Risk of symptom recurrence with medication discontinuation in first-episode psychosis: A systematic review

Schizophrenia Research, 08/29/2013

Zipursky RB et al. – The authors carried out a systematic review to determine the risk of experiencing a recurrence of psychotic symptoms in individuals who have discontinued antipsychotic medications after achieving symptomatic remission from a first episode of non–affective psychosis (FEP). The findings suggest that in the absence of uncertainty about the diagnosis or concerns about the contribution of medication side effects to problems with health or functioning, a trial off of antipsychotic medications is associated with a very high risk of symptom recurrence and should thus not be recommended.


  • Six studies were identified that met the criteria and these reported a weighted mean one-year recurrence rate of 77% following discontinuation of antipsychotic medication.


  • By two years, the risk of recurrence had increased to over 90%.
  • By comparison, the authors estimated the one-year recurrence rate for patients who continued antipsychotic medication to be 3%.

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