Related Experiment Video
Updated: Mar 13, 2026

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Effectiveness of antipsychotics used in first-episode psychosis: a naturalistic cohort study
Richard Whale1, Michael Harris2, Gail Kavanagh3
1, MD, MRCPsych, Sussex Partnership NHS Foundation Trust, Brighton, UK, and Brighton and Sussex Medical School, Brighton, UK.
Background:
One year of antipsychotic treatment from symptom remission is recommended following a first episode of psychosis (FEP).
Aims:
To investigate the effectiveness of commonly used antipsychotic medications in FEP.
Method:
A retrospective cohort study of naturalistic treatment of patients (N=460) accepted by FEP services across seven UK sites. Treatment initiation to all-cause discontinuation determined from case files.
Results:
Risk of treatment discontinuation is greatest within 3 months of treatment initiation. Risperidone had longest median survival time. No significant differences were observed in time to discontinuation between commonly used antipsychotics on multivariable Cox regression analysis. Poor adherence and efficacy failure were the most common reasons for discontinuation.
Conclusions:
Effectiveness differences appear not to be a current reason for antipsychotic choice in FEP. Adherence strategies and weighing up likely adverse effects should be the clinical focus.
Declaration Of Interest:
R.W., A.T. and S.M. have received research grant, speaker honoraria and conference attendance funding from all companies marketing antipsychotics.
Copyright And Usage:
© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
Related Concept Videos
Psychosis: Goals of Pharmacotherapy
Psychosis and Antipsychotic Drugs: Overview
Antipsychotic Drugs: Typical and Atypical Agents
Drug Therapy
Antianxiety Medications
Antipsychotic Drugs: Therapeutic Uses and Side Effects
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...

