Predictors of hospitalisation following antipsychotic discontinuation

Poster B81, Friday, October 21, 11:30 am - 1:00 pm, Le Baron

Richard Whale1; 1Brighton and Sussex Medical School

Early discontinuation of antipsychotic medication, used for the treatment of first episode psychosis (FEP) is common. Guidelines often recommend treatment for at least one year although some patients may not need such sustained antipsychotic exposure. Exploring variables associated with relapse following discontinuation is therefore of clinical value. Patients with FEP who had discontinued their first antipsychotic within one year, not switching to other medications, in Sussex UK over 3 years to 2012, were studied retrospectively. Logistic regression analysis was used to explore variables associated with hospitalisation in the year following discontinuation. Of the total cohort of 363, 21.5% discontinued prescribed antipsychotic medication within a year. Time to discontinuation from initiation was mean (range) 103 (1-350) days. Of these, 19 (24.4%) were hospitalised in the subsequent year with mean (range) time from discontinuation of 120 (1-311) days. Multivariate analysis revealed that antipsychotic initiation by a crisis team or inpatient doctor was independently associated with later hospitalisation (versus non crisis community initiation) (p = 0.06). Notably, no association with duration of untreated psychosis or duration of antipsychotic exposure was identified. A trend to association was observed with self-initiated discontinuation and hospitalisation. Severity of illness at antipsychotic initiation (of which role of initial prescriber is a marker in this service) was the only predictor of hospitalisation following antipsychotic discontinuation. A larger sample, other clinical variables including reported substance exposure and earlier clinical deterioration markers will be further considered in this study.

Topic Area: Psychopharmacology

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