First vs multiple episode schizophrenia: two-year outcome of intermittent and maintenance medication strategies

Gäebel, Wolfgang; Jänner, M; Frommann, Nicole; Pietzcker, A.; Köpcke, Wolfgang; Lindén, Michael; Müller, Péter; Müller‐Spahn, F.; Tegeler, J.

doi:10.1016/s0920-9964(01)00182-7

Cited by 114 publications

(98 citation statements)

References 27 publications

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“…The traditional method of longterm drug treatment of schizophrenia is the continuation of neuroleptic treatment for one or more years. Intermittent dosing therapy with neuroleptic agents and incremental dose reductions until discontinuation (tapering off), careful observation and early repeated dose increases at the first signs of disease were shown to be inferior to continuation treatment as they result in a higher frequency of relapse and hospital admissions (Schooler 1993;Schooler et al 1997;Gaebel et al 2002) (Level A ).…”

Section: Antipsychotic Treatmentmentioning

confidence: 99%

“…There are considerations that the severity of the first episode and the level of remission may be additional parameters determining the recommended duration of treatment in first-episode schizophrenia. Patients with full remission may be tapered off after 12 months (Gaebel et al 2002), and patients who have experienced a more severe episode or were slow to respond should be maintained for 24 months or even longer (Level D ). Based on the argument of the high relapse rate, a longer duration of relapse prevention by continuing antipsychotic medication regimen is being discussed (Robinson et al 2004;Schooler et al 2005).…”

Section: Relapse Prevention In First Episode Patientsmentioning

confidence: 99%

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World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Falkai

Wobrock

Lieberman

et al. 2006

The World Journal of Biological Psychiatry

201

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These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A Á/D). This second part of the guidelines covers the long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.Key words: Schizophrenia, long-term treatment, evidence-based medicine, practice guidelines, biological treatment, antipsychotics EXECUTIVE SUMMARY OF RECOMMENDATIONS General recommendationsSpecific treatment strategies are required not only for patients suffering from acute schizophrenia, but also in the stabilisation and stable phase of the disease. The stabilisation period follows the acute phase and constitutes a time-limited transition to continuing treatment in the stable phase. The stable phase represents a prolonged period of treatment and rehabilitation during which symptoms are under adequate control and the focus is on improving functioning and recovery. The goals of long-term therapy have to be discussed with the patient on the background of adequately provided information and his personal goals in order to find common ground to encourage a long-term medication strategy (shared-decision making). In this regard a treatment plan must be formulated and implemented. During the stabilisation phase, the main goals of treatment are to facilitate continued reduction in symptoms, consolidate remission, and promote the process of recovery. The main goals of treatment during the stable phase are to ensure that symptom remission or control is sustained, that the patient is maintaining or improving the level of functioning and quality of life, to prevent relapse, and to ensure that monitoring for adverse treatment effects continues. The antipsychotic pharmacological therapy should be accompanied by psychosocial interventions. A number of psychosocial...

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Section: Antipsychotic Treatmentmentioning

confidence: 99%

Section: Relapse Prevention In First Episode Patientsmentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Falkai

Wobrock

Lieberman

et al. 2006

The World Journal of Biological Psychiatry

201

View full text Add to dashboard Cite

show abstract

“…Outras táticas, como o tratamento com doses intermitentes de agentes neurolépticos e reduções progressivas da dose até a descontinuação (método conhecido como tapering off) ou a observação cuidadosa do paciente com incrementos de dosagem aos primeiros sinais de exacerbação da doença, são menos eficazes que o tratamento contí-nuo, uma vez que acarretam recaídas e readmissões hospitalares mais freqüentemente (Nível A) (Schooler, 1993;Schooler et al, 1997;Gaebel et al, 2002).…”

