title: Stability of medication in early psychosis: a comparison between second-generation and low-dose first-generation antipsychotics.
abstract: OBJECTIVE
  This naturalistic study aims to compare discontinuation rates for low-dose first-generation versus second-generation antipsychotics in first-episode psychotic patients.
  
  
  METHODS
  The prescription of antipsychotic medication in 301 consecutively admitted patients with first-episode psychosis from four catchment areas is described. For the first year of inclusion a first-generation antipsychotic in low dose was recommended as the first medication. From the second year a second-generation antipsychotic was recommended as first choice. Switching was allowed when any drug was judged to be ineffective or to have serious side-effects. Switching during the first 2 years after inclusion is described.
  
  
  RESULTS
  Switching from a low-dose first-generation antipsychotic was more frequent than from a second-generation antipsychotic (90.7 vs. 58.4%). Lack of therapeutic effect and side-effects were the more frequently recorded reasons for changing in the first-generation group. Akathisia, parkinsonism, dyskinesias, dystonia and dysphoria were more often reported in patients on first-generation drugs. Weight gain and sedation were more often reported in patients on second-generation drugs.
  
  
  CONCLUSIONS
  The findings suggest a better adherence to and tolerability for second-generation antipsychotics than for low-dose first-generation antipsychotics in first-episode psychosis.
authors.affiliation: Department of Research and Education, Division of Psychiatry, Ullevål University Hospital, Oslo, Norway. o.s.e.ilner@medisin.uio.no
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
authors.forename: Ulrik
authors.initials: U
authors.lastname: Haahr
authors.forename: Jan O
authors.initials: JO
authors.lastname: Johannessen
authors.forename: Tor K
authors.initials: TK
authors.lastname: Larsen
authors.forename: Bjørn R
authors.initials: BR
authors.lastname: Rund
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
authors.forename: Per
authors.initials: P
authors.lastname: Vaglum
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003006:Clopenthixol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010546:Perphenazine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy*; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D007093:Imidazoles; D007211:Indoles; D001569:Benzodiazepines; D003006:Clopenthixol; D010546:Perphenazine; C066304:sertindole; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine