Predictors of relapse after discontinuing antipsychotics in patients with schizophrenia spectrum disorders

We studied 61 patients with schizophrenia spectrum disorders who discontinued medication after achieving symptomatic remission. Over 3 years, relapse rates were significantly higher in those not meeting full recovery (p = 0.006) or remission (p < 0.001) criteria, with rates up to twice as high. Significant differences between relapsed and maintained groups included age at onset (p = 0.004), age at discontinuation (p = 0.009), and proportions meeting full recovery (p = 0.001) or remission (p = 0.003). Univariate Cox regression identified older age of onset (p = 0.038), lack of full recovery (p = 0.008) or remission (p = 0.001), and higher positive symptom score (p = 0.018) as predictors of relapse. In multivariate analysis, only full remission remained significant (p = 0.002). Our findings suggest that in making decision about discontinuation, applying more strict approaches, i.e., full recovery or remission criteria and detailed assessment of positive symptoms are critical and essential.