Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol

Amber Weller; John Gleeson; Mario Alvarez-Jimenez; Patrick McGorry; Barnaby Nelson; Kelly Allott; Sarah Bendall; Cali Bartholomeusz; Peter Koval; Susy Harrigan; Brian O'Donoghue; Alex Fornito; Christos Pantelis; G Paul Amminger; Aswin Ratheesh; Andrea Polari; Stephen J Wood; Kristi van der El; Carli Ellinghaus; Jesse Gates; Jessica O'Connell; Marianne Mueller; Lex Wunderink; Eóin Killackey

doi:10.1111/eip.12769

Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol

Amber Weller, John Gleeson, Mario Alvarez-Jimenez, Patrick McGorry, Barnaby Nelson, Kelly Allott, Sarah Bendall, Cali Bartholomeusz, Peter Koval, Susy Harrigan, Brian O'Donoghue, Alex Fornito, Christos Pantelis, G Paul Amminger, Aswin Ratheesh, Andrea Polari, Stephen J Wood, Kristi van der El, Carli Ellinghaus, Jesse GatesJessica O'Connell, Marianne Mueller, Lex Wunderink, Eóin Killackey

Psychology

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

260 Downloads (Pure)

Abstract

Antipsychotic medication has been the mainstay of treatment for psychotic illnesses for over 60 years. This has been associated with improvements in positive psychotic symptoms and a reduction in relapse rates. However, there has been little improvement in functional outcomes for people with psychosis. At the same time there is increasing evidence that medications contribute to life shortening metabolic and cardiovascular illnesses. There is also uncertainty as to the role played by antipsychotic medication in brain volume changes.

AIM: The primary aim of the study is, in a population of young people with first-episode psychosis, to compare functional outcomes between an antipsychotic dose reduction strategy with evidence-based intensive recovery treatment (EBIRT) group (DRS+) and an antipsychotic maintenance treatment with EBIRT group (AMTx+) at 24-months follow-up.

METHODS: Our single-blind randomized controlled trial, within a specialist early psychosis treatment setting, will test the whether the DRS+ group leads to better vocational and social recovery than, the AMTx+ group over a 2-year period in 180 remitted first-episode psychosis patients. Additionally, we will examine the effect of DRS+ vs AMTx+ on physical health, brain volume and cognitive functioning. This study will also determine whether the group receiving DRS+ will be no worse off in terms of psychotic relapses over 2 years follow-up.

RESULTS: This paper presents the protocol, rationale and hypotheses for this study which commenced recruitment in July 2017.

CONCLUSION: This study will provide evidence as to whether an antipsychotic dose-reduction recovery treatment leads to improved functioning and safer outcomes in first-episode psychosis patients. In addition, it will be the first-controlled experiment of the effect of exposure to antipsychotic maintenance treatment on brain volume changes in this population.

Original language	English
Journal	Early Intervention in Psychiatry
Early online date	29 Nov 2018
DOIs	https://doi.org/10.1111/eip.12769
Publication status	E-pub ahead of print - 29 Nov 2018

Keywords

antipsychotic medication
dose reduction
first-episode psychosis
functional recovery
protocol

Access to Document

10.1111/eip.12769Licence: None: All rights reserved

Weller_et_al_Can_anti-psychotic_dose_reduction_Early_Intervention_in_Psychiatry_2018
This is the peer reviewed version of the following article: Weller A, Gleeson J, Alvarez‐Jimenez M, et al. Can antipsychotic dose reduction lead to better functional recovery in first‐episode psychosis? A randomized controlled‐trial of antipsychotic dose reduction. The reduce trial: Study protocol. Early Intervention in Psychiatry. 2018;1–12. https://doi.org/10.1111/eip.12769, which has been published in final form at 10.1111/eip.12769. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Accepted author manuscript, 1.33 MBLicence: Other (please specify with Rights Statement)

https://onlinelibrary.wiley.com/doi/full/10.1111/eip.12769Licence: None: All rights reserved

