Continuation of Antipsychotic Therapy

There may be pressure from patients and their families to discontinue antipsychotic medication once acute psychotic symptoms start to improve.

However, the rate of relapse after a first episode is relatively high in the absence of continued medication [11,41,62]. Between 40% and 60% of untreated patients relapse within a year after recovery from the initial acute psychotic episode [62]. Microrelapses may be even more common [63], yet most authorities stop short of advocating long-term medication for all patients who have had a single episode of psychosis [64].

At least one year of maintenance treatment with antipsychotic medication is recommended once symptoms remit after a first episode. This may be longer than current practice in some services, but is recommended because the deterioration and losses following a relapse may be severe. Careful monitoring for an extended period (months) after medication withdrawal is highly recommended in such cases.

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