encourage it, such as the use of LAI treatments.

Filiaciones:
Catalan, A:
 Univ Basque Country, Basurto Univ Hosp, Fac Med & Odontol, Biocruces Bizkaia Hlth Res Inst,Mental Hlth Dept, Campus Leioa, Bizkaia, Spain

:
 Hosp Univ San Juan, Dept Psychiat, Alicante, Spain

 Univ Miguel Hernandez, Dept Clin Med, Edificio Muhammad Al Shafra, Alicante, Spain

Sanchez-Alonso, S:
 Jimenez Diaz Fdn Hosp, Dept Psychiat, Madrid, Spain

Gil, P:
 Bizkaia Mental Hlth Syst, Biocruces Bizkaia Hlth Res Inst, Early Intervent Serv, Mental Hlth Dept, Bilbao, Bizkaia, Spain

Diaz-Marsa, M:
 Univ Hosp Clin San Carlos Madrid, Psychiat Dept, IDISSC, Madrid, Spain

Olivares, J:
 Univ Vigo, Hosp Alvaro Cunqueiro, Galicia Hlth Res Inst CIBERSAM, Dept Psychiat,Translat Neurosci Grp, Vigo, Spain

Rivera-Baltanas, T:
 Univ Vigo, Hosp Alvaro Cunqueiro, Galicia Hlth Res Inst CIBERSAM, Dept Psychiat,Translat Neurosci Grp, Vigo, Spain

:
 Hosp Univ San Juan, Dept Psychiat, Alicante, Spain

 Univ Miguel Hernandez, Dept Clin Med, Edificio Muhammad Al Shafra, Alicante, Spain

Torres, M:
 Univ Basque Country, Basurto Univ Hosp, Fac Med & Odontol, Biocruces Bizkaia Hlth Res Inst,Mental Hlth Dept, Campus Leioa, Bizkaia, Spain

Ovejero, S:
 Jimenez Diaz Fdn Hosp, Dept Psychiat, Madrid, Spain

Tost, M:
 Univ Autonoma Barcelona, Dept Mental Hlth, Early Intervent Serv Psychosis,I3PT, CIBERSAM,Parc Tauli Hosp Univ,Dept Psychiat & For, Sabadell, Spain

Berge, D:
 Inst Neuropsiquiatria & Adicc INAD, Parc Salut Mar, Barcelona, Spain

 Fundacio Hosp Mar Med Res Inst IMIM, Barcelona, Spain

 Ctr Invest Biomed Red, Area Salud Mental CIBERSAM, Madrid, Spain

Rodriguez, A:
 Dept Psychiat, Parc Salut Mar, Barcelona, Spain

Labad, J:
 Univ Autonoma Barcelona, Dept Mental Hlth, Early Intervent Serv Psychosis,I3PT, CIBERSAM,Parc Tauli Hosp Univ,Dept Psychiat & For, Sabadell, Spain
ISSN: 17517885





EARLY INTERVENTION IN PSYCHIATRY
Editorial
Blackwell Publishing Inc., 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Reino Unido
Tipo de documento: Article
Volumen: 15 Número: 6
Páginas: 1584-1594
WOS Id: 000596108100001
ID de PubMed: 33289317

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