Key message: Continuous maintenance treatment is more effective than targeted intermittent treatment in preventing relapse.
Background
This randomised controlled trial investigated the impact of continuous maintenance treatment versus targeted intermittent treatment after stepwise discontinuation in the second year following the diagnosis of schizophrenia.[Gaebel et al., 2011]
A total of 96 first-episode patients were enrolled from the German Research Network on Schizophrenia, and 44 were assigned to treatment.[Gaebel et al., 2011]
Participants assigned to the maintenance treatment arm in the second year of the trial demonstrated lower risk of relapse and a higher survival rate from deterioration than those assigned to intermittent treatment.[Gaebel et al., 2011]
Clinical deterioration: Increase from baseline in the sum of Positive and Negative Syndrome Scale (PANSS) positive and negative scores ≥25%, or ≥10 points (if baseline value ≤40), or a Clinical Global Impression – Change (CGI-C) score ≥6.[Gaebel et al., 2011]
Mean survival time (Kaplan–Meier estimates): intermittent treatment 41.0 weeks; maintenance treatment 50.0 weeks; log rank=13.4; p<0.001.[Gaebel et al., 2011]
Reference:
Gaebel W, Riesbeck M, Wölwer W, et al. Relapse prevention in first-episode schizophrenia – maintenance vs intermittent drug treatment with prodrome-based early intervention: results of a randomized controlled trial within the German Research Network on Schizophrenia. J Clin Psychiatry 2011; 72 (2): 205–218.