Reducing antipsychotic drugs in stable patients with chronic schizophrenia or schizoaffective disorder: a randomized controlled pilot trial

Maximilian Huhn, Claudia Leucht, Philipp Rothe, Markus Dold, Stephan Heres, Susanne Bornschein, Thomas Schneider-Axmann, Alkomiet Hasan, Stefan Leucht

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

As the course of schizophrenic disorders is often chronic, treatment guidelines recommend continuous maintenance treatment to prevent relapses, but antipsychotic drugs can cause many side effects. It, therefore, seems reasonable to try to reduce doses in stable phases of the illness or even try to stop medication. We conducted a 26 weeks, randomized, rater blind, feasibility study to examine individualized antipsychotic dose reduction versus continuous maintenance treatment (Register Number: NCT02307396). We included chronic, adult patients with schizophrenia or schizoaffective disorder, who were treated with any antipsychotic drug except clozapine, who had not been hospitalized in the last 3 years and who were in symptomatic remission at baseline. The primary outcome was relapse of positive symptoms. Symptom severity, social functioning and side effects were also examined as secondary outcomes. 20 patients were randomized. Relapse rates in the two groups were not significantly different. No patient had to be hospitalized. One patient in the control group dropped out. The mean reduction of antipsychotic dose in the individualized dose-reduction group was 42%, however only one patient discontinued drug completely. There were no significant differences in efficacy or safety outcomes. This randomized trial provides evidence, that reduction of antipsychotic medication in chronic stable schizophrenic patients may be feasible. The results need to be confirmed in a larger trial with a longer follow-up period.

Original languageEnglish
Pages (from-to)293-302
Number of pages10
JournalEuropean Archives of Psychiatry and Clinical Neuroscience
Volume271
Issue number2
DOIs
StatePublished - Mar 2021
Externally publishedYes

Keywords

  • Antipsychotic maintenance treatment
  • Chronic schizophrenia
  • Dose reduction
  • Randomized clinical trial
  • Relapse

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