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Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis
Author(s) -
Thompson Andrew,
Singh Swaran,
Birchwood Max
Publication year - 2016
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12244
Subject(s) - discontinuation , antipsychotic , psychiatry , psychosis , randomized controlled trial , medicine , quality of life (healthcare) , schizophrenia (object oriented programming) , psychology , nursing
Aims Discontinuation of antipsychotics following remission in first episode psychosis ( FEP ) is a contentious area of practice. We aimed to investigate the views of early psychosis clinicians on this important clinical question. Methods We designed an 11 question online survey on medication discontinuation following remission of symptoms in FEP . The questionnaire was distributed to early intervention team workers in England and Wales via members of the National Early Psychosis Network who were requested to distribute it to their teams. Results We received 172 questionnaire responses; 37% were nurses, 33% doctors, 11% psychologists and 19% were other allied health professionals. The average years of experience in psychiatry was 16.9. 75.4% of respondents thought that greater than 60% of patients would like to be considered for guided medication reduction/discontinuation. Only 31.4% of respondents said that medication should be continued for over a year following remission. 61.4% of respondents felt that the quality of life of individuals was better in those who stop medication following remission. There was a significant difference in the response of professional groups to this question. 82.6% of respondents said they would be happy to support their patients in participating in a randomized trial of graded antipsychotic reduction/discontinuation versus maintenance medication. Conclusions The views of clinicians regarding prophylactic antipsychotic medication following remission in FEP are much less conservative than those in current guidelines; concern was expressed by many about the impact of antipsychotic medication on quality of life. A randomized trial of maintenance antipsychotic medication versus graded reduction/discontinuation is feasible and has considerable clinician support.