title: Effectiveness of antipsychotics used in first-episode psychosis: a naturalistic cohort study.
abstract: BACKGROUND
  One year of antipsychotic treatment from symptom remission is recommended following a first episode of psychosis (FEP).
  
  
  OBJECTIVE
  To investigate the effectiveness of commonly used antipsychotic medications in FEP.
  
  
  METHODS
  A retrospective cohort study of naturalistic treatment of patients (N=460) accepted by FEP services across seven UK sites. Treatment initiation to all-cause discontinuation determined from case files.
  
  
  RESULTS
  Risk of treatment discontinuation is greatest within 3 months of treatment initiation. Risperidone had longest median survival time. No significant differences were observed in time to discontinuation between commonly used antipsychotics on multivariable Cox regression analysis. Poor adherence and efficacy failure were the most common reasons for discontinuation.
  
  
  CONCLUSIONS
  Effectiveness differences appear not to be a current reason for antipsychotic choice in FEP. Adherence strategies and weighing up likely adverse effects should be the clinical focus.
  
  
  BACKGROUND
  R.W., A.T. and S.M. have received research grant, speaker honoraria and conference attendance funding from all companies marketing antipsychotics.
  © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
authors.affiliation: , MD, MRCPsych, Sussex Partnership NHS Foundation Trust, Brighton, UK, and Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Whale
authors.affiliation: , MSc, MRCPsych, Sussex Partnership NHS Foundation Trust, Brighton, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Harris
authors.affiliation: , MRCPsych, Sussex Partnership NHS Foundation Trust, Brighton, UK.
authors.forename: Gail
authors.initials: G
authors.lastname: Kavanagh
authors.affiliation: , MSc, MBBS, Sussex Partnership NHS Foundation Trust, Eastbourne, UK.
authors.forename: Vijitha
authors.initials: V
authors.lastname: Wickramasinghe
authors.affiliation: , PhD, Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Jones
authors.affiliation: , PhD, MRCPsych, Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK, and Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Marwaha
authors.affiliation: , PGCert, BMBS, Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK, and Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
authors.forename: Ketan
authors.initials: K
authors.lastname: Jethwa
authors.affiliation: , MRCPsych, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
authors.forename: Nirmalan
authors.initials: N
authors.lastname: Ayadurai
authors.affiliation: , MD, FRCPsych, Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK, and Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Thompson