Stability of medication in early psychosis: A comparison between second-generation and low-dose first-generation antipsychotics

Stein Opjordsmoen*, Ingrid Melle, Svein Friis, Ulrik Haahr, Jan O. Johannessen, Tor K. Larsen, Bjørn R. Rund, Erik Simonsen, Per Vaglum, Thomas H. McGlashan

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

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.

OriginalsprogEngelsk
Sider (fra-til)58-65
Antal sider8
TidsskriftEarly Intervention in Psychiatry
Vol/bind3
Udgave nummer1
StatusUdgivet - 1 jan. 2009

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