AUTHOR=Stürup Anne Emilie , Hjorthøj Carsten , Albert Nikolai , Dolmer Signe , Birk Merete , Ebdrup Bjørn H. , Eplov Lene Falgaard , Jensen Heidi , Vernal Ditte Lammers , Speyer Helene , Mors Ole , Nordentoft Merete 

TITLE=Tapered discontinuation vs. maintenance therapy of antipsychotic medication in patients with first-episode schizophrenia: Obstacles, findings, and lessons learned in the terminated randomized clinical trial TAILOR

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.910703

DOI=10.3389/fpsyt.2022.910703

ISSN=1664-0640

ABSTRACT=Aim: Evidence is insufficient regarding the consequences of discontinuing versus maintaining antipsychotic medication in patients with first-episode schizophrenia. Our aim was to examine tapered discontinuation versus maintenance treatment regarding remission of psychotic symptoms and impact on other areas.
Methods: Patients included had a diagnosis of schizophrenia, were treated with antipsychotic medication, and were in remission of psychotic symptoms. Participants were randomized to tapered discontinuation or maintenance treatment with antipsychotic medication. Assessments were undertaken at baseline and after one-year. The primary outcome was remission of psychotic symptoms without antipsychotic medication.
Results: The trial was terminated due to insufficient recruitment. In total, 29 participants were included: 14 in the tapering/discontinuation group and 15 in the maintenance group. Adherence to maintenance treatment was poor. At one-year follow-up, remission of psychotic symptoms without antipsychotic medication for three months was observed in five participants in the tapering/discontinuation group and two in the maintenance group. 
Conclusion: Due to insufficient recruitment this study does not provide a conclusion on whether unfavorable outcomes or advantages follow tapering of antipsychotic medication. Recruitment and adherence to maintenance treatment encountered obstacles. Based on experiences from this trial, we discussed alternative study designs as consistent evidence is still needed on whether to continue or discontinue antipsychotic medication in remitted patients with first-episode schizophrenia.