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Stability of medication in early psychosis: a comparison between second‐generation and low‐dose first‐generation antipsychotics
Author(s) -
Opjordsmoen Stein,
Melle Ingrid,
Friis Svein,
Haahr Ulrik,
Johannessen Jan O.,
Larsen Tor K.,
Rund Bjørn R.,
Simonsen Erik,
Vaglum Per,
McGlashan Thomas H.
Publication year - 2009
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/j.1751-7893.2008.00103.x
Subject(s) - akathisia , antipsychotic , discontinuation , first generation , tolerability , medicine , psychiatry , psychosis , risperidone , quetiapine , pediatrics , schizophrenia (object oriented programming) , adverse effect , population , environmental health
Aim: This naturalistic study aims to compare discontinuation rates for low‐dose first‐generation versus second‐generation antipsychotics in first‐episode psychotic patients. Methods: The prescription of antipsychotic medication in 301 consecutively admitted patients with first‐episode psychosis from four catchment areas is described. For the first year of inclusion a first‐generation antipsychotic in low dose was recommended as the first medication. From the second year a second‐generation antipsychotic was recommended as first choice. Switching was allowed when any drug was judged to be ineffective or to have serious side‐effects. Switching during the first 2 years after inclusion is described. Results: Switching from a low‐dose first‐generation antipsychotic was more frequent than from a second‐generation antipsychotic (90.7 vs. 58.4%). Lack of therapeutic effect and side‐effects were the more frequently recorded reasons for changing in the first‐generation group. Akathisia, parkinsonism, dyskinesias, dystonia and dysphoria were more often reported in patients on first‐generation drugs. Weight gain and sedation were more often reported in patients on second‐generation drugs. Conclusion: The findings suggest a better adherence to and tolerability for second‐generation antipsychotics than for low‐dose first‐generation antipsychotics in first‐episode psychosis.