ArticleSchizophrenia bulletin2022
Predictors of Lack of Relapse After Random Discontinuation of Oral and Long-acting Injectable Antipsychotics in Clinically Stabilized Patients with Schizophrenia: A Re-analysis of Individual Participant Data.
Article in Schizophrenia bulletin, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- The effects of antipsychotic discontinuation or maintenance on the process of recovery in remitted first-episode psychosis patients - A systematic review and meta-analysis of randomized controlled trials.European psychiatry : the journal of the Association of European Psychiatrists · 2024Pooled it
- [Olanzapine long acting injectable in new application form-Hope for the absence of post-injection delirium/sedation syndromes].Der Nervenarzt · 2026Review
- Not So Hasty: The Effect of Tapering Speed on Relapse May Still Be Important.Schizophrenia bulletin · 2026Article
- Community management: An effective model to reduce medication discontinuation rate in patients with schizophrenia.PloS one · 2026Article
- Helping people to discontinue antipsychotics: if, when and how.Schizophrenia (Heidelberg, Germany) · 2025Review
- The Use of Long-Acting Injectables for People with Schizophrenia: Consensus Panel Recommendations for Overcoming Barriers and Implementing Treatment.Neurology and therapy · 2025Article
- Long-acting injectable antipsychotics for patients with first-episode and early-phase schizophrenia: still not considered often enough.CNS spectrums · 2025Review
- Treatment Patterns and Outcomes from OASIS: A Prospective Observational Study of Long-Acting Injectables in Schizophrenia.Neuropsychiatric disease and treatment · 2025Article
- Optimizing long-acting injectable antipsychotic safety and care continuity through documentation best practices.Frontiers in psychiatry · 2025Review
- Does Slow and Steady Win the Race? Rates of Antipsychotic Discontinuation, Antipsychotic Dose, and Risk of Psychotic Relapse.Schizophrenia bulletin · 2024Article
- Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug.Brain sciences · 2024Review
- Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs.Therapeutic advances in psychopharmacology · 2024Article
- Symptomatic, functional and quality of life measures of remission in 194 outpatients with schizophrenia followed naturalistically in a 6-month, non-interventional study of aripiprazole once-monthly.Schizophrenia (Heidelberg, Germany) · 2023Article
- Comparative effectiveness study of paliperidone palmitate 6-month with a real-world external comparator arm of paliperidone palmitate 1-month or 3-month in patients with schizophrenia.Therapeutic advances in psychopharmacology · 2023Article
- Implementing gradual, hyperbolic tapering of long-acting injectable antipsychotics by prolonging the inter-dose interval: anTherapeutic advances in psychopharmacology · 2023Review
- The pharmacological treatment of schizophrenia: How far have we come?PCN reports : psychiatry and clinical neurosciences · 2022Review
- Calling for policy actions to increase access to long-acting antipsychotics in low-income and middle-income countries.Epidemiology and psychiatric sciences · 2022Article
- Use of Long-Acting Injectable Antipsychotics in Inpatients with Schizophrenia Spectrum Disorder in an Academic Psychiatric Hospital in Switzerland.Journal of personalized medicine · 2022Article
- Confounding of Antipsychotic Discontinuation Studies by Withdrawal-Related Relapse.Schizophrenia bulletin · 2022Article
- Time to rehospitalization in involuntarily hospitalized individuals suffering from schizophrenia discharged on long-acting injectable antipsychotics or oral antipsychotics.Therapeutic advances in psychopharmacology · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the risk and predictors of relapse among individuals with schizophrenia randomly withdrawn from antipsychotic maintenance treatment.
methodsWe re-analyzed time-to-event and baseline predictors from placebo arms in five placebo-controlled randomized trials of antipsychotics (n = 688 individuals; 173 stabilized on oral antipsychotic [OAP] and 515 on long-acting injectables [LAI]) for relapse-prevention available in the Yale Open Data Access repository. Using a survival and Cox-proportional hazards regression analyses, we estimated survival rates of "relapse-free" individuals by the end of follow-up (median = 118 days, IQR = 52.0-208.0), the rate of study-confirmed relapse, and adjusted hazard ratios (aHR, 95% confidence intervals [CI]) associated with baseline predictors. We also estimated these parameters for individuals followed for >5 half-lives of the stabilizing antipsychotic, and studied predictors of "rebound psychosis" in OAP-stabilized participants, defined as occurring within 30 days of antipsychotic withdrawal.
results29.9% (95%CI = 23.2-38.5) remained relapse-free by the end of follow-up, 11.1% (95%CI = 5.65-21.9) among those OAP-stabilized, 36.4% (95%CI = 28.4-46.7) among those LAI-stabilized. The study-confirmed relapse rate was 45.2%, 62.4% among those OAP-stabilized and 39.4% among those LAI-stabilized. Predictors of relapse included smoking (aHR = 1.54, 95%CI = 1.19-2.00), female sex (aHR = 1.37, 95%CI = 1.08-1.79), and having been stabilized on OAPs vs LAIs (aHR = 3.56, 95%CI = 2.68-4.72). Greater risk of relapse on OAP persisted even after sufficient time had elapsed to clear antipsychotic plasma level among LAI-stabilized (aHR = 5.0, 95%CI = 3.5-7.1). "Rebound psychosis" did not show predictors. CONCLUSIONS AND RELEVANCE: Our results corroborate the high relapse risk following antipsychotic withdrawal after symptom stabilization with limited patient-related predictors of safe treatment discontinuation. Stabilization with LAIs reduces the short-/medium-term relapse risk.
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