Psychosis relapse during treatment with long-acting injectable antipsychotics in individuals with schizophrenia-spectrum disorders: an individual participant data meta-analysis
This review (n=5130) found a pooled incidence of relapse of 23 per 100 patient-years; the strongest predictor was tardive dyskinesia at treatment onset (HR 2.39, 95% CI 1.05 to 5.42). Relapse was associated with functional decline (overall SMD −0.76, 95% CI −1.14 to −0.37).
Source:
The Lancet Psychiatry
SPS commentary:
A related comment notes how the risk of relapse was lower in people achieving symptomatic remission prior to the start of the trial (14.76 per 100 patient-years versus 31.51 per 100 patient-years in those without symptom remission), and that this is in keeping with previous research suggesting early antipsychotic response is predictive of longer-term outcomes. There was also an observed association between presence of a substance use disorder and relapse rate (HR 1.55; 95% CI 1.15-2.10), although the comment notes that it is difficult to determine the extent to which this association is causal. The authors note that there is no clear consensus definition of relapse, and that further exploration into symptom trajectories following relapse is needed.