Evidence map›Paper›PMID 38250810›Full record

SynthesisEuropean psychiatry : the journal of the Association of European Psychiatrists2024

The effects of antipsychotic discontinuation or maintenance on the process of recovery in remitted first-episode psychosis patients - A systematic review and meta-analysis of randomized controlled trials.

Laurent Béchard, Charles Desmeules, Lauryann Bachand, Maxime Huot-Lavoie, Olivier Corbeil, Elizabeth Anderson, Sébastien Brodeur, Annie LeBlanc, Marie-France Demers, Sophie Lauzier and 1 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European psychiatry : the journal of the Association of European Psychiatrists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Laurent BéchardFaculty of Pharmacy, University Laval, Quebec, Canada.ORCID 0000-0001-6697-1799
Charles DesmeulesCERVO Research Center, Quebec, Canada.ORCID 0000-0002-3313-3817
Lauryann BachandCERVO Research Center, Quebec, Canada.ORCID 0009-0005-3477-2513
Maxime Huot-LavoieCERVO Research Center, Quebec, Canada.ORCID 0000-0001-7378-9776
Olivier CorbeilFaculty of Pharmacy, University Laval, Quebec, Canada.ORCID 0000-0002-4192-853X
Elizabeth AndersonCERVO Research Center, Quebec, Canada.
Sébastien BrodeurUniversity Institute of Mental Health of Quebec, CIUSSS-CN, Quebec, Canada.ORCID 0000-0002-7755-9043
Annie LeBlancFaculty of Medicine, Laval University, Quebec, Canada.ORCID 0000-0002-5377-8102
Marie-France DemersFaculty of Pharmacy, University Laval, Quebec, Canada.
Sophie LauzierFaculty of Pharmacy, University Laval, Quebec, Canada.ORCID 0000-0002-7746-9208
Marc-André RoyUniversity Institute of Mental Health of Quebec, CIUSSS-CN, Quebec, Canada.ORCID 0000-0002-0123-6651

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal duration of antipsychotic treatment following remission of first-episode psychosis (FEP) is uncertain, considering potential adverse effects and individual variability in relapse rates. This study aimed to investigate the effect of antipsychotic discontinuation compared to continuation on recovery in remitted FEP patients.

methodsCENTRAL, MEDLINE (Ovid), Embase, and PsycINFO databases were searched on November 2, 2023, with no language restrictions. RCTs evaluating antipsychotic discontinuation in remitted FEP patients were selected. The primary outcome was personal recovery, and secondary outcomes included functional recovery, global functioning, hospital admission, symptom severity, quality of life, side effects, and employment. Risk of bias was assessed using the Cochrane risk-of-bias tool 2, and the certainty of evidence was evaluated with GRADE. Meta-analysis used a random-effect model with an inverse-variance approach.

resultsAmong 2185 screened studies, 8 RCTs (560 participants) were included. No RCTs reported personal recovery as an outcome. Two studies measured functional recovery, and discontinuation group patients were more likely to achieve functional recovery (RR 2.19; 95% CIs: 1.13, 4.22; I

conclusionsPersonal recovery was not reported in any antipsychotic discontinuation trial in remitted FEP. The observed positive effect of discontinuation on functional recovery came from an early terminated trial and an RCT followed by an uncontrolled period. These findings should be interpreted cautiously due to very low certainty of evidence.

Indexed as

Antipsychotic AgentsPsychotic DisordersRandomized Controlled Trials as TopicHumansWithholding TreatmentAntipsychotic Agentsantipsychoticdrug taperingfirst-episode psychosismental health recoverymeta-analysissystematic review

Identifiers

PMID38250810
PMCPMC10897830

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.