Antipsychotic drugs are the mainstay of treatment of schizophrenia, not only in the event of episodes, but also in the long-term perspective. While people might want to stop their treatment at some stage, recurrences of psychotic symptoms are known to occur after treatment discontinuation. Relapses can lead to of harm, loss of autonomy and substantial distress for individuals and their families.
The current report presents the update version of a previously published in 2012, and is based on 75 randomised controlled trials ( ) published over a long period since the 1950s and including more than 9000 participants. The effects of all antipsychotic drugs are here compared to those of - namely drug discontinuation - for maintenance treatment, that is prevention of relapses. The aim is to explore the benefits and risks of each of the two options.
The results of this show very consistently that antipsychotic drugs effectively reduce relapses and need for hospitalisation. Indeed, in case of treatment discontinuation, the of at one year is almost three times higher. Antipsychotic drugs appear to have a positive effect on the ability to engage in activities and relationships, and on the possibility to fulfil remission from symptoms, although less evidence is available in this regard. Though based again on a lower number of reports, people continuing their treatment tend to experience higher satisfaction with their life, which confirms the negative consequences on well-being of being at higher for recurrence. Conversely, antipsychotic drugs are, as a group, associated with a number of side effects such as movement disorders, weight gain and . However, this allows more understanding of the fact that stopping treatment is far more harmful than thoughtfully maintaining it.
Unfortunately, studies included in this do generally last up to one year, and this makes difficult to clarify the longer-term effect of these drugs. It is however true that the longer the the more likely that other factors - e.g. environmental – may accumulate and complicate the interpretation of results. Most of all, this supports the advantages of antipsychotic drugs among many different types of participants. The best strategy would be therefore to continue treatment with antipsychotics, eventually discussing and adapting it if any occurs.
For people with schizophrenia, the evidence suggests that maintenance on antipsychotic drugs preventsto a much greater extent than for approximately up to two years of follow-up. This effect must be weighed against the of antipsychotic drugs. Future studies should better clarify the long-term and associated with these drugs.
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