Long‐acting antipsychotic medication as first‐line treatment of first‐episode psychosis with comorbid substance use disorder
| العنوان: | Long‐acting antipsychotic medication as first‐line treatment of first‐episode psychosis with comorbid substance use disorder |
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| المؤلفون: | Emmanuel Stip, Dominic Thibault, Sofia Medrano, Stéphane Potvin, Ramzan Tahir, Amal Abdel-Baki, Martin Ladouceur |
| المصدر: | Early Intervention in Psychiatry. 14:69-79 |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Psychosis, Substance-Related Disorders, medicine.medical_treatment, Comorbidity, Kaplan-Meier Estimate, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, medicine, Humans, Prospective Studies, Antipsychotic, Biological Psychiatry, Survival analysis, Retrospective Studies, business.industry, Retrospective cohort study, medicine.disease, 030227 psychiatry, Hospitalization, First line treatment, Substance abuse, Psychiatry and Mental health, Treatment Outcome, Long acting, Psychotic Disorders, Delayed-Action Preparations, Schizophrenia, Female, Analysis of variance, Pshychiatric Mental Health, business, 030217 neurology & neurosurgery, Antipsychotic Agents |
| الوصف: | AIM Substance use disorder (SUD) is highly prevalent among patients with first-episode psychosis (FEP) and associated with poor adherence and worst treatment outcomes. Although relapses are frequent in FEP, current literature on long-acting injectable antipsychotics (LAI-AP) use in FEP is scarce and studies often exclude patients with SUD. OBJECTIVES To determine the impact of LAI-AP as first-line treatment on psychotic relapses or rehospitalizations in FEP patients with comorbid SUD (FEP-SUD). METHODS This is a naturalistic, longitudinal, 3-year prospective and retrospective study on 237 FEP-SUD admitted in two EIS in Montreal, between 2005 and 2012. The patients were divided on the basis of first-line medication introduced, either oral antipsychotics (OAP, n = 206) or LAI-AP (n = 31). Baseline characteristics were compared using χ² test and analysis of variance, and Kaplan-Meier survival analysis was performed on relapse and rehospitalization. RESULTS Compared to the OAP group, patients in the LAI-AP group presented worse prognostic factors (eg, history of homelessness). Despite this, the LAI-AP group presented a lower relapse rate (67.7% vs 76.7%), higher relapse-free survival time (694 vs 447 days, P = 0.008 in Kaplan-Meier analysis), and trends for reduced rehospitalization rates (48.4% vs 57.3%) and hospitalization-free survival time (813 vs 619 days, P = 0.065 Kaplan-Meier analysis). Of those receiving OAP as first-line, 41.3% were eventually switched to LAI-AP and displayed worst outcome in relapse and rehospitalization. CONCLUSION LAI-AP should be strongly considered as first-line treatment of FEP-SUD patients since this pharmacological option reduces the risk of relapse and rehospitalization even in the individuals with poor prognostic factors. |
| تدمد: | 1751-7893 1751-7885 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::649ccb4888dae67cd21a0aa8f7b6dbd8Test https://doi.org/10.1111/eip.12826Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....649ccb4888dae67cd21a0aa8f7b6dbd8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17517893 17517885 |
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