Predicting relapse after a first episode of non-affective psychosis: A three-year follow-up study

Substance use, medication adherence and outcome one year following a first episode of psychosis

“…Thus, poor medication adherence in patients following the first episode of psychosis (FEP) is associated with more frequent readmissions (Caseiro et al, 2012;Verdoux et al, 2000), and a greater risk of relapse (Kahn et al, 2008;Malla et al, 2006;NovakGrubic and Tavcar, 2002).…”

Developing a Digital Medicine System in Psychiatry

“…Further, a systematic review of 10 studies in schizophrenia that defined adherence as "regularly taking medications as prescribed" reported a mean rate of medication nonadherence of 41.2%. 5 Poor adherence is associated with suboptimal treatment response that results in a greater risk of relapse 6,7 ; poor functional outcomes including arrests, violence, and impaired mental functioning 1 ; and elevated health resource utilization. 2,8 Longacting injectable (LAI) formulations of oral antipsychotics have the potential to improve adherence; however, broad acceptance of the LAIs as a therapeutic option has been a challenge.…”

Antipsychotic dosing: found in translation

“…In fact, we now have various lines of evidence indicating that high and sustained antipsychotic dosing is not required, including data on single daily antipsychotic dosing with agents where multiple dosing is recommended based on peripheral kinetics; results from depot antipsychotic studies demonstrating that D 2 occupancy levels fall below the recommended D 2 occupancy threshold associated with clinical response; clinical findings that in the context of maintenance treatment depot injection intervals can be extended; and data showing that transient but finite gaps in oral antipsychotic administration (i.e., extended antipsychotic dosing) do not compromise clinical response. The implications of this work are, to say the least, controversial for a field in which antipsychotic nonadherence is an identified major contributor to poor clinical outcome 101 and in the context of earlier evidence demonstrating that intermittent antipsychotic dosing increased the risk of relapse. It would not be unreasonable to ignore this evidence and default to the "safer" continuous antipsychotic dosing strategy used for decades were it not for the side effects of antipsychotics, which simply cannot be overlooked.…”