Bowtell M, et al. - The proportion of young people who discontinued their antipsychotic medication after the first episode of psychosis (FEP), the proportion who experience relapse, and predictors of relapse were determined. As per the outcomes, antipsychotic discontinuation frequently occurred earlier than guidelines recommend. The authors revealed that individuals with a diagnosis of cannabis abuse were more prone to experience relapse and addressing this substance abuse prior to discontinuation could possibly reduce relapse rates.

• Between 01/01/11 and 31/12/13, the authors conducted a retrospective study of all individuals presenting to the Early Psychosis Prevention and Intervention Centre.
• They performed a Cox regression analysis to identify predictors of relapse.

• The authors included 544 young people with a FEP.
• By 61% of the cohort, a trial of discontinuation was undertaken.
• In this study, the median duration of antipsychotic medication prior to the first trial of discontinuation was 174.50 days.
• In a median follow-up time post discontinuation of 372 days, 149 (45.8%) experienced the relapse amongst those trialing discontinuation.
• Predictors of relapse were a diagnosis of cannabis abuse disorder (HR: 1.40) and longer duration of antipsychotic medication (HR: 1.05) in multivariate analysis.