Psychiatric hospitalization following antipsychotic medication cessation in first episode psychosis

There are questions about the risk-benefit balance of longer-term antipsychotic medication treatment following first episode psychosis, especially in relation to relapse because of dopamine supersensitivity following treatment cessation.

The purpose of this study was to determine whether hospitalization rates in first episode psychosis patients are associated with length of initial oral antipsychotic medication exposure.

We examined psychiatric hospitalization rates in patients experiencing first episode of psychosis from the total population of Sweden between 1 January 2007-31 December 2016 ( n=7043). We categorised patients by the length of first antipsychotic treatment (<6 months, 6 months to <1 year, 1 year to <2 years, 2 years to <5 years and ⩾5 years).

Compared to those treated for <6 months, individuals receiving oral antipsychotic medications for ⩾5 years had less than half the cumulative incidence of hospitalization at all times between 1-4 years after treatment cessation.

We found no evidence that hospitalization rates increased with increasing baseline antipsychotic exposure.