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The effects of guided discontinuation of antipsychotics on neurocognition in first onset psychosis

Published online by Cambridge University Press:  15 April 2020

G. Faber ,
H.G.O.M. Smid ,
A.R. Van Gool ,
D. Wiersma  and
R.J. Van Den Bosch
G. Faber*
Affiliation:
Yulius, Mental Health Institute, Hellingen 21, 3311GZ Dordrecht, The Netherlands
H.G.O.M. Smid
Affiliation:
Department of psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands
A.R. Van Gool
Affiliation:
Yulius, Mental Health Institute, Hellingen 21, 3311GZ Dordrecht, The Netherlands
D. Wiersma
Affiliation:
Department of psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands
R.J. Van Den Bosch
Affiliation:
Department of psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands
*
*Corresponding author. Tel.: +31 653395358; fax: +31 102880785. E-mail address: g.faber@yulius.nl (G. Faber).
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Abstract

Objective

To assess the effects of second generation antipsychotics on neurocognitive function in patients with stable remission of first episode psychosis.

Methods

Fifty-three patients with first onset psychosis in the schizophrenia spectrum entered a randomised controlled trial of guided discontinuation (GD) versus maintenance treatment (MT) with second generation antipsychotics. A comprehensive neurocognitive test battery was administered at the time of remission and shortly after dose reduction or discontinuation (GD-group) or at the same time in the MT-group.

Results

With the exception of negative symptoms, PANSS scores decreased over time and neurocognition improved significantly on most tests in both groups. The GD-group, however, improved significantly more than the MT-group on three neurocognitive measures in the domain of speed of processing.

Conclusion

These data suggest that, in first episode patients, dose reduction or discontinuation of second generation antipsychotics after stable remission is achieved, might improve neurocognitive function more than continuing second generation antipsychotics, suggesting a negative role for second generation antipsychotics, specifically in the domain of speed of processing.

Keywords

SchizophreniaAntipsychoticsNeurocognitive functionGuided discontinuation
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 4 , May 2012 , pp. 275 - 280
Copyright
Copyright © Elsevier Masson SAS 2012

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