Section: Estratégias De Tratamentounclassified

“…Existem considerações de que a gravidade do primeiro episódio e o nível de remissão possam ser parâmetros adicionais, determinando a duração recomendada do tratamento durante o primeiro episódio de esquizofrenia. Pacientes com remissão total podem ter a dose da medicação reduzida progressivamente até a descontinuação total (tapering off) após 12 meses (Gaebel et al, 2002), e pacientes que vivenciaram um episódio mais grave ou demoraram a responder à medicação devem ser mantidos por 24 meses ou até mesmo por mais tempo (Nível D). Com base no argumento da alta taxa de recaída, a prevenção com maior duração por meio da continuação do regime com a medicação antipsicótica está sendo discutida (Robinson et al, 2004;Schooler et al, 2005).…”

Section: Duração Do Tratamentounclassified

Diretrizes da Federação Mundial das Sociedades de Psiquiatria Biológica para o tratamento biológico da esquizofrenia. Parte 2: tratamento de longo prazo

Falkai¹,

Wobrock²,

Lieberman³

et al. 2006

Rev. psiquiatr. clín.

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ResumoEstas diretrizes para o tratamento biológico da esquizofrenia foram desenvolvidas pela Força-Tarefa da Federação Mundial das Sociedades de Psiquiatria Biológica (World Federation of Societies of Biological Psychiatry, WFSBP). As metas fixadas durante o desenvolvimento destas diretrizes foi a revisão sistemática de todas as evidências disponíveis referentes ao tratamento da esquizofrenia, tanto no âmbito clínico como no científico, e o estabelecimento de um consenso sobre as principais recomendações para a prática psiquiátrica. Estas diretrizes são destinadas a todos os médicos que atendem e tratam de pacientes portadores de esquizofrenia. Os dados usados para desenvolver estas diretrizes foram extraídos primariamente de vários painéis e diretrizes nacionais para o tratamento da esquizofrenia, assim como de metanálises, revisões e estudos clínicos randomizados sobre a eficácia do tratamento farmacológico e de outras intervenções terapêuticas biológicas, identificadas por uma busca nas bases de dados MedLine e na Biblioteca Cochrane. A literatura identificada

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“…Rates of treatment dropout are reported less often; the figures for this range from 20% to 56% in patients with schizophrenia. [12][13][14] In patients with depression, the severity of the disorder has been associated with treatment dropout in some studies, [15] but not in all. [16] Agreeing with Last et al [15] Leserman [17] indicated that patients with depression were less likely to adhere to a treatment program than patients without depression and experienced worse outcomes in health.…”

Section: Introductionmentioning

confidence: 99%

Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

Bosch¹,

Waberg²,

Noort³

et al. 2016

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Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with depression were enrolled in this study. The beck depression Inventory-II, the positive and negative syndrome scale, and the pittsburgh sleep quality index were used to assess symptom severity and quality of sleep, and sleep log data were used to measure treatment adherence. Results: The preliminary results showed no significant relationship between symptom severity and treatment adherence or between quality of sleep and treatment adherence in patients with depression. However, a significant positive relationship was found between negative symptoms and treatment adherence and a significant negative relationship between quality of sleep and treatment adherence in patients with schizophrenia. Conclusion: The present exploratory study revealed a positive relationship between symptom severity and treatment adherence and a negative relationship between quality of sleep and treatment adherence in patients with schizophrenia, but no significant relationships in patients with depression were found. Future studies are needed in order to gain a better understanding of possible risk factors related to treatment non-adherence. 10.20517/2347-8659.2015.54 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. For reprints contact: service@oaepublish.comHow to cite this article: Bosch P, Waberg J, van den Noort M, Staudte H, Lim S, Egger J. Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression.

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First vs multiple episode schizophrenia: two-year outcome of intermittent and maintenance medication strategies

Cited by 114 publications

References 27 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Diretrizes da Federação Mundial das Sociedades de Psiquiatria Biológica para o tratamento biológico da esquizofrenia. Parte 2: tratamento de longo prazo

Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

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