Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors
Background: We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) different...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
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Cambridge University Press
2017
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| Online Access: | https://eprints.nottingham.ac.uk/42508/ |
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| author | Demjaha, Arsime Lappin, J.M. Stahl, D. Patel, M.X. MacCabe, J.H. Howes, O.D. Heslin, M. Reininghaus, Ulrich A. Donoghue, K. Lomas, B. Charalambides, M. Onyejiaka, A. Fearon, P. Jones, P. Doody, G. Morgan, C. Dazzan, P. Murray, R.M. |
| author_facet | Demjaha, Arsime Lappin, J.M. Stahl, D. Patel, M.X. MacCabe, J.H. Howes, O.D. Heslin, M. Reininghaus, Ulrich A. Donoghue, K. Lomas, B. Charalambides, M. Onyejiaka, A. Fearon, P. Jones, P. Doody, G. Morgan, C. Dazzan, P. Murray, R.M. |
| author_sort | Demjaha, Arsime |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors.
Method: The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow-up period to determine the presence, course and predictors of treatment resistance.
Results: From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset, and longer duration of untreated psychosis predicted treatment resistance from illness onset.
Conclusions: The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis. |
| first_indexed | 2025-11-14T19:49:00Z |
| format | Article |
| id | nottingham-42508 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:49:00Z |
| publishDate | 2017 |
| publisher | Cambridge University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-425082020-05-04T18:41:39Z https://eprints.nottingham.ac.uk/42508/ Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors Demjaha, Arsime Lappin, J.M. Stahl, D. Patel, M.X. MacCabe, J.H. Howes, O.D. Heslin, M. Reininghaus, Ulrich A. Donoghue, K. Lomas, B. Charalambides, M. Onyejiaka, A. Fearon, P. Jones, P. Doody, G. Morgan, C. Dazzan, P. Murray, R.M. Background: We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors. Method: The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow-up period to determine the presence, course and predictors of treatment resistance. Results: From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset, and longer duration of untreated psychosis predicted treatment resistance from illness onset. Conclusions: The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis. Cambridge University Press 2017-04-11 Article PeerReviewed Demjaha, Arsime, Lappin, J.M., Stahl, D., Patel, M.X., MacCabe, J.H., Howes, O.D., Heslin, M., Reininghaus, Ulrich A., Donoghue, K., Lomas, B., Charalambides, M., Onyejiaka, A., Fearon, P., Jones, P., Doody, G., Morgan, C., Dazzan, P. and Murray, R.M. (2017) Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors. Psychological Medicine . pp. 1-9. ISSN 1469-8978 Schizophrenia First-Episode- Psychosis Treatment-Response Clozapine Treatment-Resistant doi:10.1017/S0033291717000435 doi:10.1017/S0033291717000435 |
| spellingShingle | Schizophrenia First-Episode- Psychosis Treatment-Response Clozapine Treatment-Resistant Demjaha, Arsime Lappin, J.M. Stahl, D. Patel, M.X. MacCabe, J.H. Howes, O.D. Heslin, M. Reininghaus, Ulrich A. Donoghue, K. Lomas, B. Charalambides, M. Onyejiaka, A. Fearon, P. Jones, P. Doody, G. Morgan, C. Dazzan, P. Murray, R.M. Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors |
| title | Antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| title_full | Antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| title_fullStr | Antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| title_full_unstemmed | Antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| title_short | Antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| title_sort | antipsychotic treatment resistance in first-episode
psychosis: prevalence, subtypes and predictors |
| topic | Schizophrenia First-Episode- Psychosis Treatment-Response Clozapine Treatment-Resistant |
| url | https://eprints.nottingham.ac.uk/42508/ https://eprints.nottingham.ac.uk/42508/ |