Risk of treatment discontinuation and psychiatric hospitalization associated with early dose reduction of antipsychotic treatment in first‐episode schizophrenia: A nationwide, health insurance data–based study.
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| Title: | Risk of treatment discontinuation and psychiatric hospitalization associated with early dose reduction of antipsychotic treatment in first‐episode schizophrenia: A nationwide, health insurance data–based study. |
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| Authors: | Joo, Sung Woo (AUTHOR), Kim, Harin (AUTHOR), Jo, Young Tak (AUTHOR), Ahn, Soojin (AUTHOR), Choi, Young Jae (AUTHOR), Choi, Woohyeok (AUTHOR), Park, Soyeon (AUTHOR), Lee, Jungsun (AUTHOR) |
| Source: | Psychiatry & Clinical Neurosciences. May2022, Vol. 76 Issue 5, p195-200. 6p. 3 Charts. |
| Subjects: | Termination of treatment, Psychiatric hospital care, Health insurance, Psychiatric treatment, Proportional hazards models, Risk-taking behavior, Psychotic depression, Perinatal mood & anxiety disorders |
| Geographic Terms: | South Korea |
| Abstract: | Aim: We investigated the impact of early dose reduction of antipsychotic treatment on the risk of treatment discontinuation and psychiatric hospitalization in patients with first‐episode schizophrenia (FES). Methods: The Health Insurance Review Agency database in South Korea was used to include 16 153 patients with FES. At 6 months from their diagnosis, the patients were categorized by the magnitude of dose reduction (no reduction, 0%–50%, and >50%). With a reference of no reduction, the risk of treatment discontinuation and psychiatric hospitalization associated with dose reduction in the 1‐year follow‐up period after the first 6 months was examined with a Cox proportional hazard ratio model stratified by the mean daily olanzapine‐equivalent dose in the first 3 months (<10, 10 to 20, >20 mg/day). Results: A >50% dose reduction was associated with an increased risk of treatment discontinuation in all subgroups (<10 mg/day: hazard ratio [HR] =1.44, 95% confidence interval [CI] =1.24–1.67 [P <0.01]; 10–20 mg/day: HR =1.60, 95% CI =1.37–1.86 [P <0.01]; and >20 mg/day: HR =1.62, 95% CI =1.37–1.91 [P <0.01]). In the subgroup taking <10 mg/day, an association of 0%–50% dose reduction with an increased risk of treatment discontinuation was observed (HR =1.20, 95% CI =1.09–1.31; P <0.01). A > 50% dose reduction was associated with increased risk of psychiatric hospitalization only in the subgroup taking <10 mg/day (HR =1.48, 95% CI =1.21–1.80; P <0.01). Conclusions: Our results suggest that an above certain dose of antipsychotic drugs is required to prevent psychiatric hospitalization, and extensive dose reduction of antipsychotic drugs could result in a higher risk of treatment discontinuation. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Aim: We investigated the impact of early dose reduction of antipsychotic treatment on the risk of treatment discontinuation and psychiatric hospitalization in patients with first‐episode schizophrenia (FES). Methods: The Health Insurance Review Agency database in South Korea was used to include 16 153 patients with FES. At 6 months from their diagnosis, the patients were categorized by the magnitude of dose reduction (no reduction, 0%–50%, and >50%). With a reference of no reduction, the risk of treatment discontinuation and psychiatric hospitalization associated with dose reduction in the 1‐year follow‐up period after the first 6 months was examined with a Cox proportional hazard ratio model stratified by the mean daily olanzapine‐equivalent dose in the first 3 months (<10, 10 to 20, >20 mg/day). Results: A >50% dose reduction was associated with an increased risk of treatment discontinuation in all subgroups (<10 mg/day: hazard ratio [HR] =1.44, 95% confidence interval [CI] =1.24–1.67 [P <0.01]; 10–20 mg/day: HR =1.60, 95% CI =1.37–1.86 [P <0.01]; and >20 mg/day: HR =1.62, 95% CI =1.37–1.91 [P <0.01]). In the subgroup taking <10 mg/day, an association of 0%–50% dose reduction with an increased risk of treatment discontinuation was observed (HR =1.20, 95% CI =1.09–1.31; P <0.01). A > 50% dose reduction was associated with increased risk of psychiatric hospitalization only in the subgroup taking <10 mg/day (HR =1.48, 95% CI =1.21–1.80; P <0.01). Conclusions: Our results suggest that an above certain dose of antipsychotic drugs is required to prevent psychiatric hospitalization, and extensive dose reduction of antipsychotic drugs could result in a higher risk of treatment discontinuation. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 13231316 |
| DOI: | 10.1111/pcn.13341 |
