Less is More? An Australian RCT comparing dose reduction of anti-psychotic medication to maintenance treatment.

Poster C49, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom

Amber Weller1,2, Eoin Killackey1,2, John Gleeson3, Kelly Allott1,2, Mario Alvarez-Jimenez1,2, Sarah Bendall1,2, Barnaby Nelson1,2, Peter Koval2, Susy Harrigan1, Patrick McGorry1,2; 1Orygen, The National Centre of Excellence in Youth Mental Health, 2Centre for Youth Mental Health, The University of Melbourne, 3Australian Catholic University

Background: Treatments for first-episode psychosis (FEP) patients are increasingly oriented towards meaningful recovery. Treatment guidelines recommend remitted patients receive 12-24 months antipsychotic maintenance treatment (AMTx) before dose reduction is attempted. But there is growing debate about the timing and extent of dose reduction. This is because of the potential impact medication may be having on functional recovery and reductions in brain volume. This adds to the list of physical health, tolerability, and acceptability problems, as well as persistent poor social and vocational outcomes in psychosis noted with AMTx. Method: Our randomized controlled trial, within a specialist early psychosis treatment setting, will test the whether a dose reduction strategy (DRS), in combination with our evidence based intensive recovery treatment (EBIRT), leads to better vocational and social recovery than continuous AMTx + EBIRT over a 2-year period in 180 remitted FEP patients. Additionally we will examine the effect of DRS vs AMTx on physical health, brain volume and cognitive functioning. In terms of safety this study will determine whether the group receiving DRS + EBIRT will be no worse off in terms of psychotic relapses over 2 years follow up. Results: This poster will present the method, rationale and hypotheses of this new study. Discussion: This study will provide evidence as to whether an alternative recovery treatment leads to improved functioning and safer outcomes in young FEP patients, and the first controlled experiment of the effect of exposure to AMTx on brain volume changes in this population.

Topic Area: Psychosocial Interventions

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