A1 Journal article (refereed)
Five-Year Cumulative Exposure to Antipsychotic Medication After First-Episode Psychosis and its Association With 19-Year Outcomes (2020)


Bergström, T., Taskila, J. J., Alakare, B., Köngäs-Saviaro, P., Miettunen, J., & Seikkula, J. (2020). Five-Year Cumulative Exposure to Antipsychotic Medication After First-Episode Psychosis and its Association With 19-Year Outcomes. Schizophrenia Bulletin Open, 1(1), Article sgaa050. https://doi.org/10.1093/schizbullopen/sgaa050


JYU authors or editors


Publication details

All authors or editors: Bergström, Tomi; Taskila, Jyri J.; Alakare, Birgitta; Köngäs-Saviaro, Päivi; Miettunen, Jouko; Seikkula, Jaakko

Journal or series: Schizophrenia Bulletin Open

ISSN: 2632-7899

eISSN: 2632-7899

Publication year: 2020

Volume: 1

Issue number: 1

Article number: sgaa050

Publisher: Oxford University Press (OUP)

Publication country: United Kingdom

Publication language: English

DOI: https://doi.org/10.1093/schizbullopen/sgaa050

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/72129


Abstract

The long-term effectiveness of antipsychotic maintenance treatment after first-episode psychosis (FEP) is contested. In this real-world observational study, we examined how cumulative exposure to antipsychotics within the first 5 years from FEP was associated with the 19-year outcome. Finnish national registers were used to detect all patients who were hospitalized due to non-affective psychosis in the mid-1990s, and who were treatment naïve prior to the inclusion period (N = 1318). Generalized linear models with logit link function were used to estimate how cumulative exposure to antipsychotics within the first 5 years from onset was associated with mortality, work capability, and the use of psychiatric services at the end of the 19-year follow-up. To adjust for confounding by indication, the primary outcome analyses implemented stabilized inverse probability of treatment weighting using propensity scores. Persons with a higher cumulative exposure to antipsychotics within the first 5 years from FEP were more likely to still be receiving antipsychotics (adjusted odds ratio [OR] = 2.1; 95\\% CI: 1.5−2.8), psychiatric treatment (OR = 1.4; 95\\% CI: 1.1−1.7), and disability allowances (OR = 1.3; 95\\% CI: 1.01−1.6) at the end of the 19-year follow-up, as compared to low/zero-exposure. Higher cumulative exposure was also associated with higher mortality (OR = 1.5; 95\\% CI: 1.1–2.1). After adjustment for confounders, moderate and high cumulative exposure to antipsychotics within the first 5 years from FEP was consistently associated with a higher risk of adverse outcomes during the 19-year follow-up, as compared to low or zero exposure. Due to potential unmeasured confounding, controlled trials are needed.


Keywords: psychoses; schizophrenia; mental disorders; psychiatric care; pharmacotherapy; psychopharmaceuticals; maintenance therapy; work ability; mortality; cohort study


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2020

JUFO rating: 1


Last updated on 2022-20-09 at 15:03