Maintenance Treatment Prevents Relapse in Schizophrenia but Doubles the Risk of Weight Gain

Keeping schizophrenia patients on antipsychotic drugs after an initial episode has passed prevents relapses, but also doubles the risk of weight gain, according to a new study.

Researchers at Munich Technical University (Germany), the University of Ioannina (Greece), and other institutions searched the Cochrane Schizophrenia Group, PubMed, Embase, ClinicalTrials.gov, and reference lists for randomized trials of patients with schizophrenia continued on or withdrawn from any antipsychotic drug regimen after stabilization; in all, 116 suitable reports from 65 trials were identified, with data for 6,493 patients. The primary outcome measure was relapse between 7 and 12 months. The researchers also examined safety and various functional outcomes.

The results showed that maintenance antipsychotic drug therapy reduced risk of relapse significantly at one year and during follow-up (of any duration) by 65%. Limited evidence suggested better quality of life and fewer aggressive acts with antipsychotic drugs than with placebo. Most other major efficacy outcomes were also improved with continued drug treatment, but several adverse effects, such as weight gain, sedation, and need for anti-Parkinsonian drugs were also significantly increased. The study was published early online on May 3, 2012, in the Lancet.
“We have established that antipsychotic maintenance treatment substantially reduces relapse risk in all patients with schizophrenia for up to two years of follow-up,” concluded Stefan Leucht, MD, of Munich Technical University, and colleagues. “The effect was robust in important subgroups such as patients who had had only one episode and those in remission, but seemed to decrease in size with time.”

Related Links:

Munich Technical University

University of Ioannina