Cite this

Weller, A., Gleeson, J., Alvarez-Jimenez, M., McGorry, P., Nelson, B., Allott, K., Bendall, S., Bartholomeusz, C., Koval, P., Harrigan, S., O'Donoghue, B., Fornito, A., Pantelis, C., Paul Amminger, G., Ratheesh, A., Polari, A., Wood, S. J., van der El, K., Ellinghaus, C., ... Killackey, E. (2018). Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol. Early Intervention in Psychiatry. Advance online publication. https://doi.org/10.1111/eip.12769

@article{e298f236ac2c492e8029c550a349cb84,

title = "Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol",

abstract = "Antipsychotic medication has been the mainstay of treatment for psychotic illnesses for over 60 years. This has been associated with improvements in positive psychotic symptoms and a reduction in relapse rates. However, there has been little improvement in functional outcomes for people with psychosis. At the same time there is increasing evidence that medications contribute to life shortening metabolic and cardiovascular illnesses. There is also uncertainty as to the role played by antipsychotic medication in brain volume changes.AIM: The primary aim of the study is, in a population of young people with first-episode psychosis, to compare functional outcomes between an antipsychotic dose reduction strategy with evidence-based intensive recovery treatment (EBIRT) group (DRS+) and an antipsychotic maintenance treatment with EBIRT group (AMTx+) at 24-months follow-up.METHODS: Our single-blind randomized controlled trial, within a specialist early psychosis treatment setting, will test the whether the DRS+ group leads to better vocational and social recovery than, the AMTx+ group over a 2-year period in 180 remitted first-episode psychosis patients. Additionally, we will examine the effect of DRS+ vs AMTx+ on physical health, brain volume and cognitive functioning. This study will also determine whether the group receiving DRS+ will be no worse off in terms of psychotic relapses over 2 years follow-up.RESULTS: This paper presents the protocol, rationale and hypotheses for this study which commenced recruitment in July 2017.CONCLUSION: This study will provide evidence as to whether an antipsychotic dose-reduction recovery treatment leads to improved functioning and safer outcomes in first-episode psychosis patients. In addition, it will be the first-controlled experiment of the effect of exposure to antipsychotic maintenance treatment on brain volume changes in this population.",

keywords = "antipsychotic medication, dose reduction, first-episode psychosis, functional recovery, protocol",

author = "Amber Weller and John Gleeson and Mario Alvarez-Jimenez and Patrick McGorry and Barnaby Nelson and Kelly Allott and Sarah Bendall and Cali Bartholomeusz and Peter Koval and Susy Harrigan and Brian O'Donoghue and Alex Fornito and Christos Pantelis and {Paul Amminger}, G and Aswin Ratheesh and Andrea Polari and Wood, {Stephen J} and {van der El}, Kristi and Carli Ellinghaus and Jesse Gates and Jessica O'Connell and Marianne Mueller and Lex Wunderink and E{\'o}in Killackey",

note = "{\textcopyright} 2018 John Wiley & Sons Australia, Ltd.",

year = "2018",

month = nov,

day = "29",

doi = "10.1111/eip.12769",

language = "English",

journal = "Early Intervention in Psychiatry",

issn = "1751-7885",

publisher = "Wiley",

}

Weller, A, Gleeson, J, Alvarez-Jimenez, M, McGorry, P, Nelson, B, Allott, K, Bendall, S, Bartholomeusz, C, Koval, P, Harrigan, S, O'Donoghue, B, Fornito, A, Pantelis, C, Paul Amminger, G, Ratheesh, A, Polari, A, Wood, SJ, van der El, K, Ellinghaus, C, Gates, J, O'Connell, J, Mueller, M, Wunderink, L & Killackey, E 2018, 'Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol', Early Intervention in Psychiatry. https://doi.org/10.1111/eip.12769

Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol. / Weller, Amber; Gleeson, John; Alvarez-Jimenez, Mario et al.
In: Early Intervention in Psychiatry, 29.11.2018.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial

