首发精神病患者抗精神病药物停药后的住院治疗。
Psychiatric hospitalization following antipsychotic medication cessation in first episode psychosis.
机构信息
1 Division of Psychiatry, University College London, London, UK.
2 Epidemiology of Psychiatric Conditions, Substance Use, and Social Environment, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
出版信息
J Psychopharmacol. 2019 Apr;33(4):532-534. doi: 10.1177/0269881119827883. Epub 2019 Feb 19.
BACKGROUND
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.
AIM
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.
METHODS
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).
RESULTS
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.
CONCLUSION
We found no evidence that hospitalization rates increased with increasing baseline antipsychotic exposure.
背景
首次出现精神病症状后，长期使用抗精神病药物治疗的风险-效益平衡存在疑问，尤其是在停止治疗后由于多巴胺超敏反应导致复发的情况下。
目的
本研究旨在确定首次出现精神病症状的患者的住院率是否与初始口服抗精神病药物暴露的时间长短有关。
方法
我们研究了 2007 年 1 月 1 日至 2016 年 12 月 31 日期间瑞典总人口中首次出现精神病症状的患者（n=7043）的住院率。我们根据首次抗精神病治疗的时间（<6 个月、6 个月至<1 年、1 年至<2 年、2 年至<5 年和⩾5 年）对患者进行分类。
结果
与治疗<6 个月的患者相比，治疗结束后 1-4 年内所有时间的住院累积发生率，接受口服抗精神病药物治疗 ⩾5 年的患者不到一半。
结论
我们没有发现住院率随基线抗精神病药物暴露增加而增加的证据。
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