T2 - study protocol

AU - Weller, Amber

AU - Gleeson, John

AU - Alvarez-Jimenez, Mario

AU - McGorry, Patrick

AU - Nelson, Barnaby

AU - Allott, Kelly

AU - Bendall, Sarah

AU - Bartholomeusz, Cali

AU - Koval, Peter

AU - Harrigan, Susy

AU - O'Donoghue, Brian

AU - Fornito, Alex

AU - Pantelis, Christos

AU - Paul Amminger, G

AU - Ratheesh, Aswin

AU - Polari, Andrea

AU - Wood, Stephen J

AU - van der El, Kristi

AU - Ellinghaus, Carli

AU - Gates, Jesse

AU - O'Connell, Jessica

AU - Mueller, Marianne

AU - Wunderink, Lex

AU - Killackey, Eóin

PY - 2018/11/29

Y1 - 2018/11/29

N2 - Antipsychotic medication has been the mainstay of treatment for psychotic illnesses for over 60 years. This has been associated with improvements in positive psychotic symptoms and a reduction in relapse rates. However, there has been little improvement in functional outcomes for people with psychosis. At the same time there is increasing evidence that medications contribute to life shortening metabolic and cardiovascular illnesses. There is also uncertainty as to the role played by antipsychotic medication in brain volume changes.AIM: The primary aim of the study is, in a population of young people with first-episode psychosis, to compare functional outcomes between an antipsychotic dose reduction strategy with evidence-based intensive recovery treatment (EBIRT) group (DRS+) and an antipsychotic maintenance treatment with EBIRT group (AMTx+) at 24-months follow-up.METHODS: Our single-blind randomized controlled trial, within a specialist early psychosis treatment setting, will test the whether the DRS+ group leads to better vocational and social recovery than, the AMTx+ group over a 2-year period in 180 remitted first-episode psychosis patients. Additionally, we will examine the effect of DRS+ vs AMTx+ on physical health, brain volume and cognitive functioning. This study will also determine whether the group receiving DRS+ will be no worse off in terms of psychotic relapses over 2 years follow-up.RESULTS: This paper presents the protocol, rationale and hypotheses for this study which commenced recruitment in July 2017.CONCLUSION: This study will provide evidence as to whether an antipsychotic dose-reduction recovery treatment leads to improved functioning and safer outcomes in first-episode psychosis patients. In addition, it will be the first-controlled experiment of the effect of exposure to antipsychotic maintenance treatment on brain volume changes in this population.

AB - Antipsychotic medication has been the mainstay of treatment for psychotic illnesses for over 60 years. This has been associated with improvements in positive psychotic symptoms and a reduction in relapse rates. However, there has been little improvement in functional outcomes for people with psychosis. At the same time there is increasing evidence that medications contribute to life shortening metabolic and cardiovascular illnesses. There is also uncertainty as to the role played by antipsychotic medication in brain volume changes.AIM: The primary aim of the study is, in a population of young people with first-episode psychosis, to compare functional outcomes between an antipsychotic dose reduction strategy with evidence-based intensive recovery treatment (EBIRT) group (DRS+) and an antipsychotic maintenance treatment with EBIRT group (AMTx+) at 24-months follow-up.METHODS: Our single-blind randomized controlled trial, within a specialist early psychosis treatment setting, will test the whether the DRS+ group leads to better vocational and social recovery than, the AMTx+ group over a 2-year period in 180 remitted first-episode psychosis patients. Additionally, we will examine the effect of DRS+ vs AMTx+ on physical health, brain volume and cognitive functioning. This study will also determine whether the group receiving DRS+ will be no worse off in terms of psychotic relapses over 2 years follow-up.RESULTS: This paper presents the protocol, rationale and hypotheses for this study which commenced recruitment in July 2017.CONCLUSION: This study will provide evidence as to whether an antipsychotic dose-reduction recovery treatment leads to improved functioning and safer outcomes in first-episode psychosis patients. In addition, it will be the first-controlled experiment of the effect of exposure to antipsychotic maintenance treatment on brain volume changes in this population.

KW - antipsychotic medication

KW - dose reduction

KW - first-episode psychosis

KW - functional recovery

KW - protocol

U2 - 10.1111/eip.12769

DO - 10.1111/eip.12769

M3 - Article

C2 - 30488637

SN - 1751-7885

JO - Early Intervention in Psychiatry

JF - Early Intervention in Psychiatry

ER -

Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial: study protocol

Abstract

Keywords

Access to Document

Fingerprint

Cite this